One Facing the Challenge

As parents, you’re always concerned about your child’s overall well-being. Part of that includes ensuring your child is eating and getting enough nutrients to grow strong and healthy. But that’s easier said than done, right? Eating disorders are actually more common in children than you may think.

Understanding the signs and stressors of eating disorders in children is crucial. Early detection can lead to early intervention, which can significantly improve recovery outcomes. Children may not always be able to express their struggles, so recognizing warning signs like changes in eating habits, body image issues, or emotional distress can help you step in before the disorder becomes more severe.

EDs Are Not Simple

The first thing parents need to know is that children can develop different types of eating disorders, each affecting their health in serious ways, according to The Journal of Pediatrics.

• Anorexia nervosa involves extreme dieting and exercise to lose weight, even when the child is already very thin. This is often caused by a distorted view of his or her own body and a strong fear of gaining weight, which can lead to severe malnutrition.
• Atypical anorexia nervosa is similar, but the child’s weight may still be in the normal or above-average range.
• Bulimia nervosa includes episodes of overeating, followed by actions like vomiting or excessive exercise to avoid weight gain, often paired with harsh self-judgment about body shape and size.
• A binge-eating disorder also involves overeating but without purging, leaving the child feeling guilty or upset afterward.
• Avoidant restrictive food intake disorder (ARFID) involves avoiding certain foods, either because of sensory issues or fear of negative effects, which can cause weight loss, poor nutrition, and make it hard for the child to socialize.

What Are The Signs?

The signs and symptoms of eating disorders in children and teens can vary depending on the type of disorder, but the American Academy of Pediatrics notes some common warning signs parents and caregivers can watch for.

• Changes in eating habits: Skipping meals, eating very little, or avoiding certain food groups. Some children may start obsessing over food ingredients, calories, or portion sizes.
• Rapid weight change: Significant weight loss or, in the case of binge eating, noticeable weight gain. In some cases, a child may not lose weight but still exhibit signs of disordered eating behaviors.
• Excessive concern about body image: Expressing dissatisfaction with their appearance, talking about feeling “fat” even when they are underweight, or frequently checking themselves in mirrors.
• Compulsive exercise: Exercising excessively, even when tired, injured, or sick, or becoming upset if they can’t exercise.
• Avoiding meals or eating in secret: Children or teens might make excuses to skip meals, eat in secret, or claim they’ve already eaten when they haven’t.
• Physical symptoms: Complaints of dizziness, fatigue, stomach pain, or cold sensitivity can be signs of malnutrition. Eating disorders can also cause dry skin, brittle hair, hair loss, or changes in menstrual cycles for girls.
• Mood changes: Depression, irritability, anxiety, and social withdrawal may occur, especially around situations involving food.
• Unusual food behaviors: These can include cutting food into very small pieces, hiding food, or developing new rituals around eating.

Help Starts Here

Conversations about food, body image, or weight can be difficult, especially when a parent suspects their child might be struggling with an eating disorder. Dr. Laura Hernandez, a Licensed Professional Counselor, emphasizes the importance of approaching these discussions with empathy, care,
and a non-confrontational attitude.

Dr. Hernandez suggests that parents create a safe, relaxed environment to address concerns. “A great space to talk is in the car or if you’re taking a walk,” she says. “It just feels more natural. You’re not really engaged in a confrontational situation.” These situations may also help children feel more
comfortable. Rather than jumping to conclusions, parents should focus on observable behaviors.

The key is not to overwhelm the child with adult anxieties. “Our adult brain jumps three steps ahead when we get those worried thoughts,” she explains. Instead, ask simple questions and reflect on what you notice, giving the child room to share their thoughts without feeling judged. This approach fosters an open dialogue where children can express their feelings without fear of punishment or misunderstanding.

The Role of Professional Support

If parents are concerned about their child’s relationship with food, Dr. Hernandez advises starting with a pediatrician. A physical checkup can rule out or identify any growth or health concerns, and from there, a counselor specializing in eating disorders can provide support for mental health. Eating disorders often require a team-based approach, involving not just doctors and counselors but possibly occupational therapists, dietitians, or nutritionists.

For children with sensory issues around food textures or smells, an occupational therapist might offer specific food therapy. A nutritionist can help reframe the purpose of eating, teaching children how food supports their bodies. “It’s definitely a team effort,” Dr. Hernandez says.

The Mind-Body Connection

Mindfulness plays a significant role in helping children build a healthier relationship with food, and Dr. Hernandez sees it as a valuable tool in eating disorder treatment. “Mindfulness is paying attention in the present moment,” she explains. It can help children recognize patterns, like whether they’re eating because they’re hungry or because they’re bored, anxious, or overwhelmed.

Mindfulness practices, like mindful eating or breathing exercises, can also support the mental health tools children learn in therapy. For example, by reflecting on how certain foods make them feel physically and emotionally, children can gain insights into their eating habits. Dr. Hernandez also encourages parents to model these mindful behaviors, such as narrating their own experiences with trying new foods.

Children struggling with body image or eating habits often carry shame or embarrassment. To address this, Dr. Hernandez also recommends cognitive behavioral therapy (CBT), which helps children understand the connection between their thoughts, feelings, and behaviors. CBT teaches children to challenge negative thoughts and replace them with healthier, more realistic perspectives.

Another way to foster a healthy relationship with food is to make mealtimes positive family experiences. Dr. Hernandez suggests involving children in meal preparation, putting on music, and creating space for meaningful conversation at the table. “Use mealtime to connect—talk about the best parts of your day or the not-so-good parts,” she advises.

Navigating your child’s eating disorder can be challenging, but early recognition and intervention are crucial for his or her recovery and long-term health. As parents, understanding the signs and symptoms of eating disorders and approaching conversations with care can make all the difference. Remember, you don’t have to face this journey alone—seeking professional help from pediatricians, counselors, or nutritionists can provide the support your child needs to develop a healthier relationship with food. If you notice changes in your child’s eating habits or body image, reach out to a healthcare professional. Early action can pave the way to healing and a brighter future for your child.