Eating Disorders

Eating disorders are psychiatric illnesses characterized by serious disturbances in the child’s or adolescent’s eating behaviors, body perception, and thoughts related to weight control. The most common types include Anorexia Nervosa (excessive restrictive eating and extreme thinness due to fear of gaining weight), Bulimia Nervosa (recurrent binge eating episodes followed by compensatory behaviors), Binge Eating Disorder, and Avoidant/Restrictive Food Intake Disorder (ARFID). Eating disorders in children and adolescents have been increasing in recent years; they are seen 10 times more frequently in girls than in boys, especially during adolescence.

Children and adolescents with eating disorders are usually excessively preoccupied with body weight and shape. In anorexia nervosa, excessive fear of gaining weight, distortion in body perception, and extreme efforts to lose weight (dieting, excessive exercise, use of laxatives or diuretics) are prominent. In bulimia nervosa, the person eats large amounts of food uncontrollably and then engages in compensatory behaviors such as vomiting, excessive exercise, or fasting. These disorders negatively affect growth and development in children and can lead to serious physical problems such as menstrual irregularities, osteoporosis, heart rhythm disorders, and electrolyte imbalances. In addition, psychiatric conditions such as depression, anxiety disorders, obsessive-compulsive disorder, and substance use frequently accompany them.

Risk factors include genetic predisposition, family history of eating disorder, perfectionism, low self-esteem, societal pressures related to body image, early childhood trauma, stressful life events, dieting behavior, and involvement in activities where body weight is important such as sports or dance. Diagnosis requires detailed history, physical examination, laboratory tests, and psychiatric evaluation. Diagnosing in children and adolescents can sometimes be difficult because the symptoms may overlap with normal changes during the growth period.

The most effective approach in treatment is Family-Based Treatment. Especially in anorexia nervosa, the family’s active participation in reorganizing the child’s nutrition is the primary goal. Cognitive Behavioral Therapy (CBT), nutritional counseling, individual psychotherapy, and hospitalization when necessary are among the treatment options. Medication treatment is generally used supportively in cases accompanied by depression or anxiety disorders. Early diagnosis and treatment are very important; because delay can lead to chronicity, organ damage, and even increased risk of death.

Protective factors include healthy body image, balanced eating habits, strong family support, positive self-perception, stress management skills, awareness against social media and societal pressures, and early intervention. Every child and adolescent suspected of having an eating disorder should be referred to a child and adolescent mental health specialist without delay, as this is of vital importance.