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It is common for youth to have mild eating problems such as overeating due to stress, keeping poor nutritional habits, and trying food fads. However, sometimes the urge to eat less or more spirals out of control. Children develop eating disorders when they become preoccupied with food and overly worried about their weight or shape. Often times, these youth use food and the control of food in an attempt to deal with emotions and feelings that seem over-whelming to them. Yet such behaviors can cause serious physical and emotional damage, harming the youth’s self-esteem and sense of ability and control.

Children may experience one of three types of eating disorders:

  • Anorexia Nervosa: extreme thinness and refusal to keep a healthy weight
  • Bulimia Nervosa: eating large amounts of food in a small time (bingeing), followed by efforts to not gain weight (purging behaviors such as vomiting or using laxatives)
  • Binge-Eating Disorder: loss of control with eating (bingeing without purging)

The causes of eating disorders are not exactly known, but are thought to be a mix of psychological (e.g., low self-esteem, lack of control in life, emotional problems), interpersonal (e.g., troubled relationships, history of being teased about weight, difficulty expressing emotion, history of abuse), social (e.g., cultural pressures to be thin), and biological (e.g., brain differences, eating disorders running in families) factors. Parents who notice signs of eating problems should ask their child’s pediatrician for a referral to a child and adolescent psychiatrist. Eating disorders are serious and can quickly become life-threatening without early treatment.



Children with Anorexia Nervosa may show some of the following signs:

  • Belief that they are fat despite being extremely skinny
  • Strong fear of gaining weight
  • Extremely picky eating (e.g., very small portions of certain foods)
  • Perfectionistic and high achieving
  • Physical signs: dry skin, weak hair and nails, growth of fine hairs all over the body, feeling cold or tired all the time, low blood pressure and pulse, constipation, muscle weakness, and no menstrual periods in girls
  • Other behaviors: extreme dieting or exercise, less social, irritable, moody or depressed

Children with Bulimia Nervosa may show some of the following signs:

  • Usually normal or slightly overweight, go up and down in weight
  • Strong fear of gaining weight and unhappy with their body
  • Often eat large amounts of food with a feeling of no control (binging)
  • Attempts to lose weight by extreme dieting or exercising, vomiting, using laxatives, or not eating (purging), which is often done secretly due to feeling disgust or shame
  • Physical signs: sore throat, swollen glands in neck, tooth decay, stomach problems, and dehydration

Children with Binge-Eating Disorder show signs of binging found in Bulimia Nervosa, but do not purge and are often overweight.



  • Eating disorders usually appear during teen years, but can also start in childhood
  • As many as 1 in 10 girls suffer from an eating disorder
  • Although girls are more likely to experience eating problems, boys can also suffer from the same challenges
  • Children with eating disorders often have other problems such as depression, anxiety, or drug and alcohol abuse
  • Long term risks include damage to the heart and brain, organ failure, inability to get pregnant, and heart attack.
  • People with Anorexia Nervosa are 18 times more likely to die early



  • Childhood obesity has become an ever increasing issue on our islands. In this video, Dr. David Janicke, Associate Professor in the Department of Clinical and Health Psychology at the University of Florida, makes it easy for parents to identify childhood obesity and how parents can positively contribute to their child’s treatment. This video also touches upon the physical and psychological risks of childhood obesity and highlights simple changes parents can make that greatly improve their child’s treatment outcomes. Please click here to watch the video.


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