Does your child frequently skip meals, avoid eating in front of you or say they are on strict diet? Do they avoid family dinner outings, obsessively exercise and secretly binge on food at night? If you answered yes to many of these questions, your child may be at risk for developing an eating disorder such as anorexia or bulimia nervosa. About 10 million children suffer from eating disorders in the United States. Eating disorders begin in most children by the ages of 11 to 13, although some children may develop when earlier. While the majority of eating disorder sufferers are female, an increasing number of males are also developing eating disorders.
What are Eating Disorders?
Eating disorders can disrupt daily life functioning with constant worry about body weight, food selection and eating habits. Anorexia nervosa is an eating disorder where the afflicted person has a strong fear of becoming overweight and starves to an abnormally low body weight. Bulimia nervosa is an eating disorder characterized by persistent binging and purging of food to control weight.
Raising the Issue
If you suspect your child is suffering from an eating disorder, you should be sure before you broach the topic with them. Avoid accusing them and instead express your concern for their well-being. Although they may just be following a diet fad or going through a self-conscious phase, which could be nothing to worry about, this type of behavior has the potential of developing into something more serious.
Children that have started puberty are often naturally concerned with their body and appearance towards the opposite sex. While this is something all adolescents go through, it can be a particularly sensitive time for youth, making them vulnerable to developing an eating disorder. Making yourself familiar with the signs and symptoms of eating disorders can help you notice the warning signs before it gets to be too late.
Signs of Anorexia Nervosa
Anorexia can range from mild to severe. Some of the major signs of anorexia include losing a significant amount of weight (although this may be hidden through the use of baggy clothes), continuous dieting and preoccupation with weight. The anorexic may complain of "looking fat" despite appearing obviously thin or even underweight. She may insist on eating alone, may feel depressed and withdraw from social events entirely.
Although they avoid eating, anorexics are constantly thinking about food, calories, and cooking as well as exercising compulsively. If your daughter is suffering from anorexia, you may notice that her periods have ceased. This is a result of having too little body fat. However, as teens often have irregular periods for the first few years after they start menstruating, this side effect of anorexia may not be so obvious. Other physical symptoms that you may notice if your child has developed anorexia include brittle hair and nails.
Signs of Bulimia Nervosa
As with anorexia, bulimia disorder can range in severity with a sufferer having a few symptoms to coping with a full-blown disorder. Bulimia may be harder to detect due to the fact that your child’s weight usually stays within a normal range. However, there are some very characteristic signs of bulimia such as binge eating late at night, purging with diets, fasting or vomiting.
A bulimic may abuse laxatives or diuretics as a diet aid. Another tell-tale sign is frequently visiting the bathroom after meals and having reddened fingers from forced vomiting. Bulimics may have swollen cheeks, glands and tooth decay from persistent vomiting. They may constantly ruminate over their weight and become depressed with mood swings. A female bulimic may have irregular or abnormal periods, but again irregular periods are normal for teens during the first few years of menstruation. Bulimics may complain about bloating and heartburn.
How Do I Approach My Child About This?
If you suspect your child has an eating disorder, you need to plan how you will discuss it with her. If your child is beginning to have a problem, she will be naturally defensive and probably not willing to talk about it with you. You do not want to accuse them of anything such as saying "You have a problem with eating and need help."
Be Specific About Your Concerns
Focus on your specific concerns with their health, like "I am worried that you are not eating enough." If you focus on their behavior, steering clear of any judgmental statements, you will gain your child’s trust and leave their dignity intact. If the problem worsens, you will need to make an appointment to go to see your child’s doctor and possibly a mental health professional.
Eating Disorder Treatment
It is important to remember that an eating disorder is not just a physical illness but a mental one as well. Because there are so many health risks and complications associated with eating disorders, treatment of the disorder is comprehensive. The sooner an intervention is made in an eating disorder, the better the chances of treatment and recovery.
An adolescent suffering from a severe eating disorder will need a health care treatment team made up of a medical doctor, psychologist or psychiatrist, dietician, occupational therapist and a social worker to treat all aspects of the eating disorder. Treatment may occur in an outpatient or inpatient setting, located in a hospital, eating disorder facility or medical clinic.
A Well-Informed Treatment Team
Once you child begins to receive treatment the first and foremost focus will be addressing your child’s medical needs through nutritional rehabilitation. Once nutritional health is restored, the team of medical specialists may begin a more comprehensive treatment which could include:
- cognitive behavior therapy with a psychologist
- meeting with a psychiatrist to discuss medication options or diagnosis of underlying anxiety disorders
- family counseling with a social worker
- nutritional education with a dietician
- possibly meeting with an occupational therapist for life skills