How to prevent eating disorders in teens

When they should be gobbling up their first chapter books, some kids are so scared of getting fat that they’re secretly starving themselves or vomiting after eating.

“We certainly see kids of seven, eight and nine here fairly regularly,” says Leora Pinhas, psychiatric director of the eating disorders program at Toronto’s Hospital for Sick Children.

How prevalent are these issues among kids, really? A recent US study found between two and five percent of kids have developed some kind of eating disorder by age 13. If that doesn’t sound like a big problem, consider that even based on the small number of new cases diagnosed every year here in Canada (2.6 per 100,000 child patients), more kids are developing eating disorders than child-onset type 2 diabetes.

Although some medical professionals are calling childhood eating disorders an epidemic, the kids and teens who suffer from them receive precious little attention. “There are no medication trials or randomized controlled therapy trials for children, and fewer than five for teens,” Pinhas notes. “There are whole provinces in this country that do not have any publicly funded, specialized treatment programs.” She adds eating disorders carry a stigma even among mental health professionals — for instance, in some mental health programs, kids who have an eating disorder plus, say, depression, will only be treated for the latter.

Added danger

While eating disorders are unhealthy at any age, they’re doubly damaging during childhood and adolescence. “These kids are starving their brains, so it affects development and school functioning,” Pinhas stresses. Scarier still: One in 10 people with anorexia nervosa is likely to die of it.

Children now learn that thin is in practically as soon as they can talk. “It’s important to realize that food and weight preoccupation isn’t about vanity, it’s about fitting in,” notes Merryl Bear, director of the Toronto-based National Eating Disorder Information Centre. In susceptible kids, this can morph into restricted eating.

Risk factors

So what makes some kids vulnerable? “We don’t know exactly what causes eating disorders,” admits Leanna Isserlin, a child psychiatrist and lead physician in the eating disorders program at the Children’s Hospital of Western Ontario in London. Genetics may play a role — there’s some evidence a tendency toward eating disorders may be inherited, sometimes along with a family history of depression or anxiety.

Certain temperaments also seem to place kids at a higher risk — and they may not seem negative to parents. “The traits that get you an eating disorder are the traits that get you through law school,” Pinhas says. “These kids try hard, they want to be good, they may be a little perfectionistic, a little obsessive, and they’re able to ignore physical discomfort to achieve their goals.” In a misguided way, eating disorders provide “a sense of competency that comes from setting goals and meeting them,” Bear says. A child may think, “I wanted to lose another five pounds before camp, and I did it.”

Slashing the risk

How to reduce your child’s chances of falling victim to an eating disorder:

• Make a dinner date. Research shows kids who regularly eat dinner with their families are more emotionally resilient than those who don’t. Family dinners also give parents a chance to hear kids’ worries and to keep track of what they’re eating.

• Be media-savvy. The more magazines, TV and other media girls consume, the higher their risk of developing an eating disorder, research suggests, because extreme thinness is often portrayed as being normal or desirable. To defuse those negative influences, limit little kids’ viewing to programs featuring healthy role models, and teach your kids to question what they’re seeing (“Does anybody you know really look like Barbie?”).

• Don’t put your kid on a diet. All it will do is make him feel bad about himself — and it will increase the likelihood of unhealthy behaviours like bingeing. Shockingly, Taiwanese children as young as 10 admitted to vomiting as a way to lose weight, according to a study published recently in the Journal of Clinical Nursing.

• There’s a wide range of healthy body types, says Leanna Isserlin, head of the eating disorders program at the Children’s Hospital of Western Ontario in London, and it can be dangerous to restrict any child’s food intake because his nutritional needs may not be met.

• Set a healthy example. Children of moms who diet are more prone to eating disorders. Show your children by example what healthy eating means (yes, sometimes it includes dessert!).

• Muzzle body comments. Kvetching about your own big butt or commenting on a neighbour’s slamming shape can convince kids that being thin and pretty is more important than being hard-working or kind. And never make critical comments about your child’s body.

• Make sure the doc is tracking growth. “Often kids don’t look starved when they’re not eating properly; what happens is they stop growing in height,” says Leora Pinhas of the eating disorders program at Toronto’s Hospital for Sick Children. “If you’re not measuring that, it can go undetected for a couple of years.”