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Bayli Bond

Professor Reynolds

English 1201

2 May 2021

How Do Childhood Eating Disorders Affect Development?

Eating disorders are profoundly serious conditions that can have terrible side effects.

Many eating disorders emerge in early adolescence. These deadly disorders are all conditions

that can have detrimental physical and mental side effects on the children and teens who have

them. Despite these scary odds, there are preventive measures that can be used by physicians and

parents to help these children. Family Based Treatment or (FBT) is the best form of care for

adolescents with these illnesses. Although, if eating disorders are not addressed and not treated

promptly, they can severely impact children's growth and normal body development and can

leave them with mental issues into adulthood.

Eating disorders can come in many diverse types and forms. The list of these illnesses is

constantly growing, but the popular forms include Bulimia nervosa, Anorexia nervosa, Binge

Eating Disorder, (BED), and Avoidant Restrictive Food Intake Disorder (ARFID). Since the first

documented case of an adolescent with an eating disorder 300 years ago, researchers have

refined the criteria for these illnesses. Doctors Laurie Hornberger and Margo Lane are pediatric

physicians who contributed to an article describing how to identify eating disorders in children.

Their article reveals that while some of these diagnoses have been around since the beginning,

there have not always been as many. A once popular diagnosis, EDNOS (eating disorder not

otherwise specified), has been removed from the extensive list of disorders. Healthcare providers

are discovering and recognizing specific characteristics within this previous umbrella term.

Renaming these findings created new diagnoses such as binge eating disorder (BED) and the
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new addition, avoidant/restrictive intake disorder (ARFID). This disorder is common in younger

children (Hornberger and Lane).

What causes these disorders? While there is no direct cause, there are several risk factors

that come into account. Some disorders can start out as a teenager just wanting to “eat healthy”

or a “picky eater” who will not eat their vegetables. Researchers have identified several risk

factors that eating disorders precede from. General risk factors for most psychiatric conditions

can contain stressful life situations, abuse, and poor parenting. These are also common amongst

eating disordered patients. Although according to Anja Hilbert, there are specific factors that can

trigger this kind of eating. Professor Hilbert explains that dietary restrictions, increased concern

about one’s body shape and family related eating habits can all provoke eating disorders (Hilbert

et al.). Contrary to widespread belief, the number of teens who “choose” to have an eating

disorder is small.

Poverty and food insecurity has also been shown to be linked to the development of

eating disorders. Not having immediate access to nutritious food can lead children and teens to

engage in disordered eating habits in fear of not knowing where their next meal will come from.

An article published by Obesity Research and Clinical Practice describes the habits that result

from being raised in a “food insecure” household. The study found that when compared to food-

secure groups, parents of the food-insecure children reported higher rates of excessive binge-

eating and hiding of food. 1-in-6 children suffer from food insecurity in the United States. Due to

this high rate and the decreased availability of resources, many children are not able to control

the onset of a serious illness like BED.

Other risk factors for eating disorders in children and teenagers can stem within their own

families and social lives. As dietary trends and social media get increasingly popular, these can

take a significant toll on how these adolescents view themselves. Young people are constantly
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being shown what the perfect body is by American standards, which could lead them to change

their own body to fit the perfect image, even if it is already healthy.

Dissatisfaction with body image is closely followed by low self-esteem. Low self-esteem is

known to be prevalent in the start of eating disorders, depression, and many other mental

disorders. (Ferreiro) Research has found that the rate of body dissatisfaction is higher in obese

teenagers. There is a definitive difference by gender, as the dissatisfaction among teenage girls is

experienced of half of their population, compared to boys at a quarter of theirs. (Golden et al.) If

an outside influence tells them that they are overweight, teens can often associate this with being

“ugly” leading to a deeper body dissatisfaction.

Some research suggests a link between other mental disorders and the onset of disordered

eating. Further analysis has emerged that has made a connection between ADHD and or “loss of

control eating” (LOC-E) diagnosed children and the advancement of eating disordered behavior.

Children with these conditions were given a delay of gratification task in a study done explained

by Simone Munsch and other collogues. The delay of gratification task is usually conducted by

presenting a child with an object and leaving the room, but only after presenting them with an

ultimatum. The task includes telling the child they can interact/act with the object now for

satisfaction, or wait until the adult comes back to interact, where they will receive a better

reward. In this study, the children were given snacks. Concluding the trial, participants were then

asked if they were worried about losing control of eating. The dual diagnosed and ADHD

diagnosed children were found to be worried the most about losing control (Munsch, Simone, et

al.). This behavior can relate to disordered eating in that many adolescents are afraid they will

“lose their food or control to eat on impulse.” This can lead them to “restrict or binge

excessively” (Munsch, Simone, et al.).

Eating disorders are also related to OCD in some cases. Fugen Neziroglu and Jonathan

Sandler for the International OCD Foundation explain that research suggests a higher percentage

of OCD among patients with a diagnosed eating disorder, as much as 11% – 69%. The

percentage for the development of disordered eating with pre-existing OCD is a 10% – 17%

(Neziroglu and Sandler). If a child or teen has Obsessive Compulsive Disorder, they could be at

risk for developing disordered eating, according to the evidence provided. Many of these

conditions revolve around the control and obsession over the food that is consumed daily. These

habits could lead to uncontrollable urges that could stem into OCD as children and teenagers

grow up, leaving them with more mental complications from the disorder than usual. Obsessive

behaviors that can stem from eating disorders can involve constant weighing or counting

calories, which can be difficult to get rid of even after treatment.

These illnesses may not seem like a major issue amongst children, but it is common for

them to occur during this period of growth. Following obesity and asthma, eating disorders take

the third spot amidst the top chronic conditions affecting adolescents. (Golden et al.) With these

chronic conditions, comes an extensive list of side effects. These can include physical

appearance such as early dental erosion, hair thinning, brittle nails and yellowing of the skin.

Eating disorders spare no organ within their destruction of the body. (Paediatrics & child health)

Orthostasis, constipation, depression, dehydration, and delayed executive functioning within the

brain are also quite common side effects. These can result in life-threatening situation for any

adolescents who endure these illnesses (Hornberger and Lane).

The side effects of eating disorders do not only effect children and teens as they occur.

These conditions can affect development in several ways. Pubertal delay and growth retardation

can occur as a child’s eating disorder progresses or goes without treatment. (Paediatrics & child

health) This could leave adolescents with abnormal height or weight differences throughout
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adulthood. A study found that “The impairment of bone mineral acquisition may occur at

subclinical levels of eating disorders...” (Paediatrics & child health) Further research indicated

that bone mass was more difficult to acquire in some patients later in life. (Paediatrics & child

health) Along with the physical complications, children could potentially always have a

nontypical relationship with eating and food. Eating disorders have prolonged ramifications on

mental health as well, such as a development of depression, anxiety, and other psychological

disorders. These may require more extensive treatment.

Specific long-term effects can accompany distinct types of eating disorders. For example,

anorexia nervosa has been shown to provide sufferers with many complications later in life as

adults. Childhood anorexia has been shown to reduce fertility and increase the chance of

unplanned pregnancy in women (Meczekalski, et al.). Those with anorexia nervosa are also

reported to have an increased risk of anemia, which is a lack of healthy red blood cells. BMD or

bone mineral density has also been revealed to severely diminished in women with a history of

anorexia. This can lead to spontaneous fractures and breaks. The risk of these injuries can be

increased up to seven-fold depending on the severity of the illness (Meczekalski, et al.) and can

only get worse with time.

Binge eating disorder is another serious condition that can have serious side effects that

adolescents with this disorder can develop as they grow older. This type of eating disorder can

lead to obesity in children, as well as several other fatal problems. This serious weight gain can

also carry the risk of Type 2 diabetes, which is believed to be a key complication of obesity in

children (Golden et al.). BED can also elicit high blood pressure and high cholesterol, in addition

to arthritis and other bone development issues (Better Health). Among the physical effects of

binge eating disorder, the psychological problems associated with this health issue in adolescents

can include “depression, poor self-esteem, and poor quality of life” (Golden et al.)
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Despite the physical evidence, there are many misconceptions about eating disorders and

the symptoms that accompany them. Some might argue that eating disorders only affect women,

that sufferers must be underweight, and social media is not as an influential cause of children

developing them as they seem. The fact remains that men and teen boys are prevalent victims in

this area of illness, and they can be at even greater risk of the complications following. In

“Anorexia in Men and Boys: Treatment and Statistics,” the American Addiction Centers

illustrates the vital facts about how seriously males can be impacted by these diseases. Amongst

the research by the organization, a poll conducted by the National Eating Disorders Association

was cited. This survey revealed a shocking statistic of males who used damaging methods to lose

weight, a number totaling 33 percent. Due to the ongoing stigma regarding men and eating

disorders, they are less likely to seek out treatment in fear of not being taken seriously, or the

lack of awareness when it comes to these behaviors. Men are also more likely to be fatally

affected by eating disorders, according to several studies. (NEDA).

Eating disorders such as anorexia nervosa are associated with a variety of visuals and

assumptions of a skinny or underweight body. Further research indicate that this is not always

the case. In a study by the University of Melbourne, multiple patients diagnosed with anorexia

were assessed regarding their current weight status and the severity of their condition. In the

study, it was discovered that regardless of weight upon evaluation, the diagnosis was consistent

with other physical and psychological symptoms that the patient presented. A low resting heart

rate, and a total weight loss over a recent period was found to be a key indicator of the disease.

(Whitelaw) The evidence that comes out of this study suggests that anyone can have the

cognitive behaviors and symptoms of a life-threatening disorder such as anorexia, even if they

appear to be a healthy or an even overweight individual.

Social media is known to be a beneficial way to connect with others and advocate for

prominent issues. As children grow up and are exposed to more media, this can deeply affect

their view on themselves and what is normal, especially with several platforms that are focused

on pictures and fitness. Several studies have evaluated this connection. In a related publishing by

Paediatrics & Child Health, the relationship between children’s body image and social media

was put under assessment. This allowed researchers to gauge the influence this type of media has

on children and teens perception of a healthy weight and beauty. As mentioned earlier, a teen’s

unhappiness with their body is highly linked with the development of an eating disorder. Social

media worsens this symptom. The analysis of the study revealed that when female teens were

shown images of models varying in size, their body dissatisfaction was increased after looking at

the thinner examples. Children and teenagers are more likely to be influenced by what they see

in the media, as they have a decreased ability to distinguish between what is and is not real.

Parents can prevent this by being open with their children on how the media can alter the view of

a “healthy” body and provide education on the methods the media uses to target children.

Thankfully, many lifelong developmental effects of eating disorders can be stopped using

treatment. One of the best forms of this is FBT or “Family Based Treatment.” In the initial

treatment of eating disorders, the family and parents were usually made at fault for the

development of their child’s eating disorder. Research has shown that this is false. Many

adolescents with these illnesses have no desire or motivation to get better. (Eating Disorder

Therapy LA). Blaming the parents for their child’s lack of interest in treatment in recovery does

not reflect on the parenting the child is given. Many parents are not always aware their child has

an eating disorder at first. With FBT, a specific regimen is followed, and provides families with

ways to work around the child’s avoidant behavior. In “Treatment of Adolescent Eating

Disorders: Progress and Challenges” John Lock reports that when using FBT, that 80-90%
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patients with anorexia nervosa demonstrated “good to excellent progress” as an outcome of using

this treatment. When compared to other forms of treatment, the family-based option benefits the

individual and the family, rather than making the patient conquer recovery all on their own.

If FBT does not seem like the right fit, there are several options available for families

seeking help for their child. Many types of therapy are offered and can be coupled with hospital

stays. Inpatient programs are available for children or teens that mostly show life-threatening

symptoms as it is used in only serious situations (NEDA). This treatment requires hospitalization

and constant monitoring to ensure the patients safety. These programs mostly include constant

group and individual therapy sessions. Partial programs can also be considered if the adolescent's

eating disorder impacts their daily functioning and eating behaviors (NEDA) This treatment is

less intensive as it requires less time in the hospital and there is no immediate risk to the patient.

Other techniques of psychotherapy are effective among adults but less effective among children

and adolescents. Enhanced Cognitive Behavioral Therapy is an example. This therapy was solely

created for eating disorders and is devoted to establishing a stable eating routine and dealing with

the roots of what is triggering the disorder (Columbus Park).

Apart from the inevitable effects of these conditions, there are some preventive measures

that can be taken without professional treatment being involved. Laurie Hornberger and Margo

Lane suggest, “focusing on healthy habits with patients and families” as physicians can

implement a positive outlook for families. Diminishing the amount of “weight talk” and dialogue

about dieting can also drastically change the mindset children will have about food and weight as

taught by their parents and pediatricians. Parents provide their child with steady nutritional meals

and encourage a healthy relationship with food. It is shown that if this behavior is consistent,

these healthy habits can stick with their child up to 5 years into adulthood (Golden et al.). Parents

who suspect their child has an eating disorder can prevent a potentially fatal illness by
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communicating with their child and a healthcare professional. The sooner parents can stop or

treat the behaviors, the better chance a child will be able to able fully recover.

In conclusion, eating disorders have a endless list of long- and short-term side effects on

children and teenagers. Pre-existing mental disorders and behaviors can influence then onset of

these illnesses and must be taken into consideration when deciphering risk factors. Severe

cardiovascular, skeletal, and mental complications can be caused by eating disorders in

adolescents, not to mention stunted growth and pubertal delay. Family Based Treatment is shown

to be the most effective at treating patients with an eating disorder such as anorexia nervosa.

Preventive measures that involve healthy family eating habits and parental education about

weight talk in the home can significantly reduce a child’s risk at developing one of these

illnesses. It is especially important to address a suspected eating disorder in a child before it is

too late.

Works Cited

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