Understanding and Treating Eating Disorders in Kids
Colorado still leads the nation as the most-fit state, however, it has the fifth-highest rate of eating disorders in the country among adolescents. According to Dr. Ken Weiner with the Eating Recovery Center, “Eating disorders are not a choice. They are a mental illness” Dr. Weiner has been fighting stereotypes surrounding anorexia for a long time. “It has the highest mortality rate of any psychiatric illness; highest death rate.” “What the eating disorder does is it hijacks the brain…” Weiner said. “They (patients) require a combination of dietary, therapy, medical and psychiatric, because there’s a lot of psychiatric comorbidity (two chronic diseases or conditions in a patient;) depression, anxiety, addictions, substance abuse, trauma, ADD that go with these illnesses…” Weiner said.
There are three main eating disorders in children and teens: anorexia, bulimia and binge eating.
Anorexia Nervosa is a condition where a child refuses to eat adequate calories because of an irrational fear of gaining weight. If they eat, it will be a minimal amount and when they do, they feel the need to rid themselves of the calories by dieting, fasting or by doing excessive exercise. Anorexics will generally be very thin and underweight.
Bulimia Nervosa is a condition where a child overeats and then purges the food by vomiting or using laxatives to prevent weight gain. Bulimics will generally be average weight or even overweight but will also do excessive exercise to keep weight off.
Binging is a condition where a child may gorge rapidly on food, but without purging.
Anorexia, bulimia and binge eating all involve unhealthy eating patterns that begin gradually but build to a point where a person feels unable to control them. Eating disorders may deprive brain cells of needed energy and eventually change the way people process information. This change in brain chemistry is thought to contribute to food phobias and distorted thinking, especially in regard to one’s perceived body image.
What triggers Anorexia or Bulima?
Anorexia and compulsive overeating occur among children ages 8 to 11 years. It has been estimated that 40% of Nine year olds have already dieted according to Adeola T. Adelayo, MD and there are reports that four and five year-olds feel the need to diet. Sometimes a child, teen or adult wants to lose some weight and when the loss is obvious they become addicted to the control over their body. Extreme thoughts are when a child, teen or adult feel they are fat when they’re not and withhold food so they don’t gain weight. Contributing factors such as: low self esteem, biological predisposition, cultural impact, peer pressure to be thin, trauma, divorce of parents, conflicts in a family unit or parental preoccupation with appearance and weight are behind eating disorders in young people. It is necessary to get to the root of the problem why a child, teen or adult have such a poor body image.
Signs of Anorexia:
- They become very thin, frail or emaciated.
- They are obsessed with eating, food and weight control
- They count or portion food
- They eat in secret
- They will drink excessive amounts of water prior to a doctor visit to change their weight.
- They will eat only certain foods, avoiding those that are high in calories or fat
- They weight themselves repeatedly
- They exercise excessively
- They feel fat
- They withdraw from social activities, especially meals ad celebrations involving food
- They are depressed, lethargic and feel cold often
The dangers of Anorexia:
- Drop in blood pressure, pulse and breathing rate
- Hair loss and fingernail breakage
- Loss of periods in girls
- Lightheadedness and the inability to concentrate
- Swollen joints
- Brittle bones
- Injuries to internal organs, heart problems, kidney failure
- Failure to develop
Signs of Bulimia:
- They fear weight gain
- They are unhappy with their body type
- They make excuses to go to the bathroom after meals
- They only eat diet or low fat foods
- They buy laxatives, diuretics or enemas
- They work out excessively
- They withdraw from social activities involving food
The dangers of Bulimia:
- Constant vomiting and lack of nutrients cause constant stomach pain
- Damage to the stomach and kidneys
- Tooth decay
- Swelling of the salivary glands where they permanently expand from throwing up
- Loss of periods in girls
- Loss of potassium which can contribute to heart problems and even death
There is a fourth category called Avoidant/Restrictive Food Intake Disorder (AEFID.) Children or adults with AEFID don’t have anorexia or bulimia but they still struggle with eating and as a result don’t eat enough to keep a healthy body weight. Often times they are considered “picky eaters.” Younger children may not gain weight or grow as expected.
What are some of the signs of AEFID?
- Difficulty in digesting certain foods
- Avoiding certain colors or textures of food
- Eating only very small portions
- Having no appetite
- Being afraid to eat after a traumatic episode of choking or vomiting.
What causes eating disorders?
Many people begin to develop an eating disorder between the ages of 13 and 17 during the times of emotional and physical changes, academic pressures and greater peer pressure. Many people with eating disorders can also be depressed, anxious or have other mental health issues. There is also evidence eating disorders run in families and while part may be genetics it’s also due to learning behaviors from the family.
Eating disorders can also be triggered by sports. Gymnastics, ice skating and those who do ballet are encouraged to stay as thin as possible. Athletes and runners are encouraged to weigh less or shed body fat to be lean so they are quicker.
Treatments for Eating Disorders
Discussing your child with their medical doctor is important as well as therapy counseling (individually as well as with the entire family) with a psychologist, therapist or psychiatrist. Treatments will depend on each individual but often times it will involve the entire family to understand the problem along with journaling and working with dietitians and other professionals.
According to Adeola T. Adelayo, MD – Psychiatrist, “It is extremely important once again that for children ages 8 to 12 years, that home environment changes and most psychosocial interventions are started with the parents. Parents should be a full partner in any treatment paradigm and they should be fully incorporated as part of the team. There should be frequent family therapy throughout the duration of treatment and significant amount of time spent on psycho-education about eating disorders, as parents are just as confused about the illness as the child. Parents often struggle with feelings of guilt, and this feeling should be eased by the therapeutic team. They have the duty to be as non-judgmental as possible in their approach to addressing family conflicts, as well as perpetuating family dynamics that contribute to the eating disorder.”
Eating Disorder Prevention
NEDA, National Eating Disorders Association, states “prevention is any systematic attempt to change the circumstances that promote, initiate, sustain, or intensify problems like eating disorders. This may involve reducing negative risk factors (such as body dissatisfaction, depression or basing self-esteem on appearance) or increasing protective factors (such as a non-appearance oriented self-definition, and replacing dieting and body snarking with intuitive eating and appreciation for the body’s functionality). Prevention is important to reduce the suffering associated with eating disorders. Treatment is often expensive and difficult to obtain, which makes prevention even more important.”
Rep. Judy Biggert (IL) has introduced the Eating Disorders Awareness, Prevention, and Education Act of 2011. This Act proposes improving education of students, teachers, and administrators about eating disorders, including how to identify and help at-risk individuals. Other states have adopted legislation on eating disorders as well.
The goal is to get the child or teen the support and care they need as well as encourage them to communicate so they know they have someone who supports them, cares and understands.