Can a Toddler Have an Eating Disorder?
Children as young as three years old are being hospitalized with eating disorders. The Daily Mail says that a child of three was among 600 children under 13 hospitalized for eating disorders since 2009. The German magazine Der Spiegel describes a 3-year-old girl named Klara with an eating disorder who weighs under 18 pounds. Sabine Rohde, a consultant in child and adolescent psychiatry at the University Hospital Munich Schwabing, says that diagnosing an eating disorder in a young child is “not so rare” and that, in the fifteen years that she has treated eating disorders, her patients have been getting younger and younger.
Eating disorders are psychiatric conditions; anorexia nervosa leads to death in 10 percent of cases. Cultural and societal pressures that equate being thin with beauty and self-worth have often been highlighted as causes of eating disorders, but it’s not clear how much such factors might affect a very young child. Is it possible to diagnose an eating disorder in such a young child? Might a child — a toddler — who refuses food to the point of self-starvation (i.e., to a point far beyond what would be considered “picky eating“) and who displays unusual eating behaviors (Klara will only eat when her grandmother is sitting with her) actually have a different diagnosis, such as a feeding disorder? Feeding and eating disorders in very young children can be the result of a concurrent medical condition. Tulane University’s Infant Institute notes that young children who refuse food may have post-traumatic feeding disorder or a sensory aversion to the taste, smell, sight and/or feel of certain foods.
Indeed, a recent study by researchers at Tel Aviv University suggests that such hypersensitivity in children could be an “early warning sign” of developing an obsessive compulsive disorder (OCD) in adulthood. A child who is hypersensitive to certain smells or sensations, and who is yet too young to be able to verbally articulate what is bothering her or him, may develop ritualistic behaviors to “manage” their responses to their sensory discomfort. That is, the child’s seemingly abnormal behaviors around food (including not eating) may be rooted in how their nervous system processes sensory information.
Such research may shed some light on why not only a young child, but an older one, may develop unusual eating behaviors or refuse food and shift the blame for a child displaying unusual eating behaviors away from parents. Mothers in particular have often been blamed for a child developing an eating disorder. Der Spiegel emphasizes the role of Klara’s mother, who is videotaped by doctors and then has her behavior analyzed with an emphasis on how she is (wrongly) interacting with her child.
A previous generation of medical professionals blamed “refrigerator mothers” for causing their children to become autistic because the parents were emotionally “frigid” and withdrawn from their children. While the causes of autism are not yet known — research continues into genetic, environmental and biological causes — the notion that parents and in particular parents’ behavior could causes autism now seems ludicrous. More understanding of the role of biological, sensory and other factors suggests that we need to move away from pointing the finger at parents for “causing” conditions such as eating disorders.
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