Eating Disorder

Eating Disorders: What Parents Should Know

What is an eating disorder?
An eating disorder is a serious condition in which someone is so preoccupied with food and weight that they can focus on little else. The main types of eating disorders are anorexia nervosa, bulimia nervosa and binge eating disorder. Eating disorders can cause serious and even life-threatening physical problems. Most people with eating disorders are females, but males can also develop eating disorders.
What causes eating disorders?
The exact cause of eating disorders is unknown.  Even though an eating disorder can appear to be a medical problem, it is considered an emotional or mental illness. As with other mental illnesses there is likely to be a multitude of contributing factors.  Biological, psychological, societal influences have all been implicated in the development of eating disorders
Anorexia Nervosa
Anorexia nervosa is characterized primarily by determined self-starvation and excessive weight loss.
Bulimia Nervosa
Bulimia nervosa is characterized by recurrent episodes of binge eating and purging. During a binge episode, an individual will typically eat a very large amount of food in a short period of time and then try and rid themselves of the calories by vomiting or through other harmful behaviors designed to compensate for the binge episodes, such as excessive exercise. Individuals with bulimia nervosa can be normal weight or even a bit overweight. When binge eating and purging occur in low-weight individuals, these symptoms are considered part of anorexia nervosa.
Binge Eating Disorder
Binge Eating Disorder is characterized by regularly eating excessive amounts of foods (binge eating) but without the compensatory behaviors seen in bulimia nervosa. Individuals with binge eating disorder might eat when not hungry and continue eating even after uncomfortably full. Binge eating disorder can afflict people who are normal weight, overweight or obese.
Extreme Picky Eating
Avoidant Restrictive Food Intake Disorder (ARFID) is a new diagnosis in the DSM-5, and was previously referred to as “Selective Eating Disorder.” Although many children go through phases of picky or selective eating, a person with ARFID does not consume enough calories to grow and develop properly and, in adults, to maintain basic body function. In children, this results in stalled weight gain and vertical growth; in adults, this results in weight loss.
What are the possible warning signs?
These can vary with each type of eating disorder and patients may only have some of those listed.
  • Loss of large amount of weight in a relatively short amount of time
  • Refusing to eat and denying hunger
    • Skipping meals
    • Making excuses for not eating
    • Lying about what was eaten
  • Obsession with calories, food and weight
    • Eating only a few “safe” foods
    • Cooking elaborate meals for others but refusing to eat it themselves Poor body image
    • Self-esteem overly linked to shape and weight
    • Persistent worry or complaining about being fat
    • Wearing baggy or layered clothing
  • Vague or secretive eating patterns or odd food rituals
    • Not wanting to eat in public
    • Cutting food into tiny pieces or spitting food out after chewing
  • Excessively exercising
  • Frequently being cold
  • Going to the bathroom after eating or during meals
  • Evidence of vomiting in bathroom or child’s room
  • Abnormal bowel functioning
    • Use/abuse of laxatives, diuretics or enemas
  • Damaged teeth and gums
  • Dizziness/fainting
  • Menstrual irregularities or loss of menstruation
  • Withdrawal from normal social activities
Complications of an eating disorder
The more severe or long-lasting the eating disorder, the more likely you are to experience serious complications. These complications may include:
  • Absence of menstruation (amenorrhea)
  • Stunted growth, which can become permanent
  • Decreased school attendance leading to possible school failure
  • Severe tooth decay
  • Heart disease
  • Depression
  • Suicidal thoughts or behavior
  • Bone loss
  • High or low blood pressure
  • Seizures
  • Digestive problems
  • Bowel irregularities
  • Kidney damage
  • Type 2 diabetes
  • Gallbladder disease
  • Death
What can you do to help prevent eating disorders?
Addressing disordered eating attitudes and behaviors early on can prevent them from developing into full-blown eating disorders.
  • Cultivate and reinforce a health body image in your children whatever their shape or size. Avoid overemphasizing a person’s beauty and shape in relation to self-worth.
  • Be a good role model in your attitudes about food, body image and weight-related issues. Avoid making negative comments about your body or anyone else’s body. Remember that your comments – positive and negative – impact others even when you may not intend them to.
  • Encourage healthy eating habits. Eat meals together as a family whenever possible. Serve regular meals and snacks with an emphasis on health promoting foods, while never forbidding or eliminating treats entirely.
  • Go for yearly well visits to keep track of any medical/weight changes.
  • Learn about the dangers of dieting and enjoy moderate exercise to feel healthy and strong. Discourage the idea that a particular diet, weight or body size will automatically lead to happiness and fulfillment. Understand that a body can only be changed so much; there is a residual amount of weight that is beyond a person’s control to lose without risking health and the development of a serious eating disorder.
  • Avoid using food as a reward or punishment, as this can teach your child to turn to food for comfort and tie emotions to eating. This can permanently affect a child’s relationship with food.
  • It is important not to label types of food or entire food groups as “good” or “bad” because of their fat content, nutritional value, sodium amounts, or otherwise. Eating healthy is all about moderation.
  • Keep open lines of communication with all of your children. If you find that you cannot have an open and honest conversation with your teenager or realize you don’t know much about their life, seek a referral for professional help in this area.
  • Learn your child’s style of dealing with stress or tension. If your child appears to have negative coping skills for dealing with the regular stresses of life and school, including disordered eating, seek a referral for professional help.
What does treatment involve?
Eating disorders require the care of a trained professional with expertise in the treatment of eating disorders. People with eating disorders need to seek professional help. The exact treatment needs of each individual will vary.
  • Early intervention is key
  • Parental involvement is essential
  • Discuss any concerns with your pediatrician and call RELIEF to get the help and support you need.

Relief would like to thank Katharine L. Loeb PhD (Director of Research and Training, Chicago Center for Evidence Based Treatment) for her invaluable support and guidance in helping prepare this guide for publication.