Types of Eating Disorders in Children & Adolescents

Specialists at Hassenfeld Children’s Hospital at NYU Langone recognize and manage several types of eating disorders that can affect children and adolescents. These include anorexia nervosa, bulimia nervosa, avoidant/restrictive food intake disorder, and binge eating disorder.

Anorexia Nervosa

Anorexia nervosa, often called anorexia, is an eating disorder in which people maintain a weight that is below average for their age and height. Children or adolescents with anorexia have an intense fear of getting fat or gaining weight. They may be preoccupied with food and have a distorted body image, perceiving themselves as “fat” even when very thin.

To stay underweight, children and teens with anorexia may starve themselves, eat sparsely and infrequently, purge food by vomiting or using laxatives, or exercise intensely. Often, they might not recognize that these actions are unhealthy or that their perception of their body is distorted.

Anorexia may be about more than eating or weight. It is an unhealthy way to cope with emotional problems, perfectionism, and a desire for control. People with anorexia often equate their self-worth with how thin they are.

The condition usually develops during adolescence and is diagnosed mostly in girls, although 10 percent of those diagnosed with anorexia are boys. People with anorexia commonly have other mental health problems, such as mood disorders or anxiety disorders.

Symptoms include a bluish discoloration of the fingers due to a lack of oxygen; hair that thins, breaks, or falls out; soft, downy hair covering the body; fatigue; insomnia; dizziness or fainting; and the absence of menstruation in teenage girls.

Bulimia Nervosa

Bulimia nervosa, or bulimia, is a type of eating disorder in which a person engages in episodes of bingeing—during which he or she eats a large amount of food—and then purges, or tries to get rid of the extra calories. Examples of purging include self-induced vomiting or excessive exercise, such as running on a treadmill for hours.

Binge eating is often done in private. Because most people with bulimia are of average weight or even slightly overweight, it may not be readily apparent to others that something is wrong.

The condition often begins in the late teens or early adulthood and is diagnosed mostly in women. People with bulimia may have other mental health issues, including depression, anxiety, drug or alcohol abuse, and self-injurious behaviors.

Symptoms may include discolored or stained teeth, calluses on the backs of the hands or knuckles from self-induced vomiting, swelling in the cheeks or jaw area, frequent weight fluctuations, and an irregular menstrual cycle.

Avoidant/Restrictive Food Intake Disorder

In avoidant/restrictive food intake disorder, a person is unable to or refuses to eat certain foods based on texture, color, taste, temperature, or aroma. The condition can lead to weight loss, inadequate growth, nutritional deficiencies, and impaired psychosocial functioning, such as an inability to eat with others. Unlike anorexia nervosa, there are not weight or shape concerns or intentional efforts to lose weight.

For instance, a child may consume only a very narrow range of foods and refuse even those foods if they appear new or different. This type of eating disorder commonly develops in childhood and can affect adults as well.

Binge Eating Disorder

People with binge eating disorder eat unusually large amounts of food often and in secret but do not attempt to get rid of calories once the food is consumed. People with the condition may be embarrassed or feel guilty about binge eating, but they feel such a compulsion that they cannot stop.

These people can be of average weight, overweight, or obese. They may also have other mental health disorders, such as depression. Many binge eaters have trouble coping with anger, sadness, boredom, worry, and stress.

Binge eating disorder often has no physical symptoms, but it has psychological symptoms that may or may not be apparent to others, such as depression, anxiety, or shame or guilt over the amount of food eaten. Frequent dieting without weight loss is another symptom.

Other Eating Disorders

Not every child or adolescent fits into the diagnostic categories above, but they can still have clinically significant problems with eating. Examples include a teen who does not binge but purges most meals in an effort to control weight or manage emotions. Or a child may have night eating syndrome, meaning most calories are consumed in the latter part of the day to evening, including episodes of eating late at night. Our doctors are experts at identifying these types of eating disorders in young children and teens.