Anorexia nervosa in children

Children with anorexia are obsessed with their body weight and often are afraid of gaining weight. Children’s Health℠ is home to an expert team that specializes in helping children and teens overcome anorexia and other eating disorders. We create a treatment and counseling plan that’s tailored to your child’s – and your family’s – needs, so you can get back to leading healthy, happy lives.

What is anorexia nervosa in children?

Children with anorexia typically eat very little and severely limit the types of food they eat. They may also limit the types and quantity of fluids they drink. Usually they are below normal weight and very thin for their age. But many children with eating disorders also have a normal body weight.

Eating disorders like anorexia start in the brain. The disorder affects how a child thinks and behaves toward food. For example, a child with anorexia may believe they are overweight, even though they are actually normal weight or even underweight.

What are the signs and symptoms of anorexia nervosa in children?

Children and teens with anorexia often take extreme measures to lose weight. Talk to your pediatrician and consider taking your child to a psychiatrist who treats eating disorders.

Symptoms may include:

  • Extreme thinness
  • Distorted view of body shape and weight, such as denying how thin they are
  • Extra concern about weight and body image
  • Losing weight quickly or in large amounts
  • Frequent and intense exercise
  • Constant dieting and avoiding many foods or entire food groups
  • Following very strict rules and habits around eating
  • Often moving food around on their plate without eating
  • Withdrawing from family meals or social events that involve eating around other people
  • Frequently going to the bathroom right after meals (which could mean they are making themselves throw up their food)
  • Delayed puberty or girls stopping their period

If anorexia is not treated, children can become very undernourished and develop serious health problems.

These include:

  • Anemia (iron deficiency)
  • Brain damage
  • Brittle hair, nails and bones
  • Constant fatigue
  • Constipation
  • Depression and confusion
  • Dry, blotchy or yellow skin
  • Dry mouth
  • Low blood pressure or slowed breathing
  • Organ failure
  • Weakness and signs of muscle loss

How is anorexia nervosa in children diagnosed?

Only medical professionals can properly diagnose anorexia. They do this by gathering information about your child’s health and behavior through interviews, tests and exams.

These may include:

  • Blood tests such as a complete blood count (CBC), which measure certain substances in the blood to check for disease
  • Electrolyte tests, to see whether your child’s body has enough calcium, potassium and other minerals that it needs
  • An electrocardiogram (ECG), which measures how well your child’s heart is working
  • Tests of the liver and kidneys, which can be damaged from not getting enough nutrients
  • A bone density test, which is an X-ray that shows whether your child’s bones have become weak and unhealthy

What causes anorexia nervosa in children?

A child is anorexic because of the way their brain is affected by a lack of food and starvation. This makes them unable to accurately interpret information about their own body and its size.

Many factors play a role in making this happen. These include genetics, stress and social and cultural pressures to have a certain type of body. Children do not choose to be anorexic. And they don’t become anorexic because of your parenting choices.

How is anorexia nervosa in children treated?

At Children’s Health, all questions about anorexia treatments are reviewed by a licensed professional counselor and a physician specializing in the treatment of eating disorders.

Recommendations for care are based on each child’s symptoms and are made after careful review by a psychiatrist and therapists. Some children are treated in outpatient care and some benefit from staying in the hospital until the eating disorder is under control. This is usually because they also have other health problems, such as malnutrition or depressionWe create a treatment plan based on each child’s individual needs.

Treatment may include:

  • A combination of individual, group and family therapy to help your child develop healthier eating behaviors
  • Art, music and recreation therapy to teach children and adolescents new ways to cope with stress
  • Nutritional counseling with a dietitian, who can help you and your child develop plans for healthy eating
  • Medical treatment to help restore the right balance of nutrients to your child’s body
  • Medication to help with depression or anxiety, if needed, so your child is better equipped to address their eating disorder

Anorexia nervosa doctors and providers

Our team specializes in treating eating disorders in children and teens, including boys and children under age 12. We work with you and other family members as one team, dedicated to giving your child the care they need.

Frequently Asked Questions

  • How do you talk to children about eating disorders?

    Remember that eating disorders affect a person’s brain. That means someone with anorexia doesn’t see themselves as you do. Avoid being judgmental or overbearing. Simply bring up your concerns and ask how you can help. Offer to accompany the child to see a specialist for more information.

  • What’s the difference between anorexia and bulimia?

    Children with anorexia are almost always underweight. They often stop themselves from gaining weight by eating only small amounts of food and exercising excessively.

    Children with bulimia follow a pattern of binge eating and then doing something like vomiting to prevent weight gain. They are usually average weight. Some children with anorexia may also engage in bulimic behavior.

  • Can boys and men get anorexia?

    Yes. Anorexia is more common in girls and women, but it affects boys and men as well.

  • Can my child take medication to treat anorexia?

    Some medications can help children with anorexia manage symptoms of depression and anxiety. But medication won’t directly improve your child’s eating disorder. To properly treat anorexia, your child will need therapy and nutrition counseling. Some medications may cause serious side effects in children and teens. Talk to your child’s doctor about what is best for your child.

  • Do parents cause anorexia?

    No. Anorexia is a problem in the brain, not a result of poor parenting. It has many complex causes, and it affects children and adolescents from all types of families.

  • Can counseling help children with anorexia?

    Yes. Individual, group and family counseling can all be beneficial. Counseling can help children understand how anorexia changes their thoughts and perspective. Children also learn to set goals and develop skills that help them overcome the unhealthy eating and exercise behaviors that have become routine.

  • Why involve the family in anorexia treatment?

    Families are essential to helping children with anorexia get better. Your child needs your help to follow through on meal plans and other things that are important for their recovery. Your child also needs to feel safe and supported as they deal with the fears and struggles associated with their disorder. Have compassion for your child, and make sure everyone in the family is committed to helping. If one of you is critical or working against your child’s treatment, it can make it hard for them to improve.