BENGALURU: Eating disorders in children? Does something like this exist? These are some of the questions and comments that keep arising very often. But unfortunately, eating disorders are a common issue in today’s world. Eating disorders (ED) are characterised by either excessive intake or by reduced intake of food owing to distorted body image of self.
The changing dietary trends coupled with the revolution of social media have brought a paradigm change in the thinking and perception about body image in the current generation, especially among children. The ‘self-image’ is distorted in the current ‘virtual’ internet world. The conflict has resulted in an enormous increase in eating disorder in children and adolescents of either gender. There is also a heightened awareness that the onset of such problems is often at a young age, specifically, in childhood or early adolescence.
According to the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) there are different types of eating disorders, namely:
Anorexia Nervosa is a restrictive form in which food intake is severely limited because of the fear of weight gain. In bulimia, binge-eating episodes are followed by attempts to minimise the effects of overeating via vomiting, catharsis, exercise or fasting. In binge eating, the child indulges in overeating without control, however it not followed by purging behaviours.
Eating disorders are associated with serious biological, psychological and sociological morbidity and significant mortality. They lead to various nutritional deficiencies viz calcium, vitamin D, folate, vitamin B12 and other minerals, leading to impairment of growth and development in children as well as adolescents. Eating disorders also lead to obesity and pubertal delay, particularly in adolescent females. Psychological issues in the form of anxiety, depression, social isolation, anger dysregulation, increased substance use, poor coping skills and increased risk of suicide are all associated with eating disorders.
Family members need to identify distorted eating habits and body image issues early in young individuals. Extreme concern about weight gain even when thin, recurrent episodes of binge, repetitive purging behaviours, in adequate growth and development, changes in behaviour and social isolation are all red flags to be watched out for by parents.
Further, any change in eating behaviours among children has to be evaluated
meticulously by an interdisciplinary team. A psychiatrist, physician, paediatrician, nutritional therapist, psychologist and other allied professionals with expertise in eating disorders will aid the patient in treating the illness.
Early recognition, appropriate treatment, empathetic understanding of the complex phenomenon in an individual’s milieu are all important factors that will aid the successful treatment of the condition.
Addressing or treating the condition is crucial; however the key would be to prevent the onset of the condition. Preventing eating disorder will require a comprehensive approach by the parents. Some of the strategies that they can adopt are:
-The author is a consultant psychiatrist, Narayana Multispeciality Hospital Whitefield