Anorexia nervosa is a serious mental health condition that involves changes in eating habits, among other symptoms. It can start in childhood.

Anorexia nervosa usually affects people in their teenage years and early 20s. Pediatric anorexia nervosa occurs before the age of 18 years. Early onset anorexia nervosa appears before a child is 14 years old. Both males and females can develop it.

In this article, learn more about how anorexia nervosa can affect children and the options for addressing it.

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A child with anorexia nervosa avoids consuming or digesting food. They may fear gaining weight or being overweight, but, at its root, anorexia nervosa is a mental health condition. The child does not choose to avoid food. They do it because they are unwell.

“Anorexia” is a medical term meaning a loss of appetite or desire to eat. In anorexia nervosa, a person stops eating because of a mental health challenge.

People with anorexia nervosa may avoid food in one of two ways.

In the restricting type, individuals limit their food intake by not eating. In the bulimic type, the person purges food they have already eaten to prevent their body from digesting it.

The person may feel hungry or wish to eat food, but they feel an overwhelming need to overcome this desire.

Anorexia nervosa often occurs in childhood, before a person is 18 years old. It commonly appears between the ages of 13 and 19 years. However, it can develop from age 10 years or younger. Before age 14 years, it is called early onset anorexia nervosa.

Anorexia nervosa can be particularly harmful for children, as their minds and bodies are still developing. The lack of a nutritious diet can lead to long-term health problems.

A child with anorexia nervosa may:

  • think or talk a lot about weight, dieting, and food
  • refuse to eat, avoid food, or say they are not hungry
  • believe they are overweight despite evidence to the contrary
  • have a distorted body image, known as body dysmorphia
  • exercise excessively
  • withdraw from friends and social activities
  • use laxatives or vomit frequently
  • appear sad, anxious, or depressed
  • be unaware that their relationship with food is problematic

Limiting food intake can lead to nutritional deficiencies.

In children, these deficiencies can lead to:

A child with anorexia nervosa may show signs of severe weight loss or lack of weight gain, but this does not always happen. People with atypical anorexia nervosa have the same disorder, but their weight is within the “normal” or “overweight” range. This is likely because the person had significant overweight when the eating disorder and weight loss began.

Experts do not know precisely what causes anorexia nervosa, but it may stem from a combination of genetic and familial, social, psychological, and biological factors.

Factors that may increase the risk include:

Still, anorexia nervosa can affect people of any:

  • sex or gender
  • socioeconomic background
  • race or ethnicity

Those who feel a lack of social acceptance due to weight stigma, sexuality, race, or other factors may be more at risk.

Anorexia nervosa can be difficult to diagnose in children. A pediatrician may consider it if the following criteria are present:

  • restricted energy intake, leading to a body weight lower than expected for the child’s age and sex
  • intense fear of gaining weight
  • disturbed perception by the individual of their body weight and size
  • excessive influence of body shape and size on the individual’s sense of self-worth

However, these criteria do not tell the whole story, and doctors sometimes miss a diagnosis. For this reason, experts also recommend:

  • assessing the child’s nutritional status, for instance, with blood tests
  • measuring blood pressure and heart rate
  • involving other experts, such as a psychologist

Various factors can also mask the condition. For instance:

  • During adolescence, people typically seek to take control of their lives, including their appearance and diet.
  • The developmental years can also be a time of emotional upheaval, regardless of mental health status.
  • Some restrictive behaviors and habits of autistic people can also resemble those of an eating disorder. Some people say there may be a link between autism and anorexia nervosa.
  • A low body weight may not occur in people with atypical anorexia nervosa.
  • Some children may meet the criteria occasionally but not all the time.

In males, the doctor may also consider a link with the use of body-building steroids or other substances.

Treatment for anorexia nervosa in children may include:

  • psychotherapy and counseling
  • family therapy
  • nutrition therapy to help the body accept and maintain an intake of nutritious foods
  • medication for depression, anxiety, and other issues
  • treatments to address complications such as heart failure

A child may need to spend time in the hospital, where they will receive intensive treatment. This may include supplements and forced or compulsory feeding.

Effective treatment helps many people, but many need ongoing support due to a risk of relapse.

Anorexia nervosa can have a range of complications, particularly in children.

They include:

  • a lack of pubertal development or loss of menstruation, which can lead to infertility
  • constipation
  • slow growth
  • cardiovascular issues, including heart failure, irregular heart rate, and low blood pressure
  • kidney problems, especially if the person is not taking enough fluids
  • ongoing mental health challenges, including depression and a risk of suicide
  • dangerously low blood sugar
  • seizures

The physical and mental toll of this disease can be life threatening without treatment.

It can be challenging to raise the issue of anorexia nervosa with a young person.

They may not realize they have a problem. They may be embarrassed to talk about their weight or eating habits or resent what they see as another person’s interference. They may also fear treatment will cause them to gain weight.

For tips on how to start, see our article: How to help someone with anorexia nervosa.

Needing more support?

If a person has any concerns about a loved one’s eating habits or mental health, they can contact one of the following. These organizations can help decide if it is time to seek medical help and, if so, how to get loved ones to agree.

A child with anorexia nervosa restricts their calorie intake either by avoiding food or purging it. It often affects teens but can start from a much younger age.

Anorexia nervosa is a complex condition that affects a person both mentally and physically. It can lead to life threatening complications without treatment.

It can be hard to raise concerns with a person who is showing signs of anorexia nervosa.

If a person is concerned about a loved one’s eating habits, they should speak with a pediatrician or one of several free helplines for more help.