Question: My tween daughter seems obsessed with weight and sometimes refuses to eat. Could she have an eating disorder?
Answer: It's unlikely that your daughter has a full-blown eating disorder, but she could have an eating disturbance, which could set the stage for future disorders. Full-fledged eating disorders are very rare in the preteen years; they tend to develop during the teen and early adult years. In fact, fewer than a half a percent of middle and high school students have either anorexia nervosa or bulimia nervosa. That said, some preteens do have eating disorders, and many are affected by precursors to eating disorders called eating disturbances.
One of the few studies to focus on preteens found that almost a quarter of 9 to 13-year-old girls said that their weight and shape affected their self-image. More disturbing, about 13 percent of the girls reported actively restricting their diet in the preceding month. A strong relationship exists between dieting and later development of an eating disorder, according to the researchers, making these findings alarming. Although most children who diet for weight loss purposes will not progress to a full-blown eating disorder, weight loss obsession and calorie restriction could be the start to unhealthy habits. Note that although boys suffer from eating disorders and eating disturbances less frequently than girls, boys are also at risk and their eating habits should be taken seriously.
So what can you do? Start by talking to your child about why she's restricting her eating. Sometimes just showing that you notice and care is enough to create change. You might also work on building her self-esteem, especially if her eating habits seem to center around self-image concerns. Also help your child understand the importance of good nutrition. Finally, make sure that you're being a good role model for her by eating a balanced diet, not obsessing over your own weight and portraying a healthy relationship with food. If her dietary restrictions begin to impair her everyday life and/or she begins to lose weight, contact her doctor. Since eating disorders can be life-threatening, it's better to err on the side of caution than to ignore a possible problem. Early intervention can make a big difference in heading off future issues.
Sources:
Ackard, D. M., Fulkerson, J., & Neumark-Sztainer, D. "Prevalence and utility of DSM-IV Eating Disorder Diagnostic Criteria Among Youth." International Journal of Eating Disorders 2007 40:409-417.
Colton, Patricia A., Olmsted, Marion P., & Rodin, Gary M. "Eating Disturbances in a School Population of Preteen Girls: Assessment and Screening." International Journal of Eating Disorders 2007 40:435-440.