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The Perspective
The Perspective

February 5, 2016

The younger face of eating disorders

Dr. Seena Grewal, Associate Head, Eating Disorder Program; Medical Director of Acute Inpatient Day hospital and Emergency psychiatry (AIDE); Department of Psychiatry, Hospital for Sick Children, on behalf of the SickKids Centre for Brain & Mental Health.

It used to be a given that when you spoke of someone having an eating disorder you were referring to a teenager or young adult and most likely a female. It is an image that most people continue to believe represents eating disorders in the 21st century and, to be fair, one that fits with some of the risk factors for eating disorders. We know there is no one cause or risk factor for an eating disorder but rather a combination of factors such as genetics or family history, stressful life experiences or trauma, dieting, and being in environments that put pressure on having a certain look to be accepted or successful.

The teen years are definitely when those different factors can come together in a way that increases the chances of developing an eating disorder. The reality is, though, that the face of eating disorders in the 21st century has changed. Eating disorders don’t have “a type.”  It doesn’t matter what your ethnicity is, your gender, or your age. Of particular concern is the growing number of younger children who now need treatment for an eating disorder and even more concerning is that we don’t know why.

Data collected by the Eating Disorders Program at SickKids tells us that the number of young children presenting with eating disorders seen in 2008-2010 increased by 60 per cent in 2011-2013 and the number of children presenting to our Eating Disorders Program has continued to increase since then. To address this, in 2014 the Eating Disorders Program at SickKids launched a specialized clinic, called COPE –– Children’s Outpatient Program for Eating Disorders –– to treat patients under 13 years old.

We can make some educated guesses about what is contributing to this changing face of eating disorders. One possible contributor is that children are experiencing the pressures to be successful and accomplished much earlier and these pressures used to mainly be directed towards teens and adults. This increased pressure can lead to increased anxiety, which in turn, can be a risk for developing an eating disorder.

We also talk about food and weight a lot in today’s society and kids are listening. GMO-free, organic, gluten-free, low-carb, and low-fat are terms that swirl around them. I have had nine year olds tell me how they have been taught how to calculate the percent of calories from fat in food, even though they don’t know what to do with the information.

When a particular body image becomes a focus in the media –– whether it’s the thigh gap or the six pack ––  I know in a few months I will be hearing children tell me that’s what they want their body to look like. While I’m not suggesting that these messages cause eating disorders I do wonder why they have such power for these children, compared to the messages out there that promote being healthy and active regardless of your body shape.

Figuring out why something is happening is a tough job and risks a “blame game,” but in this case figuring out the why could aid us in determining how to help children feel better about themselves and how to reduce the risk of children developing an eating disorder.