Eating disorders among children are on the rise in the US, according to research cited in the December issue of Pediatrics.
Between 1999 and 2006, hospitalizations for eating disorders jumped by 119 percent, according to the report, with some of the steepest increases occurring in boys and minorities.
Severe cases of anorexia and bulimia have risen, as well as \”partial-syndrome\” eating disorders — young people who have some, but not all, of the symptoms of an eating disorder.
Athletes and performers, including dancers and models, may be particularly at risk.
The report suggests not only an increase in prevalence, in general, but also significant increases among populations that were rarely associated with eating disorders in the past — including boys, elementary school-age children, people of color and those among lower socioeconomic backgrounds.
The stereotypical patient: a white, affluent, adolescent female may have never been accurate, but now it’s clear that we can toss the old image out the window. Eating disorders are equal-opportunity problems.
While an estimated 0.5 percent of adolescent girls in the United States have anorexia and about 1 to 2 percent have bulimia, experts estimate that up to 14 percent of Americans, in general, have at least some of the physical and psychological symptoms of an eating disorder, according to the report.
Boys now represent about 5 to 10 percent of those with eating disorders, although some research suggests that number may be even higher, said Lisa Lilenfeld, incoming president of the Eating Disorders Coalition for Research, Policy and Action in Washington, D.C.
Most studies that have been focused on prevalence were based on patients in treatment centers, who tended to be white females, Lilenfeld said. \”That does not represent all of those who are suffering,\” she said.
It\’s hard to know if eating disorders are on the rise in males, or if we\’re just doing a better job of detecting it.
While much is unknown about what triggers these conditions, experts now understand it takes more than the ever-present media images of waifish models, although that\’s not to say those don\’t play a role. Most young women are exposed to the same media influences, but only a small percentage of them develop eating disorders.
Like other mental health problems and addictions, ranging from depression to anxiety disorder to alcoholism, family and twin studies have shown that eating disorders can run in families, indicating a strong genetic component.
At the same time eating disorders have risen, the obesity epidemic has also exploded. Concerns about overweight and obese children have prompted some physicians to counsel their young patients about nutrition. That\’s an approach that can backfire when not handled correctly, however. A significant number of kids trace the origins of their eating disorder to their family doctor telling them “You could stand to lose a few pounds.\”
Physicians need to make sure conversations are not inadvertently hurtful or impact their young patients’ self esteem. For people who are genetically vulnerable, dieting itself is a risk factor for eating disorders, while strict dieting is even a bigger risk, Lilenfeld said.
The message kids get from physicians, teachers, parents and other influential adults should consistently relate to health and wellness and not body shape or the distorted definition of beauty perpetuated in fashion magazines and in Hollywood.
Parents and pediatricians should look for signs of eating disorders, including a child whose progress on growth charts suddenly changes, very restrictive eating, compulsive over-exercising, making concerning statements about body image, vomiting, disappearing after meals or use of laxatives and diet pills.
Eating disorders, especially anorexia, can have long-term consequences for health, including leading to early osteoporosis and death.
The good news is that with proper treatment and maturity, kids can successfully move beyond their eating disorder and fully recover.
\”We know the sooner they get some evidence-based treatments, the better the outcome,\” Lilenfeld said.
Notes: Eating disorders are real, treatable medical illnesses with complex underlying psychological and biological causes. They frequently co-exist with other psychiatric disorders such as depression, substance abuse, or anxiety disorders. People with eating disorders also can suffer from numerous other physical health complications, such as heart conditions or kidney failure, which can lead to death.
The two main types of eating disorders are anorexia nervosa and bulimia nervosa. A third category is \”eating disorders not otherwise specified (EDNOS),\” which includes several variations of eating disorders. Most of these disorders are similar to anorexia or bulimia but with slightly different characteristics. Binge-eating disorder, which has received increasing research and media attention in recent years, is one type of EDNOS.
Read “10 Things Parents Can to Help Prevent Eating Disorders” from the National Eating Disorders Association.