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Tweens and Anorexia

Brian Hagiwara

Unfortunately, Sheila Walker is not alone. Consider these real cases:

—A 7 year old announces that she's become a vegetarian because she loves animals. Then she starts eating less and less of her food. When her parents bring her into treatment, she is emaciated but pinches a tiny amount of flesh between her thumb and forefinger to illustrate "how fat" she really is. She is a full-blown anorexic.

—A 10-year-old girl, newly back in the U.S. after her missionary parents return from overseas, feels guilty about the abundance of food she finds here when children in other parts of the world are starving. She cuts her food into smaller and smaller bites and eats fewer and fewer of them. Her parents have no idea she's anorexic until a pediatrician notes that though the girl has grown taller, she hasn't gained weight in more than a year. 

—An 8 year old whose parents are involved in a very messy divorce is frequently too upset to eat. The less she eats, the more concerned her parents become about her health. Soon the fighting virtually stops, transformed into a shared fear for their daughter. The family dynamic has shifted away from the divorce, and her parents have inadvertently reinforced the girl's eating disorder.

Stories like these alarm experts. Eating disorders are dangerous at any age, but when one isn't recognized in a child, or when treatment comes too late, the effects can be catastrophic.

Children have a lower percentage of body fat, which means they get much sicker much faster than adolescents and adults. And because their bodies and brains are still developing, the most severe cases can permanently affect their development—limiting growth potential, damaging vital organs (particularly the heart, kidneys, and brain)—even when the eating disorder is eventually successfully treated.

Once considered a risk only for wealthy, high-achieving teenage girls, eating disorders such as anorexia (and, more rarely, bulimia) are becoming increasingly common among children, even little boys.

"In the last two years, we've actually had to add a treatment track to deal with kids ages 9 to 11," says Margaret Kelley, clinical nurse manager for the eating disorders treatment program at The Children's Hospital in Denver. "And we're getting many more boys. We used to see one or two a year at most, but we've almost always got one or two boys in the program now."

The average age for the onset of anorexia used to be 13 to 17. Now it's 9 to 12, and children as young as 7 have been diagnosed, says Abigail Natenshon, a psychotherapist and author of "When Your Child Has an Eating Disorder." 

No one knows how many preteens are affected today, though 5 percent of adolescents are affected. What is known is that at least 10 percent of adult anorexics first showed clear symptoms of the condition before they were 10 years old—and kids growing up today may be even more vulnerable. 

More than 60% of elementary and middle school teachers reported that eating disorders are a problem in their schools, according to a study by the National Association of Anorexia Nervosa and Associated Disorders. 

The vast majority of kids in this country don't have an eating disorder and will probably never develop one. But experts are concerned about the rise in nearly epidemic proportions of "disordered eating"—a pattern of dieting or calorie restriction that's unhealthy and a known trigger for eating disorders. Some troubling statistics from the National Eating Disorders Association: 

—42 percent of kids in first through third grades wish they were thinner

—81 percent of 10 year olds are afraid of becoming fat

—51 percent of 9- and 10-year-old girls say they feel better about themselves when they are on a diet

Numbers like these are red flags for experts. And perhaps the most worrisome news is that it's not just overweight kids who are restricting calories.

According to the Centers for Disease Control and Prevention, significant numbers of normal-weight and underweight kids are also dieting: 16 percent of girls ages 8 to 11, and 19 percent of girls ages 12 to 15. The numbers are slightly lower for boys, though these, too, are rising.