In a culture that tells individuals to get rid of fat instead of getting rid of the stigma around it, it’s no surprise that the number of people who experience eating disorders (ED) is growing and skewing younger.
EDs are complex conditions that can be challenging for parents to identify and address. The signs and symptoms can vary greatly from the stereotypical portrayals we see on TV, and many children struggle with food or body image in ways that don’t meet all the rigid criteria for an formal diagnosis.
In fact, clinical descriptions and symptoms of EDs can seem so “extreme” that parents often write off otherwise alarming thoughts, behaviours, and attitudes—leading many children to slip through the cracks of our dominant diagnostic system.
We at the Kyla Fox Centre believe that a lack of formal diagnosis should not discourage parents from seeking care for their child if it is preventing them from feeling safe in their body and around food. A diagnosis is not always the first step (or even a necessary step) for recovery.
To get a clearer grasp of when it’s time to intervene, let’s take a deeper look at what you may or may not know about the spectrum of EDs, disordered eating, and body image challenges.
1. There are three main types of eating disorders
The following are diagnoses under the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) that you’re likely familiar with:
Anorexia nervosa: Characterised by an intense fear of gaining weight, a distorted body image, severe calorie restriction, and low body weight.
Bulimia nervosa: Involves episodes of binge eating followed by purging behaviours such as vomiting or using laxatives.
Binge eating disorder: Involves recurring episodes of binge eating without purging behaviours.
Note that not everyone who struggles with EDs struggles in the ways described under these
well-known conditions.
2. But there are other diagnoses that you may not know
Other Specified Feeding or Eating Disorders (OSFED) is a "catch-all' group of diagnoses that apply to individuals who are struggling with food and body image but do not necessarily meet all the strict diagnostic criteria for anorexia nervosa, bulimia nervosa, or binge eating disorder. A few examples of OSFED include:
Atypical anorexia nervosa: Involves many of the same symptoms as anorexia nervosa, but the person's weight remains within or above the normal range.
Avoidant/restrictive food intake disorder: Characterised by a persistent avoidance or restriction of food intake, and can result in significant weight loss, nutritional deficiencies, and impairment of daily functioning.
Rumination disorder: Involves the regular regurgitation of food, which may be re-chewed, re-swallowed, or spit out, but the person does not seem to be attempting to do so—nor do they seem to be stressed, upset, or disgusted.
Unspecified Feeding or Eating disorders (UFED) refer to situations in which symptoms are characteristic of an eating disorder and cause significant distress or impairment, but symptoms don't fit neatly into the standard DSM-5 categories.
Orthorexia nervosa: Characterised by an obsession with healthy eating and focusing on food quality and purity to the point that it interferes with daily life.
Compulsive exercise: Characterised by exercise that significantly interferes with daily life and responsibilities and continues despite injury or other medical complications
Laxative abuse: Involves the frequent use of laxatives to eliminate unwanted calories, lose weight, or feel "thin" or "empty".
Note that cases of OSFED and UFED can be just as severe and deserving of attention as their better-known counterparts.
[More on Orthorexia: Disordered Eating, Rebranded: How Wellness Trends Can Go Too Far]
3. A diagnosis isn’t critical for intervention
Most people with eating disorders don't fit neatly into the rigid criteria under the DSM-5. In fact, OSFED and UFED cases are more prevalent than anorexia nervosa, bulimia nervosa, or binge eating disorder. Eating disorders symptoms and experiences are not static—they fluctuate over time and can overlap between multiple. Consider the following examples:
Eating disorders can be ever-evolving: Some children may start with a restrictive eating pattern that develops into anorexia nervosa, while others may start with binge eating disorder that turns into bulimia nervosa.
Eating disorders exist on a spectrum: While the diagnostic criteria for anorexia nervosa, bulimia nervosa, and binge eating disorder may be strict, the reality is that many individuals may experience disordered eating behaviours and attitudes that fall somewhere in between these categories.
3. Families play an important role in recovery
Create a supportive home environment that promotes balanced eating habits and positive body image, and encourage your child to talk openly about their feelings and experiences, and provide them with emotional support and reassurance.
Pay attention to your child's eating patterns and behaviours. Look for warning signs such as skipping meals, restricting food groups, binge eating, purging, excessive exercise, weight change, or obsessive rituals around food. If you notice any of these signs, talk to your child and express your concerns in a calm and non-judgmental manner.
Contact a healthcare professional specialising in EDs if you suspect your child may need it—even if you're unsure if the symptoms meet the diagnostic criteria for a specific disorder. It's essential to intervene as early as possible to prevent long-term health consequences and improve the chances of recovery.
Recovery is often long and difficult—but it's not impossible. By participating actively in the recovery process, providing support and encouragement for your child, and celebrating even the smallest of victories with them, your child can overcome their eating disorder.
A note from our team
If your child is struggling in their relationship with food and body, we invite you to reach out to us to ask questions, share part of your story, and determine if this is the right place for support.
The Kyla Fox Centre treats the entire spectrum of EDs and disordered eating through an individualised approach. Healing children, regardless of age, means healing parents and families overall. We are committed to educating you about EDs and expectations of recovery—and fostering openness, transparency, and active engagement in the process.
Sources:
Eating disorders grow more prevalent and skew younger. (n.d.). Penn Today. https://penntoday.upenn.edu/news/eating-disorders-grow-more-prevalent-and-skew-younger
National Eating Disorders Association. (2023). Warning signs and symptoms. https://www.nationaleatingdisorders.org/warning-signs-and-symptoms
Canadian Mental Health Association Ontario. (2023). Understanding and Finding Help for Eating Disorders. https://ontario.cmha.ca/documents/understanding-and-finding-help-for-eating-disorders/
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Hay P, Girosi F, Mond J. (2015). Prevalence and sociodemographic correlates of DSM-5 eating disorders in the Australian population. Journal of Eating Disorder; 3:19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4408592/