Eating Disorders on the Rise in Children

Eating disorders are serious mental health conditions that involve unhealthy thoughts, feelings and behaviors about food, body weight and appearance. They tend to affect children, teenagers and young adults more often than older people. In recent years, more people under 18 have been diagnosed with these disorders. One study found that from 2018 to 2022, medical visits for eating disorders more than doubled for children under the age of 17.

What’s behind the increase? And what can you as a parent do if you think your child has an eating disorder or is at risk of developing one? Two adolescent medicine experts from University Hospitals Rainbow Babies & Children’s Hospital share some helpful information and advice.

Why Are More Kids Developing Eating Disorders?

Many factors can lead to an eating disorder. These include genetics, environment and cultural pressures. During and after the COVID-19 pandemic, there was a noticeable rise in eating disorders among children and teens.

“Lockdowns, isolation, changes in daily routines and fear about COVID-19 increased stress, anxiety and depression for many young people,” says adolescent medicine specialist Courtney Batt, MD. “For some, controlling food became a way to cope with these difficult emotions.”

Social media also plays a role. During and since the pandemic, kids have been spending more time online, where many social media platforms often show content that promotes unrealistic body standards. Also, some influencers promote and glamorize fad diets that can be unsafe for teenagers.

Are Some Children More at Risk Than Others?

Factors that can increase your child’s risk of developing an eating disorder include:

• A family history of eating disorders.
• Past feeding problems.
• Sensory issues.
• Other mental health conditions like anxiety, depression or obsessive-compulsive disorder (OCD).
• Trauma related to eating (such as choking).
• Bullying, especially about body weight or shape.
• Playing sports that focus heavily on weight, such as gymnastics, ballet, figure skating or wrestling.

Types of Eating Disorders That Affect Kids

Eating disorders that can affect teens and younger children include:

• Anorexia nervosa: Eating very little food because of an intense fear of gaining weight.
• Bulimia nervosa: Eating large amounts of food in a short time (binge eating) followed by purging (excessive exercising, vomiting, or misusing laxatives and water pills).
• Binge eating disorder: Binge eating without purging or limiting food.
• Avoidant restrictive food intake disorder (ARFID): Common in younger children. This disorder involves not eating enough food, but it’s not caused by fear of weight gain. ARFID can stall weight gain and growth in children.
• Other specified feeding and eating disorder (OSFED): This term is used when someone has symptoms of one or more eating disorder but does not meet all the exact criteria for a specific diagnosis.

Signs of Eating Disorders in Kids

“Children and teens with eating disorders often hide their behaviors,” says Amy Middleman, MD, a pediatric and adolescent medicine physician and chief of the UH Rainbow Division of Academic Pediatrics & Adolescent Medicine. “Some may even receive praise for losing weight, which can make the problem harder to notice. Others may feel ashamed and try to keep it secret.”

Parents should watch for warning signs, which can include:

• Limiting food or switching to “diet” or nonfat foods.
• Avoiding eating meals with others.
• Talking often about their body or other people’s bodies.
• Frequently weighing themselves.
• Frequently checking their body in the mirror.
• Wearing baggy clothes to hide their body shape.
• Frequent claims of having “already eaten.”
• Complaints of stomach pain before or after meals (these should be evaluated by a healthcare provider).
• Avoiding parties or other events where large amounts of food are available.
• Exercising much more often or more intensely than usual.
• Frequent constipation.
• Feeling cold when others feel comfortable.

Not Just Girls

The stereotype is that eating disorders only affect girls and young women. It’s true that disorders linked to body image and fear of gaining weight—like bulimia nervosa and anorexia nervosa—are still more common in females. However, new research shows that about 1 in 3 people diagnosed with an eating disorder are male. Not only are more boys and young men getting diagnosed more often with these well-known disorders, they are at risk for other eating disorders that girls are less likely to experience.

Some male body ideals focus on being muscular or very lean (having low body fat and being “cut”) instead of simply being thin or losing weight. Because of this, some adolescent boys and young men develop unhealthy habits to change their bodies. These habits may include eating too much protein, overexercising or lifting weights too often, and using performance-enhancing substances like anabolic steroids.

Eating disorders in boys can also overlap with a condition called muscle dysmorphia, also called “bigorexia.” People with this condition become obsessed with building the biggest muscles possible.

Tips for Parents

Dr. Batt and Middleman agree the best advice they can offer parents who suspect their child has an eating disorder is to get them professional help right away. Left untreated, eating disorders can lead to serious health problems and can even be life-threatening. A pediatrician can evaluate your child and refer you to specialists, such as an adolescent medicine doctor, dietician or therapist.

Here are some other ways parents can help:

• Learn about eating disorders. The more you understand them, the better you can support your child.
• Be a positive role model. Eat balanced meals, exercise in healthy ways and avoid negative comments about your body and others’ bodies. Your child will notice when you skip meals or make unkind comments about your body or someone else’s.
• Set regular mealtimes. Encourage three balanced meals and one to two snacks each day. Skipping meals can lead to binge eating.
• Have family meals. Eating together at least three times a week can improve healthy habits.
• Encourage activities not focused on food. Support hobbies, sports and time with friends.
• Keep communication open. Talk with your child about healthy eating and unrealistic messages they may see online.
• Build your child’s confidence. Praise their efforts, kindness and strengths — not their appearance.
• Show your love. Remind your child often that you love them and are there to support them no matter what.

Related Links

The interdisciplinary behavioral specialists of UH Rainbow Babies & Children’s Hospital’s Division of Developmental and Behavioral Pediatrics and Psychology offer state-of-the-art clinical care to diagnose and treat children and adolescents with developmental and behavioral issues.