No matter the cause, more and more children and adolescents are endorsing mental health concerns. When a child or an adolescent finds their way into my office, I’m consistently struck by the magnitude of pressures they face on a daily basis.
Consistently, children and adolescents are expected to take many high achieving courses, complete anywhere from three to six hours of homework each day, and are expected to complete numerous sports teams and extracurricular activities. Not to mention, any free time that is left over, is used to stay current with trends in order to be accepted by their peers. The pressures of childhood and adolescents lead many kids to feel overscheduled and have little time to express these pressures to parents or other supports around them.
In this society, it is very easy to get caught up with wanting to be “good enough” compared to peers or school/society standards of success. It becomes difficult for children and families to allow space and time to slow down, reflect, process, and respond to emotional needs. Overall, many children and adolescents do not feel that there is enough space and time throughout the day to share their needs. Frequently, kids turn to behaviors such as an eating disorder rather than “burdening others” with their emotional needs.
Not to mention, increasingly eating disorders, such as anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder (ARFID), and eating disorder behaviors are becoming a consistent threat and plaguing the lives of many youths. For more about the different types of eating disorders please visit these great blog posts by Dr. Dana Harron:
What should parents know about eating disorders?
Society paints a picture that eating disorders have a certain “look”. Usually, when people think of eating disorders they view Karen Carpenter: a young, underweight female. This view of eating disorders is actually quite dangerous and can lead to numerous individuals feeling that their symptoms aren’t severe enough or that they aren’t “sick enough” to receive help. Many individuals not only don’t fit this stereotype but also many encompass many different symptoms that don’t fit into a cookie-cutter diagnosis. Teens and parents should understand that eating disorders do not discriminate against gender, culture, sexuality, race, socioeconomic status, or age. This means any child or teenager is at risk for developing an eating disorder or disordered eating behaviors. Believe it or not, as a professional I not only see kids that are of middle and high schoolers with disordered eating patterns, but I even see kids under the age of 12.
I urge parents to become aware of warning signs for eating disorders in children and adolescents. If you feel that your child has any of the following warning signs please seek guidance from an eating disorder therapist, dietitian, or medical professional. Early detection can be key to help your child prevent severe medical complications and emotional development regressions. More importantly, early detection can lead to emotional growth and understanding between child and parents.
What are the Warning Signs for Eating disorders?
Medical Warning Signs
- Delayed growth
- Abnormal weight loss or weight gain
- Delay of puberty
- Difficulty gaining weight
- Low potassium readings
- Low heart rate
- Muscle weakness
- Breaking bones more frequently
- Frequent sore throat
- Teeth degeneration
- More frequent GI issues
Emotional/Behavioral Warning Signs
- Fear or aversion of gaining weight
- Using the bathroom after meals or taking showers after meals
- Evidence of purging or excessive bowl movements in the bathroom
- Changes in demeanor or mood
- For instance, isolating self more frequently from peers or the family
- Angry outbursts or mood swings
- Fear of stomachaches or nausea that lead a child to eat certain foods in attempts to control stomachaches.
- Body image dissatisfaction
- Change in school-related performance (difficulty concentrating/focusing/drop in grades)
- Utilizing exercise as a way to process emotions
- Increasing one’s exercise routine
- Needing to exercise after meals or when they feel they ate “too much”
- Feeling guilty after eating
Food Related Warning Signs
- Difficulty eating certain tastes or textures around food
- Moving food around on one’s plate in an attempt to see as though more has been eaten
- Hiding food
- Counting calories
- Not eating during the day, but eating more caloric intake at night
- Being secretive around food or meal times
- Hiding food or evidence of food items in the room
- Eating food a certain way and unable to change these rules without anxiety
- Only having certain foods that child will eat
- Dieting- kids are more likely to develop an eating disorder when dieting is present.
- Feeling guilty after eating certain food items
- Recent life transitions (i.e. moving, starting high school)
- Trauma (i.e. emotional, physical, sexual abuse)
- Academic pressure
- Going through puberty and understanding body changes
- Family stress
- Parents and peers attitudes towards food and body image
- Having a family member with mental health issues or an eating disorder
- History of mental health diagnoses (individuals with eating disorders tend to have another mental health diagnosis).
What are the causes of Eating Disorders in Children and Adolescents?
Eating disorders are multifaceted, meaning there is never one cause, but most usually different puzzle pieces that fit together to create a reason the eating disorder is necessary. Many times, I like to understand what is currently “maintaining” the eating disorder within this child’s life. Eating disorders are an emotional outlet for children and adolescents. They may feel that their eating disorder is a great way to not have to deal with everyday pressures, depression, anxiety, or their needs. Eating disorders become a way to make any kid feel strong and in control, when deep down they may feel completely insecure. Eating disorders become a strong and maladaptive coping mechanism, not to mention potentially medically dangerous.
Controlling the uncontrollable
Think about it, from childhood to age 18, children and adolescents go through many emotional, relational, and physical changes. They are developing into adults and begin to understand for the first time that they are responsible for many aspects of life, such as their school work, outcomes in sports in academics, feeling as though they fit in.
In addition, these kids are going through so many physical changes with puberty and from a developmental perspective and haven’t even established the emotional language or emotional processing to begin to describe what it feels like to be in their bodies or the distress that they feel. More often than not, when a child does not know how to express their emotions in a world that is changing so fast, and eating disorder can become a helpful outlet to control the uncontrollable. Remember, this is more about your child’s emotional distress. Your child needs an outlet to describe their fears, hopes, dreams, concerns, rejections, etc. An eating disorder offers an escape. It is easier to think about food, weight, or other eating disorder behaviors than some of the pressures listed above.
As a parent what should you do?
With all the ways that an eating disorder can manifest it can be nerve-wracking for any parent to know what to do next. It is important not to become overwhelmed and avoid the subject. Also, it is important to not blame yourself even if you feel that your thoughts and feelings may have contributed to your child’s eating disorder.
As a parent, your first urge may be to want to fix all of the warning signs that you read above. Of course, that makes sense because you love and care for your child! However, sometimes fixing can be invalidating. Your child’s eating disorder is a way of vocalizing the need of being seen and heard. Take a pause and let’s focus on the emotional distress that your child is feeling. Ask them about what is leading them to feel the need to diet, their friends at school, or even label the mood swings they have been experiencing.
Remember, your awareness and willingness to approach these hard conversations with your child can also lead you to become the solution to the problem. Begin to open up about your concerns with your child and have these conversations about the behaviors you are noticing. Sometimes, an open conversation and letting your child know you are with them and want to hear what they have to say can make a world of difference to your kid.
Eating disorders can be one of the most disconnecting experiences for both your child and your family. Finding ways to bring words to your child’s emotional distress can model that these emotions are helpful to talk about. Although, life gets busy, find ways to stay invested in your child’s emotional health, such as regular family meals throughout the week, scheduling family meetings, or even five-minute emotional check-ins each day. These actions can make a world of difference and will help your child find the words for what they are feeling. You can be an important tool of emotional development for your child and help model emotional communication. This can make your child feel uncomfortable at first, but it is an important step for their growth!