Diagnosing Eating Disorders in Children & Adolescents

Doctors at Hassenfeld Children’s Hospital at NYU Langone have expertise in diagnosing eating disorders in children and adolescents. These disorders can lead to serious medical consequences, and in the most severe cases can be fatal.

If you suspect that your child may have an eating disorder, contact the specialists at the Child Study Center, part of Hassenfeld Children’s Hospital. We also treat adults with eating disorders.

Psychological Assessment

After speaking with an intake specialist, parents and the child or teen with a suspected eating disorder meet in person with one of our team members. This may include a psychiatrist or psychologist for an in-depth diagnostic evaluation.

Child Study Center Specialist with Pediatric Patient

Our experts work closely with you and your child or teen to perform a full assessment and make a diagnosis.

The evaluation of children or adolescents includes an assessment of their eating problems; taking a medical history; and a review of any past treatment for an eating disorder. A doctor may also ask about the child or teen’s attitude toward food, eating, weight, and exercise.

A full assessment of other psychiatric symptoms, such as depression and anxiety, is also part of this evaluation.

Your specialist may recommend additional diagnostic testing—including blood work, a physical examination, or a nutritional evaluation—depending on the severity of the symptoms.

An evaluation may include interviews with other family members and friends. It may also involve filling out several questionnaires.

Most children and teens who have an eating disorder, especially anorexia, resist being diagnosed and may withhold or provide misleading information. Our specialists work as a team with family members and other people close to the child to assess his or her condition and arrive at an accurate diagnosis.

Diagnostic Criteria for Eating Disorders

Each type of eating disorder has its own set of diagnostic criteria, which means a person must experience several symptoms to be diagnosed. For a diagnosis of anorexia nervosa, for instance, a person’s body weight must consistently be significantly below what is healthy, either through weight loss or a failure to gain weight.

A doctor determines during the evaluation if a person is troubled by weight gain or the prospect of being fat, even though he or she is thin. The expert also looks for evidence of an unrealistic body image or denial of the severity of the condition.

To diagnose bulimia nervosa, bingeing and purging must occur at least once a week for three months or more. A person must binge eat and have a lack of control to stop themselves during the binge episode—and then compensate for the binge by vomiting, using laxatives or diuretics, fasting, or exercising excessively.

For a doctor to diagnose binge eating disorder, a person must repeatedly eat unusually large amounts of food in a relatively short period of time and feel that those binges are beyond his or her control. At least three of the following factors must also be present: eating rapidly, eating to the point of uncomfortable fullness, eating when not hungry, eating in shame or in secret and feeling disgusted, depression, or feeling ashamed after eating.

The behavior must occur at least once a week for a period of six months. Binge eating is not associated with inappropriate methods to compensate for overeating, such as self-induced vomiting.

Many children and teens have some or most of the above symptoms without meeting the full criteria for one of these disorders. For example, a teen may show all symptoms of anorexia nervosa at a normal weight if he or she was previously overweight or obese. People with some, but not all, of the symptoms associated with an eating disorder may still be at risk of medical or psychological problems, and may require evaluation and treatment.

After the evaluation, which typically takes place in a single extended session, you meet with a team member from the Child Study Center to review the specialist’s findings and discuss treatment recommendations.

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