Eating Disorders in Children and Teens

Eating disorders can cause serious health problems for children and teens. Here is what to watch for.

From the WebMD Archives

Eating disorders in children and teens cause serious changes in eating habits that can lead to major, even life threatening health problems. The three main types of eating disorders are:

  • Anorexia , a condition in which a child refuses to eat adequate calories out of an intense and irrational fear of becoming fat
  • Bulimia , a condition in which a child grossly overeats (binging) and then purges the food by vomiting or using laxatives to prevent weight gain
  • Binge eating, a condition in which a child may gorge rapidly on food, but without purging

In children and teens, eating disorders can overlap. For example, some children alternate between periods of anorexia and bulimia.

Eating disorders typically develop during adolescence or early adulthood. However, they can start in childhood, too. Females are much more vulnerable. Only an estimated 5% to 15% of people with anorexia or bulimia are male. With binge eating, the number rises to 35% male.

What causes eating disorders?

Doctors aren't certain what cause eating disorders. They suspect a combination of biological, behavioral, and social factors. For instance, young people may be influenced by cultural images that favor bodies too underweight to be healthy. Also, many children and teens with eating disorders struggle with one or more of the following problems:

  • distress
  • fear of becoming overweight
  • feelings of helplessness
  • low self-esteem

To cope with these issues, children and teens may adopt harmful eating habits. In fact, eating disorders often go hand-in-hand with other psychiatric problems such as the following:

The dangers of eating disorders

Eating disorders in children and teens can lead to a host of serious physical problems and even death. If you spot any of the signs of the eating disorders listed below, call your child's doctor right away. Eating disorders are not overcome through sheer willpower. Your child will need treatment to help restore normal weight and eating habits. Treatment also addresses underlying psychological issues. Remember that the best results occur when eating disorders are treated at the earliest stages.

Anorexia in children and teens

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Children and teens with anorexia have a distorted body image. People with anorexia view themselves as heavy, even when they are dangerously skinny. They are obsessed with being thin and refuse to maintain even a minimally normal weight.

According to the National Institute of Mental Health, roughly one out of every 25 girls and women will have anorexia in their lifetime. Most will deny that they have an eating disorder.

Symptoms of anorexia include:

  • anxiety, depression, perfectionism, or being highly self-critical
  • dieting even when one is thin or emaciated
  • excessive or compulsive exercising
  • intense fear of becoming fat, even though one is underweight
  • menstruation that becomes infrequent or stops
  • rapid weight loss, which the person may try to conceal with loose clothing
  • strange eating habits, such as avoiding meals, eating in secret, monitoring every bite of food, or eating only certain foods in small amounts
  • unusual interest in food

Anorexia can lead to several serious health problems. Those problems include:

Anorexia is fatal in about one out of every 10 cases. The most common causes of death include cardiac arrest, electrolyte imbalance, and suicide.

Treating anorexia

The first aim of treatment is to bring the young person back to normal weight and eating habits. Hospitalization, sometimes for weeks, may be necessary. In cases of extreme or life-threatening malnutrition, tube or intravenous feeding may be required.

Long-term treatment addresses psychological issues. Treatments include:

Bulimia in children and teens

Like children and teens with anorexia, bulimic young people also fear weight gain and feel extremely unhappy with their bodies.

They will repeatedly eat too much food in a short amount of time. Often the child or teen senses a loss of control. Feeling disgusted and ashamed after overeating, young people with bulimia try to prevent weight gain by inducing vomiting or using laxatives, diet pills, diuretics, or enemas. After purging the food, they feel relieved.

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Doctors make a diagnosis of bulimia after a person has two or more episodes per week for at least three months.

People with bulimia usually fluctuate within a normal weight range, although they may be overweight, too. As many as one out of every 25 females will have bulimia in their lifetime.

Symptoms of bulimia include:

  • abusing drugs and alcohol
  • abusing laxatives and other treatments to prevent weight gain
  • anxiety
  • bingeing on large amounts of food
  • eating in secret or having unusual eating habits
  • excessive exercise
  • mood swings
  • overemphasis on physical appearance
  • regularly spending time in the bathroom after eating
  • sadness
  • scarring on knuckles from using fingers to induce vomiting
  • unusual interest in food
  • vomiting after eating

Complications can be serious. Stomach acids from chronic vomiting can cause:

In addition, bulimia can also lower blood levels of potassium. This can lead to dangerous, abnormal heart rhythms.

Treating bulimia

Treatment aims to break the binge-and-purge cycle. Treatments may include the following:

  • antidepressants medication
  • behavior modification
  • individual, family, or group therapy
  • nutritional counseling

Binge eating in children and teens

Binge eating is similar to bulimia. It includes chronic, out-of-control eating of large amounts in a short time, even to the point of discomfort. However, binge eaters do not purge the food through vomiting or other means. As a result, they tend to become overweight or obese.

Binge eaters may be struggling to handle their emotions. Anger, worry, stress, sadness, or boredom may trigger a binge. Often, binge eaters are upset about overeating and may become depressed.

The excess weight caused by binge eating puts your son or daughter at risk of these health problems:

Treating binge eating

Treatments include the following:

  • behavioral therapy
  • medications, including antidepressants
  • psychotherapy
WebMD Feature Reviewed by John M Goldenring, MD, JD, MPH on April 14, 2007

Sources

SOURCES: National Institute of Mental Health: "Eating Disorders: Facts About Eating Disorders and the Search for Solutions." Cleveland Clinic: "Eating Disorders." NIH News: "College Women at Risk for Eating Disorder May Benefit from Online Intervention." MedlinePlus: "Anorexia nervosa" and "Bulimia." The Merck Manuals Online Medical Library: "Bulimia Nervosa." NIDDK: "Binge Eating Disorder."

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