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Eating Disorders: First With Kids - Vermont Children's Hospital, Fletcher Allen


Advice on Eating Disorders that’s Easy to Swallow

Parents have been feeding me lots of questions about eating disorders in their teenagers. Let me help everyone digest some information on this topic.

An eating disorder occurs when a teen experiences negative thoughts and feelings about their body weight and food, often as early as 11 to 13 years of age. While more common in girls, boys can be affected as well.

Two percent or so of teens will have an eating disorder. Anorexia nervosa, a fear of weight gain and distorted self-image of their body, is common. So is bulimia, which is characterized by binge eating and then purging via self-induced vomiting or use of laxatives.

What causes an eating disorder? It’s unclear but thought to be a combination of genetic factors, psychological stress or trauma, and social and family challenges. Sports that can emphasize a need to maintain a specific weight such as cheerleading, gymnastics, ballet, wrestling and skating can sometimes precipitate an eating disorder. The often too lean images of people conveyed by the media  can also contribute to this problem.

What are some warning signs that might point to an eating disorder? If your teen appears to be losing weight too quickly and is obsessed with food and what they can or cannot eat, then that might indicate an eating disorder—especially if behaviors like this are in combination with stepping onto a scale repeatedly. Also, exercising excessively, appearing to become more depressed and lethargic, and feeling cold a lot can all represent early signs and symptoms of anorexia. 

If your child makes excuses to go to the bathroom after meals, is very unhappy with their body size or shape, and is found to be buying laxatives, these could be early signs of bulimia.

Untreated eating disorders can become a medical emergency and result in dehydration, heart problems, kidney failure, malnutrition and even death.

If you suspect your child or teen has an eating disorder, the sooner you seek help from your child’s health care provider, the better. Many teens will deny they have this problem so rather than accuse them of having an eating disorder, tell them you are concerned about their losing weight and want them to see the doctor to put your own mind at ease.

Treatment involves medical care combined with nutritional counseling and psychological therapy, which often involves work the entire family needs to do to help their child overcome this problem. Occasionally, hospitalization is warranted if the problem is picked up late and malnutrition and other medical complications are detected.

The best way to deal with an eating disorder is not to let one happen so don’t focus, comment on, or criticize on your own size and shape in front of your children. Do what you can to create a healthy lifestyle and promote the development of positive self-esteem in your child. Point out the good things they do rather than constantly point out and criticize what they can do better.

Hopefully, tips like these will weigh well with you and your older child or teen when it comes to knowing more about what to do about an eating disorder.

Lewis First, M.D., is chief of Pediatrics at Vermont Children's Hospital at Fletcher Allen Health Care and chair of the Department of Pediatrics at the University of Vermont College of Medicine. You can also catch "First with Kids" weekly on WOKO 98.9FM and WPTZ Channel 5, or visit the First with Kids video archives at


  October 01, 2014