National Children’s Mental Health Awareness Day: Children and Eating Disorders

National Children’s Mental Health Awareness Day is nationally sponsored by Substance Abuse and Mental Health Services Administration (SAMHSA) and takes place on May 4th 2017. This year’s theme is “Partnering for Health and Hope” and Olympic medalists, Michael Phelps and Allison Schmitt will be hosting this event in Washington D.C. This day will feature the importance of social, emotional, physical, behavioral and mental needs of children and young adults throughout the United States. According to the National Institute of Mental Health (NIH), approximately 20 percent of all children in the Unites States either currently, or at some point in their life, will be diagnosed with a mental health disorder. Common mental health disorders in children 8-15 years of age order of prevalence include the following: 

• Attention-Deficit Hyperactive Disorder (ADHD)
• Major depression and mood disorders
• Conduct disorder
• Anxiety disorders
• Eating disorders

Eating disorders in childhood

Although eating disorders are technically more common in adults, the average age of onset for anorexia nervosa, binge eating disorder and bulimia nervosa is 15 years of age and there are some specific eating disorders such as pica and ARFID that are more common in children than any other age group. Dieting in early childhood is becoming more and more common due to the peer pressure from society and the media that children as young as seven and nine years old are developing anorexia nervosa and bulimia nervosa. The messages about food and weight gain can be emotional and can even be linked to moral clauses, labeling food as either “good food” or “bad food”, potentially creating a perfectionistic outlook on food instead of a balanced outlook.

Pica: A childhood eating disorder

Pica is an eating disorder formally recognized by The American Psychiatric Association (APA) or The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as the persistent ingestion of non-nutritious substances for at least one month in duration at an age which this behavior is considered developmentally abnormal (at least two years of age). Common substances ingested in this disorder include ice, clay, lead, dirt, sand, stones, paint chips, coals, chalk, wood, light bulbs, needles, string, cigarette butts, and wire.  Pica is most commonly found in children however it is the most common eating disorder in individuals with developmental disabilities such as intellectual disability, autism and Asperger’s syndrome. Research suggests that pica occurs in 25-33% of young children and 20% of children seen in mental health clinics.

Avoidant-Restrictive Food Intake Disorder (ARFID)

Avoidant-Restrictive Food Intake Disorder commonly known as ARFID is an eating disorder characterized by the persistence refusal to eat specific foods or refusal to eat any type of food due to a negative response from to certain foods colors, texture or smell. Additionally individuals may refuse to eat out of fear of becoming sick or the fear of choking on food. This disorder is not characterized by the obsession with body shape or weight but rather is simply due to the disinterest and avoidance of foods. This disorder can result in excessive and unhealthy weight loss and malnutrition leading to the need for tube feeds or nutritional impairment. Oftentimes, psychosocial impairments result from this eating disorder as well. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM V), recognizes avoidant-restrictive food intake disorder as an eating disorder that is clinically distinct from both anorexia nervosa and bulimia nervosa. It most commonly occurs in children and was once considered a disorder of childhood and infancy but is now known to affect all ages.

Dieting in children

“Obesity” is on the rise and in an effort to curb this epidemic many healthcare professionals and parents alike, are using diets to encourage children to lose weight. Dieting can be dangerous because it can lead to an obsession with food, body weight and body image resulting in low-self esteem and a perfectionistic personality, which are both underlying factors for the development of children and eating disorders. Educating children on the importance of balanced meals and why we need food to nourish our body can give them a healthier outlook on food. Although it is important to cut out salty, sugary and fatty foods in children who have “obesity”, there is an art to doing this and always keeping in mind that cutting out unhealthy foods and replacing them with nourishing foods is all about balance.

Please note, the terms “obese” and “obesity” have been criticized as weight stigmatizing and imprecise. Although we use the terms to quote others’ work, “obese” and “obesity” are terms that Center For Discovery rejects.