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Eating disorders in childhood and adolescence - How to spot the early signs.

Did you know that Eating Disorders (ED) rank first in terms of mortality rate for mental health disorders?

ED have a very profound impact on the emotional, social, physical and mental levels of patients. Usually beginning in late adolescence / early adulthood, many signs of ED can appear earlier, for example in late childhood / early adolescence.

Indeed, in recent years, the rate of development of ED at an early age (below 12 years) has been on the rise. When not diagnosed in time, in this age group, besides the emotional impact that an ED may imply, there may be an irreversible physical impact, considering that this is an age group in which physical development represents a very important component of children and adolescents' existence.

Of note, the early signs of an ED can be quite subtle and easily mistaken for simple desires to conform to social / group rules. However, given the dangerousness associated with these disorders, it is critical that parents, caregivers and other educational agents be alert to some of the signs that may mark the development of an ED. It is not necessary for a child or adolescent to be focused on their weight or body image in order to suffer from an ED, nor do they need to meet all the criteria to benefit from appropriate intervention.

Some early signs to watch for are:

Behavioral signs

  • Aversion to certain textures and tastes (infancy);

  • "tantrums" (infancy);

  • reduction of food portions ingested;

  • excessive exercise;

  • unusual eating behaviors, such as cutting food into small pieces, insistence on using certain plates or cutlery to eat;

  • marked interest in cooking with refusal to consume what they make;

  • eating alone or in secret;

  • hiding or hoarding food;

  • shifting to wearing loose clothing;

  • using the bathroom immediately after meals;

  • eating in quantity without weight gain;

  • weighing themselves frequently;

  • social isolation;

Psychological signs:

  • mood swings;

  • marked fear of abdominal pain, "tummy" pain (childhood);

  • concern about body image;

  • constant appearance-based comparison and/or obsession with appearance of others;

  • marked stress at mealtimes;

  • insomnia;

Physical signs:

  • abdominal pain;

  • excessive bowel movements;

  • feeling cold;

  • tiredness;

  • marked weight loss or weight gain;

  • slowed growth;

  • hair loss;

  • delayed puberty;

  • constipation or digestion problems;

  • growth of fine body hair - "lanugo", especially on the back and shoulders;

  • dental problems;

  • bad breath;

  • lesions on the knuckles;

Contact your pediatrician, general practitioner, or mental health professional if you identify signs like those in the child/adolescent in your care. The age of detecting an ED and initiating intervention is a good predictor of treatment success and is associated with a good prognosis in terms of child or adolescent development and functioning.

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