Eating Disorders in Children: Types, Warning Signs, Risk Factors and Treatments

It’s common to associate eating disorders with females, teenagers and young adults. The truth is, eating disorders often develop in younger children (as well as teens), and impact males and females alike. Sadly, the rate of children under 12 years old with eating disorders has been rising in recent years.

Our mental health program at AdventHealth for Children recognizes that body, mind and spirit work together; if one part is hurting, it affects the whole child. While the symptoms and complications caused by eating disorders are primarily physical, the source of eating disorders in children can be connected to underlying mental health struggles such as anxiety, depression, obsessive-compulsive disorder and more.

Keep reading for important information and expert advice on eating disorders in children with our pediatric psychiatrist, Tina Gurnani, MD. With early detection, you and your child’s care team can help them recover from an eating disorder before it gets out of control.

Eating Disorder Warning Signs

“While there are different types of eating disorders, the red flags tend to overlap,” says Dr. Gurnani. If you notice any of these warning signs associated with eating, don’t hesitate to approach your child about their problem and get help as soon as possible:

• Anxiety surrounding eating (saying “I’m full,” or “I’m not hungry,” a lot)
• Avoiding meals
• Binge eating
• Eating in secret
• Excessive exercising (for multiple hours a day)
• Dizziness or lightheadedness
• Looking in the mirror excessively
• Fixating on perceived, but untrue, body flaws (calling themselves “fat”)
• Forcing themselves to vomit and spending too much time in the bathroom
• Missing one or more menstrual cycles (females)
• Palpitations
• Purging with laxatives
• Restricting food or calorie intake
• Using weight-loss supplements or diuretics
• Wearing oversized, baggy clothing
• Weight loss

What Causes Eating Disorders?

Researchers are finding that eating disorders are caused by a complex interaction of genetic, biological, behavioral, psychological and social factors.

According to Dr. Gurnani, “Eating disorders can be linked to multiple factors: inherited through one’s genetics, a history of trauma and abuse, a way to cope with anxiety and depression, a subconscious method to control something in one’s life when everything else feels out of control, an effort to fit in with peers, imitating images in the media and celebrity personas, or a combination of some or all the above. There is usually an internal struggle of some sort, and the symptoms manifest as an eating disorder.”

Who Is Most at Risk for Developing an Eating Disorder?

Anyone can develop an eating disorder at any time and for any number of reasons. However, there are risk factors that make it more likely. Children and teens at higher risk for developing an eating disorder include the following:

• Athletes
• Being abused
• Being bullied
• Being isolated
• Bodybuilders
• Dancers
• Gymnasts
• Substance abuse
• Those with low self-esteem

Many of these individuals feel pressured to uphold a certain body image, whether that means very thin, muscular or fit. Sometimes, what may start out as a desire to be and look healthy can quickly become excessive and devolve into an eating disorder.

Dr. Gurnani explains, “It’s important to use positive body talk in front of and to your children and teens as they are very impressionable. Do not pressure them to be perfect, whether that means physically, academically, athletically and so on. Instead, work on building their self-esteem and encourage them to be healthy without a focus on weight.”

Different Types of Eating Disorders

Here are the main eating disorders that impact children, teens and adults as well. Reach out for help if any of these are impacting your family.

Anorexia Nervosa

Anorexia is where a child refuses to eat enough calories out of an intense and illogical fear of becoming fat.

“Children and teens with anorexia have a distorted body image. They see themselves as overweight, even when they are dangerously skinny. They are obsessed with being thin and struggle to maintain a normal weight out of fear,” says Dr. Gurnani.

Bulimia Nervosa

With bulimia, a child or teen overeats to the extreme, also called bingeing, and then purges the food by vomiting, overcompensating with exercise or using laxatives to prevent weight gain. As with anorexia, bulimic young people also fear gaining weight and feel unhappy with their bodies.

They consistently eat too much food in a short amount of time. Often the child or teen senses a loss of control. Purging after the binge is a way to avoid gaining weight and may be part of their anxiety to regain control. Feelings of shame and guilt are often associated with bulimia.

The team in our pediatric weight-loss and wellness program at AdventHealth for Children can help your child differentiate between a healthy and unhealthy body image and help them gain back their self-esteem.

Orthorexia Nervosa

Orthorexia is a bit different than anorexia and bulimia in that weight isn’t necessarily the main focus, but it still results in restrictive caloric intake and unhealthy outcomes. Children and teens with orthorexia develop an obsession with healthy eating. Ironically, being extreme about one’s health can quickly turn unhealthy through overly restrictive behaviors and irrational thinking about food.

Dr. Gurnani explains, “Young people with orthorexia engage in “perfect eating” and avoid foods that they don’t consider safe. Their rules surrounding food may not make sense. They might limit their choices to only a few very specific, non-fat foods that they think are healthy and clean, but that don’t provide the nutrients to help their bodies and brains develop.”

It may be a possibility that a child who suddenly starts following a specific diet (vegan, gluten-free, keto, etc.), along with other red flags like special rules and anxiety about eating and excluding many foods, may have orthorexia.

Body Dysmorphia Disorder

Kids and teens with body dysmorphia disorder might not be concerned specifically about their weight, but there is a particular part (or parts) of their body that they focus on and perceive as flawed. Whether there is no flaw or a minor flaw, their perception of themselves is way out of proportion to reality. They spend a huge amount of time and energy thinking about what they don’t like about themselves.

“Self-esteem building and positive body talk are crucial to helping a child with body dysmorphia disorder recover,” encourages Dr. Gurnani.

Treatment Options for Children With Eating Disorders

Our team encourages a multidisciplinary approach. Your child should have a supportive therapist that specializes in eating disorders, as well as a nutritionist, a primary care provider, and possibly a pediatric psychiatrist like Dr. Gurnani.

There are inpatient residential programs if the eating disorder is severe and your child needs a higher level of care. Our team can refer your child to residential care if needed.

Dr. Gurnani reminds us, “If your child has an eating disorder, you have a role to play. You’re part of the support for your child, along with their treatment team. As parents, we can be key players in the trajectory of their treatment and prognosis of their eating disorder.”

Here to Help You Find Hope for Wholeness

There is always hope. If you suspect your child is struggling with an eating disorder and needs expert help and resources, call us at Call407-517-7593, or visit our website at AdventHealthforChildren.com/MentalHealth.