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Eating problems and eating disorders in children

Some children are picky eaters, others are easy eaters. New foods and even vegetables are accepted without any problems. However, just like in adults, eating problems and eating disorders can occur. This is not limited to not wanting to eat certain foods, there are many more possible eating disorders in children such as rumination disorder, Pica, the food disorder, obesity, anorexia and bulimia nervosa.

Eating disorders in children

Eating problems in children are common: approximately 25 to 45 percent of children who develop normally in other areas have mild to moderate problems with, for example, eating behavior. It is even more common in children with chronic diseases and general developmental delays. In addition, it appears that a large number of children in the Netherlands do not achieve the daily recommended amount of fruit and vegetables. However, in some children the eating problems appear to be so severe that they can be referred to as an eating disorder.

Eating disorders in children are divided into different categories:

  • Rumination disorder
  • Pica
  • Food disorder
  • Obesity
  • Anorexia nervosa
  • Bulimia nervosa

 

Rumination disorder

Rumination disorder is a condition in which a child – without any apparent physical cause – regurgitates food he has just eaten. The child tilts the head back and makes chewing and swallowing movements until the food is back in the mouth. This is often very unpleasant for bystanders to see. However, the child itself shows few signs of stress. On the contrary, some children seem to derive pleasure and satisfaction from giving up food. When rumination occurs frequently, serious medical complications can arise.

What is normal?

Rumination is normal during the child’s first year. The child then experiments with the body and its possibilities. It is also a form of self-stimulation. Rumination seems to occur more in boys and in children with a lower intelligence level. Rumination is usually treated by providing parents with tools to create a responsive environment for the child. Emphasizing the desired behavior and rewarding it instead of punishing the child has a stimulating effect on the child.

Pica

The term Pica comes from Latin. Pica means magpie . The condition is named after the magpie because of the wide variety of material and food that the magpie eats. Pica is characterized by eating substances and objects that are not intended for this purpose, such as mud, paint and soap. Most children do this as an experiment during their first year of life. However, in the second year they learn to distinguish between edible and non-edible material. The diagnosis of Pica is therefore only made after the second year of life. Pica appears to be common in children with developmental delays. The possible causes of Pica vary: lack of parental attention, lack of supervision and lack of adequate stimulation. Pica can have serious consequences such as poisoning and transmissible infections.

Food disorder

The essence of the feeding disorder is a persistent failure to eat adequately, resulting in the child not gaining sufficient body weight or even losing weight. This problem is often part of failure to thrive ; weight loss or lack of weight gain to such an extent that it becomes life-threatening.

Obesity

Obesity is another name for being overweight . Whether there is obesity or not is determined on the basis of the BMI ; the Body Mass Index. BMI is calculated by dividing weight in kilos by height in meters squared. A BMI at or above the 95% percentile of age and gender is considered overweight. Obesity is a common problem that can have serious consequences for a child’s health. It is estimated that 17% of children between the ages of 2 and 17 are obese. From an early age, overweight children appear to have fewer social contacts because many children have a negative image of obesity. Negative attitudes towards obese children are already evident when the children are only 3 years old.

Causes of obesity

There is partly a biological factor in the development and maintenance of obesity. This includes genetic influences and the metabolic effects of diet and exercise. The social aspect of eating also plays a role. Eating can be seen as a pleasant activity or as an outlet. Often a drastic change in diet and attitude towards food is necessary.

Anorexia and Bulimia Nervosa

Anorexia Nervosa and Bulimia Nervosa are eating disorders that involve inadequate attempts to control body weight and cause significant disturbances in eating patterns. There is also an abnormal attitude towards the body.

Anorexia and Bulimia have several distinguishing features:

  • One can be underweight, normal or overweight
  • One can be a ‘ binge ‘ eater or not: whether or not to consume extreme portions of food without having control over the eating
  • The ways in which one wants to control one’s weight (restricting food intake or regurgitating ingested food)

Bulimia Nervosa is diagnosed more often than Anorexia Nervosa. Worrying a lot about the figure and body at primary school age and Pica at a young age appear to be risk factors for developing an eating disorder later in life. There also appears to be an increased risk of developing an eating disorder as a result of childhood sexual abuse. The eating disorder occurs more often in girls than in boys. However, anorexia or bulimia can also occur in boys.

Anorexia

Children whose body weight is far below a healthy weight may have anorexia. A desire for an extremely thin body and fear of gaining weight are hallmarks of this disorder. The criterion for a diagnosis is around 85% of a healthy body weight.

Bulimia

Unlike people with anorexia , the weight of people with bulimia is not below a healthy weight. Bulimia is mainly characterized by recurrent binge eating. However, there is also a persistent over-concern about body shape and weight. People with bulimia compensate for their excessive eating behavior. They usually do this by vomiting the food or using laxatives.