When most people think of eating disorders, they think of teenagers and adults, and mostly among women and girls. More than 9% of Americans (28.8 million people) will have an eating disorder at least once in their lifetime. A new study from The Keck School of Medicine of USC shows not only are dangerous eating behaviors starting in younger children, but they are also affecting boys and girls equally.

Key Takeaways

  • Disordered eating behaviors, such as binge eating, vomiting, over-exercising, and calorie restriction, affect children as young as 9.According to a new study, there’s no difference in sex regarding the prevalence of eating disorders, indicating that boys and girls face the same risk.Children with higher BMIs, or those who were further along in puberty, also were more likely to engage in behaviors that promoted disordered eating.

Researchers looked at almost 12,000 boys and girls ages 9 and 10. They analyzed certain disordered eating patterns such as binge eating, vomiting, over-exercising, and calorie restriction. They were looking to measure the associations between those behaviors and other factors, such as sex, BMI, and puberty. They were trying to figure out whether certain factors contributed more to disordered eating and whether sex played a role.

The study found no difference in sex when it comes to the prevalence of eating disorders, indicating boys and girls faced the same risk. It also found children with higher BMIs, or those who were further along in puberty also were more likely to engage in behaviors that promoted disordered eating.

Disordered Eating vs. Eating Disorders

The study, which was published in JAMA Pediatrics on August 1, 2022, focused exclusively on disordered eating versus eating disorders. It’s important to note here is a stark difference between the two.

Body Mass Index (BMI) is a dated, biased measure that doesn’t account for several factors, such as body composition, ethnicity, race, gender, and age.

“An eating disorder is an actual clinical diagnosis, whereas disordered eating refers to an abnormal eating pattern that doesn’t meet the criteria for a diagnosis,” says Holly Schiff, PsyD, a licensed clinical psychologist based in Connecticut. “An individual who is diagnosed with an eating disorder may exhibit disordered eating, but not all with disordered eating will necessarily be diagnosed with an eating disorder.” 

Holly Schiff, PsyD

An individual who is diagnosed with an eating disorder may exhibit disordered eating, but not all with disordered eating will necessarily be diagnosed with an eating disorder

Disordered eating does not include as severe symptoms as eating disorders do. Disordered eating frequently involves many of the same behaviors that occur in eating disorders, but such symptoms occur less frequently or less intensely. It’s important to note disordered eating can contribute to the development and onset of an eating disorder in time, especially if it isn’t kept in check.

How Common is Disordered Eating in Children?

Data surrounding the number of children under 12 with disordered eating has been scant. The study from USC looked at data from 11,878 children, ages 9 to 10, collected between 2016 and 2018 through the National Institutes of Health-funded Adolescent Brain Cognitive Development study. That’s the largest long-term study of brain development and children’s health in the United States. Researchers found that of this sample, 5% of children in the study had engaged in binge eating, while 2.5% had taken measures to avoid gaining weight.

While there isn’t too much other data to specifically support disordered eating in children, studies have shown nearly half of all adolescents in the U.S. suffer from eating disorders, and the lifetime prevalence of such disorders was 2.7%. This indicates prevalence increases with age and suggests disordered eating in younger children can lead to more severe eating disorders down the road.

Are Boys Less Likely to Have an Eating Disorder?

A common misconception is that eating disorders affect women and girls more than they affect men and boys. This study, however, proves this may not be the case. It found no difference in the prevalence of disordered eating between boys and girls. The study’s lead author, Stuart Murray, PsyD is the Della Martin Associate Professor of Psychiatry and the Behavioral Sciences at the Keck School of Medicine of USC.

“We tend to think that eating disorders predominantly afflict girls, but there’s more and more data showing that boys struggle just as much,” Dr. Murray said in a statement. “This is a call to arms to make sure we’re taking those cases seriously.”

The warning signs for boys when it comes to the likelihood of them developing eating disorders include higher BMIs in adolescence, according to the study. Children further along in puberty were also more likely to exhibit behaviors indicative of disordered eating. For parents, no matter the sex of your child, it’s important to keep the lines of communication open when it comes to disordered eating and body image. 

Stuart Murray, PsyD

We tend to think that eating disorders predominantly afflict girls, but there’s more and more data showing that boys struggle just as much.

“When talking to your kids about disordered eating or if you see any signs that something is not quite right, ask if they are okay,” says Dr. Schiff. “See if there is anything they want to talk about. Children with disordered eating habits tend to become highly stressed or anxious around meal times. Observe their relationship with food and when/if they tend to be hungry or not, and allow a safe environment in which they can speak to you about it.”

Nutritionist Oz Garcia says children may even try to look like people they see on TV or online. “Many times, children start becoming obsessed with a celebrity who has the body type that they admire, and try to emulate that celebrity,” he says. “In this case, it’s also important to discuss how the media can portray unrealistic body standards as well.”

Early Screening to Prevent Disordered Eating

If you worry your child may be at risk of developing an eating disorder, it’s possible to monitor them early in order to prevent it, and have the conversations needed to find the root causes of the situation. Here are some ways to keep an eye out for signs of disordered eating, according to Dr. Schiff.

  • If you see they’re “not hungry” or picking at their food more often, it could be a sign they have an eating disorder or are exhibiting disordered eating. In this case, Dr. Schiff suggests having meals together as a family as often as possible, so you can monitor their eating habits.
  • Speak to your child’s doctor about changes in weight or height, or if they seem nervous about being weighed.
  • As children with disordered eating tend to get more anxious around food, Dr. Schiff suggests also observing how long it takes them to eat a meal — and also whether they inhale it too fast, which could suggest a “binging and purging” dynamic.
  • “Talk to teachers at school to see whether they’re actually eating their meals,” adds Garcia. “Also ask whether the teachers have seen other changes in behavior, such as over-exercising.”

What This Means For You

As parents, we all worry about whether our children are getting proper nutrition from the time they are born. As our children grow, some may develop potentially dangerous disordered eating behaviors. A new study finds these behaviors are not only starting at an earlier age but also don’t discriminate between boys and girls. If you worry your child might be at risk of disordered eating, experts recommend having honest conversations about it and monitoring their height and weight, as well as their eating behaviors at family meals. If necessary, you might want to consider counseling for your child.