Anorexia nervosa – anorexia nervosa is a mental disorder related to food intake. Girls in adolescence usually suffer from anorexia. However, this is not a rule, as this disorder more and more often affects smaller and smaller children (including boys) and even infants. Infantile anorexia or anorexia in young children is not the same as anorexia in older children and adolescents.
Infantile anorexia (disturbed separation process) it usually begins between 6 months and 2-3 years of age. Infantile anorexia, according to the guidelines of the DC 0-3R Diagnostic Classification, occurs when a child meets all of the following criteria:
- the child refuses to eat an age-appropriate amount of food for at least a month;
- symptoms started before the child was 3 years old;
- there is a clear shortage of growth in the child;
- the child does not indicate hunger, shows a lack of interest in eating, but is strongly interested in exploring, interacting with the caregiver (or both);
- refusal to eat is not caused by a physical illness or any food-related traumatic event in the child’s life (e.g. choking, eating a meal that is too hot, severe sore throat, parents’ lack of calmness and arguments while the child is eating).
If a young child’s period of disinterest in eating is short-lived, this is usually completely normal and should not be a cause for concern for parents. If such a situation is long-term, the child is not hungry, refuses to eat, does not gain (or loses) weight, it is necessary to consult a doctor about this situation.
Usually the cause of infant anorexia there are inappropriate or no relationships between the caregiver (usually the mother) and the child. At this age, food is the basic and most important form of communication between a toddler and his mother. Refusal to eat food is a message that the child feels an unsatisfied, very important need – he has too little or no closeness with his mother, he feels lonely, unloved, scared. The reason may also lie in improper breastfeeding of a baby (incorrect technique, strong, negative emotions of the mother during breastfeeding). The stress experienced by the mother of a breastfed child (feeding problems, postpartum depression, the feeling that she is not a good enough mother) is also felt by the infant and it may happen that the infant starts to run away from breastfeeding in order not to feel this tension.
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The situation is different when it comes to anorexia in older children and adolescents. The most common symptoms include:
- significant weight loss (often masked with loose clothes);
- elimination of more and more consumed products;
- despite being clearly underweight, the child still believes that he or she is not slim enough and should lose even more weight,
- fear of gaining weight;
- tension, depressed mood, social isolation;
- lowered self-esteem, not accepting your appearance;
- the use of laxatives, diuretics, vomiting;
- the use of strict diets, fasting;
- very frequent, intensive sports (in order to “get rid” of calories after eating);
- chronic fatigue, difficulty concentrating;
- constantly counting calories, measuring the amount of food;
- avoiding eating meals in the company of other people;
- hormonal disorders (in girls the onset of irregular periods or their complete disappearance);
- hair loss, nail brittleness;
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Causes of anorexia in children and adolescents
There is no one specific cause responsible for the development of this disorder, it is a multifactorial problem:
Family factors (genes, home / family situation of the child):
- parents’ failure to treat food solely as meeting one of their child’s basic physiological needs. Unfortunately, parents often want to influence the child’s behavior by means of food, eg sweets. »You are polite – you will get a candy bar, you are naughty – you will not get it». In this way, the child learns that sweets are something extremely attractive, inextricably linked with the reward. These types of situations have a huge impact on the formation of a child’s eating habits. Such children as teenagers may have a greater chance of developing eating disorders, eating problems (they eat “emotionally”, reward themselves with food, etc.). It also happens that parents in the world are most happy when their child “eats nicely” – they applaud, loudly communicate their delight, tell others how their little one “eats” beautifully (that is, he is very “polite”). The child hears these messages and again – combines eating with a reward;
- too much control of the child on the part of the parents, constant checking of the child, being “too close”, no consent to becoming independent, making decisions about oneself;
- huge expectations of a parent towards their child (often absolutely inadequate to their abilities), constant pressure to achieve better and better results at school, in sports, comparison to other children;
- blocking the child’s ability to express feelings (usually negative ones), not resolving difficult situations (leaving the child “to himself” with a problem, thus causing the accumulation of many emotions);
- inducing guilt in a child by constantly persuading him to eat a meal “to the last bite” (“I have been making this dinner for so long”, “products are so expensive nowadays”, “children in Africa are starving”);
- tense atmosphere at home, conflicts between parents, lack of peace;
- nervous atmosphere during family eating;
- bad domestic situation – neglect, rejection, parental alcoholism, violence.
Personality factors (e.g. excessive need for control, high emotionality and low self-esteem, perfectionism, need to compete).
Socio-cultural factors: Nowadays, there is more and more emphasis on being slim, the pressure that the child sees and hears around (TV commercials, slim dolls, photos of models, celebrities on social media). The second, also common reason, is sometimes a huge desire to control (if I cannot control my family situation, school failures, social difficulties, and at the same time I have a lot of different requirements on each side – to deal with it – food – this is the only area for which I have 100 percent influence, so I start to control it, so that the sense of control is satisfied, to feel like a causative person, on whom at least it depends). According to psychological research, when the average teenager looks at photos of slim models, her self-esteem drops by as much as 25 percent.
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Treatment of anorexia
First of all, it is necessary to exclude somatic diseases, e.g. diseases of the digestive system, respiratory system, cardiovascular system, metabolic disorders, allergies, etc. (medical consultation is recommended here), as well as sensory integration disorders (a child may refuse to eat certain foods due to the presence of certain foods during them). consuming unpleasant, strong feelings). It should also be checked whether the “adequate amount of food” that our child eats is too small for his age or too small for us, parents (we believe that he should eat more, we have misconceptions about the amount of food that our child should eat. kid). Then, of course, the child’s refusal to eat is a reaction to overfeeding him. If a young child suffers from anorexia – the parents should undergo treatment.
It is necessary to clearly examine the relations in a given family, find the sources of the problem and necessarily introduce changes in family patterns (work on improving communication in the family, recognizing and meeting the needs of oneself and the rest of the family, changing behavior).
Treatment of anorexia in older children and adolescents – here psychotherapy is the basis, sometimes pharmacotherapy is needed. In extreme cases, hospitalization and enteral feeding are necessary. In the case of infant anorexia nervosa, mother-child relationship therapy is often prescribed. It is also necessary to educate the parents (concerning, among others, the child’s illness, proper nutrition, better understanding of emotions). In addition, treatment is essential if the baby’s mother suffers from postnatal depression.
Let us remember that we, the parents, shape the child’s attitude to many issues from the very beginning, how he treats himself, his body, other people, but also how he treats food and how he treats him.
It is thanks to us, parents, that the child learns many issues, including those related to nutrition. That is why our time devoted to the child is so important, our attention and our support that we can offer him. Let’s create a secure bond with him. Let us be there, be attentive and react to the needs of our children. Let us take care of the quality of communication in our family, let us respect our opinion and our emotions. And when it comes to eating – let’s treat it “normally”, let’s not use it as a means to improve the child’s behavior (reward / punishment), let’s eat together in a calm atmosphere, without forcing the child to eat the whole meal.
Source: doktorekradzi.pl