Eating disorders are on the rise, which raises serious concern for parents. Although eating disorders normally appear during adolescence or in early adulthood, children as young as 4 have also been susceptible to body image issues that can help to trigger eating disorders. Parents should understand the signs of an eating disorder so that it can be caught and treated early on.

Who is affected by eating disorders?

Females are more likely to suffer from anorexia. Approximately only 5% to 15% of those who are anorexic or bulimic are male; but when it comes to binge eating, this can affect as much as 35% of males. Eating disorders can affect all people regardless of gender, family background, age or socio-economic position, so it's important to rid yourself of the idea that a boy won't develop an eating disorder or that it can't affect your adult daughter.

Types of Eating Disorders

There are 3 primary types of eating disorders:

• Bulimia - This is binge eating (excessive eating) where an individual will then purge (get rid of) their food by vomiting, taking laxatives, and/or through compulsive exercise.
• Anorexia - This refers to a person whose obsessive fear of food or gaining weight (because of a distorted self image, body dysmorphic disorder, depression, control issues, or related issue) results in consuming very little food. This person has an inability to maintain a healthy body weight.
• Binge Eating - This often involves bouts of impulsive, uncontrolled, and/or continuous eating without the purging that accompanies bulimia.

Signs of Bulimia

Bulimia and anorexia are similar in that there is an obsessive fear of gaining weight or a need to exert extreme control over this particular aspect of the person's life. Even if a child is not overweight, they may have the perception that they are. Here are some signs that you can look for concerning bulimia:

• Child seems to have a lack of control when eating, often eating past their "full" comfort level, yet does not gain weight;
• You see and/or hear the child vomit up the food they have just eaten; or you notice the child constantly goes to the bathroom immediately after eating;
• Child has an unhealthy relationship with food including sneaking food when no one is around, wanting to eat alone in their room, etc.
• Child hides food and/or you notice food disappearing;
• Bloodshot eyes and/or blisters on the hands or fingers from where the child inserted them into the mouth to induce vomiting;
• Exercises excessively;
• Experiences mood swings;
• Unhealthy focus and concern about their physical appearance; and
• Depression.

It is important to recognize the signs of bulimia because of the devastating effects it can have on a child's body. Some of them include:

• Weight gain (many children and adults with bulimia are actually at a normal weight, fluctuate weight constantly, or are slightly overweight)
• Tooth decay and mouth sores
• Damage to the heart
• Chronic sore throat (from vomiting)
• Swollen cheeks and salivary glands
• Ulcers
• Ruptured stomach or esophagus
• Chronic constipation (if laxatives are involved)
  

These possible effects are in addition to the psychological trauma of engaging in an eating disorder as well as pain, weakness, dizziness, and if potassium levels drop significantly for an extended period of time, kidney failure.

Signs of Anorexia

With anorexia, there is also an obsessive (and often irrational) fear of becoming fat. Unlike bulimia, the child usually refrains from eating. However, sometimes a child will suffer from both bulimia and anorexia. The child may binge and purge but is also underweight. Here are some signs that you can look for concerning anorexia:

• Child is underweight;
• The belief that they are overweight even if they are underweight;
• Child does not recognize that their low weight is an issue;
• An unhealthy perception of their body image;
• An obsession with only eating low-fat foods, reading food labels, constant fixation on the calories and fat content in foods they are eating, repulsed by foods they formerly loved (like ice cream, desserts, and fattier foods);
• Frequently talks about fear of gaining weight and/or need to lose weight;
• Exercises excessively;
• Child lies about how much food they are eating;
• Child weighs themselves frequently;
• Child develops eating rituals such as cutting food into tiny pieces, pushing food around on plate, hiding food under napkins, etc.;
• If menstruating, cycle becomes irregular or stops;
• Child avoids eating, skips meals, will not eat in front of others, comes up with excuses why they can't/won't eat with the family.
  

Anorexia can result in very serious health problems. Some of those health problems include:

• Dizziness and fainting
• Stunted growth
• Anemia
• Heart abnormalities including an irregular heartbeat
• Kidney problems
• Changes in brain function
• Weak bones

Approximately 1 in every 10 cases of anorexia will result in death. This is usually the result of:

• Cardiac arrest
• Suicide
• Imbalance of electrolytes

Signs of Binge Eating

Binge eating is similar to bulimia in that a child will compulsively eat an excessive amount of food, but the child does not purge. This can result in a child becoming overweight or obese. Not all children who are overweight are binge eaters. Binge eating, or compulsive overeating, is when a child develops an unhealthy relationship with food and consumes large amounts of food quickly and uncontrollably, way past the point of feeling comfortably full.

Binge eating is the most common eating disorder that children develop.

Signs of binge eating:

• Child eats a lot of food quickly;
• Child turns to eating large amounts of food when presented with stress;
• Child eats when they are not hungry;
• Child develops an irregular eating pattern (skipping meals, eating at unusual times);
• Child feels ashamed of themselves, and/or is experiencing depression and anxiety;
• Child hides food; and
• Child develops an unhealthy focus on food.

The consequences of binge eating, particularly weight gain, can lead to serious health problems. Some of the health problems that can develop include:

• High cholesterol
• Heart disease
• High blood pressure
• Type 2 diabetes

Why Children Develop Eating Disorders

Many people wonder why children-or adults-develop eating disorders in the first place. There is no known cause for eating disorders and no singular factor to represent all cases. Most medical and mental health experts believe that it is a culmination of factors, which are behavioral, biological and social.

There is an obvious focus in today's society on physical appearances. The culture surrounding us gives children a pretty clear-cut message of what the ideal person should look like and leaves little room for reality. Some children are greatly influenced by these types of messages.

Other children may develop an eating disorder because they struggle with emotional issues such as low self-esteem or worthlessness or the after-effects of abuse. Psychiatric problems can also play a part. If a child suffers from depression, obsessive compulsive disorder, an anxiety disorder or deals with substance abuse it can make them prone to develop an eating disorder.

Parents should be aware of the signs to look for in eating disorders, observing their child's eating habits and knowing what is going on in their child's life. It is also important that parents have regular, non-confrontational conversations with their children about these issues. Keeping open lines of communication will help children to feel safe talking to you about any struggles they may have.

Remember that most children don't need to diet. Instead, work with your child on making smart choices in what they eat.