It’s common for kids to be concerned about their looks—especially during the ‘tween and teen years. Unfortunately for a growing number of kids, that concern can grow into a weight obsession that can lead to serious physical and psychological complications. Eating disorders most commonly occur between the ages of 14 and 17 but may occur earlier or later. Females are affected most often, but males can be affected as well.

Warning signs of an eating disorder
•    Food clues: eating tiny portions, avoiding meals with other people, eating secretly or hiding food, refusing to eat, “not being hungry” at meal times, avoiding fat, sugar or meat, unusual food choices or cravings, unusual eating habits such as cutting food up into very tiny pieces, moving food around a lot on their plate, disappearing after eating, often to go to the bathroom.
•    Thought clues: like vocalization of intense fear of being or becoming fat, obsession about appearance and body or withdrawing from family or friends.
•    Activity clues: insisting on exercising every day,  feeling “stressed out” if a workout is missed, refusal to stop activity when injured and secretive exercise.
•    Physical cues: weight loss or frequent weight fluctuations, abdomen pain or bloating, irregular or loss of menstrual cycles, feeling cold much of the time, stress fractures or repetitive injuries.

It’s important to remember that eating disorders are caused by many factors. It also is very important for parents of children with eating disorders not to blame themselves. Families do not cause eating disorders, but they can help prevent them and are key to recovery if an eating disorder does develop.

What can parents do to help prevent eating disorders?
Model healthy eating behaviors at home.
•    Encourage family meal times. Research has shown that children in families who eat meals together most days of the week have better nutritional intake and a decreased risk for unhealthy weight control practices.
•    Offer balanced meals that incorporate whole grains, fruits and vegetables, proteins and heart healthy fats.
•    Replace sugary juices and soft drinks with low-fat milk and water.
•    Enjoy food. Desserts and other snacks are not bad when eaten in moderation.
Encourage an active but not overactive life style.
•    Make time for family walks, bike rides and active fun. 
•    Find activities your child enjoys.
•    Avoid over-programming your child in sporting events. Have them choose one sports team or activity at a time.
Avoid teasing about weight. Researchers have shown that kids who are teased about their weight are at higher risk for developing an eating disorder.
•    Become wise media watchers. Be aware of inappropriate messages about body image in the television shows your child watches.
•    Limit media use to one or two hours a day. Avoid putting a TV in your child’s bedroom.
•    Watch TV or look at magazines with your child and talk about what you are seeing.
•    Help your child appreciate and resist ways in which the media distorts the true diversity of human body types and imply “thinner is better.”

If you suspect your teen has an eating disorder, your pediatrician or family practice physician is a good judge of the physical symptoms and can call in specialists to help treat this serious disease. The Adolescent Health and Medicine Program at Children’s Hospital of Wisconsin specializes in assessment for eating disorders. For more information or to have your child evaluated, call Central Scheduling at (414) 607-5280.

An Eating Disorder Parent Support Group, hosted by the Adolescent Health Clinic, is open to any family of a child with an eating disorder. The group meets from 6 p.m. to 7 p.m. the first and third Tuesday of each month in the Adolescent Health Clinic, first floor, Children's Clinics Building connected to Children's Hospital in Wauwatosa. For more information call Pat Stoll, MSW, at (414) 266-2754.

Sarah J. Lerand, MD, is an adolescent medicine physician at Children’s Hospital of Wisconsin.

FAST FACT: The growing field of adolescent medicine specializes in caring for kids ages 10-21, with issues related to physical development, nutrition, body image and emotional well-being. Adolescent Medicine complements the care your pediatrician or physician provides. The team at Children’s Hospital of Wisconsin includes board-certified adolescent medicine physicians, nurses, a dietitian and social worker who work together to provide care in a team setting.