Many people have heard of eating disorders but are not aware of how dangerous they can be. Eating disorders are the third most common chronic illness in adolescents, behind asthma and diabetes. They affect people of all age, socioeconomic, racial, ethnic, and gender groups.

We know that these illnesses are on the rise, especially following the COVID-19 pandemic. Additionally, as a field, we continue to improve our ability to recognize eating disorders when they occur, which is reflected in the growing numbers of people being diagnosed over time. Eating disorder onset can occur earlier than many people think, with children as young as five or six reporting eating disordered thoughts. Among children, the average age of onset is in late childhood or early adolescence, but eating disorders can occur in all age groups.

What is an eating disorder?

The term “eating disorder” encompasses a family of psychiatric illnesses characterized by abnormal eating patterns that result in physical and/or emotional dysfunction over time. Children can experience any type of eating disorder. Common eating disorders include anorexia nervosa, bulimia nervosa and binge eating disorder—however, other eating disorders (avoidant restrictive food intake disorder and unspecified feeding or eating disorder) also exist.

Anorexia nervosa

Anorexia nervosa is characterized by a hyper-focus on eating as little food as possible and includes a profound fear of gaining weight.

Bulimia nervosa

Bulimia nervosa includes cycles of eating large amounts of food followed by purging (which could include vomiting, over-exercise, or use of pills or supplements to prompt elimination of food from the body).

Binge eating disorder

With binge eating disorder, a person may eat a large amount of food in a short amount of time, with a sense that they have no control over their eating. Some people may even eat well past the point of being full.

Eating disorder symptoms

It’s vital that caregivers and other child/adolescent support-people—teachers, coaches, clergy, etc.—know the signs of eating disorders and the high prevalence among children and adolescents. Some signs include:

  • appearing to be losing or gaining weight rapidly
  • radically changing their diet or eliminating whole food groups from their diet
  • avoiding meals with others
  • chronically feeling tired
  • fainting episodes
  • declining grades in school
  • withdrawing from social groups or activities

If caregivers have any of the above concerns, or something “just doesn't seem right” about their child's nutrition or exercise regimen, they should bring the child to see their primary care doctor and express their concerns while seeking medical attention.

What are some causes of eating disorders?

As with other mental health diagnoses, eating disorders are caused by changes in brain chemicals and are not under the control of the individual. While there are some known risk factors for an eating disorder—for example, trauma, family history of eating disorder, gender diversity—there is no one reason why some people develop an eating disorder. According to the National Eating Disorders Association, contributing causes include biological, psychological, and social factors.

Some people may think that films, tv shows, or social media may be to blame. While media and social media help create unrealistic societal ideals of weight and body shape that could impact the development of eating disorders, implying that the media is the cause risks implying that eating disorders are in some way the patient's fault.

How are eating disorders treated?

Eating disorders can be life-threatening and can also become chronic the longer they go untreated, so early recognition and diagnosis are critical to recovery. The sooner the illness is identified and treatment is initiated, the better the long-term prognosis.

In general, people with eating disorders should have a medical provider, a therapist, and a registered dietitian involved in their care. In Rhode Island, there are many community-based providers who are very skilled in managing eating disorders. There are also hospital-based programs like ours for adolescents and young adults, including inpatient medical and psychiatric care, partial hospitalization/day programming, and outpatient specialty clinical care with experts in the eating disorder treatment field.

At Hasbro Children's Hospital, our Eating Disorder Program offers both outpatient and inpatient services for children and adolescents with eating disorders. We provide a range of services in a safe, confidential environment. To learn more, visit us online or call 401-444-4712.

Abigail A. Donaldson, MD

Dr. Abigail Donaldson is an adolescent medicine specialist with expertise in eating disorders and their treatment. She leads the team of providers in the Eating Disorder Program at Hasbro Children's Hospital.