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How can eating disorders be diagnosedin a young child?

Asked by Julie, Inkom, Idaho

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Is there a way to diagnose eating disorders in small children? When should a parent be concerned?

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Living Well Expert Dr. Jennifer Shu Pediatrician,
Children's Medical Group

Expert answer

Eating disorders are most common in teenagers and young adults, however, they can also occur in younger children. To help answer your question, I consulted Sari Fine Shepphird, Ph.D., a clinical psychologist and author of "100 Questions and Answers about Anorexia Nervosa."

Dr. Shepphird reports that although the majority of new cases of anorexia are diagnosed between the ages of 13 and 18, about 10 percent of patients with eating disorders show an onset of their symptoms before age 10, and eating disorders have been reported in children as young as 5. Recent studies show that it is increasingly common for young children to be on a diet and to express a fear of gaining weight and that even young kids may engage in unhealthy and potentially harmful diet behaviors such as excessive exercise, fasting and making themselves throw up.

While an otherwise healthy child's "picky eating" is likely just a phase that will go away, there are many signs that can signal a potential concern. These include the unhealthy behaviors listed above as well as unexpected changes in weight, a preoccupation with one's weight and "feeling fat," hoarding food and persistent refusal of all but a few types of food.

Certain feeding disorders of early childhood can look very similar to eating disorders, so it is essential to get an accurate diagnosis. Common feeding disorders in children according to Dr. Shepphird include pica (eating non-nutritive substances such as dirt, clay, paper or chalk), rumination disorder (regurgitating partially digested food before re-chewing the food or spitting it out), and failure to thrive (not growing and gaining weight at the rate expected for a child's age).

Parents who are concerned about nutrition, growth or a possible eating disorder in their child should consult with their pediatrician for an evaluation and further information or treatment if necessary.

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