Parenthood, by its very nature, opens the floodgates of attention to issues and responsibilities you may never consider otherwise. Car seats, potty-training schedules, childproofing everything in your home, monitoring social media activity – the list grows as your child grows. So don’t despair of your parenting skills if “researching eating disorder behaviors” doesn’t top your list of things to do today. 

You expect a learning curve to your child’s developing palate – a certain amount of finickiness and food-throwing en route to finding favorites. You may even wonder how your child grows at all, given how little seems to make it down the hatch.

As your child starts to develop a sense of self, especially in the context of family dynamics and social influences, new issues arise. And the topic of eating disorder behaviors becomes relevant.

Eating disorders present in different ways and can be serious. They don’t discriminate based on age, gender, cultural background, or social media use.

If you think you have your child pegged – the “good” child, the smart child, the popular child, etc. – be forewarned. Eating disorders can find any child, teen, or adult, and for any number of reasons.

So it’s imperative that you take this topic seriously. You teach your child how to safely cross the street, how to drive, and how to recognize stranger-danger. You even deliberate about having “the talk” to help your sexually developing child make informed, wise, and safe choices.

The topic of eating disorders and is no less important.

In fact, eating disorder behaviors can be deadly, whether by their own physiological/medical consequences or by suicide. Think that sounds crazy? Read about anorexia nervosa and its link to suicide here. 

Eating disorders are serious. And, even if your child never develops one, your ability to recognize and talk about the signs is crucial. 

You will plant the seed of awareness in your child’s mind. And you may even help your child save another child from going down the dangerous path of eating disorders.

Let’s discuss eating disorder behaviors every parent should be able to recognize as the red flags they may be.

There are 6 main categories of eating disorders:

1. Anorexia nervosa (AN)
2. Bulimia nervosa (BN)
3. Binge eating disorder (BED)
4. Avoidant restrictive food intake disorder (ARFID; AR)
5. Otherwise specified feeding eating Disorder (OSFED: O)
6. Unspecified feeding or eating disorder (UFED: U)

The three eating disorder diagnoses of anorexia nervosa, bulimia nervosa, and binge eating disorder will be addressed in more detail in this article. 

Before that, however…

A note about OSFED and UFED:

A person must present with symptoms similar to other eating disorders but not meet the full criteria (e.g. of AN, BN, BED) in order to be diagnosed with OSFED  or UFED.

THESE EATING DISORDERS ARE NO LESS SERIOUS than any other eating disorder. 

Examples of OSFED and UFED:

• A person eats a ‘normal’ amount of food (i.e. does not binge or restrict) and uses laxatives or self-induced vomiting to affect weight or shape.
• Night eating syndrome: When a person wakes up during the night to eat after already having eaten dinner. The behavior isn’t better explained by social or cultural norms or the environment. 

• Someone who meets anorexia criteria except for significant weight loss. The person’s weight might be within or above the “normal” range.
• Binge eating disorder (of low frequency and/or limited duration): When a person meets all the criteria for BED, but binges happen less frequently than expected or have been happening for under three months.
• Bulimia nervosa (of low frequency and/or limited duration): When a person has all the symptoms of bulimia, but the binge eating and subsequent purging occur less often and/or for less than three months.

Below are 16 general eating disorder behaviors that every parent should recognize, followed by the relevant disorder(s) abbreviated in parentheses:

1. Counting calories and refusing to eat food without knowing the calories (AN).
2. Eating food in a specific sequence (AN).
3. Preoccupation with food, such as baking for everyone but not partaking (AN).
4. Reluctance to eat with other people (AN, BN).
5. Consuming lots of gum, diet soda, and coffee instead of food (AN, BN).
6. Eating very slowly (AN, AR).
7. Cutting food into tiny pieces (AN).
8. Pushing food around the plate (AN, AR).
9. Secretly disposing of food during meals (AN, AR, BN).
10. Physical changes, including weight loss or gain, hair loss, frequently feeling cold, and loss of menses (AN).
11. Hiding food (AN, BN, BED).
12. Food disappearing in the house (AN, BN, BED).
13. Thoughts or statements about being fat and/or ugly (AN, BN, BED).
14. Spending an excessive amount of time in front of mirrors or deliberately avoiding them (AN, BN).
15. Increased anxiety around food.
16. Frequent use of body-weight scale. 

Beyond the general signs of eating disorders, there are also signs that tend to pertain specifically to one of the three primary disorders. These are listed below.

Anorexia nervosa symptoms:

• Distorted body image: perception and belief that body size is larger than it is.
• Fanatical exercise: exercising despite injury, in unsafe environments, and/or when ill.
• Hair loss, dry skin, brittle nails, lanugo (fine downy hair on jawline and arms).
• Cold intolerance.
• Unstable or low pulse.
• Preference to stand rather than sit.

Bulimia nervosa symptoms:

• Leaving the table frequently during meals to go to the bathroom.
• Water running in the bathroom to hide sounds of vomiting.
• Disappearing to the bathroom after eating.

Binge eating disorder symptoms:

• Hidden package wrappers in the bedroom.
• Extremes in eating behavior, such as strictly limiting intake or having “Last Supper” experiences, often on Sunday nights.
• Planning to “start again” (strict dieting) at some designated time (tomorrow, Monday, the first of the month).

Next Steps

You may find the following steps helpful if you think your child is showing signs of eating disorder behaviors.

If you suspect your child is developing an eating disorder (or may already have one), communicate  your concern. Ask your child what support would be helpful from you. 

If your child doesn’t want to talk to you, encourage them to open up to another person that they trust, such as another family member or a teacher. Let them know that you’re there to listen and support them.

Take your child seriously, even though  it can be difficult to understand why someone with an eating disorder is engaging in certain behaviors. Some issues around food may seem silly but could be a major source of distress for your child. 

No matter what, avoid being critical. Validating your child’s feelings can go a long way.

Learn about eating disorders. Not only will doing so help you understand your child’s behavior, but it will also help you spot warning signs. And, just as importantly, it lets your child know that you care and are there to help.

And please: Stop the body and food talk. Dieting and weight are frequent topics of conversation —  on social media, in schools, in the workplace… among children, teens, and adults. 

Steer conversations away from Diet Culture and toward just about anything else.

You know your child best. If there’s something that just doesn’t seem right, consult  your child’s pediatrician. (Not all pediatricians, however, have adequate training in identifying and treating eating disorders.)

Your best bet is to seek information and referrals through an organization such as the National Eating Disorder Association NEDA;  (https://www.nationaleatingdisorders.org) or the Multiservice Eating Disorder Association MEDA; (https://www.medainc.org).

Elayne Daniels, PhD is an international coach and private-practice clinical psychologist specializing in eating disorder recovery, body image, and helping Highly Sensitive People thrive. Contact her here. To read more of her blog articles, go here.