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Preventing Eating Disorders in Children and Teens
by Dr. Randi Fredricks, Ph.D., Director of San Jose Therapy and Counseling
In 2013, the latest version of The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders was released. It contains a number of conditions that are new to the DSM including a childhood eating pattern called “selective eating disorder (SED).” Children with SED have extreme reactions and sensitivity to the sights, smells and textures associated with specific foods. They typically exhibit a hypersensitive gag reflex and the thought of trying new food tends to terrify them. One of primary complications in children with SED is malnutrition.While SED has significant negative health and social effects that can follow children into adulthood, there are far more serious eating disorders that parents need to watch for, particularly anorexia nervosa. The mortality rate associated with anorexia is 12 times higher than the death rate of all other causes of death for females 15 to 24 years old.
Although anorexia nervosa typically develops during adolescence, more and more cases have been appearing in young children. Some eating disorders specialists have observed disordered eating patterns in children as young as four. In addition to complications such as malnutrition, childhood-onset anorexia is associated with a delay in puberty, growth patterns, and breast development.
Children with eating disorders, most of whom are girls, generally have less body fat than their adolescent counterparts, so they can become skeletal more quickly. In some instances, a 15 percent weight loss, rather than the usual 25 percent needed for a diagnosis of anorexia nervosa, could signal a high risk for developing the disorder.
Psychologists have long known that parents are primarily responsible for shaping a child's body image and eating lifestyle. Additionally, parents (both mothers and fathers) who are themselves preoccupied with body image and weight increase the likelihood of their child developing an eating disorder. Studies have found that the children of anorexic mothers already eating dysfunctional by the age of five and were significantly more depressed than their peers.
Fortunately, parents who are sensitive to their child's developmental stages and spend time talking with their children can help to prevent the development of an eating disorder even when there is a genetic and environmental susceptibility.
Many parents are uncertain what to do if they suspect that their child has an eating disorder. First of all, it is important to visit a physician to rule out medical causes. Next, create a healthy and sustainable eating lifestyle at home and expect your child to fully participate in it, helping to prepare and cook meals whenever possible. It also helps to offer your child healthy food choices, prepare at least three nourishing meals a day, and try to eat those meals together with the whole family.
Remember that your child learns by imitating your behaviors, so never skip meals and keep your lifestyle active. Raise your awareness about your own personal attitudes about eating, body image and weight control. Sometimes parents unknowingly encourage a son to eat so that he can become big and strong, but caution daughters against overeating and becoming fat, even implying that they are becoming unattractive. Parents sometimes need to be more careful in not criticizing their child's weight, and to avoid making derogatory comments about other people's weight.
If you believe that your child has a disordered eating problem, get professional help in the form of child therapy as soon as possible. When children are young, going for family therapy with your child and spouse is always a good place to start. In many instances, a few family therapy sessions might be enough to help correct whatever might be troubling your child.
Dr. Randi Fredricks, Ph.D., is an author, researcher, and Licensed Marriage & Family Therapist (#47803) in San Jose, California. She works with teenagers and adults with anxiety, depression, addiction, and eating disorders. To learn more about Dr. Fredricks' work, visit www.drrandifredricks.com or www.SanJoseAnxietyCounseling.net.