Eating disorders spike among children and teens: What parents should know

A small wooden pawn sees itself reflected in a round mirror in a distorted way as much heavier; concept of eating disorders

During the pandemic, we have seen many more children and teens go to the emergency room with mental health problems. And there has been a notable rise in eating disorders, particularly among adolescent girls. Eating disorders include a range of unhealthy relationships with food and concerns about weight.

Unfortunately, eating disorders are common. In fact, one in seven men and one in five women experiences an eating disorder by age 40, and in 95% of those cases, the disorder begins by age 25. Many kinds of eating disorders may affect children and teens:

  • Anorexia nervosa is an eating disorder characterized by an extreme fear of gaining weight. People with anorexia nervosa often see themselves as overweight when they are at a healthy weight, and even when they are greatly underweight. There are two forms of anorexia nervosa: The restrictive form is when people greatly limit what and how much they eat in order to control their weight. In the binge-purge type, people limit what and how much they eat, but also binge and purge — that is, they will eat a large amount at once and try to get rid of the extra calories through vomiting, laxatives, diuretics, or excessive exercise.
  • Bulimia nervosa involves binging and purging but without limiting what and how much a person eats.
  • Binge eating disorder is when people binge eat but don’t purge or restrict. This is actually the most common eating disorder in the United States.
  • Avoidant restrictive food intake disorder is most common in childhood. The person limits the amount or type of food they eat, but not because they are worried about their weight. For example, someone with inflammatory bowel disease may associate eating with pain and discomfort, and so may avoid eating. Children with sensory issues may find the smell, texture, or taste of certain foods deeply unpleasant, and so will refuse to eat them. This is more than just “picky eating” and can lead to malnutrition.

Misunderstandings about eating disorders

When most people think of eating disorders, they think of someone who is overly thin. However, you can have an eating disorder and have a normal weight, or even be overweight. The most important thing that many people don’t realize about eating disorders is that they are a serious mental health issue and can be very dangerous. They can affect and damage many parts of the body — and can even be lethal. Of all the kinds of eating disorders, anorexia nervosa is the one that is most likely to lead to death.

What parents need to know: Signs of eating disorders

It’s not surprising that eating disorders have been on the rise in children and teens during the pandemic, given the disruption, isolation, and stress — and excessive time on social media — that it has brought. It’s important that parents watch for possible signs that their child or teen could have an eating disorder, including:

  • changes in what, when, and how much they eat
  • being restrictive or regimented about their eating
  • unusual weight fluctuations
  • expressing unhappiness with their body or their weight
  • exercising much more than usual
  • spending a lot of time in the bathroom.

If it even crosses your mind that your child might have an eating disorder, remember that eating disorders are not about choice. Mental health problems such as anxiety and depression play a big role; emotional suffering often underlies eating disorders. And research shows that when you undereat or overeat, it affects the brain processes that control hunger and food intake, reinforcing the eating disorder.

If you have concerns, talk to your child — and talk to your doctor. Even if you are wrong, it may lead to an important conversation about healthy eating and body image that could help prevent a future eating disorder. And if you are right, the sooner your child gets help, the better.

Summer camp 2022: Having fun and staying safe

A boy and three girls walking in the woods with hiking sticks; out of focus trees are leafy green, suggesting summertime

It’s time to make summer plans, and for many families those plans include summer camp. After the past couple of years, the idea of getting out of the house, being active, and seeing other children sounds very appealing.

While COVID-19 is still with us, vaccines and the fact that so many people have gotten sick and developed some natural immunity has made activities like summer camp less treacherous. Unfortunately, this doesn’t mean that families don’t need to think about COVID-19 as they make their plans, because they still do.

What to do before signing up for summer camp this year

Before even thinking about camp, take into account your family’s particular risk factors. If children are 5 or older and haven’t been vaccinated, now is the time to get the vaccine. If you have any questions or concerns about the vaccine, please talk to your doctor. While you are at it, make sure that children are up to date on routine childhood vaccinations. Many children have gotten behind because of the pandemic.

Talk to your doctor about the pros and cons of camp if your child

  • isn’t or can’t be vaccinated, since it’s important to think about factors that might make getting COVID riskier.
  • has health problems like asthma or congenital heart disease that put them at higher risk of complications of COVID-19.
  • has a weakened immune system for any reason. Whether or not your child is vaccinated, it’s always important to check in with their doctor before sending them to camp, or any group activity.

Questions to ask any camp you’re considering

These days, most communities have dropped mask mandates. While it’s certainly nice to not have to wear one — and to see people’s faces — masks do make a difference when it comes to preventing the spread of infection. COVID-19 is still causing illness and is likely to be with us beyond this summer. Before signing up for camp there are things parents should think about — and questions they should ask.

Where is the camp, and where are the campers and staff from? A local day camp with children and staff mostly from a town with low numbers of COVID cases is going to be lower-risk than one in a community with higher numbers, or one that draws from many different communities, including some with higher numbers. The Centers for Disease Control and Prevention has a database of case numbers by county.

What is the vaccination status of the staff and campers? Ideally, all eligible staff and campers should be vaccinated — with not just their primary series, but any booster doses they are eligible to receive.

How is the camp screening for symptoms or exposures, and what guidelines do they have in place? This is most important when there are unvaccinated staff or campers, or in areas of higher case counts. The camp should have a plan for screening campers and staff for symptoms, with appropriate plans for staying home, testing, and quarantine based on the results of those screenings. Find out how exposures outside of camp will be handled for campers and staff. Sleepaway camps should have designated quarantine space, and access to testing. Ask about their testing requirements, as well.

Are activities mostly indoors or mostly outdoors? The more outdoor activities, the better. Indoor activities are safest in well-ventilated spaces.

What is the policy on wearing masks? Wearing a mask for 10 days after testing positive for COVID or being in close contact with someone who has it is essential to help others stay healthy. (Also follow recommendations for quarantine or isolation described in this tool from the CDC.) Masks may also be a good idea for indoor situations where people are close together — and some staff and campers might simply feel more comfortable wearing a mask. The camp should have a culture that allows those who choose to wear masks to feel comfortable doing so.

What is the plan for shared equipment and surfaces? One is far more likely to catch an infection from a person than a surface, but it’s important that anything that multiple people touch be wiped down regularly.

What is the plan for hand washing? Regular hand washing with soap and water or hand sanitizer is important to limit the spread of germs, including the virus that causes COVID-19. Parents should ask how often campers will be washing their hands, and about the availability of hand sanitizer.

What is the plan for meals? Eating together increases the risk of transmission of COVID-19. The risk is lower if people eat outdoors or have some space to spread out — and if they bring their own food rather than sharing.

As much as we may all feel done with COVID-19, the reality is that COVID-19 isn’t done with us. Children need the experiences camp can bring, especially after their lives have been so disrupted — and with just a few precautions, they can have fun and be safe too.

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