Eating disorders occur most often in young adolescents and teens; however, young children can develop eating disorders as well. Healthcare professionals are seeing a disturbing trend of children as young as age 5 developing eating disorders. While these eating disturbances often seem similar to the anorexia nervosa and bulimia, most commonly found in young teen girls, those occurring at a very young age often have other causes.

Types

Food Refusal

With this disorder, children use food refusal as a means of manipulation. The behavior is often erratic and inconsistent. While this tactic is certainly frustrating for parents, it is sometimes associated with a recent source of stress or sadness and is not usually thought of as a threat to health.

Restrictive Eating

With restrictive eating, very young children eat a variety of foods, but clearly restrict portions. The underlying causes of this disorder remain unclear and although children exhibiting restrictive eating habits may have low weight or growth for their age, they generally eat a balanced diet, albeit portion restricted, causing medical staff to consider them healthy in most cases. As with most eating disturbances in very young children, restrictive eating seems to have no basis in a preoccupation with body image and weight.

Selective Eating

Selective eating disorder syndrome can begin as early as infancy and can mimic the common picky eating habits of many infants and toddlers. Children exhibiting picky eating behavior usually overcome their aversion to other foods relatively quickly before any nutritional threat is imminent. Those with selective eating disorder only eat foods from very narrow categories, often those high in simple carbohydrates.

Recognizing the symptoms of selective eating and taking steps to mitigate negative nutritional and psychological consequences can stop the child from developing a full-blown disorder that threatens health and well-being. Children with true selective eating disorder have an aversion to certain food textures and smells. They associate the texture, odor, or both with a traumatic incident, which they now associate with food. When coaxed to try the food group associated with the event, they often gag, cough, or choke. This disorder is often associated with an underlying psychological condition involving anxiety or autism.

Food Avoidance Emotional Disorder

Children can exhibit symptoms of food avoidance emotional disorder (FAED) very early in life. With this disorder, children can be as thin or thinner than those with untreated anorexia nervosa. The difference being that these children often feel shame at their thin bodies and know that their eating habits are irrational. Symptoms are closely related to  obsessive-compulsive disorder. Many times, children with this disorder do not know exactly why they cannot overcome their eating issues, but desperately want to eat like their peers. They are often plagued with intense worry, sadness, and anxiety. Untreated, atypical eating disorders, such as FAED, can result in profound health and social issues for the child.

Causes

Eating disorders in very young children can often mirror those of adolescents and teens with anorexia nervosa or bulimia, but generally manifest themselves much differently in the mind of the child patient. Anorexics and bulimics usually have profound body image and self-esteem issues because of their emotional stresses. Very young children with eating disorders do not have body image concerns. They exhibit no fear of becoming overweight. These children often have a first or second degree relative with an eating disorder, which indicates a genetic factor in the disease. Many have anxiety disorders and fear of separation from their primary parent (usually their mother). Other contributing factors include perfectionism, inability to effectively cope with daily stresses, and depression marked by tearfulness.

Treatments

Eating disorders in pre-pubescent children are new to prominence in the medical community. Consequently, specific treatments have not been established, but possible treatment options can be administered by a  pediatric physician or psychiatrist. Concerned parents can stay informed and involved by keeping regular appointments with their child’s pediatrician. Those who strongly suspect the onset of an eating disorder in their prepubescent child should bring the child in for evaluation by a pediatric psychiatrist. The psychiatric physician may prescribe medication to attenuate the underlying anxiety or obsessive-compulsive condition thought to cause the child difficulty. Both individual and family therapy may benefit the family unit and the child specifically.