About Eating Disorders in Children

Overview

Eating disorders in children are severe mental health conditions characterized by abnormal eating habits that negatively impact a child's physical and mental well-being. These disorders can include various conditions such as anorexia nervosa, bulimia nervosa, binge eating disorder, and other specified feeding and eating disorders.

Children with eating disorders often exhibit symptoms like food restriction, extreme weight loss, excessive exercise, vomiting, and distorted body image. These disorders can affect children of all ages, but they are most commonly reported during adolescence and young adulthood. It is important to note that eating disorders can have significant consequences on a child's growth, development, academic performance, and relationships. If you suspect your child may have an eating disorder, it is essential to talk to their doctor for proper evaluation and guidance.

Causes and Risk Factors

The pathophysiologic causes of eating disorders in children are not fully understood. However, there are several non-modifiable and modifiable risk factors that have been identified:

Non-modifiable risk factors cannot be changed or controlled. These include:

• Having a close relative with an eating disorder
• Historical trauma
• Sexual trauma in childhood
• Experience of violence and post-traumatic stress disorder (PTSD)
• Limited social networks

Modifiable risk factors can be influenced or changed. These include:

• Body dissatisfaction
• Bullying
• Appearance ideal internalization (believing they must look a certain way, based on societal or media standards)
• Anxiety disorder
• Food insecurity

It's important to note that these risk factors do not guarantee the development of an eating disorder, but they may increase the likelihood. Additionally, it's crucial to remember that eating disorders are complex conditions influenced by a combination of genetic, environmental, psychological, and social factors. If you suspect your child may be at risk or showing signs of an eating disorder, it is important to consult with a healthcare professional for a proper diagnosis and guidance on appropriate interventions.

Symptoms

Early symptoms of eating disorders in children may include:

• Slowed heart rate
• Low blood pressure
• Loss of regular menstrual cycles (in girls)
• Dehydration and associated kidney failure
• Loss of muscle mass
• Tiredness and weakness
• Dry skin
• Feeling cold all the time
• Rotting of the teeth and damage to the esophagus from vomiting
• Irregular bowel movements and constipation

As the disorder progresses or becomes more severe, additional symptoms may occur, such as:

• Dizziness and fainting
• Low body temperature
• Underweight or extreme weight loss
• Anxiety
• Vomiting
• Irregular menstrual periods (in girls)
• Slow growth
• Brittle nails
• Bruising
• Hair loss

It's important to note that not all children will experience the same symptoms, and some symptoms may vary depending on the specific type of eating disorder. If you suspect your child may have an eating disorder, it is crucial to talk to their doctor for a proper evaluation and guidance.

Diagnosis

To diagnose eating disorders in children, healthcare professionals typically perform the following examinations, tests, and procedures:

• Physical examination: A healthcare professional will conduct a thorough physical examination to assess the child's overall health and look for any signs or symptoms of an eating disorder.
• Medical history: The healthcare professional will ask the child and their parents or caregivers about their symptoms, eating habits, weight changes, and any relevant medical history.
• Blood tests: Blood tests may be conducted to check for any abnormalities in the child's blood count, electrolyte levels, liver function, and kidney function. These tests help assess the child's overall health and identify any complications associated with the eating disorder.
• Urine tests: Urine tests may be performed to evaluate kidney function and detect any abnormalities that could be related to the eating disorder.

Additional examinations, tests, and procedures to determine the stage or severity of eating disorders in children may include:

• Psychological assessments: Healthcare professionals may use various psychological assessments or questionnaires such as the Eating Attitudes Test (EAT-26), Children's Eating Attitudes Test (ChEAT), or Eating Disorder Examination Questionnaire (EDE-Q) to evaluate disordered eating behaviors and attitudes.
• Nutritional assessments: Nutritional assessments can help determine if the child is receiving adequate nutrition and identify any deficiencies or imbalances that may be contributing to their eating disorder.
• Bone density scans: In certain cases, a bone density scan (DEXA scan) may be performed to assess bone health and detect any signs of osteoporosis or osteopenia, which can be associated with severe eating disorders.

It is important to note that these examinations, tests, and procedures should be conducted by healthcare professionals experienced in diagnosing and treating eating disorders in children.

Treatment Options

The goals of treatment for eating disorders in children are as follows:

• Restoring adequate nutrition: The primary goal is to ensure that the child's nutritional needs are met and their weight is brought to a healthy level. This may involve working with a registered dietitian to develop a balanced meal plan.
• Reducing excessive exercise: In some cases, children with eating disorders engage in excessive exercise as a way to control their weight. Treatment aims to help them develop a healthier relationship with physical activity and establish a balanced approach.
• Stopping binge-purge and binge-eating behaviors: For children with bulimia nervosa or binge-eating disorder, the focus is on addressing these specific behaviors through therapy and developing healthier coping mechanisms.

The recommended treatments for eating disorders in children include:

• Psychotherapy: Talk therapy, such as cognitive-behavioral therapy (CBT), is commonly used to treat eating disorders in children. It helps them identify and challenge distorted thoughts and behaviors related to food and body image.
• Family-Based Treatment (FBT): FBT involves actively involving parents in the treatment process. It aims to empower parents to take charge of refeeding their child and separate the illness from the child. This approach has shown positive outcomes in treating adolescent eating disorders.
• Nutritional counseling: Working with a registered dietitian can help children establish regular eating patterns, develop a healthy relationship with food, and address any nutritional deficiencies.
• Health behavior changes, such as promoting regular meals and snacks, incorporating enjoyable physical activities, and fostering a positive body image, are also essential components of treatment.

It's important to note that there are no specific medications approved for the treatment of eating disorders in children. However, in some cases, medication may be prescribed to manage co-occurring conditions like depression or anxiety. Remember, each treatment approach is tailored to the individual needs of the child, so it's crucial to work closely with healthcare professionals to determine the most appropriate treatment plan for your child's specific situation.

Medication dosing may be affected by many factors, so it's essential to consult with your healthcare professional about dosing for your individual situation. Other side effects can occur, so it's best to check with your healthcare professional or read the information provided with your medication for additional side effect information.