What is an eating disorder?

An eating disorder is an eating problem that strongly focuses on weight and appearance. It causes abnormal eating patterns and changes in other behavior. Eating problems often involve:

• Eating very large or very small amounts of food

• Throwing up or purging food after eating

• Exercising a lot

• Abusing certain medicines like diuretics and laxatives

Types of eating disorders

The most common eating disorders are:

• Anorexia nervosa.  Eating so little that body weight is well below normal. It often involves a lot of exercise to keep weight down.

• Bulimia nervosa. Throwing up or purging after eating to stop weight gain. It often involves a lot of exercise to keep weight down.

Even if a child’s eating problems don’t fit the definition of either of these two diagnoses, they may still have an eating disorder. Problems like these are known as an unspecified eating disorder. For instance, a child may eat a lot of food without purging it after. This is known as binge eating disorder. Or the child may eat only certain types or colors of food or stay away from specific foods because of their odor or texture. This is known as avoidant or restrictive food intake disorder (ARFID). Children and adolescents with ARFID don't have a distorted body image. ARFID can lead to much weight loss, nutritional deficiencies, and mental health problems. These disorders can be very serious. If your child shows any signs of problem eating, reach out to a healthcare provider right away.

Do both boys and girls get eating disorders?

Girls by far have the most problem with eating disorders. But boys can also get them. In fact, binge eating disorder affects almost the same number of boys as girls.

What causes eating disorders?

No one really knows what causes eating disorders. Certain things can make your child more likely to get one. These include:

• Having a parent or sibling with an eating disorder

• Being a teen or in the early 20s

• Taking part in a sport or activity that focuses on weight or appearance (such as modeling, wrestling, dance, gymnastics, diving, or long-distance running)

• Needing to be perfect all the time

• Having some other mental health problem, such as depression, anxiety, or obsessive-compulsive disorder

What are the signs to watch for?

Most teens have issues with how they look. Teens also tend to have issues around eating. But there are signs you can watch for that may signal a problem. If you notice any of these signs, talk to your child’s healthcare provider about treatment:

Food-related signs

• Constant dieting and trying fad diets (such as liquid diets), or reading lots of diet books

• Staying away from certain foods or making a sudden change in diet (such as becoming a vegetarian overnight)

• Suddenly eating less food

• Making food but not eating it, or eating only a very small amount

• Not wanting to eat with family or friends

• Going to the bathroom often after meals

Other signs

• Rapid weight gain or loss

• Constant talk about weight

• Constant checking of weight

• Negative talk about a specific body part

• Fear of gaining weight

• Lots of exercise

• Seeming to take many showers (to hide sounds of throwing up)

• Taking diet pills or laxatives

• Missing periods

• Change in relationship with peers

• Interest in websites that promote eating disorders

• Muscle wasting and weakness

• Brittle hair and nails

• Dry and yellowish skin

• Growth of fine hair all over the body (lanugo)

Treating eating problems

If you think your child has a problem, it’s best to act now. This is better than waiting until the problem gets worse and harder to treat. Early treatment can also help prevent harm to your child’s health. If your child shows signs of an eating problem, talk about your concerns with them and take your child to see a healthcare provider. The healthcare provider can talk to and examine your child. Then, you, your child, and the healthcare provider can talk about treatments. Treatment will depend on how serious an eating disorder your child has. Work closely with your child’s healthcare providers to follow any treatment plan that is advised. Your child's healthcare team may encourage your child to keep a food diary. This is a log of what your child eats and drinks each day. A food diary can help give insights into your child's eating routine and habits. If your child is too young to keep a diary, keep it for them. Bring the diary to your next visit.

Tips for parents

These tips can help make disordered eating less likely. They will also help you catch an eating problem earlier:

• Have family meals as often as you can. If your child has disordered eating, have sit-down family meals every night you can. Require that your child be there at meals.

• Encourage activities that are not linked to food or weight that your child finds rewarding. This may include learning a new skill, developing a hobby, or volunteering.

• Keep track of the content, quality, and time your child uses media, including social media. Be aware of the health risks linked to media use. Examples are its picture of the romantic and unreachable images of beauty. Discuss media content and health with your child.

• Be a good role model when it comes to food. Don't glamorize or demean certain body types. Don't binge eat or constantly diet yourself.

• Don't speak critically about your child’s weight or look, your own weight or appearance, or the weight of others. Praise your child for their accomplishments and behaviors, rather than how they look.

• Pay attention to your child’s behavior and food intake. Be alert for signs of a problem. Don't wait to talk about your concerns with your child and a healthcare provider.

To learn more

For more information, visit the National Eating Disorders Association site at www.nationaleatingdisorders.org.