Eating Disorders Among Children and Teens on the Rise

As parents and guardians, we want to protect our children from harm and danger. Unfortunately, for a growing number of adolescents and teens this includes safeguarding them from their own minds as negative self-talk and a poor perception of their bodies is leading many youth to the dangerous development of an eating disorder.

“Eating disorders are a serious and growing concern among adolescents and teens, and are often underdiagnosed and not properly treated.” says pediatrician Maria Aramburu de la Guardia, MD, with LVPG Adolescent Medicine and Lehigh Valley Reilly Children’s Hospital. “These complex and chronic medical illnesses, such as anorexia nervosa, bulimia nervosa and binge eating disorder can have serious physical, mental and psychosocial consequences as well as association with high mortality rates. Because of how dangerous they are, it is important for us – parents and doctors – to recognize signs and symptoms of disordered eating and get our kids the help they need for recovery as soon as we can.”

Here's what every parent of an adolescent and teenager should know.

Eating disorders are not only medical illnesses, but they’re mental health diagnoses where those suffering have formed an unhealthy relationship with food and their body, and it causes a significant interference with their daily functioning.

There are several types of eating disorders. This includes:

Anorexia nervosa or atypical anorexia nervosa

Both forms of anorexia are characterized by an extreme fear of gaining weight. Those who struggle with this eating disorder often see themselves as overweight when they are at a healthy weight or even greatly underweight. In order to control their weight, people who struggle with anorexia either develop a restrictive form – where they greatly limit what and how much they eat – or a binge-purge form – where in addition to limiting what and how much they eat, they also binge and purge, which means they will eat a large amount at once and try to get rid of the extra calories through vomiting, laxatives, diuretics or excessive exercise.

Bulimia nervosa

Bulimia nervosa is categorized by a pattern of binge eating followed by purging – which could mean puking, fasting, laxative or diuretic use, and/or excessive exercise – to prevent weight gain. Unlike with anorexia, a person with bulimia does not limit what and how much they eat.

Binge eating disorder

The most common eating disorder in the United States, binge eating disorder, is when a person binge eats but doesn’t purge or restrict. It involves eating larger than normal portions of food in one sitting and an inability to stop eating excessively large portions. It’s accompanied by negative self talk and disgust feelings after binging episodes, which can affect mental health.

“The earlier we can detect an eating disorder, the higher the chance is they can fully recover, so it’s extremely important that if you notice any warning signs, you bring your child into their pediatrician to discuss it,” Dr. Aramburu says. “If your pediatrician suspects your child may have an eating disorder, they can refer them to one of our adolescent medicine specialists who are trained to provide adolescents and teens with the proper support they need to achieve recovery.”

Keep your eye out for eating disorder warning signs, such as:

• Changes in what, when and how much they eat – i.e., skipping meals; eating small portions; refusing to eat high-sugar, high-fat foods; overall restrictive food intake
• Being restrictive or regimented about their eating – i.e., calorie tracking
• Unusual weight fluctuations or severe weight loss
• Expressing unhappiness with their body or their weight
• Exercising much more than usual
• Fear of gaining weight
• Spending a lot of time in the bathroom
• Hiding/sneaking food
• Refusal to participate in social events involving food
• Mental health symptoms, such as isolating themselves or eating by themselves.

“A big red flag is if your child is declining in weight, or not gaining weight properly. Through adolescence and their teenage years, your child is growing, and the scale should reflect that,” Dr. Aramburu says. “They should be tracking with their percentile. If they drop 2 percent in percentile, that’s a big red flag.”

“Starvation and malnutrition causes severe consequences to the body, both medically and mental health-wise,” Dr. Aramburu says. “This includes: rapid weight change, low heart rate or heart rhythm abnormalities, hormone changes (which can result in the loss of one’s period), electrolyte shifting, fatigue, breathing problems, hair loss, blood pressure changes, fainting and even death. Mental health concerns include: social isolation, loneliness, significant anxiety, withdrawal, depression and suicidal ideation.”

Dr. Aramburu urges you to take these concerns seriously. “If it even crosses your mind that your child might have an eating disorder, talk to your child and to their pediatrician. Even if you are wrong, it may lead to an important conversation about healthy eating and body image that could help prevent a future eating disorder. And if you are right, the sooner your child gets help, the better.”

“And remember, eating disorders are not about choice. They are both medical and mental health disorders where emotional suffering is often a root cause. So, it is incredibly difficult for children/teens to recover on their own. In fact, getting nutrition back into the body and a very complex support system needs to be in place in order to make recovery possible. This includes working through the thoughts and mental health aspect of their disease as well as the nutritional and physical health components.”

“How you talk about food matters,” Dr. Aramburu says. “We encourage parents to avoid labeling food as either ‘good’ or ‘bad’ because we know there are nutrients and benefits to gain from eating a variety of foods.”

You should also avoid talking about dieting. “Talking about dieting to an adolescent, even if they need to lose weight, has negative behaviors. The focus of the conversation should be about balancing and nourishing our bodies in healthy ways – even if they’re overweight. Focus on saying what food is important for, what food does to the body. For example, you need protein to build muscles.”

Make sure to encourage body positive self-talk. “Parents should not see or talk about body dissatisfaction within themselves or their child. Avoid weight talk – don’t tell a teen they need to lose weight. If they are overweight, instead of asking your child if they’re being bullied about their weight, assume they are and be super sensitive in how you talk about it.”

Other things Dr. Aramburu suggests is to make mealtime really important, so your child wants to eat together with your family, not alone. And be wary of social media.

“Restrict the content your kids are seeing and keep an eye out for ‘fitness inspo’ your child may look for on social media. While they may be searching for healthy recipes and exercise ideas, the algorithm can lead them to anorexic unhealthy guidelines from ‘influencers’ who are malnourished and giving bad advice. They also could be putting dangerous ideals in their head, such as no skinny is too skinny, thigh gaps are healthy, and if you’re hungry maybe you’re not hungry and you’re just thirsty. Make sure to talk to your kids about what they see or watch, helping them to identify what’s not appropriate,” Dr. Aramburu says.

However, the best thing you can do for your child is to continue with your regular pediatrician visits. “Preventive visits with your child’s pediatrician are extremely important in their teenage years as they can monitor their weight and other concerns that may be going on. When your child goes to the pediatrician as a teen, it’s more comprehensive and more confidential of a visit, which allows for the teen to disclose information that may not be as easily disclosed with the parent in the room.”

Lehigh Valley Reilly Children’s Hospital’s Adolescent Medicine Program focuses on the unique physical, developmental, emotional and behavioral health conditions that affect your child during ages 10-23. Our team of experts offers specialized care for the unique health concerns of children, teenagers and young adults ages 10-23.

Through our Adolescent Medicine Program, your child will have access to adolescent medicine specialists, licensed clinical social workers, therapists and dieticians who will provide evaluation, care and support for an assortment of concerns, including eating disorders.

LVPG Adolescent Medicine–3080 Hamilton is welcoming new patients. If your child is suffering from an eating disorder, we will set up the team your child needs to receive the comprehensive care they need for their eating disorder.