Eating disorders and your child

Eating disorders and your child

Meghan Feehan, left, and Stephanie Levine
Meghan Feehan, left, and Stephanie Levine

An eating disorder is not easy or comfortable to talk about, but it is essential to know how to start a conversation with your child about this important topic.

Eating disorders are behavioral conditions characterized by severe and persistent disturbances in eating behaviors, according to Meghan Feehan, PsyD., and Stephanie Levine, DO with Atlantic Medical Group. Dr. Feehan said eating disorders are often coupled with distressing thoughts and emotions. Examples of eating disorders include anorexia nervosa, bulimia nervosa, and avoidant restrictive food intake disorder (ARFID).

Anyone can be affected by an eating disorder. There is a common misconception that eating disorders primarily affect affluent, white women, Dr. Feehan said. In fact, eating disorders cut across all socioeconomic and ethnic groups. Although women are affected at higher rates, all genders can develop these conditions.

It is essential for parents to know what to look for in their kids. During adolescence, children are going through changes and oftentimes parents may not notice something is wrong, Dr. Levine said. “If you have some suspicion talk to your pediatrician,” she said. “We are available if the pediatrician needs to call us. We have a doc-to-doc line. It’s a great resource.”

Dr. Feehan said the pandemic has driven an increase in the need for help with eating disorders.

“We have been inundated with requests for evaluations,” she said. “With these illnesses, there is a genetic predisposition. The kids we treat are high-achieving, perfectionist kids. They like predictability and certainty and right now, something that we don’t have. That is one of the reasons we have seen this marked increase.”

The following are some common questions regarding eating disorders:

How are eating disorders identified?

Dr. Levine said it is easier to physically identify patients with anorexia because they are more likely to present symptoms such as low weight. Other eating disorders, including bulimia, manifest in different ways, with both psychological and physical symptoms. She added that during adolescence, parents should be aware of unusual changes in the physical and mental health of their children. “It is really important that if you have some suspicion, the first step is to talk to your pediatrician,” Dr. Levine said. “Bring it up. Do not be afraid.”

What is ARFID and is the condition more prevalent in individuals who have food allergies, like celiac disease?

ARFID stands for avoidant restrictive food intake disorder. Individuals who are affected by ARFID experience significant weight loss or fail to make appropriate weight gains. Unlike other eating disorders that stem from an individual’s concerns about body image or fear of weight gain, people who suffer from ARFID have often experienced an adverse result from eating, Dr. Feehan explained.

For example, they may have choked or become nauseated when eating, and as a result, limit their intake to a very narrow group of foods to avoid a similar experience or discomfort. Sometimes, this avoidance is related to food allergies, especially if an individual has had a very negative reaction to a specific type of food.

What are signs and symptoms of anorexia?

Dr. Levine said that in addition to weight loss, behaviors that may indicate anorexia include not eating with the rest of the family, skipping meals, avoiding friends, isolation, and disengagement. Dr. Feehan added that if you suspect your child is experiencing symptoms of anorexia, based on your observations, it is important to be direct with your concerns. Tell them you are worried for their health and “rely on your parental gut” about your child’s reaction.

What is the time frame for recovery?

Dr. Levine noted that there are many medical consequences to having an eating disorder. Weight restoration is a small step on the journey to recovery. The process of recovery using family-based treatment typically takes between nine and 12 months. Dr. Feehan said it is important to note that the path to recovery is not always a straight line and there may be setbacks along the way.

“We say it’s like walking up a sand dune. For every couple steps up, you slide back a little bit.”

What should someone consider when choosing a doctor for an eating disorder?

Dr. Levine said it is important to find a specialist with experience. Explore your options, do research on different facilities and resources that are available, and ask questions that are specific to your circumstances.