NEWS | August 15, 2018

Q&A with Laura Kester: Eating disorders and what families need to know


In her role as an adolescent medicine physician at UC Davis Children's Hospital, Laura Kester diagnoses and treats children and teens with eating disorders and helps to provide them with the resources and support that they need. The following is a Q&A with Kester, providing advice and help for families on this topic.  

Q: What is an eating disorder?

A: Eating disorders can often be hard for parents to recognize because many teens can have unusual eating habits. With eating disorders, you are looking for abnormal eating habits that can present in a variety of ways, including missed or skipped meals, excessive eating, whether consistently or intermittently, becoming sick after eating, significant exclusion of types of food or food groups and even excessive exercise or inappropriate usage of medications that can influence a teen's metabolism. Eating disorders occur when these abnormal eating habits persist for prolonged periods of time and result in negative effects on physical, physiological, and social health and functioning.

Q: What are signs and symptoms of an eating disorder?

A: Signs and symptoms of an eating disorder include:

  • Introduction of strict “healthier” dietary changes with the intention of weight loss (these can be transitions to vegetarian/vegan/low-fat diets)
  • Scrutiny of ingredient lists
  • Initiation of precise calorie counting
  • Weighing oneself multiple times a day
  • Smaller portions or taking a longer time to eat
  • Secretive eating behaviors
    • Avoiding eating with family or friends
    • Hiding food during social meals
  • Excessive exercise
  • Multiple trips to the bathroom after meals
  • Unusual change in dressing patterns or wearing multiple layers of clothing 

Q: How common is this?

A: Eating disorders are thought to exist on a broader spectrum and that individuals with one type of eating disorder can change behaviors over time and present with different eating disorders.

Approximately 10 percent of the general population suffers from some type of eating disorder. Unfortunately, only a small number of these patients are identified or seek treatment. Untreated children and adolescents with eating disorders can become adults with chronic and disabling eating-related medical problems.  

Q: What are the risk factors for an eating disorder?

A: Risk factors for eating disorders can exist within an individual or an individual’s family. Some other risk factors:

  • Females are at highest risk, although males do get eating disorders
  • Being a teen or early adult, with the highest age of onset for eating disorders being 15-19 years old
  • Having a family history of an eating disorder
  • Having other mental health concerns like anxiety and obsessive-compulsive disorder
  • History of dieting
  • Transitions
  • Participation in elite or individual sports, whereas team sports tend to be protective
  • Perfectionist mentality
  • Struggling with coping skills. Better developed coping skills can be protective.
  • Being different from your peers, particularly early maturation
  • Using food-tracking apps that placeslarge focus on calorie counting

Having supportive and close relationships can be protective, but having overprotective relationships, neglect, family conflict or significant discussions around the topics of weight or shape can be risk factors.

Q: What should parents do if they suspect their child has an eating disorder?

A: If you are concerned that your child has an eating disorder, talk with your child in a non-judgmental and supportive way. Avoid specific questions that introduce ideas of ways to have an eating disorder. Questions that you can ask include:

  • How do you feel about your weight, body shape or body size?
  • Does your weight affect the way you feel about yourself?
  • Are you worried that you are overweight or in danger of becoming overweight?
  • Are you doing anything to try to change it?

Eating disorders are best addressed and diagnosed by medical professionals with experience in eating disorders. If you have a concern or suspicion that your child has an eating disorder, bring your child to his or her primary care provider to be evaluated. Specialist doctors can also provide additional evaluation and medical treatment and support.