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THE ROAD AHEAD I EATING DISORDERS
Feeding and eating disorders are problems with eating that are unhealthy and can cause emotional and social problems. There are several different types of eating disorders children can have and each have different symptoms. Explore the questions below to learn how to recognize the signs, understand what causes eating disorders, and to discover effective treatment options.
What caregivers might notice in their child
Kids and teenagers with feeding and eating disorders have problems with eating and nutrition. These disorders can cause other problems with their health, so it is important to get help from a doctor and from a mental health professional. The main categories of feeding and eating disorders are:
Kids avoid eating because they are afraid of gaining weight or being fat.
Kids eat a lot of food and then make themselves throw up, take medication (e.g., laxatives), or exercise too much because they are afraid of gaining weight or being fat.
Kids eat a lot of food and can’t seem to control how much they eat.
Diagnoses like pica (eating things that aren’t food), rumination disorder (regurgitating food), or avoidant/restrictive food intake disorder (avoiding eating food because you don’t like the sensation of it) also fall in this category but are less common. These diagnoses can be more common in kids and adults with autism or intellectual disabilities (learn more here).
Feeding and eating disorders can cause a lot of problems in kids’ physical and mental health. All people are different sizes and need different amounts of food, and kids’ nutrition needs can also change as they grow. However, if your child eats things that are not food, makes themselves throw up or exercise too much, eats too much even if they aren’t hungry, or seems scared of gaining weight, these are usually signs of unhealthy eating.
If you’re concerned about your child’s weight and eating, talk to a professional to figure out what’s going on. Because of the physical health risks, kids with eating disorders may need a team of people to help them: both to monitor their weight and medical concerns, and to help them with their feelings and behaviors about eating and body image. Families are really important in helping kids and teenagers get better from an eating disorder, so your child will need your help and support on their journey!
Signs my child’s eating habits are getting worse
Dietary needs change and it can take a long time for kids to learn how to eat right and nourish their body well. While your child’s eating habits might change over time, these are some signs you may notice in a child with an eating disorder:
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Not wanting to participate in social activities (especially ones that involve food)
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Eating lots of food at once and seeming like they can’t stop
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Sore throat or dental problems that are caused by making themselves throw up to lose weight
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Skipping meals or not eating with the family
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Focusing too much on their weight and body and talking a lot about trying to lose weight
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Exercising more than they should (e.g.,i.e. missing other activities because they have to work out, being unwilling to take a day off from exercising, exercising multiple times a day)
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Sneaking food and/or eating in secret
What causes eating disorders?
Feeding and eating disorders are not caused by just one thing – there are a few factors that can make it more likely that a child will develop this kind of disorder. Kids with anorexia, bulimia, or binge-eating disorders usually have a lot of feelings related to controlling what they eat. Kids with anorexia and bulimia may feel the need to have too much control about what they eat and what happens after they eat, and kids with binge-eating disorder might feel out of control with their eating habits.
Anorexia nervosa and bulimia nervosa are eating disorders that happen when kids are scared of gaining weight or being fat. Scientists tell us that social media has made these diagnoses more common in kids and teenagers, likely because they are comparing the way they look to other people they see online and constantly getting messages about the importance of being thin.
Binge-eating disorder is one of the most common eating disorders. Kids of any weight and size can have binge-eating disorder. We don’t know a lot about what causes binge-eating disorder and lots of different people might struggle with this.
Some things that make it more likely for kids to develop an eating disorder include having parents or siblings who have struggled with eating, being diagnosed with other mental health problems (like trauma, anxiety, depression, OCD), being bullied about their weight, and feeling stressed. Kids who have dieted before might also be more likely to develop an eating disorder, and kids who have high expectations for themselves and aren’t happy with how they look are also more likely to have an eating disorder.
Who is affected by eating disorders?
Anyone can struggle with an eating disorder. For a long time, many people have thought that eating disorders only affect girls, but this is actually not true. While more girls than boys in the US are diagnosed with eating disorders, they have become more common in boys too. Sometimes kids who are very involved in sports are more at risk for eating disorders. For example, in sports like wrestling, kids have to weigh themselves a lot and sometimes have to lose weight quickly before a match. This can contribute to unhealthy eating habits for some kids.
About 3% of teenagers between 13 and 18 years old are diagnosed with an eating disorder.
Genetics: Research hasn’t shown that there is something specific in some kids’ brains that causes them to develop eating disorders. But we do know that eating disorders can run in families – if parents or siblings have an eating disorder, kids might be more likely to have one, too. This is most likely because kids observe the behaviors and actions of other people and learn from them, so one of the best things you can do as a parent to prevent eating disorders is to develop healthy habits around food in your house (more about this below!)
Treatments that work for feeding and eating disorders
There are a lot of things that you can do to help your child who has an eating disorder – and you’re already taking a big step by learning more! Many kids & parents see a lot of improvement with the right support. Here are some treatments that scientists have found to help with feeding & eating difficulties:
Interpersonal therapy is a great form of therapy for eating disorders, especially for kids with binge-eating symptoms. It helps kids learn about problems in their relationships that are related to their eating disorder, and helps them build healthy relationships that can support them in their recovery. There are even some great virtual programs for kids with eating disorders that are covered by most insurance companies – your child can get help from the comfort of home! Check out places like Equip Health.
This type of therapy is done with parents and their child and the therapist helps parents learn skills to help support their child as they work on recovering from an eating disorder. The family and therapist work together, because the therapist is the expert on eating disorders, and the family is the expert on their child and what is happening in their home. At the beginning of therapy, parents help decide what their child will eat, and as the child gets better, they can start to make some decisions about eating on their own again.
This type of therapy helps kids change the thoughts they have about food and eating and also works on other problems that can go along with eating disorders, like perfectionism, low self-esteem, and problems in relationships.
Sometimes doctors will prescribe medication to help kids with eating disorders. There are some medications that seem to help kids and adults with eating disorders, and there are also medications that can help when kids have an eating disorder along with another diagnosis like depression, anxiety, or OCD. Ask your child’s doctor if there is a medication that might help them.
PHP and IOP programs offer more support than traditional therapy. In both programs, kids live at home but spend a lot of time almost every day getting help for their eating disorder. Sometimes kids with severe eating disorder symptoms need this type of care, or even spend some time in the hospital, because when people don’t eat well, it can cause a lot of health problems. These types of programs might involve things like individual therapy sessions, group therapy sessions, nutrition counseling, and supported meals.
ADVOCATING FOR HELP I EATING DISORDERS
Getting support for eating disorders starts with knowing what to ask for. Use the questions below to find out how to get help, talk with providers, and access the tools your child may need.
How to get help
There are a few ways to get diagnosed with an eating disorder. Here is how you can get started:
They can do a basic screening and look at your child’s weight and overall health to see if your child is getting the nutrition they need. A pediatrician can also tell you if your child’s weight seems healthy based on their age, height, and how much they exercise.
Therapists, psychologists, and psychiatrists can help assess your child. They might do an interview with you and your child to learn more about what’s going on, and sometimes they might have you fill out some questionnaires that ask specific things about your child’s feelings and actions. Psychiatrists can prescribe medication if needed, and mental health providers can also help determine if your child might have depression, anxiety, or something else going on in addition to problems with eating.
Click here to find a provider.
If my child has an eating disorder, what treatment components should I ask my provider about?
Treatment for eating disorders usually includes therapy to talk about the thoughts and feelings that cause eating disorders, nutrition counseling to help kids eat better and fuel their bodies right, and medical support to help their bodies recover and deal with any health problems that started because of an eating disorder.
It’s important to talk to your child’s providers right away to figure out how much support your child needs. Some kids with eating disorders spend time in the hospital or living at a treatment center for a while because they aren’t eating enough for their body to work well. Other kids go to therapy and get treatment every day but still live at home, and other kids just go to therapy once or twice a week and get support from their parents. Your child’s doctor can ask you the right questions to figure out how much support your child needs to help them recover.
Eating disorders can cause a lot of health problems, so it’s usually a good idea to talk to a therapist and someone who is an expert in nutrition and food. Nutrition counseling can help kids and families learn about what vitamins and nutrients they need to help their bodies work best, and how to plan healthy meals that will help their bodies feel good and get to a healthy weight.
Eating disorders can cause a lot of health problems including things like heart problems, digestive issues, dental problems, bones not being strong enough, and kids not growing the way they should. Girls who are old enough to get their period might not get it anymore because they aren’t eating enough. A doctor can check on all these things and see if there are any problems that need to be worked on to help kids heal from an eating disorder.
Supporting a child with an eating disorder requires some help from the whole family, and going to family therapy can help the rest of the family, too. Families can learn new ways to communicate and how to improve their relationships with each other, and it can help provide additional support for kids who are struggling with an eating disorder.
Kids and teenagers with eating disorders might have a hard time understanding how this can impact them long-term. Working with kids to set long-term goals can help them figure out how healthy eating can help them in the long run, and it can also help them find other things that are important to them outside of diet and the way their body looks.
PROGRESS OVER TIME I EATING DISORDERS
This section offers a few extra tools to help you along the way. Whether things are going smoothly or getting more challenging, these resources can support you as your child grows and their needs change.
My child has a diagnosis, now what?
Once your child has been diagnosed and is getting treatment, there are still more ways you can support them – and yourself. Here are some next steps to consider:
Learning healthy eating habits is important for all people, not just kids with eating disorders. Working on healthy eating can help parents and siblings feel better too and is a great skill for everyone to have! Some ways to make food & meals fun, safe, and healthy in your home include:
Eating lots of different types of foods: it’s good for kids to try new foods and eat lots of different things. Usually foods that have simple ingredients are best for kids as they grow (like eating fresh fruit and vegetables, or food from the store that only has a few ingredients listed on the package). You can learn more about healthy eating for kids & families here.
Prepare and eat meals as a family: it’s good for kids to be involved in cooking and making food, and it’s great when families spend time together to eat meals. Sitting down together helps make sure your child eats the right amount to fuel their body, and can also be a good way for parents and kids to connect and talk with each other.
Explain nutrition to kids: most kids are naturally curious and like to learn about things. You can talk to your kids about where food comes from and how it helps our bodies. For example, most adults know that it’s important to eat fruits and vegetables because they give us vitamins and nutrients that we need. You might explain to a young child that it’s important to eat carrots because they can help our eyes see well (vitamin A is important for vision) and they help keep us from getting sick (vitamin C helps our immune system).
Try not to use food as a reward or punishment: it’s common for parents to give food rewards sometimes (e.g.i.e. “if you listen to me while we’re at the store, I’ll let you eat a cookie later”). If this is you, you’re not alone! However, this can make it harder for kids to learn healthy eating habits. If you can, offer other rewards that aren’t related to food (maybe you can listen to their favorite music together, get them some new stickers, or play a game together).
Having access to the internet and using social media sites (like Instagram, TikTok, etc.) can be hard for all kids and can impact their self-esteem and the way they feel about themselves and their bodies. Scientists tell us that more people are anxious and depressed now than before people had smart phones and social media. It’s so important for parents to talk to their kids about what they see on the internet and social media, and how this makes them feel about themselves and others. Learn more about parenting strategies related to technology and social media here.
Try “The Parent’s Guide to Eating Disorders: Supporting Self-Esteem, Healthy Eating, and Positive Body Image at Home” by Marcia Herrin, Ed.D., M.P.H., R.D. and Nancy Matsumoto
“How to Nourish Your Child Through an Eating Disorder: A Simple, Plate-by-Plate Approach to Rebuilding a Healthy Relationship with Food” by Casey Crosbie and Wendy Sterling
My child is getting worse, what can I do?
It’s hard to see your child struggling, especially when it feels like things are getting more intense, not better. You’re not alone—and there are steps you can take to get support and stabilize things.
Let them know what’s changed. Sometimes therapy needs to be more frequent or focused differently, or something needs to be changed in your child’s routines or environment. Be specific about what you’re seeing: more aggression, bigger meltdowns, school issues, more frequent outbursts, etc. This will help your provider to identify areas of change that might help your child.
Every family should have a plan for what to do if things get worse or if you or your child feel unsafe. This might include knowing who to call during a crisis (like a mobile crisis team or behavioral health urgent care), when to head to the ER, or how to calm things down safely at home. Your provider can help you build a plan that fits your family. If you think your child has an eating disorder, ask your provider what you should look out for. In some eating disorders (like anorexia), providers look at your child’s weight to see if they are getting better or worse. There may be signs and symptoms like weight, blood pressure, or other things that you can monitor at home to see how your child is doing.
Many communities offer intensive programs for eating disorders that bring together a team to support your child in several areas (usually mental health, nutrition, and medical supports). Your child might stay overnight at a hospital or residential program, or they might be able to stay at home and go to therapy and classes most days during the week. It’s not uncommon for kids with eating disorders to need some extra support, at least at the beginning of their journey, so don’t be afraid to ask for this if your child needs it!
When your child is in crisis and struggling with their physical and mental health, it can take a toll on your whole family. Connecting with other parents, talking to a therapist, or simply having a support system in place can help you stay grounded while you’re supporting your child.
CAREGIVER TOOLKIT I EATING DISORDERS
This section offers simple, practical tools to help you support your child—from building routines and healthy habits to improving communication and recognizing their strengths. It’s also a reminder that taking care of yourself is part of the plan—you’re not alone on this journey.
Daily habits that help
It’s very common for kids with eating disorders to struggle with their self-esteem, and no matter how many times you tell them that they look beautiful, their body is healthy and strong, or you don’t think they’re overweight, they’re probably still going to struggle with their eating and self-image. Focusing on things that are great about them, outside of the way they look, can help build healthy self-confidence no matter what they weigh or how much they eat. It’s great to give your child compliments about internal characteristics they have (i.e. they are kind, they are resilient, they are creative), so that even when other things change, they know who they are on the inside.
Think about how you talk about food and exercise. What are your eating habits? How do you talk about your own body and self-esteem in front of your kids? How does your family exercise? Kids look to parents and other trusted adults to learn about how they should do things and think about things. Working on your own healthy habits and thinking about yourself positively encourages your child to do the same.
Kids with eating disorders often feel very alone. They may not want to eat in front of other people, hide to make themselves throw up, or avoid being with other people because of how they feel. Spending time with them helps them to know that you’re in their corner – and you can also find fun ways to be healthy and strengthen your bodies as a family! Maybe you can play on a playground with them, go on a family bike ride, or walk to the store together. Set goals for your health together – not just weight related, but goals for how you want your body to feel and what you want to be able to do.
Caregiver self-care
Parenting a child with an eating disorder is a big job. It’s okay to ask for help, and it’s good for your child to learn that they can also ask others for help when they need it!
It makes a big difference when you can be consistent in the way you respond to your child, but you don’t have to do it alone. The good news is – while it can be a big change & a lot of effort to start working on eating and behavior changes with your child, once you establish these rules and expectations, it will make things easier in the long run and your child will learn how to practice their new skills and make healthy choices on their own!
There are lots of support groups specifically for parents and loved ones of children with eating disorders, both online and in-person. Some organizations and resources to explore include:
F.E.A.S.T. (Families Empowered and Supporting Treatment of Eating Disorders): Walks alongside families navigating the challenges of their loved one’s eating disorder.
National Alliance for Eating Disorders: Free helpline and groups for individuals with eating disorders and their loved ones
ANAD (National Association of Anorexia Nervosa and Associated Disorders): Helpline, learning library, and community groups for individuals with eating disorders
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