Flinders University research has identified the most common early warning signs of eating disorders in children, to provide a guide for parents and caregivers about when to seek help.
It's not always easy to recognise when a child has an eating disorder, but missing important warning signs and delays in diagnosis and intervention could make a difference between life or death.
While eating disorders can affect people of all ages and backgrounds, most are likely to take hold during adolescence and can quickly become serious and potentially life-threatening.
It is estimated that a third (31.6%) of Australian adolescents engage in disordered eating behaviours during any given year.
Eating disorder expert and lead author Dr Jamie-Lee Pennesi says more young children are being diagnosed with eating disorders than ever before, with parents typically reporting a delay between noticing any warning signs and seeking help.
"Spotting the early signs of an eating disorder in a child can be difficult, because it can start very innocently with subtle changes to their habits, such as changes in eating patterns, only eating certain foods, not finishing their meal, wearing baggy or oversized clothing, overexercising," says Dr Pennesi.
"If these behaviours aren't addressed, they can quickly develop into serious eating disorders, such as anorexia nervosa or bulimia nervosa.
"Until now, research in this area has been limited. Our new findings are valuable because they draw on the perspectives of parents and caregivers to identify distinct early warning signs of eating disorders in children.
"We want parents and caregivers to be able to recognise the early signs of eating disorders in children as early as possible and to act swiftly in seeking professional support."
The study, published in the International Journal of Eating Disorders, found the 10 most common early warning signs for an eating disorder in a child are:
- Excessive or compulsive exercise - such as exercising in secret (in the middle of the night or in their bedroom).
- Any obvious weight loss or gain.
- Obsession or preoccupation with food or food preparation.
- Cutting out major food groups such as carbohydrates or dairy.
- Secrecy or dishonesty around food or eating - such as reporting they have eaten elsewhere, or saying they have already eaten with a friend.
- Obsession or preoccupation with body image, weight, shape and size.
- Self-induced vomiting or making themselves sick, or signs of self-induced vomiting.
- Changes in bathroom habits - such as frequent visits to the bathroom after meals or eating.
- Skipping meals - such as avoiding food, mealtimes, or situations involving food.
- Rituals and rules about food and eating - such as eating food in a certain order, cutting food into tiny pieces, or a fixation on using the same crockery or cutlery.
Dr Pennesi encourages parents and caregivers with any concerns about their child's eating habits to seek professional advice.
"If parents spot any of the early warning signs, we'd encourage them to start having conversations about their concerns and ask their GP for an assessment," says Dr Pennesi.
Professor Tracey Wade, senior researcher at Flinders University's College of Education, Psychology and Social Work, says there are many reasons why parents may delay talking to their GP about their children's eating habits, including not recognising the early warning signs of an eating disorder, or understanding the potential severity of the situation.
"The good news is that most young people who are identified early in the development of an eating disorder, and who receive appropriate treatment, are reported to recover," says Professor Wade.
The research team is working on a new study and is looking for volunteers who have a child in primary school (aged 5-12 years) diagnosed with an eating disorder to take part in a brief online survey about children's eating habits and provide feedback on questions in the survey.
