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
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
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
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
- brittle nails and hair
- feeling cold all the time
- weakness and fatigue
- dizziness
- dry skin
- lanugo, fine hair that appears all over the body
- constipation
- slow breathing and pulse
- non-arrival of puberty
- lack of physical growth expected at the child’s age
- frequent infections
- yellowing of the skin, which may be harder to see on darker skin tones
A child with anorexia nervosa may show signs of severe weight loss or lack of weight gain, but this
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:
- having a physical condition that requires dietary control, such as diabetes or celiac disease
- exposure to weight stigma, for instance, through family, peers, the media, modeling work, and certain sports
- being gay, lesbian, transgender, or in another sexual minority
- various mental health challenges, such as:
- an anxiety disorder
- obsessive-compulsive disorder (OCD)
being female
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
Anorexia nervosa can be difficult to diagnose in children. A pediatrician may consider it if the
- 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
- 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
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.
- The National Alliance for Eating Disorders, with a toll-free helpline on 866-662-1235
- Substance Abuse and Mental Health Services Administration (SAMHSA) for general mental health support on 1-800-662-4357 (or 1-800-487-4889 for TTY)
- The National Association of Anorexia Nervosa and Associated Disorders for a helpline, support, and information.
- F.E.A.S.T. to learn from others and share experiences.
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.