An elevated proportion of children and adolescents around the world, particularly girls or those with high BMI, experience disordered eating as shown in a meta-analysis of 32 studies from 16 countries.

The overall proportion of children and adolescents with disordered eating was 22.36 percent (p<0.001).

Girls were significantly more likely to report disordered eating than boys (30.03 percent vs 16.98 percent; p<0.001). Disordered eating became more elevated with increasing age and BMI (p<0.001).

“This is concerning from a public health perspective,” said the researchers led by Dr José Francisco López-Gil from the University of Castilla-La Mancha, Ciudad Real, Spain. “Our findings can inform intervention priorities for disordered eating.”

Disordered eating, if undetected and untreated, can lead to eating disorders, with harmful consequences. “Eating disorders are a global public health problem we must not ignore,” he emphasized. “People with these conditions die 10–20 years younger than the general population.” [World Psychiatry 2014;13:153-160]

Eating disorders are psychiatric disorders characterized by abnormal eating or weight control behaviours. These include anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorders not otherwise specified.

Summary of findings

“Identifying the magnitude of disordered eating and its distribution in at-risk populations is crucial,” said the researchers.

Parents and healthcare professionals should be aware of the symptoms of disordered eating such as weight loss dieting, binge eating, self-induced vomiting, excessive exercise, and use of laxatives or diuretics without medical prescription, López-Gil said.

What are the signs and symptoms of an eating disorder in children?

The signs and symptoms of eating disorders can vary from person-to-person and also depend on the type of eating disorder. However, if you notice a combination of the following signs in your child, it may be that they have developed, or are starting to develop, an eating disorder.

Behavioural symptoms;

• Compulsive or excessive exercising
• Unusual behaviour around food e.g. insisting on using certain cutlery, cutting food into tiny pieces
• A sudden interest in cooking, but refusing to eat what they have cooked
• Wanting to eat alone or in secret
• Wearing baggy clothes
• Vomiting after eating, or going to the toilet immediately after eating
• Eating large quantities of food without appearing to gain weight
• Repeatedly weighing themselves
• Social isolation

Physical symptoms:

• Abnormally low or high weight
• Long-term weight stagnation (adolescents typically continue to put on weight until the age of 20)
• Exhaustion
• Feeling cold
• Stomach pains
• Dizziness or feeling faint
• Mouth infections
• Sensitive or damaged teeth
• Scars on their fingers, knuckles or the back of their hand from making themselves sick
• Bad breath

Psychological symptoms:

• Having an obsession with appearance and other people’s perception of their body
• Talking about feeling guilty after eating
• Getting stressed at mealtimes
• Low self-esteem
• Depression
• Anxiety
• Anger
• Intense mood swings
• Insomnia
• Panic attacks
• Self-harm
• Suicidal thoughts and impulses

Why does my child have an eating disorder?

There are a number of factors that can make children more vulnerable to developing an eating disorder. These include:

• Having a close family member with an eating disorder
• Having an existing mental health difficulty such as depression or anxiety
• Stressful life events
• Abuse
• Bullying
• Pressures at school
• Pressure from the media to be thin
• Having hobbies where being thin is seen as important, such as dancing or athletics

I think my child has an eating disorder – what are the next steps?

You may find the following steps useful if you think that your child is showing signs of an eating disorder:

Talk to your child – ask if they are OK and if there’s anything they want to talk about. If your child doesn’t want to talk to you, encourage them to open up to another person that they trust such as another family member or a teacher. Let them know that you’re there to listen and support them.

Take them seriously – it can be difficult to understand why someone with an eating disorder behaves the way they do. Some of their issues around food may seem irrational to you but could be a major source of distress for your child. This is why it’s crucial to take them seriously and avoid being critical.

Learn about eating disorders – not only will this will help you to understand your child’s behaviour, but will also mean that you are able to spot the warning signs. It also lets your child know that you care and are there to help.

Stop the body and food talk – we all talk about dieting, body shape and weight, but this can be a very sensitive subject for someone with an eating disorder. Try to steer conversations away from food.

Seek professional help – it is essential that you seek professional help if you think that your child has an eating disorder. Your child will likely need support to prevent their eating disorder from becoming worse. You can visit your GP to talk through your concerns and worries about your child

Sources: mims, priorgroup
*SCOFF: Sick, Control, One, Fat, Food