Millions of children and teens are obsessed with their weight, especially girls. More than 90% of people with an eating disorder are female. One out of every three teen girls believe they are overweight. Teenage boys are also concerned with their appearance. Many boys aim for the perfect physique by compulsive training. These concerns are exacerbated by the beauty culture (unattainable perfection); for which teens are particularly susceptible to; at a time when they are already insecure about the ways their bodies are changing. They face increased social pressures as puberty begins. Even pre-pubescent children as young as six have a high incidence rate for eating disorders and are considered an at-risk group.
Unfortunately, these factors may lead to an obsession with appearance, which oftentimes leads to an eating disorder; either anorexia nervosa or bulimia nervosa (for further definition, keep reading). If undetected and untreated, these disorders can permanently affect one’s health and every normal life. Even more so with children who need the daily nutrients to accommodate their developing bodies.
What causes eating disorders is a complex question with a myriad of answers. The most current research suggests that a combination of psychological, genetic, social, family dynamics, and environmental, are usually involved. Many children and teens diagnosed with an eating disorder additionally struggle with low self-esteem, stress, fear of becoming “fat,” and experiencing helplessness and denial of the problem behaviors as problems.
When children have an eating disorder, there is a discrepancy between the way they see themselves and how they actually appear to others; a related condition is body dysmorphic disorder; which is characterized by gross exaggeration of perceived flaws on the face and body. With anorexia and bulimia, a person often has a fear or gaining weight and they think they look much larger than they actually are.
As noted before, these concerns are beginning at increasingly younger ages. Studies have shown that 42% of 1st through 3rd grade girls want to be thinner and 81% of 10-year-olds are afraid of being overweight.
Oftentimes these problems begin in the home environment, in which families members can unknowingly foster unhealthy eating behaviors. Additionally, research suggests that other environmental factors, of which media influence is a prime example, contribute to the increased incidence of eating disorders. Celebrities in advertising, movies, the music industry and television are often extremely thin and seen as role models for beauty – the result being that girls believe that in order to be beautiful, one must be extremely thin whatever the cost. Boys as well are susceptible; and may try to restrict their eating and exercise compulsively to build muscles like celebrity icons.
Many children develop low self-esteem that has the potential to develop into an eating disorder. This focus on weight can be an attempt to gain a sense of control at a time when their lives feel more out-of-control. To cope, children and teens may increase unhealthy eating behaviors.
Eating Disorders go hand-in-hand with other psychiatric conditions underlying the problems, such as depression and anxiety disorders: PTSD, OCD, to name a few. Many healthcare professionals aren’t adequately trained to detect eating disorders when conditions such as depression are also present and overshadow eating problems.
Eating disorders can be physically and emotionally destructive. They can lead to serious physical problems and even death. If you spot any of the signs of disordered eating, contact the child’s pediatrician right away. A common misconception is that eating disorders can be fixed with just strong willpower, which is false. An eating disorder can escalate out of control very quickly and have immediate serious health consequences. Dehydration, heart problems, and kidney failure can occur. In severe cases, malnutrition and even death can be the end result.
Anorexia Nervosa is based on restriction; the body goes into starvation mode as a means to maintain body heat. The binging and purging behaviors that characterize Bulimia Nervosa can be present as well, but over-all restricting intake is the main focus.
Features of Anorexia include:
- Depression, anxiety
- Perfectionism
- Excessive preoccupation with food
- Dieting even when thing or emaciated
- Compulsive exercising
- Intense fear of becoming fat while clearly underweight
- Immediate menstrual irregularities
- Rapid weight loss in which the person may try to disguise with large clothing
- Makes excuses to avoid eating and mealtimes
- Amenhorria (menstruation stops)
- Developing lanuga: soft, very fine hair that grows all over the body in order to maintain a stable body temperature and pulse)
Features of Bulimia include:
- A plethora of gastrointestinal issues
- Blood in vomit
- Esphogal and over-all throat destruction
- Chipped nails and finger callouses
- “chipmunk cheeks”
- Tooth decay
The excess weight caused by binge eating puts your child at risk for:
- Heart disease
- High blood pressure
- High cholestrerol
- Type 2 diabetes.
- Anorexia
According to the National Institute of Mental Health, one out of every 25 girls will meet the criteria for anorexia in their lifetime. Most of them will deny that they have an eating problem.
Children and teens with anorexia or bulimia have distorted body image. They are obsessed with being skinny and refuse to eat and maintain their normal weight. People with anorexia specifically, believe they look heavy even when they are dangerously thin.
Anorexia is fatal in approximately 10% of reported cases; as a result of cardiac arrest, electrolyte imbalance, or suicide.
Treating anorexia
The first plan of treatment for anorexia is to get back to a stable weight and implementing healthy eating behaviors. Depending on the severity of the condition, sometimes it is necessary to be hospitalized, ranging from a week to several months at an inpatient facility or residential setting. In severe cases, intravenous feeding may be necessary with around-the-clock monitoring.
The underlying psychological issues are addressed over the course of long-term treatment that include medication management, nutrition education and modification, individual psychotherapy, family therapy, and supports group. A treatment team collaborates together throughout the treatment process.
Bulimia
Just like children and teens with anorexia, those with bulimia are also unhappy with their bodies and are afraid of weight gain. As many as one out of every 25 females will meet the criteria for bulimia in their lifetime.
People with bulimia frequently eat too much of in a short time period, known as binging. They often feel disgusted and ashamed after overeating. Once they stop eating, the panic sets in and they turn to drastic measure to get rid of the food they just consumed. They induce vomiting, known as purging, which becomes an addictive behavior as a feeling of euphoria and calm occurs once the purge is complete. They may also abuse diet pills and laxatives/enemas or over-exercise excessively to avoid gaining weight from the binge.
Symptoms include:
- Abusing diet pill and laxatives
- Binging and purging
- Anxiety and sadness
- Binging at increasingly larger amount of food in a shorter amount of time
- Eating/binging/purging in secret
- Usual preoccupation with food
- Compulsive/excessive exercise
- Mood swings
- Overemphasis on physical appearance
- Spending time in the bathroom after eating regularly
- Excessive weighing
- Scarring on fingers from induced vomiting
- Excessive gum chewing
As with anorexia, complications can be severe. The natural process of the acids in the stomach goes on overdrive and can permanently change the way the stomach process and digests food. Damaged to the teeth enamel, esophagus inflammation, and the salivary glands in the cheeks can swell. Additionally, bulimia can also lower the potassium blood levels which can lead to dangerous, abnormal heart patterns.
Binge Eating
Binge eating and bulimia appear similar in the constant, out-of-control eating or large amounts of food in a short amount of time. However, binge eaters do not purge the food and as a result, they become obese or overweight. Additionally, while the addictive nature of over-eating is present, the even greater addictive nature of purging is absent, and so any feeling of relief to mitigate panic and shame are not experienced. Those symptoms can then get out of control as well, as follows.
Binge eaters often struggle to cope with intense feelings of guilt, self-hatred, stress, anger, sadness, and even boredom. All of these feelings can trigger a binge, which then re-trigger the original feelings, causing a never-ending cycle; creating a long-term unhealthy relationship with food. Binge eaters are often feel intensely guilty about overeating while also feeling helpless to stop and subsequently suffer from depression.
Treating binge eating disorders
Treatment for binge eating includes psychoeducation, medication management, behavior therapy, psychotherapy, as well as support groups and other community services.
The Good News!
The good news is that when someone is struggling with eating or body image issues, they are not destined to develop an eating disorder. It makes a world of difference if the signs are caught and treated at the earliest stages. This increases the likelihood that recovery will be successful and last longer. The longer the eating disorder goes untreated, the harder it will be to overcome with any kind of lasting success.
Treatment is necessary to help your child restore healthy eating habits and weight. Besides restoring health to the body, the main goal of treatment is to address the underlying psychological problems that led to the eating disorder in the first place.
Treatment is available. Recovery is possible.
If you begin to recognize the signs and symptoms of an eating disorder in your child, seek help immediately. This is a problem that can spiral out of control very quickly. It is important you that you find somebody to talk to about what they are going through with specialized training or background in disordered eating.
Family support is crucial. Everyday tasks like grocery shopping or preparing meals can be especially difficult for a family member with an eating disorder. It is common for families to attend counseling sessions together as well as individually to make sure the home environment is helping, not hindering.
The most effective treatment for any eating disorder is the combination of psychotherapy or counseling, together with careful attention to the medical and nutritional needs. This treatment is customized to each individual since the severity of the disorder differs for each child’s problems and needs.
Many children and teens will fully recover from their eating disorder, but relapse is common and can happen at any time after treatment is concluded. You can have a profound impact by offering your compassion and unconditional support through the treatment process. The better the child’s family support, the more likely they will be to have a long-lasting positive outcome.
This information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
