Eating disorders in children – symptoms, causes and treatment.
Is your child losing weight, avoiding shared meals, or becoming overly concerned with their composition and calorie count? Many parents search for questions like "eating disorders – what does it actually mean?", "what are the symptoms and causes?", or "is there a test to help assess this?" In this article, we'll explain the definition of eating disorders in children in simple terms, discuss their most common symptoms and types, and suggest where to seek help and what treatment is available. This will help you better understand your child's situation and know when it's worth consulting a specialist.
Eating and eating disorders – definition, what they are and what are their types in children
Eating and eating disorders (ED – eating disorders) are complex disease entities of psychological originwhich are related to chronic and abnormal eating behaviorsIf you're wondering what it is, or rather what eating disorders in children are, it's worth knowing that they concern both the way of taking food and its absorption, which can lead to serious health consequences and difficulties in everyday functioning.
Modern medicine distinguishes various types of eating disorders, which can present differently. Each has its own specific characteristics, which is why the definition is not limited to eating problems, but also includes the child's way of thinking and behaving: body image, low self-esteem and the pursuit of unrealistic appearance-related goals.
Below are simplified definitions of some of the types of eating disorders seen in children:
- Anorexia nervosa (anorexia) – involves deliberate and extreme restriction of food intake in order to be slim, which leads to significant underweight.
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Individuals with anorexia experience a significant fear of gaining weight and have a significantly distorted body image – despite extreme emaciation, they still perceive themselves as obese. The International Classification of Mental Disorders defines anorexia as two forms: restrictive (self-starvation, excessive exercise) and binge/purging (episodes of binge eating or purging, vomiting, and use of laxatives).
- Bulimia nervosa - what is thisThis form of eating disorder is characterized by uncontrollable binge eating, during which the child consumes large amounts of food in a short period of time. Such an episode is followed by compensatory behaviors to prevent weight gain, such as self-induced vomiting, laxative abuse, or strenuous exercise.
- Binge eating disorder – Similar to bulimia, this disorder involves recurrent episodes of excessive eating (significantly exceeding what most people would eat at a similar time and in similar circumstances) accompanied by a sense of loss of control. The sufferer then makes no attempt to eliminate the food (e.g., by vomiting). This often results in overweight or obesity and metabolic problems.
- ARFID (food avoidance or restriction disorder) – is a specific type of eating disorder in children in which the child refuses food due to its sensory characteristics (smell, color, texture) or due to fear of negative consequences (e.g., choking). Unlike anorexia, the motivation here is not a desire to lose weight – the cause of this type of eating disorder is not fully understood.
- Pica (adverse appetite) - What is this, what is it like? definition What is this disorder? Pica involves the persistent consumption of inedible, devoid of nutritional value foods, such as dirt, ice, chalk, or paper. It is diagnosed in children over 2 years of age, for whom such behavior is no longer developmentally normal.
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Among children and adolescents, there is an increasing awareness of other eating-related problems, such as orthorexia (an obsessive focus on the quality and "healthiness" of products) or bigorexia (an excessive focus on the appearance and muscularity of the body, associated with strict dietary restrictions and the use of dietary supplements).
This shows that eating disorders do not have one form or simple definition, and the answer to the question of what it is, or rather what eating disorders are, covers a wide spectrum of different problems and behaviors.
Causes of eating disorders in children: are they different in boys and girls?
Eating disorders in children and adolescents they do not have one specific cause, and their development is the result of the overlapping of many complex psychological, familial, biological and socio-cultural factorsThey often represent a young person's attempt to regain control over their own body and environment, for example during the difficult period of adolescence.
Common causes - general risk factors for developing eating disorders in children
- Psychological and individual factors: Low self-esteem and lack of acceptance of one's appearance, resulting from a distorted body image, play a very important role.
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These children often exhibit perfectionist tendencies and a strong need for competition and achievement. Various eating disorders may also serve as a form of escape from difficult emotions, stressful events (e.g., changing schools, parents' divorce), or traumatic experiences such as sexual abuse or the death of a loved one.
- Influence of family environment: Family plays a key, often decisive, role in shaping a child's attitudes. The risk of eating disorders in children increases in homes where overprotectiveness, rigid relationships, high expectations, and difficulties in communicating emotions and resolving conflicts prevail. The eating habits of caregivers also play a role in determining the possible causes of eating disorders in children – obesity or "stress eating" in parents significantly increase the likelihood of eating disorders in children.
In this article we write more about how excessive care can affect a child's development.
- Biological and genetic background: Increasingly often, especially in the case of anorexia nervosa, the cause is seen in a genetic correlation: the risk of developing the disease is higher in people whose first-degree relatives also struggled with this problem.
- Cultural pressure and media: The contemporary cult of thinness promoted on social media and the promotion of "ideal" celebrity bodies act as accelerators of eating disorders. Children, fearing peer rejection, strive for unrealistic beauty standards.
Differences in the causes and symptoms of eating disorders in children depending on gender
Although eating disorders are mainly associated with girls, in whom they occur more frequently, boys also suffer from them, and their causes and symptoms may be different.
- Girls: In their case the dominant cause is striving for extreme thinnessThey are more likely to succumb to social comparisons and peer pressure to be thin, which translates into drastic diets and fasting. A characteristic biological symptom is the cessation of menstruation.
- Boys: In males, the disorders often take the form of the above-mentioned bigorexia, where the goal is not weight loss, but obsessive growth of muscle tissue and achieving the perfect body shape. They are more likely than girls to react to the disease with a strong a sense of shame and guilt, perceiving it as a “women’s” problem, which makes it difficult for them to seek help.
It is worth remembering that in boys, excessive physical activity is the most common compensatory mechanism, while in girls it is more common to mask the figure with loose clothing and avoid eating together.
Eating disorders in children – symptoms that should alarm parents
Diagnosing eating disorders in children can be a big challenge because the disease often develops gradually, and young patients can hide your behavior for a long timeThere is no single, universal test for detecting eating disorders in children.
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That's why it's so important to be alert to the first signs of an eating disorder, which can affect eating habits, emotional functioning, and changes in the body. In practice, the definition of an eating disorder isn't limited to just food—it also encompasses thinking, experiencing emotions, and body image.
Changes in behavior and eating habits – the first symptoms of eating disorders
One of the earliest symptoms is changing the approach to eatingA child may drastically limit the amount of food consumed, introduce restrictions, or eliminate entire food groups – even despite visible weight loss.
Other disturbing symptoms of eating disorders include:
- avoiding shared meals (e.g. explaining that they have already eaten),
- obsessive calorie counting and analyzing the composition of products,
- hiding or throwing away food to create the appearance of eating it,
- excessive control over what ends up on the plate (quantity, quality of food),
- sudden, very intense physical exercise aimed at burning calories,
- frequent visits to the toilet immediately after meals,
- wearing loose clothes to hide weight loss.
Physical and somatic symptoms – how does a child's body react to eating disorders?
In the course of eating disorders, especially anorexia, there are clear changes in the functioning of the body, resulting from malnutrition.
The most common physical symptoms are:
- significant weight loss or failure to gain weight appropriately,
- hormonal disorders (e.g. amenorrhea in girls),
- dry, flaky skin and the appearance of fine hair (lanugo),
- low blood pressure, slow heart rate and constant feeling of cold,
- weakening of hair and nails.
In the case of bulimia, characteristic symptoms of the eating disorder include:
- enamel damage and tooth decay (due to vomiting),
- swelling of the parotid glands (rounding of the face),
- changes in the hands (so-called Russell's sign).
Mental and Emotional Symptoms – When Food Stops Being Just Food
One of the key symptoms of eating disorders is disturbed body imageDespite being clearly underweight, a child may perceive themselves as "too fat" and constantly strive to lose weight. It is often accompanied by symptoms such as:
- strong fear of gaining weight,
- excessive focus on food and appearance,
- irritability and mood swings,
- withdrawal from social relationships,
- symptoms depressive.
This shows that Eating disorders are not just a problem with food – the answer to the question of what an eating disorder is also covers the sphere of the child’s emotions and psyche.
Symptoms of eating disorders characteristic of younger children
In the youngest children (preschool and early school age), symptoms of eating disorders may also occur, such as:
- Fear of eating (phagophobia): Some children have a strong fear of swallowing or choking, which often appears suddenly after a traumatic event, such as choking or a painful oral examination.
- Already mentioned in the article ARFID and food selectivity
- Physical and developmental symptoms: A very important indicator is stunted growth and lack of expected weight gain appropriate to age, which may lead to, among other things, anemia or osteoporosis (in the future).
- Social withdrawal: The baby may become apathetic, avoid eye contact with the caregiver during feeding, and show complete lack of interest in food and the surroundings.
It is worth remembering that the period between 18th and 24th month of life This is a time of natural neophobia (fear of new food), but if difficulties in eating persist and affect the child's psychophysical development, professional consultation is required.
Eating disorders – is there a test to help recognize them?
Although many parents are looking for an answer to the question whether there is a simple test for eating disorders, it is worth emphasizing that final diagnosis always requires consultation with a specialist – a psychiatrist or psychologistHowever, there are supportive tools in the form of questionnaires that can support the diagnostic process and help initially assess whether eating disorder symptoms require further evaluation.
In adolescents above 14 years of age specialists can use Eating Disorders Inventory (EDI), while incorrect attitudes towards food are often used to assess EAT-26 testWhen specific types of eating disorders, such as orthorexia, are suspected, the following are used: Bratman's test and/ or ORTO-15 questionnaire, and if night eating syndrome is suspected – Night Eating Questionnaire.
However, it's important to remember that available tests for eating disorders aren't always tailored to young children and can't replace a professional diagnosis. Their results are only a guide – a thorough medical history, observation of the child, and a comprehensive assessment of their functioning are crucial.
Eating disorders – where to seek help and what does treatment look like in children?
If you suspect your child has an eating disorder, it is crucial take action quicklyEarly intervention significantly increases the chances of successful treatment, regardless of the type of eating disorder being addressed. Many parents wonder where to seek help – the answer isn't always obvious, so it's important to know where to start and what the next steps might be.
Where to seek help if you suspect a child has an eating disorder?
- General practitioner (pediatrician) – This is usually the first step. The doctor will assess the child's health, check their weight, and may order basic tests (e.g., complete blood count, electrolyte levels) to rule out other causes of weight loss or assess the effects of malnutrition.
- Child psychiatrist – a specialist who makes a diagnosis and coordinates leczenie eating disorders. In serious situations, when the child's health or life is at risk, the doctor may decide to require hospital treatment.
- Free support hotline – Parents can call the 24/7 hotline 800 080 222, where psychologists and educators are on duty. Additionally, there is the National Health Fund (NFZ) hotline: 800 190 590, which helps find the right facility and indicates where to seek help in a given region.
What is the treatment for eating disorders in children?
Treatment for eating disorders is a complex, usually long-term process and requires cooperation of various specialistsDepending on the type of eating disorder and its severity, the treatment plan may vary, but most often includes:
- Psychotherapy – individual and family, which helps to understand the causes of the problem and introduce real changes in the functioning of the young person and their family,
- Dietary support – learning proper eating habits,
- Medical care – health monitoring and treatment of complications of eating disorders,
- Collaboration of a team of specialists – depending on needs, these may also include a cardiologist, endocrinologist or doctors of other specialties.
In some cases they are also helpful specialist centers and rehabilitation stays, which combine diet, psychotherapy and physical activity under the supervision of a team of experts.
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Family plays a crucial role at every stage of eating disorder treatment. Parental involvement, attentiveness, and collaboration with specialists are among the most important factors supporting a child's recovery.
*This article is for informational purposes only and cannot replace medical advice if a child is suspected of having an eating disorder. individual consultation with specialist.
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