Researchers say children between 8 and 12 years old can display restrictive eating behaviors signaling eating disorders before puberty.
The researchers, from the University of Montreal in Canada and the CHU Sainte-Justine children's hospital, presented their findings this week at the Eating Disorders Association of Canada conference in Vancouver.
Led by Prof. Dominique Meilleur, a clinical psychologist, the research questions how eating disorders develop and are diagnosed, as she explains:
"Many researchers believe that bulimia only appears at adolescence, but our studies indicate that the problem can arise much earlier. It is possible that it is currently under-diagnosed due to a lack of awareness and investigation."
According to the National Institute of Mental Health (NIMH), an eating disorder is defined as an illness that causes significant disturbances to an individual's everyday diet. This can include eating very small amounts of food or severely overeating.
The organization notes that increasingly, researchers are finding that eating disorders arise as a result of interactions between genetic, biological, behavioral, psychological and social factors. Additionally, eating disorders often occur alongside other illnesses such as depression, substance abuse or anxiety disorders.
Being mocked or bullied served as trigger to eating problems
To conduct their studies, Prof. Meilleur and colleagues studied the psychological, sociodemographic and physiological characteristics of 215 children between the ages of 8 and 12 with eating problems.
Fast facts about eating disorders
- Common eating disorders include anorexia nervosa, bulimia nervosa and binge-eating disorder
- Eating disorders may begin by just eating smaller or larger amounts of food but can spiral out of control with the urge to eat less or more
- People with anorexia nervosa are 18 times more likely to die early compared with people of similar age in the general population.
Children were excluded if they had physical issues that could cause eating problems, such as diabetes or cystic fibrosis. The children in the study often suffered from anxiety, mood disorders and attention deficiency, the researchers noted.
The team found that 95% of the children had restrictive eating behaviors, 69.4% were afraid of putting on weight and 46.6% described themselves as "fat."
"These behaviors reflect the clinical presentations we observe in adolescents and support findings that body image is a preoccupation for some children as early as elementary school," says Prof. Meilleur.
Additionally, the study revealed that around 15.5% of the children occasionally made themselves vomit and 13.3% had bulimic behaviors. "These results are very concerning," adds Prof. Meilleur, "but they may help clinicians reach a diagnosis earlier by enabling them to investigate these aspects."
Of the children, 52% had been hospitalized at least once as a results of their eating problem, and 48% had been treated as outpatients. The researchers add that psychiatric issues were also present in the families of 36.3% of the children.
"Many factors are associated with the development and persistence of eating disorders," says Prof. Meilleur. "For some children, bullying can initiate or reinforce body image preoccupations and possibly lead to a change in eating behavior."
Of the children in the study, 22.7% reported being mocked or insulted for their appearance, which they identified as a trigger for modifying their eating behaviors.
Eating disorders are not just a 'girl problem'
Although eating disorders are typically ascribed to females, the study found that boys in the same age group were similar to the girls in most cases, with the exception being a link with social isolation, which the researchers say was greater and lengthier for boys.
According to the NIMH, some boys with eating disorders display symptoms similar to those seen in females, while others may have muscle dysmorphia - an extreme concern with becoming more muscular.
Unlike girls with eating disorders who typically want to lose weight, some boys with muscle dysmorphia want to gain weight or bulk up, leading to steroid use in some cases. The organization notes that males are less likely to be diagnosed with what is often considered a female disorder and says "more research is needed to understand the unique features of these disorders among males."
Prof. Meilleur concludes:
"The profound similarity between boys and girls supports, in our opinion, the hypothesis that common psychological and physical factors linked, amongst other things, to the developmental period, are involved in the development of an eating disorder."
Medical News Today recently reported on a study that suggested distorted positive emotions about weight loss fuel anorexia nervosa.