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Posted on: April 12, 2010

The Other Weight Epidemic

How to talk to your child about eating disorders

By Anna Sachse
CTW Features

Thanks to popular television programs like “The Biggest Loser,” “Half Ton Dad” and Chef Jamie Oliver’s new “Food Revolution,” not to mention hundreds of frightening headlines, most Americans now know that the U.S. is in the grip of a deadly obesity epidemic.

However, an equally if not more dangerous consequence of all this media coverage geared toward preventing obesity is that it may be pushing impressionable teenagers and pre-teens in the opposite direction, warns Darlene Atkins, director of the Eating Disorders Clinic at Children’s National Medical Center, Washington, D.C.

Indeed, according to the Seattle-based National Eating Disorders Association (NEDA), recent studies show that over one half of teenage girls and nearly one third of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting and taking laxatives. Anorexia nervosa – which results in more fatalities than any other mental illness – is the third most common chronic illness among American adolescent females, with girls age 15 to 19 accounting for 40-percent of all newly identified cases.

But anorexia, as well as bulimia nervosa and binge-eating disorder, has been diagnosed in children as young as seven-years-old.

“It’s possible to recover from an eating disorder, but the key to success is catching it early,” says NEDA chief executive officer, Lynn S. Grefe.

Here are some ways to recognize disordered eating behavior in your child, as well as tips for how to talk about it and advice on how to help.

Risk factors and possible symptoms

An eating disorder isn’t vanity, dieting gone badly or a choice; it’s a complex medical/psychiatric illness listed in the American Psychiatric Association’s “Diagnostic and Statistical Manual of Mental Health Disorders (DSM-IV).” According to NEDA, causes typically include socio-economic, environmental, cultural and biologic factors, and they are often symptomatic of deeper psychological issues related to self-esteem and the need for control.

“Eating disorders rarely ‘travel alone,’” Grefe says. “Often they co-occur with other mental illnesses, such as obsessive-compulsive disorder, anxiety or depression.”

Additional risk factors include: a family history of eating disorders or other mood disorders or addictive behaviors; intense events, such as a divorce, death or big move; and onset of puberty ahead of the child’s circle of friends.

In general, signs of a potential eating disorder may include dramatic weight changes, failing to gain weight at the proper rate, avoidance of meals, withdrawal from social activities, rituals like excessive chewing or eating strange food combinations, excessive exercise and, among boys, obsession with increasing muscle mass and steroid use.

Symptoms of anorexia may include complaints about being fat despite weight loss, denial of hunger, cold intolerance, loss of menstrual period and lethargy or excess energy.

Signs of bulimia may include disappearance of large quantities of food, excessive empty containers in the garbage, drinking large amounts of water with meals, frequent visits to the bathroom after meals, excessive use of mints or gum and bloat from fluid retention. Binge eaters share many of the same binging habits as bulimics, but without the purging. Keep in mind that both bulimics and binge-eaters are often within their normal weight range, or can even be overweight.

How to talk to your child

If you’ve watched your child sustain problematic food behavior over time, start a conversation by calmly bringing up what you’ve observed and asking non-judgmental questions like “How do you see yourself?” and “How do you think others see you?” Avoid saying things like “You’re not fat” or creating rules about food, Atkins says, as you might motivate your child to further hide their habits.

“Tell them that there is nothing to be ashamed of,” Grefe says, “but gently explain that you are concerned and think they might benefit from talking to someone who is an expert. It’s not your job to diagnose your child.”

How to help

Help your child develop a positive body image by modeling healthy eating and exercise habits – eat nutritious meals at regular intervals, indulge in occasional treats and encourage fun physical outlets, like dancing or kickboxing. Cut out praise or criticism of anyone based on weight. Talk to your children about how bodies change during puberty, openly challenge body-obsessed media messages and encourage open communication.

If you’ve determined that your child’s behavior merits a professional opinion, the pediatrician is a good place to start, Atkins says. “But treatment is usually a three legged stool: medical, nutritional and psychological.”

For extensive information and resources, including referrals to doctors, nutritionists, counselors and inpatient and/or outpatient facilities in your area, call the National Eating Disorders Association toll-free hotline (800-931-2237) or see them online at NationalEatingDisorders.org.