Is Your Child Suffering from an Eating Disorder?
“I’m fat,” my 11-year-old daughter said one day near the end of fifth grade, pouting. “When I bend over, you can see fat over my pants.”
A little background: My daughter is, and always has been, in the 25th percentile for weight. She eats like a bird, and a very finicky bird at that. So I did what any patient, sensitive parent would do and shrieked, “You’ve got to be kidding!”
It turns out my daughter was comparing her “muffin top” to another girl’s seemingly flab-free middle. Fortunately, I was able to reassure her she was just fine, and her concern was short-lived. She hasn’t said anything negative about her body since, but my antennae are always on the lookout.
Millions of families aren’t so lucky.
Thin is in
Adolescents are wired to focus on their looks. More and more, girls — and, to a surprising degree, boys — are unhappy with what they see in the mirror. They want to be thinner, stronger, prettier — to look like the “hot” girls and boys in their school and the pop stars, actors and models they admire. They use appearance as a measure of value. They often don’t take into account the personal trainers and stylists celebrities use or calorie restrictions models endure. (The average fashion model is in the fifth percentile for weight.)
What preteens and teens who obsess about their body don’t realize is that they’re a work in progress. “Teens and children need more information about how their body grows,” says Nancy L. Zucker, director of the Duke Center for Eating Disorders in Durham. “We don’t need to demonize body fat” in kids who are in the normal weight range, she says.
All too often, feeling bad about their body — especially their weight — leads kids to an unhealthy relationship with food and activity. But it’s not always easy to pin down the issue. Eating problems fall onto a continuum, with fad diets and exercise kicks on one end to full-blown psychiatric disorders like anorexia nervosa — the most widely known eating disorder involving distorted body image and severe calorie restriction — on the other.
Because less-severe problems don’t produce obvious symptoms or dramatic weight loss, many kids who seem fine spend years obsessing over their weight, body fat percentage or clothing size.
“I was the girl who sat next to you in class. I was the social secretary of my sorority, yet I had an eating disorder for 15 years,” says McCall Dempsey, the founder of Southern Smash, which raises eating-disorder awareness. The nonprofit organization based in Baton Rouge, La., stages “scale smashing” events at colleges throughout the Southeast, including one scheduled Oct. 28 at UNC-Chapel Hill.
Dempsey eventually sought help at Carolina House, a residential treatment center for eating disorders in Durham. It took eight months for her to let go of her perfectionism and develop a healthier mindset regarding her weight.
Food as the enemy
For adolescents in the grip of an eating disorder, listening to their instincts is almost impossible. So is seeing themselves objectively. In addition to causing eating disorders, this tendency can manifest itself in a rare but serious disorder called body dysmorphic disorder, says Cynthia Bulik, director of the UNC Center of Excellence for Eating Disorders in Chapel Hill. This disorder is a “preoccupation with one or more perceived deficits or flaws that are not observable to other people or appear slight to others,” she says. “This can be absolutely devastating.”
But eating disorders are far more prevalent. According the National Eating Disorders Association, 20 million women and 10 million men will suffer from a clinically significant eating disorder sometime in their lives. Up to 1 percent of adolescent girls have anorexia, and 1-2 percent suffer from bulimia, purging through vomiting or laxative use, according to an American Academy of Pediatrics report. Blame it on social media, the entertainment industry or fashion magazines, but the truth is even the youngest children are vulnerable to negative body images.
“Clinically, we are seeing this in younger and younger children, although we don’t have good epidemiological data to back up our observations,” Bulik says.
Data from other sources validates Bulik’s claim: 40-60 percent of girls ages 6-12 are concerned about their weight or about becoming too fat, according to the National Eating Disorders Association.
When it comes to observing possibly unhealthy body-image behaviors in their children, Bulik says many parents often think it is just a phase. “But what’s happening is that it is becoming entrenched and becoming indelibly etched in their child’s self-esteem and body esteem,” she says. “It might become less overt, but in fact it might just have gone underground.”
And it’s not just girls who are prone to negative self-images. “Boys are not immune to eating disorders or body dysmorphic disorder at all, and boys can be terribly cruel to each other if they don’t measure up physically,” Bulik says. “It can also be a stepping stone to taking steroids to try to change their body so they are never teased again.”
Both Bulik and Zucker stress the importance of making your child’s physician an important ally if you suspect a possible problem with body image or eating. Physicians can reassure tweens or teens that their weight is normal for their height (if that is indeed the case) and stress the importance of a balanced diet and moderate exercise. Some physicians might also list the potential dangers of dieting, restricting food groups or over-exercising.
Parents can set the stage for their children’s healthy regard for their body and weight, Zucker says. “They’re picking up on our modeling, so don’t talk about other folks in reference to their weight or appearance,” she notes. “It’s also important for everybody to have dinner together so you can see what they’re eating, or not eating.”
Suzanne M. Wood is a Raleigh-based freelance writer and mother of three.
Eating disorders defined
The three most common eating disorders are:
Anorexia nervosa – A psychiatric disorder involving distorted body image and severe calorie restriction, which can lead to death by starvation or suicide. Symptoms include dangerously low body weight, denial of the situation and a deep fear of getting fat.
Bulimia nervosa – A psychiatric disorder involving purging (i.e., vomiting and laxative use) to restrict calories after eating or binging.
Binge eating disorder – The newest eating disorder to receive a diagnosis code, this one involves binge eating without compensatory behaviors (i.e., purging) and is more often associated with overweight rather than normal-weight individuals.
Eating disorders signs
Signs of a potential eating disorder in children:
- Changes in body weight not associated with normal growth.
- Comments about hating their bodies.
- Not wanting to go out because of how they look.
- Covering themselves up.
- Not wanting to go swimming or to the beach.
- Spending hours in front of the mirror.
- Not wanting to eat with the family or noticeable changes in eating behavior, moodiness and increased comparisons to other kids’ bodies.
‘I'm, Like, SO Fat!’ Helping Your Teen Make Healthy Choices about Eating and Exercise in a Weight-Obsessed World by Dianne Neumark-Sztainer, Ph.D.
Almost Anorexic: Is My (Or My Loved One’s) Relationship with Food a Problem? by Jennifer Thomas, Ph.D., and Jenni Schaefer
Treatment resources in the Triangle
Duke Center for Eating Disorders
UNC Center of Excellence for Eating Disorders