Kids Who Won't Eat: How to Help Children with Eating Disorders

An Alarming Trend

Child picking at peas on plate

Robyn Lehr

Lily's story is becoming increasingly familiar, as more and more young kids are developing anorexia, government statistics reveal. They're limiting their food intake so dramatically that they drop to a weight that's 85 percent or less of what it should be for their height, according to American Academy of Pediatrics' diagnostic criteria. Or, as they get older and more independent, they become bulimic, vomiting or using laxatives after eating an unusually large quantity of food in one sitting. Left unchecked, bulimia may cause serious digestive and dental problems, while anorexia can lead to brittle bones, an abnormally slow heart rate, and, in 10 percent of cases, death. In fact, the National Eating Disorders Association (NEDA) says that eating disorders have the highest fatality rate of any mental illness, including depression.

It's estimated that up to 10 million Americans have an eating disorder, according to the National Association of Anorexia Nervosa and Associated Disorders, but hard data on the prevalence of these conditions in children are scarce. The number of children under 12 who were hospitalized with eating disorders more than doubled between 1999 and 2006, the biggest increase for any age group, according to the Agency for Healthcare Research and Quality. "The typical onset of anorexia used to be 13 to 17 -- but now it's dropped to 9 to 13," says psychotherapist Abigail Natenshon, author of When Your Child Has an Eating Disorder, and director of Eating Disorders Specialists of Illinois, a clinic in Highland Park. And the very youngest patients are getting younger: "We're treating 6- and 7-year-olds with anorexia, and 11- and 12-year-olds with bulimia -- a problem that used to be almost nonexistent in children," says Ovidio Bermudez, M.D., medical director of child and adolescent services at the Eating Recovery Center, in Denver. "It baffles the mind." The pressure is also growing for boys, who make up 5 to 15 percent of anorexia and bulimia cases.

Unfortunately, these cases may be the tip of the iceberg. The number of children dieting or complaining about their body -- considered "gateway" behaviors to anorexia and bulimia -- is rising too, says Lynn Grefe, CEO of NEDA. "We're hearing about first- and second-graders who ask, 'Mommy, do I look fat in this?'" she says. "More children are displaying an unhealthy concern about food and body image. And parents are at a crossroads: They don't want their children to have eating disorders, but they don't want them to be overweight either."

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