What is Disordered Eating?
Written by: Nicole Bartek, DNP
What a “good, healthy meal and/or body” looks and feels like can become a fixation for many kids, teens and families. As parents we want our kids to be healthy. There is very real social concern about obesity that can encourage families to take steps to take better care of their bodies. However, these same concerns can also drive negative thoughts, feelings and conversations about our bodies that can negatively affect self-esteem, self-confidence and mental health.
When concerns about body image, poor self-esteem, depression and anxiety start to direct eating behaviors the potential for developing an eating disorder exists. Eating disorders come in all body shapes and sizes and can bring serious medical risks. The most commonly discussed eating disorders are Binge Eating Disorder, Bulimia and Anorexia Nervosa. There are other less commonly discussed eating disorders inducing Avoidant and Restrictive Food Intake Disorder (ARFID). What ties all of these disorders together is the impact they can have on the physical and mental health of the person suffering. Eating disorders are not a choice or an exercise of will power but instead an illness that can keep bright, beautiful kids and teens from ever knowing how wonderful they are.
The good news is there is great hope for recovery from the destructive grip of an eating disorder. The key to recovery is identifying when normal thoughts of self-doubt or desire to take better care of the body turn into disordered behaviors. Below are some signs to lookout for in the kids and teens in your life:
Drastic Changes in Food Preferences:
Normal: Food preferences change over time as the pallet changes and new foods are experienced. Teens in particular may love new foods and forget some of their childhood favorites like choosing steak over chicken nuggets.
Concerning: Drastic change in food preferences like “I hate chocolate ice cream” or “I don’t like mom’s famous meatballs” are more concerning. These drastic changes away from favorite foods may be a sign that the change is not about preference but about concern for body image and weight.
Dieting:
Normal: In pediatrics the goal is growth and development, generally the goal is for children to grow into their weight, meaning stop weight gain as opposed to losing weight. Weight loss even in what looks like a healthy teen can have negative effects on overall health. A healthy diet should include 3 meals a day with 2-3 snacks and a good variety of foods from all the food groups with plenty of water.
Concerning: Diets that restrict or eliminate whole food groups like fats, carbs or animal products can be a big health risk. These kinds of diets are often prevalent on social media and even mainstream media and are NOT intended for kids or teens. Teens in particular are sensitive to what they see on the internet and the promise that a change in weight might improve their life quickly.
Hiding food and avoiding eating in front of others:
Normal: Social eating is a joy in life! Birthday celebrations and going out (or in) for dinner with friends and family is an important part of social and cultural life. Kids and teens should be actively involved in social eating.
Concerning: The shame of the eating disorder, guilt about eating, either too much or too little, can lead to eating alone. This can look like refusing to go out to eat with friends and family, taking food to their room or stating they are not hungry, only to later find dishes or wrappers in their room.
Ridged exercise routines:
Normal: Healthy exercises is enjoyable, often social and should be flexible. 3-5 days a week for formal exercise like running or working out and activities like walking the dog or playing a game with friends every day.
Concerning: When an eating disorder is active, exercise gets corrupted and can become a punishment for eating. As a result, kids and teens struggling with eating disorders may develop very elaborate, time consuming exercise routines and they may become very upset if they are not able to complete a routine say while on vacation or because of weather.
Going to the bathroom or private place immediately after meals:
Normal: After meal clean up, socializing is common in many households. Even if families have a routine of abruptly leaving after a meal, it would be normal to be flexible to stay if asked.
Concerning: Leaving the table to isolate after meals can be a sign of purging. The behavior is concerning if the child or teen cannot stay to socialize after the meal or becomes upset when stopped from leaving. For those with urges to purge it can be very distressing not to engage in the behavior.
There is hope and help! If you see concerning behaviors in your child reach out to your pediatrician to discuss your concerns and see if meeting with a dietitian or eating disorder expert could be helpful for your child.
Stay well!