When it comes to our children, as parents we only want the best for them. We want to shield them from all the dangers of the world, and give them a life that was better than ours. However, we have to realize that we can’t keep them away from the dangers of the world. Since we can’t be with them 24/7, we don’t know everything that our children are going through.
At school, on the web and even around their peers, children can be constant victims of bullying. According to StopBullying.gov, children who are most at risk of being bullied are often viewed by their classmates as different. The Center for Disease Control says that amongst students in grades 6-12 in the U.S., 28% of them have experienced bullying, and for students in high school (grades 9-12) 20% of them have been bullied.
Typically, victims of bullying are often overweight or undeweight. In their struggle to gain acceptance by their peers, children will sometimes go to extreme measures in order to do it, which can mean developing eating disorders.
We at Holiner Psychiatric Group created this e-guide as a reference for parents who may be worried that their child has developed an eating disorder. We’ll discuss the types of eating disorders and what signs you should look for if you think your child has developed an eating disorder. We’ll also give you tips on starting the conversation with your child and resources that you can use that can help further with the recovery process.
We’re going to begin this guide by telling you about the different types of eating disorders: anorexia nervosa, bulimia, and binge
eating disorder. All of these affect the body in different ways, but they all are mental illnesses that could severely affect your child.
We’ll begin with the most well-known eating disorder, anorexia nervosa. Anorexia is an eating disorder in which a person restricts how much food they eat. Anorexics can also have unusual eating habits, becoming overly obsessive about being thin, with an irrational fear of gaining weight. Anorexia has the highest mortality rate among all psychological disorder. Because of the malnutrition that anorexiacauses, people suffering with it are at more risk for other health issues, such as heart conditions and organ failure. The chances of suicide are also at a much higher rate for people who are battling anorexia.
When it comes to anorexia, and other mental health
disorders, there isn’t a single definitive cause of them. While they can be passed on through genetics, there are also other environmental factors that can cause them. Some risk factors to look for in your child’s life are:
Anorexia often begins in early adolescence or young adulthood, when there may be a lot of pressure to fit in and meet society’s “requirements” of the perfect body type. Teens will often feel the social pressures of keeping up and fitting in with – looking like, acting like, being perceived like – the other “cool” kids. This can include keeping their weight at a certain threshold. Some symptoms you should look for if you think you child is anorexic are:
If untreated , anorexia can lead to more drastic symptoms, sicknesses, and ultimately death. Anorexia that goes unnoticed can lead to symptoms such as:
To diagnose the severity of anorexia nervosa, the DSM V recommends that physicians measure the patient’s Body Mass Index (BMI). Here’s the scale that is used – the lower the BMI, the more severe the case of anorexia.
Next on the list is bulimia nervosa, more commonly referred to as just bulimia. The difference between bulimia and anorexia is that bulimics don’t starve themselves, in fact, they do the exact opposite. According to the Mayo Clinic, bulimia can be a potentially life-threatening disorder. Bulimia is an eating disorder that involves both binge-eating and purging oneself of the food.
A person with bulimia eats a large quantity of food in a very short amount of time – bingeing. If you want to find out more about binge eating, you can skip to the next section where we go into further details about binge eating. After the food binge, they then will purge themselves of the food by either forcing themselves to vomit, using laxatives, excessively exercising immediately afterward, or any combination of these actions. Like people with anorexia, people with bulimia have the same intense fear of gaining weight. Some will also use bulimia to maintain their current weight.
Just like anorexia, there isn’t one direct cause of bulimia. Because bulimia is very similar to binge eating, often they can be confused with one another. Some signs to look for in your child are:
Repeated purging over a period of time can have detrimental effects on your child’s health. With the constant vomiting, they’re putting their bodies at risk of dehydration. Vomiting and using laxatives and diuretics can cause an imbalance of electrolytes in the body, which can cause low potassium levels in the body. According to Helpguide.org, low potassium levels can trigger a wide range of symptoms ranging from lethargy and cloudy thinking to irregular heartbeat and death. These are some other dangerous effects and symptoms to watch for:
The Mayo Clinic defines binge eating as an eating disorder where an unusually large amount of food is consumed frequently couple with a feeling of not being able to stop eating. Unlike bulimia, there isn’t any purging involved with binge eating.
Binge eaters will use food to cope with negative emotions and stress. Often, after a session of binge eating, your child will feel worse than before. They’ll try to hide their binge eating by eating in secret or by going out to binge eat. Of the major eating disorders, binge eating is the most common in the United States, with around 3.5% of women and 2% of men diagnosed with it. Among adolescents in America, about 1.6% are diagnosed with binge eating disorder.
Overeating in itself isn’t a bad or dangerous thing. We all tend to eat more than we should during big holidays like Thanksgiving and Christmas and regret it afterwards. However, binge eaters take over eating to the extreme. If you’re worried that your child may be binge eating here are some signs to look for from the National Institute of Diabetes and Digestive and Kidney Disease.
Unlike anorexia and bulimia, binge eating isn’t used for weight loss. Often sudden weight gain can occur, which can be looked at as another warning sign for binge eating. Just like anorexia and bulimia, there isn’t a direct cause of binge eating. The cause of binge eating likely involves imbalances in the brain, which can be caused by things such as stress and depression. Binge eating can also be passed down genetically. If your child is suffering from BED, chances are they could also be suffering from other mental health disorders such as:
With binge eating, your child may also become upset with themselves, leading down a path of even more depression. WomensHealth.gov lists just a few of the health effects that can happen if your child’s binge eating disorder goes untreated:
What if your child’s eating habits, or lack thereof, aren’t as drastic as the main three eating disorders, but you can still see symptoms you are concerned about? What used to be known as Eating Disorders Not Otherwise Specified (EDNOS) in the DSM-IV are now known as Other Specified Feeding or Eating Disorder (OSFED). These are disorders that cause significant distress or impairment but don’t meet the criteria for another eating disorder.There is no a clear-cut line between each eating disorder, and often people who suffer in that grey area are misdiagnosed, mistreated, or not treated at all. According to the National Association of Anorexia Nervosa and Associated Disorders, there are 5 subtypes to OSFED. They are:
For the first 3 on the list, we won’t go into too much detail about them since we’ve discussed them earlier in the guide.
For atypical Anorexia, your child could be exhibiting the same restrictive behaviors that typical anorexics show, however they don’t meet the low weight criteria. For an atypical case of Bulimia Nervosa, your child may meet the criteria for bulimia but suffers at a lower frequency and/or limited duration. So, perhaps they don’t purge after every meal, but when a major stressor occurs (i.e. cheer tryouts, prom, sport tryouts, etc.), they begin to exhibit the signs of bulimia.
Purging disorder is similar to bulimia and anorexia, the difference being that the purging act doesn’t come from an episode of binge eating. Without the excessive overeating, your child could be purging calories from a normal dinner by vomiting, excessive exercise and using laxatives improperly. Research has shown that purging disorder could be as common as both anorexia and bulimia. Some signs that you should view as cautionary flags are:
Purging disorder shares some of the same medical risks as bulimia and anorexia, and those are:
Night Eating Syndrome , or NES , is when individuals have recurrent episodes of eating late at night. Sometimes your child will wake up in the middle of the night to eat, or might eat even more after dinner. Don’t mistake this for your child wanting a late night snack – this is more along the lines of your child wanting a late night dinner after having dinner! NES also includes an awareness and recollection of the eating, so not a case of sleep-eating. According to a diagnostic proposed in the International Journal of Eating Disorders , the criteria to be diagnosed with NES are as follows:
Three of five associated symptoms must also be present:
You want your child to be able to talk to you about anything and everything that is going on in their lives, but we know that won’t always happen. So, if you start seeing signs that your child may have an eating disorder, how do you approach them about it?
The first thing is to do is to get past the initial fear of saying something wrong or thinking that you’ll alienate your child. As a parent, it ’s your duty to care for your child’s well-being, and that includes having uncomfortable or confrontational conversations. Often, your child’s eating disorder can be a cry for help, and just like you, they’re also struggling to ask for help and start the conversation.
When having the conversation, schedule a time where both of you can talk with no distractions and pressures from outside sources. The last thing you want to do is make your child feel rushed or attacked in a large group setting.
Don’t use accusatory statements during the conversation. Even in a private setting, they can still feel attacked if you’re using statements such, “ You’re spending too much time in the gym,” and “ You’re skipping too many meals.” Instead, the National Eating Disorder Association recommends that you focus on the behaviors that you’ve seen, which can also go beyond just their eating habits, by using ‘I’ statements. By using this type of speech, you’re better able to portray the concern that you have for their well-being. “I’ve noticed a change in how much you eat.”
Mirror-Mirror.org offers some more tips and things to keep in mind when approaching your child about their eating disorder:
Now that you’ve had the conversation with your child and they are ready to get help for their disorder, the next big step is finding a local psychiatrist to formally diagnose them and find out if there are any other mental disorders that could be afflicting your child. Once you find your preferred psychiatrist, they’ll give a formal diagnosis along with the level of care that is needed.
There are 5 levels of care that can be implemented, depending on the severity of diagnosis. The earlier you can notice behavioral changes in your child, the better. The levels are:
It is essential to find a therapist who can help your child work through the triggers that caused them to turn to their eating disorder and teach them the skills to either avoid these triggers or handle them without returning to their eating disorder. Along with individual therapy sessions that are between the therapist and your child, there are also group therapy sessions where your child will be among other individuals who are recovering from the same struggles as your child. Group therapy sessions are good because they can show your child that they are not alone in their struggles, and they can also support each other in developing healthier habits to cope with their problems.
You’ll also need to help them reestablish healthy eating habits at home and when your child isn’t at home. Finding a dietitian who specializes in helping people recover from eating disorders is very important.