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Many kids — particularly
adolescents — are concerned about how
they look and can feel self-conscious about
their bodies. This can be especially true when
they are going through puberty, and undergo
dramatic physical changes and face new social
pressures.
Unfortunately,
for a number of kids and teens, that concern
can lead to an obsession that can become an
eating disorder. Eating disorders such as anorexia
nervosa or bulimia nervosa cause dramatic weight
fluctuation, interfere with normal daily life,
and can permanently affect their health.
Parents can
help prevent kids from developing an eating
disorder by building their self-esteem and encouraging
healthy attitudes about nutrition and appearance.
If you become worried that your son or daughter
might be developing an eating disorder, it's
important to step in and seek proper medical
care.
About
Eating Disorders
Generally, eating disorders involve self-critical,
negative thoughts and feelings about body weight
and food, and eating habits that disrupt normal
body function and daily activities.
While more
common among girls, eating disorders can affect
boys, too. They're so common in the U.S. that
1 or 2 out of every 100 kids will struggle with
one, most commonly anorexia or bulimia. Unfortunately,
many kids and teens successfully hide eating
disorders from their families for months or
even years.
People with
anorexia have an extreme
fear of weight gain and a distorted view of
their body size and shape. As a result, they
strive to maintain a very low body weight. Some
restrict their food intake by dieting, fasting,
or excessive exercise. People with anorexia
try to eat as little as possible, and take in
as few calories as they can, frequently obsessing
over food intake.
Bulimia
is characterized by habitual binge eating and
purging. Someone with bulimia may undergo weight
fluctuations, but rarely experiences the low
weight associated with anorexia. Both disorders
can involve compulsive exercise or other forms
of purging food eaten, such as by self-induced
vomiting or laxative use.
Although anorexia
and bulimia are very similar, people with anorexia
are usually very thin and underweight but those
with bulimia may be a normal weight or even
overweight.
Binge eating
disorders, food phobia, and body image disorders
are also becoming increasingly common in adolescence.
It's important
to remember that eating disorders can easily
get out of hand and are difficult habits to
break. Eating disorders are serious clinical
problems that require professional treatment
by doctors, therapists, and nutritionists.
Causes
of Eating Disorders
The causes of eating disorders aren't entirely
clear. However, a combination of psychological,
genetic, social, and family factors are thought
to be involved.
For kids with
eating disorders, there may be a difference
between the way they see themselves and how
they actually look. People with anorexia or
bulimia often have an intense fear of gaining
weight or being overweight and think they look
bigger than they actually are. Also, certain
sports and activities (like cheerleading, gymnastics,
ballet, ice skating, and wrestling) that emphasize
certain weight classes may put some kids or
teens at greater risk for eating disorders.
There is also
an increased incidence of other problems among
kids and teens with eating disorders, like anxiety
disorders and obsessive-compulsive disorder.
Sometimes, problems at home can put kids at
higher risk of problem eating behaviors.
Some research
suggests that media images contribute to the
rise in the incidence of eating disorders. Most
celebrities in advertising, movies, TV, and
sports programs are very thin, and this may
lead girls to think that the ideal of beauty
is extreme thinness. Boys, too, may try to emulate
a media ideal by drastically restricting their
eating and compulsively exercising to build
muscle mass.
Concerns about
eating disorders are also beginning at an alarmingly
young age. Research shows that 42% of first-
to third-grade girls want to be thinner, and
81% of 10-year-olds are afraid of being fat.
In fact, most kids with eating disorders began
their disordered eating between the ages of
11 and 13.
Many kids who
develop an eating disorder have low self-esteem
and their focus on weight can be an attempt
to gain a sense of control at a time when their
lives feel more out-of-control.
The
Effects of Eating Disorders
While eating disorders can result from serious
mental and behavioral health conditions, as
well as trauma (for example, sexual abuse),
they can lead to very serious physical health
problems. Anorexia or bulimia may cause dehydration
and other medical complications like heart problems
or kidney failure. In extreme cases, eating
disorders can lead to severe malnutrition and
even death.
With
anorexia, the body goes into starvation mode
and the lack of nutrition can affect the body
in many ways:
- a drop in blood pressure,
pulse, and breathing rate
- hair loss and fingernail
breakage
- loss of periods
- lanugo hair, a soft hair
that can grow all over the skin
- lightheadedness and inability
to concentrate
- anemia
- swollen joints
- brittle bones
With
bulimia, frequent vomiting and lack of nutrients
can cause:
- constant stomach pain
- damage to the stomach and
kidneys
- tooth decay (from exposure
to stomach acids)
- "chipmunk cheeks,"
when the salivary glands permanently expand
from throwing up so often
loss of periods
- loss of the mineral potassium
(this can contribute to heart problems and
even death)
Warning
Signs
It can be a challenge for parents to tell the
difference between kids' normal self-image concerns
and warning signs of an eating disorder.
While many
kids and teens — girls in particular —
are self-conscious, compare themselves with
others, and talk about dieting, this doesn't
necessarily mean they have eating disorders.
Kids with eating disorders show serious problems
with their eating and often have physical signs.
Someone
with anorexia might:
- become very thin, frail,
or emaciated
- be obsessed with eating,
food, and weight control
- weigh herself or himself
repeatedly
- count or portion food carefully
- only eat certain foods,
avoid foods like dairy, meat, wheat, etc.
(of course, lots of people who are allergic
to a particular food or are vegetarians avoid
certain foods)
- exercise excessively
- feel fat
- withdraw from social activities,
especially meals and celebrations involving
food
- be depressed, lethargic
(lacking in energy), and feel cold a lot
Someone
with bulimia might:
- fear weight gain
- be intensely unhappy with
body size, shape, and weight
- make excuses to go to the
bathroom immediately after meals
- only eat diet or low-fat
foods (except during binges)
- regularly buy laxatives,
diuretics, or enemas
- spend a lot of time working
out or trying to work off calories
- withdraw from social activities,
especially meals and celebrations involving
food
If
You Suspect an Eating Disorder
If you suspect your son or daughter has an eating
disorder, it's important to intervene and help
your child get diagnosed and treated.
Kids with eating
disorders often react defensively and angrily
when confronted for the first time. Many have
trouble admitting, even to themselves, that
they have a problem. Sometimes getting a family
member or friend who has been treated for an
eating disorder can help encourage someone to
get help. A fear of being fat or overweight
is a core problem for anyone with an eating
disorder. So it's understandable that kids with
eating disorders don't want to go to a clinic
and "get fat."
Trying to help
when someone doesn't think he or she needs it
can be hard. Still, getting the professional
assistance needed, even if your child resists,
is essential. Enlist help from friends and family
that your son or daughter trusts and loves —
people known to have your child's best interests
at heart.
Your child
may be more receptive to a conversation if you
focus on your own concerns and use "I"
statements rather than "you" statements.
For example, steer clear of statements like
"you have an eating disorder" or "you're
too thin," which may only prompt anger
and denial. Instead, try "I'm worried that
you have lost so much weight so quickly."
Cite specific things your child has said or
done that have made you worry, and explain that
you will be scheduling a doctor's appointment
to put your own mind at ease.
If you still
encounter resistance, talk with your doctor
or a mental health care professional about other
approaches.
Treating
Eating Disorders
Treatment focuses on helping kids cope with
their disordered eating behaviors and establish
new patterns of thinking about and approaching
food. This can involve medical supervision,
nutritional counseling, and therapy. The professionals
will address a child's perception about body
size, shape, eating, and food.
Kids who are
severely malnourished may require hospitalization
and ongoing care after their medical condition
stabilizes.
Generally,
the earlier the intervention (ideally, before
malnutrition or a continual binge-purge cycle
starts), the shorter the treatment required.
Preventing
Eating Disorders
You can play a powerful role in your child's
development of healthy attitudes about food
and nutrition. Your own body image can influence
your kids. If you constantly say "I'm fat,"
complain about exercise, and practice "yo-yo"
dieting, your kids might feel that a distorted
body image is normal and acceptable.
At a time of
great societal concern about obesity, it can
be tricky for parents to talk with their kids
about their eating habits. It's best to emphasize
health, rather than weight. Make sure your kids
know you love them for who they are, not how
they look.
It's OK to
appreciate attractiveness in celebrities —
if your kids (and you!) feel fine about how
they look, it won't prompt them to try to change
to be like someone else. Getting the message
that they're great as they are and that their
bodies are healthy and strong is a wonderful
gift that parents can give their kids.
Try to avoid
power struggles regarding food — if your
teen wants to "go vegetarian," be
supportive even if you're an avid meat-eater.
Teens frequently go through trendy eating periods,
so try to set good limits, encourage healthy
eating, and avoid fighting over food issues.
Kids can catch on pretty quickly if their parents
panic over one skipped meal. Try to gain perspective
and talk to your kids about what's going on
if they don't want to eat with the family.
Finally, take
an active role in creating a healthy lifestyle
for your family. Involve your kids in the preparation
of healthy, nutritious meals. Let them know
that it's OK to eat when hungry and refuse food
when they're not. Also, make exercise a fun,
rewarding, and regular family activity.
Developing
your own healthy attitudes about food and exercise
will set an excellent example for your kids.
Reviewed by: Michelle New, PhD
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