Reader’s Digest
September 2017

At least 30 million people of all ages and genders suffer from an eating disorder in the U.S., according to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), and diagnosed cases of eating disorders in American children are on the rise. “This is partly due to better screening and more open conversation about mental health in general,” explains Heather Russo, Site Director at The Renfrew Center of Los Angeles, one of the country’s top treatment centers for eating disorders. “We also see some stigma vanishing as social media has allowed children to openly speak about their own eating and body struggles. The difficulty facing children now is the abundance of messages about food and appearance on every screen in front of them.”

For parents of children with eating disorders, help is out there. “Parents need allies in the fight against an eating disorder,” says Russo. “They need to work with a team of skilled professionals who can address the dietary, psychological and medical needs of their child.” However, children don’t often have the ability to express what they struggle with emotionally, so parents can watch out for the silent signs of an eating disorder.

Abnormal weight changes
Children should be gaining weight in a fairy predictable way, and if they don’t gain weight or, more problematically, lose it, this could be a warning sign, says Stacey Rosenfeld, PhD., CGP, CEDS, author of Does Every Woman Have an Eating Disorder? Challenging Our Nation’s Fixation with Food and Weight. According to Walden Behavioral Care, eating disorders in teens and adults are often diagnosed in part by a significant (non-medically related) weight loss. It’s a little different for children, who may not exhibit a significant weight loss, but may fail to gain expected weight for their height. Any unexplained weight fluctuations (be it increase, decrease or plateau) may reflect a change in eating patterns.

Avoidance of family meals
Family meals encourage healthy eating habits in kids, but some children with eating disorders may do anything to avoid them. Look for a child insisting they ate with their friends, or refusing to eat in front of other family members. “Previously enjoyed foods may be turned away or labeled unhealthy by children,” says Russo. “Or they may pick food apart at the dinner table, rather than actually eating it.” Other red flags are excessive concern about the way in which foods are prepared (e.g. fried vs. baked, or with butter vs. without), an obsession with portion sizes (too much or too little food), and repetitive label reading.

Adoption of a specific diet or meal plan
A child who shows a sudden interest in a fad diet or seemingly “healthy” eating plan might claim this is motivated by something other than weight loss, but it can be a red flag, says Rosenfeld. Kids may also claim to be “scared” of certain kinds of food. According to Walden Behavioral Care, it is not uncommon for children with disordered eating to believe that they will lose weight by following a vegan diet and/or to perceive the diet as a justification for skipping meals at home.

Missing food in the home
Eating disorders come in many different forms. Children with bulimia or binge eating disorder (which was only recently formally defined and included as a recognized eating disorder) may hide food in their rooms and secretly consume food when no one is around, says Russo. According to KidsHealth, a binge usually involves eating unusually large amounts of food quickly. Because it is typically done alone, parents may not realize their kid’s weight gain is a result of binging. Other signs of bulimia include self-induced vomiting, misuse of laxatives, and feelings of guilt or shame about eating. Here are tiny ways to encourage your kid every day.

Increase in physical activity
Kids suffering from disordered eating may exercise compulsively. According to KidsHealth, compulsive exercising doesn’t have to accompany an eating disorder, but the two often go hand in hand. In anorexia nervosa, excessive workouts usually begin as a means to control weight, and becomes more and more extreme, while a young person with bulimia may use exercise as a way to compensate for binge eating. Yoga for kids is a great way to introduce your child to a type of fitness that will also boost their self-esteem.

Increased focus on appearance
A child who spends an excessive amount of time in front of the mirror, or has an unusual or increased interest in weighing themselves, may be a cause for concern. While it’s not unusual for young people to feel self-conscious or lack body confidence, skipping pool parties, avoiding the beach, wearing baggy clothing to hide their body, and connecting their perceived appearance with self-worth, could be signs of a bigger problem. These empowering swimsuit pictures prove there is no one type of bikini body—an important message to send to all children.

Change in demeanor
Children who become more withdrawn or irritable, or isolate themselves socially, are not necessarily hiding an eating disorder, but mood changes are typical in kids with disordered eating. Walden Behavioral Care suggests looking out for unexplained changes in mood, grades, and/or interpersonal relationships. Kids who normally do well in school may start to get poor grades. Kids who have a wide circle of friends may start to turn down party invitations or isolate themselves from social events. Formerly happy-go-lucky, carefree kids may suddenly seem like they have the weight of the world on their shoulders.

Spiked interest in cooking
It might seem strange for someone with an eating disorder to want to cook or prepare food for others, but it’s not uncommon. This may relate to a need for control, or be a reminder from the brain, telling a starving person they need to eat. Whatever behaviors are making your concerned about your child, the most important thing you can do is start talking to them. “The sooner that children get help, the better the outcome, so early intervention is key,” says Rosenfeld. “Parents can be important allies in the treatment process and can work with treatment providers to ensure that their children are restored to health.” Here’s how to raise emotionally intelligent children.