It might be small things at first: a favorite treat refused, a sudden interest in calorie counts or a need to excessively exercise. While none of these are sure signs your child has an eating disorder, they can be red flags signaling you might want to keep a closer eye on their habits and talk to them about their concerns.
According to the National Alliance on Mental Illness, eating disorders are a group of related conditions surrounding a preoccupation with food and weight that cause serious emotional and physical problems. Common eating disorders include anorexia nervosa, bulimia nervosa, binge eating disorder (BED), orthorexia and avoidant-restrictive food intake disorder (ARFID).
Eating disorders can affect people of all ages, genders, races and socioeconomic groups, but symptoms commonly appear in adolescence. If not treated, they can lead to serious complications — even death.
According to Linda Santangelo, PhD, lead clinical psychologist with the Sharp Mesa Vista Hospital Eating Disorders Program, as a result of the pandemic, there has been an increase in mental health struggles, with a particularly profound impact on people with or at risk of eating disorders. In fact, a recent report from the Centers for Disease Control and Prevention found that pediatric emergency room visits due to mental health conditions skyrocketed during the pandemic with an increase of 24% in kids ages 5 to 11 and 31% among adolescents ages 12 to 17. The proportion of ER visits related to eating disorders doubled among adolescent females.
“We know that eating disorders have been on the rise pre-pandemic, illustrated by a rise of 119% in less than a decade among kids under 12,” she says. “Then, when you factor in the various stressors associated with the COVID pandemic and uncertainty about the future, the results can be disastrous for our children and adolescents.”
Signs and symptoms of an eating disorder
However, the National Eating Disorders Association reports that early detection of an eating disorder can lead to appropriate treatment and a higher likelihood of recovery. There are some warning signs — generally focused on weight loss, dieting and control of food — parents can watch for.
“Parents are in a unique position to assist their children in accessing early treatment for symptoms of an eating disorder,” Dr. Santangelo says. “They are able to observe their children in a more comprehensive way — not just a change in their eating or weight but also their social functioning, moods, school performance and other subtle changes in behaviors. I always tell parents to ‘trust their gut’ when it comes to their kids.”
Signs your child might have an eating disorder include:
- New preoccupation with weight, food, calories, carbohydrates, fat grams and dieting
- Refusal to eat certain foods, such as carbohydrates, meat, dairy or sugary foods — any foods they deem not “healthy,” “pure” or “clean”
- Discomfort eating around others
- Food rituals, such as mashing, excessive chewing and pushing food around the plate
- Skipping meals, making excuses to avoid meals or eating very small meals
- Excessive consumption of water
- Extreme concern with body size and shape
- An excessive, rigid exercise regime — despite weather, fatigue, illness or injury
- Frequent checking in the mirror — or touching or squeezing areas of the body — for perceived flaws
- A noticeable fluctuation in weight — up or down
- Complaints of stomach cramps or other nonspecific gastrointestinal complaints
- Menstrual irregularities — missing periods or only having a period if on hormonal contraceptives
- Dizziness or fainting
- Evidence of binge eating — disappearance of large amounts of food or excessive empty wrappers and containers — or hoarding food
- Expressing negative self-talk or exhibiting feelings of guilt, anxiety or depression after eating
- Cuts and calluses across the top of knuckles, frequent trips to the bathroom after meals, or smells and signs of vomit — all potential signs of induced vomiting, known as purging
Parents should also watch for extreme mood swings and excessive irritability, worrying or feelings of sadness. Additional behaviors of concern include changes in sleeping habits, unusual poor performance at school, and the avoidance of spending time with family and friends or participating in activities they previously enjoyed.
How to get help for your child
Dr. Santangelo advises parents and guardians not to be quick to disregard any changes in their children’s behaviors. Family members can make a tremendous difference in getting children the help that they need, she says, and are an important part of the recovery process.
“If you have questions or concerns, your child’s doctor or a professional mental health clinician who specializes in eating disorders can be a valuable resource,” Dr. Santangelo says. “This is not something parents and their children have to navigate alone — help is available.”