PREVENTION AND DIAGNOSIS OF EATING DISORDERS IN CHILDREN

After some conversations with parents about behavior issues of their children related to food, we’ve asked our collaborator Mª Victoria Sánchez López, specialist in Clinical Psychology some questions in order to publish a post on the topic. Again it is a pleasure to welcome her on-board and out some light in this complex issue.

What should parents and teachers know about eating disorders in children?

There are many ways in which a child or adolescent may express discomfort, one of which are alterations in eating behavior. Understanding eating habits as a reflection of the person’s emotional needs and mental state, we can understand there’s a very close relationship between eating and mood.

It is important to keep in mind that there are disorders that involve all aspects of the person, from the individual: self-image and capacity to know one’s needs, to the relational: family, educational, social and community context. Thus, they can be conceptualized as an alteration in the way we relate to ourselves and to others.

Among the individual factors associated we find puberty (insecurity regarding physical and psychic changes), first sexual contacts, perfectionism, impulsiveness, body dissatisfaction, criticism about the body, social isolation, lack of assertiveness and low self-esteem, emotional instability, separations and losses and vital events.

From a social point of view, advertising and the media promote, for the most part, extremely thin bodies and figures that, through repetition, end up becoming ideals of beauty.Its influence is even greater in the minors as they are in a more vulnerable group, since their personality image and values are being conformed. They can get to a level of self-demanding and unreachable perfectionism associated with a high level of personal dissatisfaction.

On the other hand, we must not forget the relationship between gender and food since being a woman implies a different social requirement in relation to the body image.

• There are family characteristics associated with the occurrence of Eating Disorders; among them we find: Lack of communication – Low conflict resolution – Over-protection – Stiffness or mixing of family roles – Excessive concern of parents about the image – Having relatives with affective disorder, addictions or eating disorders
• In many cases there is a relationship between binge and stress, as a dysfunctional way of managing anxiety

Taking a deeper analysis, beyond the relation of these disorders with the physical aspect, it is necessary to bear in mind that children are especially vulnerable to this type of issues, since on the one hand they do not have so many tools to manage the stress, and many times they haven’t developed a critical attitude towards the dominant esthetic values, which can have an impact on their self-confidence.

It is the responsibility of the adults around them to generate a secure attachment that allows them to manage criticism without harming their self-concept.If tranquility, security and personal value, are surrounding a child, the impact of social judgments will be much less.

However, given the fact that a minor is exposed to continuous criticism and demands, in a social climate of cult to the body, and does not have a support on the part of the adults in his/her surroundings, the repercussion in his/her identity will surely lead to an associated emotional disorder. 

WARNING SIGNS

There are different indicators that may indicate that a child has an eating disorder. These indicators should alert adults so that they can value it and seek the necessary solutions, should the alarm be justified.

• Physical Signs: Weight loss of unknown origin. Normal growth failure for the age and weight.• Medical complications from abusive physical exercise.• In women, menstruation irregularities and / or amenorrhea. • Osteoporosis.• Hirsutism or lanugo.• Parotid hypertrophy. • Dental anomalies.• Calluses on the knuckles of the hands.
• Behavioral signs: Disappearing after meals and lock his/her-self in the bathroom • Increasing interest in gastronomic themes, clothes and fashion• Tendency to hide certain parts of the body with clothing. • Avoidance of concrete food on a frequent basis. Social isolation.• Increase of “useful” activities and hours of study.
• Psychological signs: Obsession with weight and figure. Severe distortion of body image.• Perfectionism and dissatisfaction.. • Emotional instability. • Low self-esteem.• Impulsiveness.

GUIDE FOR PARENTS AND TEACHERS

• There are a number of issues that can make it easier for children to feel better with themselves, we can underline: – Love and unconditional trust for the development of a secure attachment – have spaces of leisure and enjoyment, sharing – being available to listen to them about their concerns, to be able to speak naturally not judging them.Be a reference for them.- help them develop the critical sense with the aesthetic values prevailing: advertising and media – contribute to boost personal initiative and creativity when facing problems – to promote autonomy and assertiveness to maintain their opinion and values in the face of group pressure – to promote social and vocational skills: to consolidate values that favor the knowledge and acceptance of one’s own body and of others, personal freedom, responsibility, self-esteem , Tolerance, equality, respect for differences, solidarity, justice, critical spirit, peaceful resolution of personal, family and social conflicts, and maturity.- Secure family environment: not over-protection, neither rigid rules nor high expectations – help the children to detect their needs – facilitate emotional expression, through verbal and nonverbal means (ex: playing, arts & crafts …) – emotional regulation: impulsiveness, tolerance to frustration (ex: mindfulness)

When to ask for professional help?

If the school or family environment a problem is found in the child’s eating behavior, it is important not to let the time go by and ask for help as soon as possible.Anorexia or bulimia are not just eating problems, but related to the way the child values and perceives his/her-self and to the way they are facing life, and it is necessary that a clinical psychologist can assess the need for a psycho-therapeutic intervention.

Psycho-therapeutic treatment, from a trusting relationship, will allow a space for listening, helping the child and the family to express themselves, to put in words and think about what is happening, to elaborate and to understand in order to be able to relax self-demand and perfectionism, to reduce the associated symptomatology, and improve individual and family well-being.

Author: Mª Victoria Sánchez López, Psychologist. Specialist in Clinical Psychology.