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Children Can’t Understand Their Own Eating Disorders

child eating disorderContrary to common stereotypes, eating disorders do not simply afflict teenage girls, they also affect grown women, men, teenage boys, and children. Often times disordered eating patterns are overlooked in children because the illnesses manifest or are expressed differently. The medical community seems to finally be moving toward being capable of identifying and treating eating disorders in patients that have been historically ignored or treated as anomalies.

A study published in the January issue of the International Journal of Eating Disorders, indicates that different symptoms should be looked at when diagnosing children under twelve with eating disorders. The research was conducted a team from the Eating Disorders Program at Princess Margaret Hospital for Children and School of Paediatrics and Child Health lead by David A. Forbes, MBBS, FRACP. The study used 656 patients with eating disorders (104 children and 552 adolescents). Adolescents are defined as under 18-years-old and children as under 13-years-old.

DailyRX describes Forbes’ and his team’s methods:

A medical assessment and interviews were used to make the diagnosis of an eating disorder. A diagnosis of eating disorder was determined by meeting criteria for a psychiatric illness of eating disorder.

 

Both the patients and the parents gave interviews.

The patients reported on their attitudes about their weight and shape, their understanding of eating disorders and their eating habits and behaviors. This involved questions on laxative and diet pill use, binging, purging and exercising.

 

Doctors examined physical features like body weight, body temperature, blood pressure and heart rate. They also compared the patients’ body weight when they came to the emergency room with other weight measurements taken earlier in their life to determine amount of weight loss and how fast it was lost.

 

The researchers compared the interview information given by both the patients and the parents and used both sets of information in their research.

Here are some of the study’s findings:

  • Over 82% of the children with eating disorders were girls
  • Over 95% of the adolescents with eating disorders were girls
  • The researchers were more likely to find an eating disorder in a boy 12-years-old and under than in a boy over 12.
  • Children were less likely than adolescents to be “concerned about their body weight or shape.”
  • Children showed less understanding about eating disorders compared to adolescents.
  • In children under 13-years-old, restraining from eating was their main symptom
  • Bulimia is more common in adolescents than in children (10.3% vs 1.9%)
  • Adolescents had lost an average of 20.4 % of their body weight at a rate of 3.2 pounds per month
  • Children had lost 17 % at a rate of 4.1 pounds per month.
  • Adolescents had been afflicted with their eating disorders for about nine months
  •  Children for about seven months
  • Blood pressure, heart rate, body temperature and body mass were comparable between both groups.

The team concluded that different standards must be set when it comes to evaluating children for eating disorders. They may have different symptoms, levels of visible severity, and they may not be articulate enough or be able to “recognize their eating disorder enough to be able to discuss it with a doctor.”

This study, like many others, shows that we know so very little about eating disorders and ahve been very limited by the information and biases we already have. We need to continue to research and find ways to help those suffering even if they deviate from the classic affluent white teenage anorexic.

via Daily RX//Image via Shutterstock

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  • Amy

    I certainly find it to be the case that my child has little understanding of her ED. She began restricting in early 2013 at age 11. We are doing family based therapy using the Maudsely approach and finding it very effective, albeit extremely difficult. At 11/12 children so not have the cognitive capacity to comprehend their ED. The aim is refeeding and feeding and fighting any of the ED desire to restrict. We dissacociate the ED from my child and she herself seems to on occasion recognize when ED is acting…although usually her understanding comes after a behavior that she feels guilty about (eg hiding food) and confesses later. The main goal with ED in children is in addressing the weight loss through intensive refeeding and weight restoration. Only when weight is restored and the brain can begin to function normally again can we address any other issues…many that I think arise simply because of the treatment and interfere with normal development.