You never talk about weight. You're careful never to mention "diet" in front of your daughter. You teach your son to do his best but never expect him to be perfect.
But even avoiding all the traps does not erase the possibility of an eating disorder.
There is no single cause: It's a perfect storm of environmental,
psychological, and biological factors that drive children as young as 8
to the edge of starvation and sometimes tragically beyond.
The best way to protect your child is to be alert for telltale behavior and move quickly when it's spotted. Daniel Le Grange, director of the Eating Disorders Program at the University of Chicago Medical Center,
urges parents to follow their gut instincts. "Too often physicians tell
parents that it may be just a phase, that they should wait and see what
happens," says Le Grange, who likens this to an oncologist who ignores
the earliest signs of cancer.
"Parents are nine times out of 10 spot on in their thinking that
something is amiss. The sooner you recognize and diagnose the disorder
the better the chances of recovery," Le Grange says. Here are 5 signs
your child may be at risk.
1. Weight loss or lack of expected gain.
For children at a healthy weight, loss of even 5 to 10 pounds warrants
concern. Indications of a looming problem, unfortunately, aren't always
as evident. One of the first signs that Harriet Brown, author of Brave Girl Eating: A Family's Struggle With Anorexia,
recognized was her 14-year-old daughter's failure to gain weight at her
annual checkup. Brown remembers asking, "Shouldn't she have gained
weight this year?" She doesn't blame the pediatrician for reassuring
her, but in retrospect she regrets not pushing harder. "We're all
trained to think doctors know best," she says. "I think there is a bias
right now in pediatrics to think that thinner is always better. A doctor
is much more inclined to be concerned about a child they feel is too
heavy than one they feel is too light."
2. Sudden change in eating habits. Most children change
how they eat over time without developing an eating disorder, but Le
Grange advises parents to watch for a meaningful change that seems out
of character—swearing off entire food groups like meat or carbohydrates,
say. Look for a child who rejects foods that used to be favorites,
skips meals (but insists she's not hungry), or continually leaves her
school lunch at home. New mealtime rituals that interfere with normal
eating may be worrisome: cutting food into tiny pieces, endlessly
chewing it, drowning it in ketchup, salt, and pepper to make it "taste
better" are a few examples.
3. Significantly increased exercise or activity. For
kids already on sports teams, overactivity is difficult to detect.
According to Le Grange, it's anything that goes above and beyond an
already busy schedule. At a young age, exercise should be for fun, not a
way to shed calories. If you catch your daughter doing 100 sit-ups or
push-ups in her room on days she has swim practice or dance class, she
may be tipping towards an exercise obsession.
4. Distorted body image. While "I'm so fat" comments
are all too common, especially from 'tweens and adolescent girls,
intervening before the thought becomes an obsession is important. How
often does she make disparaging comments about her body? How much time
does she spend in front of the mirror?
5. Anxiety. It often goes hand in hand with an eating disorder and may even make your child more likely to develop one. According to the American Journal of Psychiatry, two out of three adults with eating disorders struggled with anxiety
when they were children. These feelings may be the most obvious in
situations involving food, but Brown first noticed her daughter's angst
while on a bike ride. She writes in Brave Girl Eating that
about a half a mile into the ride, for no apparent reason, Kitty began
to cry hysterically. "It was the kind of thing we did all the time, and
suddenly there was a child so anxious she couldn't bike for five minutes
without falling apart," she says. In the days that followed she began
paying closer attention to her daughter's anxiety. It became clear rather quickly that it wasn't just a teenage mood
swing; obsessive thinking was infiltrating her daughter's everyday life.
"The bike ride was the day the red flag went up," says Brown. "I just
didn't know until later what it was signaling."