A leading pediatricians' group says families often spot eating disorders too late -- and offers new guidelines to reach an earlier diagnosis.
"For too long, eating disorders were considered a disease that afflicted mostly affluent white teenage girls," said Dr. Laurie Hornberger, lead author of the report written by the American Academy of Pediatrics Committee on Adolescence.
"We know today that girls and boys of all ages, income levels and racial and ethnic groups may be struggling with eating disorders," she said in an academy news release. "Our hope is to help counter the stigma they may experience and provide an environment for open nonjudgmental conversations."
Studies have shown a delay in identifying boys and young men with eating disorders because of misperceptions that they only affect females. Behaviors that indicate a boy or young man could be experiencing an eating disorder include purging or taking muscle-building supplements, as well as substance abuse and depression. Their focus may be on leanness, weight control and muscularity.
"Some adolescents may have dietary habits that disguise eating disorders, such as those who become increasingly restrictive about the quality -- as opposed to the quantity -- of their food consumption," committee chair Dr. Elizabeth Alderman said in the release. "Teens may spend excessive amounts of time in meal planning and experience extreme guilt or frustration when their food-related practices are interrupted."
A pediatrician can diagnose the eating disorder and refer young patients to outpatient nutrition and mental health professionals, or to a hospital if the patient is medically unstable. Early response to treatment is associated with a better outcome. If local resources aren't available, pediatricians may recommend partnering with health experts farther away for care.
Pediatricians can help families reduce stigma around weight through using sensitive language and being supportive toward kids of all shapes and sizes, said report co-author Dr. Margo Lane.
The mean age of a child with an eating disorder is 12.5 years old, according to the report. It contains the most recent definitions of eating disorders, as well as the estimated prevalence of each type, which include the categories of anorexia nervosa, avoidant/restrictive food intake disorder, binge eating disorder and bulimia nervosa.
The report was published online Dec. 21 in the journal Pediatrics.
An earlier report highlighted establishing healthy habits with patients and families rather than focusing on weight and dieting. Recommendations include more frequent family meals, discouraging "weight talk" and "weight teasing" in the home, closely monitoring weight loss in patients advised to lose weight, and promoting a healthy body image.
The National Eating Disorders Association offers a helpline.
SOURCE: American Academy of Pediatrics, news release, Dec. 21, 2020