Warning signs of eating disorders

Have you ever wondered if your child has an eating disorder? Would you be able to recognize the signs?

Anorexia nervosa (also called anorexia), bulimia and binge eating are all eating disorders that can cause serious emotional and physical problems. They can even be life-threatening. 

Typically signs begin at around 12-13 years old. Parents and doctors may not even notice until years later. Be aware of little signs around changing attitudes, emotions, and behaviors about food and body image. The sooner the problem is identified, the better. Children who receive prompt treatment for eating disorders have the best chance for recovery.

Anorexia nervosa signs:

(1) considerably underweight usually by self-starvation which leads to weight loss or not able to gain weight

(2) fear of being fat or gaining weight

(3) distorted thoughts about their body image.

Bulimia signs:

(1) binge eating large amounts of food, usually when the child feels out of control, which is followed by self-induced vomiting or other behaviors such as using laxatives

(2) body weight seriously affects their self-esteem.

Binge eating signs:

(1) binge eating large amounts of food, usually when the child feels out of control, but these events are not followed by unhealthy behaviors

(2) children with binge eating disorder typically feel shameful about their eating and their health suffers from being overweight 

Recognizing the warning signs of eating disorders can help parents begin a conversation with their son or daughter if disordered eating is suspected. Warning signs may include:

• Weight loss.
• Preoccupation with weight, body image, or specific body parts.
• Refusal to eat certain foods or entire categories of foods (e.g., "I don't eat carbs because I want to be healthy).
• Comments about body shape, feeling "fat", or comparison to others.
• Avoidance of family meals or activities involving eating.
• Obsessive exercise that occur rain or shine. For boys, this may include excessive weight lifting.
• New food rituals (e.g., pushing food around on the plate, refusing to eat past 5 pm).
• Frequent visits to the bathroom after meals to vomit. Parents may also notice increased laxative use or the smell of vomit.
• Vomiting may also result in damage to teeth.
• Constantly chewing gum or drinking diet sodas.
• Wearing baggy clothes to cover up weight loss.
• Withdrawal from friends and previously enjoyed activities.
• Difficulties with concentration.

If symptoms of disordered eating are suspected, concern should be expressed in a non-judgmental and open manner, such as by saying, "I'm worried about changes in your eating and body lately" and give specific examples. These concerns can be expressed during a visit with your child's pediatrician to explore best treatment options.

I am particularly pleased to have this article by Bonney Reed-Knight, PhD, a Clinical Psychologist at Emory University School of Medicine and Children's Healthcare of Atlanta, not just because it's a wonderful help for parents who are concerned about the possibility that their child has an eating disorder, but also because Bonney was one of my patients as a teen and it's gratifying to now have her contributing as a respected colleague. 

Dr. Stan