Eating disorders in young children–how bad is it?

It’s hard to escape the media coverage of eating disorders in young children. The stories are usually framed around the growing numbers of young children (generally meaning pre-pubescent, typically 10 or 11 and under) that are presenting for treatment. The articles generally consist of a breathless assessment of how bad the situation is, with no small amount of blaming the media and a child’s increasing exposure to images of super-skinny models.

Take this one:

Children under 10 are being hospitalised due to eating disorders – drawn in by horrific “Thinspiration” photos posted on social media, shocking new research reveals.

In the past year alone, 42 children under the age of 10 were taken to hospital and admitted.

Disturbing new statistics reveal the “primary diagnosis” was an eating disorder.

Charities believe social media is a major factor, with many young victims posting ‘selfies’ of their emaciated bodies on Twitter.

First, consider the source. Second, where’s the research? Third, what if more children being diagnosed with an eating disorder isn’t quite as bad as some news stories make it sound?

So before I go any further, let me unequivocally state that I hate when I learn of anyone having an eating disorder. I’m not going to argue that EDs in anyone, including young children, are a good thing. All of that being said, here’s what we know:

The shorter the duration of an eating disorder, the better the outcome.

For years, researchers had believed that EDs were a ‘teen thing.’ If you weren’t a teen, you pretty much couldn’t have an eating disorder. Not only did that leave those of us that had EDs long into adulthood with difficulties getting diagnosed and finding help, it also hurt children and pre-teens who had EDs but were ‘too young for that sort of thing.’

Thus, kids who had EDs weren’t diagnosed and treated adequately. By the time they had entered their teenage years, their EDs were already entrenched. So even when it may have looked like early diagnosis, it really wasn’t. This makes recovery more challenging and less likely. If we can get people proper diagnosis and treatment more quickly, isn’t that a good thing?

Although some evidence suggests that EDs might be striking people earlier than before, there is such little data on EDs at all, that I can’t really say for sure. We are definitely seeing more children with EDs presenting for treatment, but that doesn’t mean that children weren’t suffering from EDs before. We just weren’t aware of it, or perhaps gave it different names.

Instead of talking about the increase in EDs in children as a universally Bad Thing, maybe it’s not as bad as we think because it means that more kids are getting treatment when they need it. This thinking is supported by new research that was presented this week at the Eating Disorders Association of Canada conference in Vancouver by Dominique Meilleur and colleagues.

They created detailed biological, psychological, and social profiles of 215 children between ages 8 and 12 that had presented with “eating problems” that didn’t have a known physical cause. The vast majority of these children had anxiety and mood disorders, along with ADD/ADHD. The researchers found that:

  • 95% of the children had restrictive eating behaviors
  • 69.4% were afraid of putting on weight
  • 46.6% described themselves as “fat.”
  • 15.5% of the children occasionally made themselves vomit
  • 13.3% had bulimic behaviors

In a story in Medical News Today on the research, Meilleur says:

These results are very concerning but they may help clinicians reach a diagnosis earlier by enabling them to investigate these aspects…Many researchers believe that bulimia only appears at adolescence, but our studies indicate that the problem can arise much earlier. It is possible that it is currently under-diagnosed due to a lack of awareness and investigation.

Nor are EDs in this age group only appearing in girls. Says Meilleur:

The profound similarity between boys and girls supports, in our opinion, the hypothesis that common psychological and physical factors linked, amongst other things, to the developmental period, are involved in the development of an eating disorder.

To me, getting treatment is far better than suffering in silence. Sure, it might distort statistics and make things initially look worse than before. But if the rise in childhood eating disorders means that more people are getting treated, I think that’s something we should be celebrating.

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6 Responses to “Eating disorders in young children–how bad is it?”

  1. Well put. I remember symptoms of my ED first showing up when I was 8 or so, but nobody thought anything of it because I was way too young, or so the thinking went, to have an eating disorder. I wasn’t diagnosed until I was 31. That’s an awful lot of wasted time.

  2. Carrie, I agree. As for my own daughter’s ED (diagnosed at 7 1/2) I am very grateful that she didn’t linger at sub-optimal nutrition for years, with us thinking she was healthy but skinny and muscular, which is what we were thinking. She ate her meals in front of us. How could we know? We were fortunate that she TOLD us. She never lost weight, but failed to gain as she grew. I think in the weeks before she told us, her ED was clamping down–she was forced to restrict liquids as well as foods, and had started getting upset when she saw large portions. My husband and I, not knowing it was ED, gave her smaller portions that didn’t upset her and she ate them. How could we have guessed? Well, we couldn’t but when I took her to the pediatrician and the pediatrician saw *no weight gain in a year* despite linear growth and said “little girls get skinny”, well, I do think that the PEDIATRICIAN should have seen red flags! At any rate, I’m grateful that my daughter told me she couldn’t eat or drink and was hungry all the time. Because of that, we were able to step in with full meal/snack support, and get her back up on her growth curve, and she’s doing great!

  3. By the way, I credit the wonderful parents at the Around the Dinner Table Forum with getting me on track right away as a caregiver, and quickly giving me the tools I needed to get my daughter well. We also were able to find good local treatment, but the ATDT parents were my biggest support and source of great information and strategies.

  4. interesting ideas and theories-perhaps, we may see why it may be difficult to begin to feel hopeful when there is still so much more research needed into EDs in general but particularly within the paediatric population. The treatment being offered within this population varies from things like The Maudsley method to prayer chains to medication. I took a glance back at a previous post-Feb 25 2014 ‘Misguided attempts at prevention by parents’- whoa-you can feel the tension and the defensive position taken by some parents seems way too intense in relation to a child being unwell.
    I wouldn’t be so naive as to think that more diagnosis automatically equals more ‘proper treatment’. There is no agreed definition of proper treatment anyway, apart from weight restoration .

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