Eating disorders are common conditions that can affect anyone – boys, girls, men, and women. These disorders lead to changes in eating habits that can be serious and even life threatening. If your older child or teen has an eating disorder, he or she may be best treated by a teen eating disorder specialist. There are three main types of eating disorders:
- Anorexia nervosa (anorexia) – Anorexia is characterized by a refusal to eat enough to maintain health. It is a complex disorder, but it generally occurs in response to a fear of becoming fat.
- Bulimia nervosa (bulimia) – Bulimia is characterized by over-eating followed by vomiting or using laxatives to prevent weight gain. The eating/vomiting cycle is often referred to as a binge/purge cycle.
- Binge eating – Binge eating is characterized by quickly eating large amounts of food. Unlike bulimia, it is not usually followed by purging.
Some children have more than one eating disorder or have symptoms of more than one. A child with anorexia may have bouts of binging and purging, and a child with bulimia may go through periods of not eating or not eating enough.
Anorexia is the most common type, and it tends to develop in young teens. The median age of onset is between 12 and 13 years; however, any eating disorder can develop in people of any age. All eating disorders are more common in girls and women. Experts estimate that between 5 and 15 percent of people who have anorexia and bulimia are male, and about 35 percent of people who have binge eating disorder are male.
Eating disorders rarely occur alone. Most people who have an eating disorder also have a mental health condition, such as anxiety, depression, or mood disorder, or substance abuse disorder.
Warning signs of eating disorders
Eating disorders have many signs and symptoms, and they vary from person to person and from disorder to disorder. If your son or daughter shows any of the following signs, he or she may have an eating disorder.
- Anxiety problems or behavior changes around food, like avoiding meals, eating secretly, monitoring food consumption, eating only small amounts, or an unusual interest in food or calories
- Rapid weight loss or dieting while already thin
- Wearing baggy, oversized clothing to conceal weight
- Fear of becoming fat even if underweight or frequent talk about weight or body shape
- Negative self-image, high degree of self-criticism, or overemphasis on physical appearance
- Exercising excessively or compulsively
- Taking laxatives or other pills to lose weight or prevent weight gain
- Eating large amounts of food at one time (binging)
- Scarring on knuckles (which can be a sign of inducing vomiting with fingers)
- Spending time in the bathroom or vomiting after eating
Common causes of eating disorders
Experts aren’t sure what causes eating disorders, but most agree that the causes are complicated and a combination of biological, sociological, psychological, and behavioral factors. Family dynamics may also play a role.
Sociological causes – Social influences and cultural pressures may have an effect on the development of eating disorders. For example, culture in the United States often seems to value thinness and perfect bodies. Definitions of beauty in entertainment tend to be narrow, and some cultural norms value people’s appearance over personality. All of this can put pressure on people to fit into what they perceive as the standard of beauty. There is frequent bullying about weight and size, which adds to the pressure some children and teens feel to be thin and in shape.
Biological causes – There is ongoing research about the possibility that there are biochemical or biological causes of eating disorders. For example, it seems that some people with eating disorders have an imbalance in the brain chemicals that control hunger, appetite, and digestion. There may also be genetic causes of eating disorders since eating disorders can run in families.
Behavioral causes – There are some experts who also believe that some people with eating disorders are changing their eating habits to help them feel in control when they don’t feel like they have control of much in their life. Eating or binging and purging may be used as a coping mechanism when people are overwhelmed by painful emotions they can’t express or handle.
Psychological causes – Psychological problems, like low self-esteem, depression, anxiety, and anger can play a role in eating disorders. Loneliness and feeling socially isolated may also have some effect on eating disorders.
Interpersonal causes – Difficult family or peer relationships can be a factor in eating disorders, as can a history of being teased about weight and other things. A history of abuse also puts children at higher risk.
Risks and consequences of eating disorders
Eating disorders have potentially serious consequences. If eating disorders are severe enough, they can lead to death. Some of the longer-term consequences of untreated eating disorders are malnutrition, stunted growth, and emotional distress.
Malnutrition – Children who don’t eat enough, eat too much of the wrong foods, or vomit after eating may not get the nutrition they require to be healthy. Malnutrition is a serious complication of eating disorders that can have life-long effects. For example, children who are malnourished may not grow and develop normally, which can set them up for problems throughout their lives.
Heart problems – When the body does not have enough food to work properly, it uses muscle tissue to get the energy it needs. When the heart doesn’t have enough fuel to operate effectively, blood pressure and pulse rate tend to drop. When the body doesn’t get adequate nutrition for a longer period of time, it can lead to irregular heartbeats and heart failure.
Stunted growth – Inadequate nutrition can have a negative effect on growth and can actually stunt children’s growth.
Tooth decay – Frequent vomiting can damage the teeth as stomach acid eats away at the teeth’s protective enamel.
Weakened bones – When the body doesn’t get enough nutrients, the bones can become weak and brittle, which puts people at risk of broken bones and other musculoskeletal disorders.
Emotional distress – Emotional problems are often a contributor to eating disorders, but eating disorders can also lead to additional emotional problems due to strained family and peer relationships and difficulty at school (both academically and socially).
Treatment options and interventions
Eating disorders don’t just go away on their own. No one can simply stop the eating disorder just because someone tells them to or they want to.
All children with eating disorders will need some sort of treatment, both for their physical health and their mental health. Treatments are easier and more effective the earlier they are begun. So, if you notice any signs or symptoms of an eating disorder in your child, seek professional help. As a parent, you know your child better than anyone. Go with your gut. If you think your child needs help, he or she probably does.
Treatments for eating disorders vary depending upon the type of disorder and the associated symptoms, among other things.
Treatment for anorexia
The first goal of treating anorexia is to restore a healthy weight and eating habits. Some children may need to be hospitalized to accomplish this goal. Although it’s rare, some children may require tube feeding or IV nutrition during this period of treatment. There are anorexia treatment programs throughout the country that can help.
Another aspect of treatment is addressing the underlying psychological issues at the root of the anorexia. That treatment may include a combination of:
- Antidepressant medication
- Psychotherapy, including individual, family, or group counseling
- Behavioral modification therapy
- Nutritional counseling
- Support groups
- Medical to address the side effects of the eating disorder
Treatment for bulimia
The first line of treatment for bulimia is to break the cycle of binging and purging. Other therapy is similar to that used for anorexia, including:
- Antidepressant mediation
- Behavior modification therapy
- Psychotherapy, such as individual, family, or group counseling
- Nutritional education
- Support groups
- Medical and dental care to treat problems associated with the eating disorder
Treatment for binge eating
Since binge eating is similar to bulimia (minus the purging), treatment is similar. Individual, family, and group therapy; behavior modification therapy; and antidepressant medications may be used.
What to do if your child has an eating disorder
If you suspect an eating disorder, talk with your child – and your child’s pediatrician. Make sure you child knows you are worried and you care. A non-judgmental approach is most effective. Children with eating disorders may believe that they aren’t good enough or that they aren’t loved or liked as they are. It’s important not to get angry, but instead to approach your child with compassion and concern.
Eating disorders are serious. Children can die from the effects of eating disorders if they do not get effective treatment. If you even suspect your child might have an eating disorder, seek treatment from an eating disorder specialist right away. People with eating disorders can become quite skilled at hiding their eating habits and other signs of their conditions, so parents must be vigilant.
The Hough Center For Adolescent Health
The Hough Center for Adolescent Health uses a collaborative, "no blame" approach that involves you and your child, providing you with techniques to navigate the daily recovery process. Each adolescent is encouraged and empowered to take an active role in his or her recovery. Call 248-594-3142 to set up an appointment for your child.
To speak with an eating disorders specialist at the Hough Center for Adolescent Health, call 248-594-3142. For a referral to other Beaumont physicians who treat eating disorders, call 855-480-KIDS or find one online.