When food becomes the enemy: Spotting, addressing eating disorders in children

Scary fact: Many factors relating to eating disorders have little to do with food or eating, according to Dr. Jeremy Barnes, professor of health promotion at Southeast Missouri State University.

"There are several psychological factors, including low self-esteem, feelings of inadequacy or lack of control in life, depression, anxiety, anger, stress or loneliness," he explains. "There are many interpersonal factors, including troubled personal relationships, difficulty expressing emotions and feelings, a history of being teased or made fun of based on size or weight, and sometimes there is a history of physical or sexual abuse. Most experts feel cultural pressures that glorify thinness or muscularity and the pursuit of the 'perfect body' also play a role."

Anorexia nervosa, bulimia nervosa and binge eating are the most common eating disorders, but Barnes says there are many others, including body image disorders and food phobias. Pressure to maintain a certain weight or body type for sports like wrestling can lead to eating disorders in girls as well as boys, adds Shannon Anderson, licensed professional counselor, national certified counselor and owner and clinical director of Tender Hearts Child Therapy Center.

People with eating disorders are secretive about their habits, but parents can watch for some symptoms in their children:

* An obsession with weight and food -- "Your child seems to spend a lot of time worrying about calories, fat grams, their weight and being thin," says Barnes.

* Exercising all the time, or talking about exercising more in order to compensate for eating too much

* Avoiding family meal time

* Eating alone

* Unusual eating habits, like cutting food into tiny pieces and moving it around the plate instead of eating it

* Wearing baggy clothes to hide body and shape

* Spending a lot of time in the bathroom, especially after meals: "Often they will run water into a sink or turn the shower on to hide the noise of their purging," says Barnes.

* Taking laxatives or diet pills

* Anxiety, depression, mood swings

* Perfectionist tendencies

* Rapid weight loss

Eating disorders are serious and potentially life-threatening, says Barnes, and parents need to address worrisome behaviors with their children. Be honest, caring and supportive in your discussion.

"You may want to share examples of specific times when you felt concerned about their eating or exercise behaviors," says Barnes. "Explain that you think these things may indicate that there could be a problem that needs professional attention."

It's likely to be a sensitive subject for your child, and he or she may be unwilling to discuss it with you, says Anderson. A counselor, therapist, nutritionist or doctor with knowledge of eating disorders can help identify what's behind the disorder and work with you and your child to overcome it.

Barnes and Anderson agree that positive body image and leading by example should be a focus even before an eating disorder comes into play.

"Parents should take a look at their own views and beliefs about body image and any casual things they might be saying to unknowingly perpetuate the problem," says Anderson.

Encourage children to focus on inner qualities rather than outward appearance. Help them recognize that every person is unique, and that includes a unique body.

"Urge them not to talk about food, weight, diets or people's body shapes. Focus instead on people's strengths and qualities," says Barnes. "Try and focus on the fact that some people are talented musically, others athletically, others may be funny, other good at science or math. Everyone has talents. It is important to get (children) to understand that their value is not based on their physical appearance."