On the occasion of the Lilac Bow Day, focus on the youngest. The onset of eating disorders moves before puberty: how to recognize the alarm bells and how to intervene
infantile anorexia
usually appears around eight years and indicatively concerns children up to 13 years of age. “It manifests itself through the refusal of food, a significant reduction in weight and an excessive concern for body shapes, as in adolescents and adults – explains Lucilla Bonvini, child neuropsychiatrist and head of the diagnosis and treatment service for nutrition and Meyer Children’s Hospital in Florence -. Even if in children attention to weight and physical appearance does not emerge immediately but after a few months. In the meantime there is noticeable weight loss and the most frequent mistake is to think that it is due to an endocrinological problem, fat malabsorption or celiac disease, wasting time with useless diagnostic tests».
Symptoms
There are several alarm bells that allow parents to realize that their daughter or son has that eating disorder.
A emotional level: «Change of mood with major irritability and nervousness and tendency to withdraw ea isolate themselves from peers, sleep disturbance, increased perfectionism in school and in sport. There are children who come to have a very high muscle mass and a total loss of fat – says Bonvini -. Secondly, as we said, the fear of being fat and weight control appear».
The signals a physical levelon the other hand, are: «The perception of being swollen or full – continues the neuropsychiatrist -, complaints about abdominal paindark eye area or red eyes, tiredness, a feeling of passing out, feeling cold, loss of concentration in class, trouble sleeping, as well as of course weight loss ». Finally, behaviors such as the expert closes the list should not be overlooked: «Pretending to eat food and then hiding it, throwing it away or passing it on to someone else,
strictly select foods
to ingest, eliminating those that in the collective imagination make you fat, such as pasta, bread and sweets, to then chop them up on your plate and consume them slowly and wear loose clothing because you are dissatisfied with your body, increasephysical exerciseeven every day, with the impossibility of avoiding it».
Emergency Department emergencies
In extremely serious situations, when all the symptoms described above have been underestimated for too long, there are gods emergency signals “in the presence of which the parents will have to take the child immediately to the emergency room for life-saving assistance” warns Bonvini, who recalls what they are: “Loss of consciousness, fainting, severe tiredness, unstable mood with frequent crying and high anger, insomnia and fasting for more than two days, chest pains, breathing difficulties, bradycardia, i.e. when the heart beats drop below 60 per minute or 50 if the child is sporty».
The risk factors
An excessive selectivity at the table starting from 2-3 years of age it may be a risk factor for the early development of anorexia. «When the child reluctantly tastes new foods and selects what he eats based on texture, color and flavor. There are those who for months – Bonvini gives an example – feed almost exclusively on milk and cocoa, salami, fried food or rigorously white pasta. It’s always a good idea to talk to your pediatrician about it. This behavior can become pathological and develop into “avoid-restrictive food intake disorder” (the English acronym is Arfid, ed), characterized by a state of malnutrition and underweight. Other factors that can predispose to infantile anorexia are some aspects of the personal character, such as «the pathological perfectionismthat is, when we witness obsessive attention and an end in itself not to make mistakes – clarifies Bonvini – the dependence on the judgment of others to feel good, the continuous need for external confirmation of one’s worth, overweight and obesity, the urgency to keep everything under control, including parental behavior, separation anxiety from one or both parents, the incapacity to have experiences independently».
Family and social networks
Then there are some family conditions that can contribute to the onset of the eating disorder: «Mother’s or father’s depression, poor care and little attention to the emotional needs of the child, the high level of demand for school and sports performance, the presence of an eating disorder in the family, comments and judgments on physical appearance by relatives and friends». Last but not least, the influence of the web: «The use of social networks at an increasingly early age enhances the dependence on the judgment of others through the “like” system and reinforces the idea of putting the body is at the center of the relationships. I think of all those children who perform with persuasive dances and movements on Tik Tok» observes Bonvini.
What to do
From infantile anorexia if caught in time and treated adequately you heal. The disease has an average duration of two years – explains Meyer’s neuropsychiatry -. An early onset of the disease is usually associated with a better prognosis. About 60% of cases make full recoveryanother 10-15% chronic the disorder for life, while the rest undergo alternating phases of remission and relapse”.
In the presence of “spy” symptoms, the first thing to do is contact your trusted pediatrician. “If you suspect it’s anorexia, you can refer the family to a specialized centre for eating disorders for children or, in the absence of a dedicated structure, to local child neuropsychiatry services» says Bonvini. The course of treatment varies according to the type of physical and psychological impairment caused by the disorder. «It is essential that the patient is always followed up by a multidisciplinary team made up of child neurospichiatry, psychotherapist and dietitian» underlines Bonvini, who explains the three levels of assistance provided: «The outpatient one, with weekly or fortnightly sessions, which especially if the child is small they must involve the whole family for greater effectiveness of the intervention. In case of difficulty eating meals at home, there is a care taken at the day care center and in the most serious conditions hospitalization is required”.
March 16, 2023 (change March 16, 2023 | 08:05)
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