11/30/2010 01:19 am ET Updated May 25, 2011

Eating Disorders: Identifying Warning Signs in Children

In Western society, we have relative freedom of choice when it comes to thoughts and action. Yet the prevalence of eating disorders continues to climb, and the percentage of young people partaking in destructive behaviours is reaching disturbing proportions.

Today an ABC news article highlighted a recent report from the American Academy of Pediatrics which warns doctors that eating disorders are happening to children at an alarming rate.

"People tend to have this idea of who gets eating disorders, but an eating disorder doesn't discriminate between age, gender, race, or class," says Johanna Kandel, founder and director of the Alliance for Eating Disorders Awareness, based in Florida.

"Some research says that as much as ten percent of those with eating disorders are under the age of ten. What I'm finding at the alliance is that the number of parents seeking help for their 7-, 8-, 9-year-olds is escalating rapidly," she says.

The articles goes on to mention how a 2009 analysis found that in the last decade, hospitalizations for eating disorders more than doubled among children under twelve and now account for four percent of all such hospitalizations.

"Pediatricians need to be aware of the early symptoms of eating disorders because they are the medical professional that a child is mostly likely to see in any given year," says Dr. Jim Lock, director of the Eating Disorder Program at Packard Children's Hospital. "They are the gatekeepers."

In a recent media interview, I was asked whether it is my personal belief that negative body image in children is perpetuated by images portrayed in the media. I believe young girls and boys are susceptible to falling into disordered eating patterns if they are suffering low self esteem, and a common trigger is images of extreme thinness.

The average child in the UK, US and Australia sees between 20,000 and 40,000 television advertisements per year. They are bombarded with images about how they should look and what they should own. Children struggle to keep up, suffering from anxiety, stress and lower satisfaction in themselves. (1)

In Australia, societal pressure is taking its toll on our young people. More than two thirds of 15 year old girls are on a diet (2) and a quarter of children diagnosed with anorexia nervosa are boys (3).

Now more than ever, it is important that parents and caregivers become aware of the early warning signs and observe their child's behaviour around food.

Here are five tips that will help you identify if your child is developing an eating issue:

1. Eat with your child as often as you can so that you become familiar with their eating habits; lead by example in terms of eating a healthy, balanced meal.
2. Watch for changes in your child's eating habits, especially anything that appears unusually strict and lasts for several weeks.
3. Listen to the language your child uses around food. If they start talking about diets, calorific content or complain that they are fat (when they're not) this indicates a negative shift in their feelings towards food.
4. Watch for a change in disposition. If your child displays hostility around meal times they could be experiencing internal conflict towards food.
5. If your child eats large amounts of food constantly but doesn't realise how much they are eating, or isn't enjoying it, especially during times of stress, this could indicate obsessive eating.

In my book Why Can't I Look the Way I Want; Overcoming Eating Issues, there is a chapter dedicated to the early warning signs. These signs are subtle and can be passed off as 'normal' behaviour - unless you know what to look for. Some common warning signs are avoiding eating with the family or in public, becoming obsessed with food preparation, adopting a tag such as 'vegan' in order to cut out entire food groups under the guise of being 'healthy', ritualistic behaviour such as cutting food into tiny pieces, insisting that meals are eaten at a particular time each day and a fixation on using the same crockery and cutlery.

There are also warning signs before the warning signs. If your child is constantly complaining of headaches or fatigue and appears to have trouble coping at school, this could indicate that something deeper is going on. It is worth finding out what is causing this change in your child in the event there is a psychological issue that needs to be addressed.

Whilst images in the media can heighten our children's anxiety when it comes to self image and body image, becoming vigilant about the early warning signs means there is a very real chance of catching the behaviour early on. Early intervention is critical in reframing the mindset before a full blown eating disorder takes hold.

(1) Williams, Z 2006, The Commercialisation of Children, Compass, London
(2) Patton, G.C., Selzer, R., Coffey, C.,Carlin J.B. and Wolfe, R. (1999), 'Onset of adolescent eating disorders: population based cohort study over 3 years', British Medical Journal, vol. 318, pp. 765-8
(3) Paxton, S. (1998), 'Do men get eating disorders?', Everybody - Newsletter of Body Image and Health Inc., vol. 2, August, p. 41