teen with hand on head in frustration while sitting at table in front of slice of watermelon

Although eating disorders in kids are generally uncommon, parents should be aware of the signs as their child grows from adolescence into their teen years.

Jo Everett, MD, a psychiatrist specializing in eating disorders at the Loma Linda University Behavioral Health Institute, says even though it’s unusual to see an eating disorder in a child younger than 10-years-old, eating disorders are unfortunately being diagnosed in younger and younger children, including anorexia, bulimia, and binge eating.

Everett explains that eating disorders are so serious that they have the highest mortality rate of any mental health disorder.

What is an eating disorder?

“Eating disorders are diagnosed when individuals struggle with their relationships with food to the point that they are engaging in dangerous behaviors,” Everett says. “A key component of eating disorders is a disturbance in the way an individual views their own body, and their body image becomes incredibly distorted.”

Anorexia nervosa includes restricting food intake to the point of excessive weight loss and a significantly low body weight. “Individuals struggling with anorexia nervosa have an intense fear of gaining weight or becoming fat,” she says.

Anorexia is generally diagnosed after the onset of puberty and is the most commonly diagnosed eating disorder in younger children and early adolescents, Everett says. In younger children, anorexia is seen equally between both boys and girls. However, as kids move into adolescence and young adulthood, this disorder is much more common in girls.

Bulimia nervosa includes repeated occurrences of binging foods followed by a person’s attempts to undo those binges and prevent weight gain.

“A ‘binge’ is eating an excessive amount of food to the point of feeling overly full and feeling a sense of lack of control while eating,” Everett says. “Compensatory behaviors can include self-induced vomiting, using laxatives or diet pills, fasting, or engaging in excessive exercise.”

It is often diagnosed in late adolescence or early adulthood and is less common in younger children, she says.

Binge eating is the rarest eating disorder in kids and adolescents and is characterized by repeated episodes of binge eating, Everett says. This includes:

  • Eating more rapidly than normal
  • Eating until uncomfortably full
  • Eating large amounts of food when not feeling hungry
  • Eating alone due to embarrassment of how much one is eating
  • Feeling guilty or unhappy after binge eating

Signs for Parents

Eating disorders can present in different ways, but Everett outlines some common behaviors health professionals often see:

  • Counting calories and having difficulty eating food without knowing the calories
  • Eating very slowly
  • Cutting food into tiny pieces
  • Pushing food around plate
  • Secretly disposing of food during meals
  • Eating food in specific sequence
  • Using inappropriate eating utensils
  • Preoccupation with food, such as baking for everyone in the family or insisting on grocery shopping
  • Reluctance to eat with other people
  • Leaving the table frequently during meals to go to the bathroom
  • Consuming lots of candy, gum, diet soda, frozen yogurt, and coffee in lieu of nutritious food
  • Hiding food
  • Eating large quantities of food when upset
  • Water running in the bathroom in order to hide sounds of vomiting
  • Disappearing to the bathroom after eating
  • Food disappearing in the house
  • Thoughts or statements about being fat and/or ugly
  • Spending an excessive amount of time in front of mirrors

“In addition to changes in behavior, parents may also notice some physical changes including weight loss, losing hair, brittle nails, frequently being cold, loss of menstrual cycle, and the face appearing puffier,” she says.

Next Steps

Everett recommends reaching out to your pediatrician as a good first step if you have concerns your child may have an eating disorder. Additionally, if you child has a therapist or psychiatrist, they would also be able to further investigate and potentially make a diagnosis.

Resources Available

At Loma Linda University Behavioral Medicine Center, individual therapists and psychiatrists can aid in the treatment of eating disorders and the anxiety and depression that sometimes go with them, Everett says.

“We also have a partial hospitalization program for adolescents diagnosed with eating disorders, in which patients spend the day with us in a group setting working on nutrition, body image, self-esteem, and coping skills,” she says.

She encourages parents that communication is key. “If you have concerns, talk to your child,” Everett says. “I promise, you won’t make it worse! Please reach out for support from your child’s doctor. Eating disorders can be scary diagnoses and can take a long time to treat, but there are interventions available.”

Make an appointment to talk to your pediatrician or learn more online about resources at the Behavioral Medicine Center.