9 things to know about eating disorders in children

Eating disorders can cause serious health problems and even death in children. Here’s what you should know.

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Your adorable toddler has now lost most of her chubby cheeks and chunky thighs. Her limbs are growing long and slender, and you soon realise that she’s become a young lady.

However, while toddlers – and even older children - sometimes experience food preference phases, frequent food refusal can lead to an eating disorder in older kids.

Eating orders – like anorexia nervosa (having an illogical fear of weight gain) and bulimia (excessive eating, then purging) – commonly occur after puberty in females, particularly those aged between 12 and 25, notes Gleneagles Hospital psychiatrist Dr Lim Boon Leng.

“About one in 30 people may be afflicted with eating disorders and it can be genetically linked. Many patients also have psychological problems such as low self-esteem, impulsive or perfectionistic personalities and troubled relationships,” Dr Lim adds.

While you may think your child may be too young to have an eating disorder, do note that kids as young as 7 have been known to suffer from these disorders.

Author Abigail Natenshon writes in her book, When your Child has an Eating Disorder, that “younger children are challenging to diagnose, as only 38 per cent meet the criteria for anorexia nervosa”. For instance, amenorrhea – or missing her menstruation, which is a criteria for anorexia – does not apply to young girls.

We round up nine things that you ought to know about eating disorders in children.

It can delay puberty
One study by the Department of Endocrinology at the Children’s National Medical Center in Washington, DC, found that the ability for girls to reproduce could be linked to the amount of body fat they have. This is nature’s way of ensuring that pregnancy will not occur unless there are adequate fat stores to sustain both the mother and the growing foetus. As such, if the child is suffering from anorexia, the proportion of body fat can get unhealthily low, which can cause a delay in puberty.

"She may even develop calluses on the knuckles of her hand, because she “repeatedly scrapes them with her teeth, in order to induce vomiting”.

Besides weight loss, there may be other physical symptoms
Common signs of an eating disorder include the child frequently complaining that she looks fat, and worrying about her body image. She may even start exercising excessively in order to lose weight, or start binge eating.

“Other physical symptoms include developing fine body hair or lanugo, dry skin due to dehydration, or an orange tinge of skin from excessive consumption of vegetable with carotenoids,” says Dr Lim. He also adds that she may even develop calluses on the knuckles of her hand, because she “repeatedly scrapes them with her teeth, in order to induce vomiting”.

The media and social media play a role
“Media influences and peer pressure to look thin can play a part in tipping a person over,” Dr Lim notes. In addition, when women are portrayed to be desirable only when they’re skinny, it can influence youths to want to look that way, “resulting in distorted sense of body image in impressionable youth,” adds Dr Lim.

Certain environments can increase the risk
Simply having a well-meaning relative comment that she’s putting on weight can cause your sweetie to fear being judged or laughed at. “Those who have been laughed at or bullied for being overweight, or been praised for being skinny may also take their dieting to an extreme,” Dr Lim explains. “Eating disorders can also be triggered by the stress of school, and work relationships.”

In certain sports, coaches and parents may encourage the kids to lose weight as well – “athletes, dancers and models are at a higher risk of eating disorders,” says Dr Lim. One mum, Noelle Tham, shared that she was uncomfortable when her perfectly healthy 9-year-old was told by her gymnastic coach to “stop eating so much”. “I had a word with the teacher-in-charge and while my daughter loves the sport, I won’t hesitate to look for another coach if I find that she starts showing unhealthy eating habits,” says Tham.