Eating disorders in children and adolescents have in recent years become one of the most common reasons for seeking professional help in the field of mental health. Although they are often associated with teenagers, they are increasingly observed in younger children as well, even in the early years of primary school.

In young people, eating disorders are not expressed only as problems with food. They are often a manifestation of emotional distress, difficulties with self-image, feelings of pressure, or a need for control. Children are often unable to clearly describe their inner experiences, so their distress is expressed outwardly—through the body, behavior, or their relationship with food.

Understanding the different types of eating disorders helps us recognize them more quickly and provide timely support to children and adolescents.

What are eating disorders in children and adolescents?

Eating disorders are a group of mental health conditions in which a person’s relationship with food, eating, the body, or physical activity is significantly altered. In children and adolescents, they may appear as:

• restricting food intake

• overeating

• self-induced vomiting

• excessive physical activity

• avoiding certain foods or textures

• fear of eating

• obsessive focus on appearance or body weight

It is important to emphasize that eating disorders are not a choice, but serious conditions that can strongly affect physical development, emotional stability, and social life in young people.

Types of eating disorders in children and adolescents

Below are 8 of the most common eating disorders seen in childhood and adolescence, along with their characteristic signs.

1. Anorexia nervosa

Anorexia is the most commonly recognized eating disorder in children and adolescents. Its characteristics include intentional restriction of food, intense fear of gaining weight, distorted body image, and often excessive physical activity. In children and adolescents, it typically appears as rapid weight loss or slowed growth; skipping meals, eating small portions, and avoiding “forbidden” or “bad” foods; fatigue, dizziness, feeling cold, and hair loss; irritability, withdrawal, perfectionism; and avoiding family meals or other food-related activities.

2. Bulimia nervosa

Bulimia more often appears in high school or later adolescence. It is characterized by episodes of binge eating (consuming large amounts of food in a short period), feelings of loss of control, and compensatory behaviors such as self-induced vomiting, use of laxatives, or excessive exercise. Signs include vomiting after meals (frequent bathroom visits after eating), damage to tooth enamel or sore throat; fluctuations in body weight; disappearance of large amounts of food or food hoarding; shame, secrecy, and impulsivity.

3. Binge-eating disorder

This disorder is common among adolescents dealing with stress, emotional emptiness, or low self-esteem. Its signs are similar to bulimia, except that there are no compensatory behaviors after binge episodes. It appears as rapid, uncontrolled eating, eating without hunger, eating alone and in secret, feelings of guilt afterward, and gradual weight gain.

4. ARFID (Avoidant/Restrictive Food Intake Disorder)

ARFID is more common in younger children but can continue into adolescence. It is not related to body image. Its characteristics include avoidance of certain textures, colors, or smells of food; fear of choking or vomiting; a very limited range of accepted foods; lack of interest in eating; and weight loss or inadequate nutrient intake. Children with ARFID often eat only “safe foods” (e.g., 3–5 selected items), which can lead to nutritional deficiencies.

5. Pica

Pica is an eating disorder most commonly seen in early childhood. It is characterized by the consumption of non-food substances (e.g., soil, paper, chalk, plaster, hair, ice) for at least one month, and the behavior is not part of cultural or developmental norms. Signs include regularly eating non-edible items, with risks of poisoning, infection, or gastrointestinal injury. It is often associated with developmental conditions (e.g., autism spectrum disorders) or stress. The name “Pica” comes from the Latin word for magpie (Pica pica), a bird known for eating almost anything.

6. Rumination disorder

Rumination disorder can occur in infants, children, or adolescents. It is characterized by the repeated regurgitation of food from the stomach back into the mouth, where it is re-chewed, swallowed, or spit out, and is not caused by a medical condition. It may present as weight loss, irritability, social withdrawal during meals, and school difficulties due to fatigue or hunger. When it occurs in infants between 3 and 12 months, it often resolves on its own.

7. Orthorexia

Orthorexia is more common in adolescence, especially among physically active individuals, and is often mistaken for anorexia. Like anorexia, it involves strict eating rituals and avoidance of social situations involving food. It is characterized by an obsessive focus on “healthy” eating and lifestyle taken to an extreme. Signs include obsessive checking of food ingredients (e.g., whether food is “clean” or organic), strong dietary restrictions, and excessive exercise.

8. Bigorexia (muscle dysmorphia)

Bigorexia is increasingly common among boys in later adolescence. It is characterized by the belief that one’s body is “not muscular enough.” These adolescents may see themselves as thin and lacking muscle, even if they are very muscular. It is considered the opposite of anorexia, where individuals see themselves as overweight despite being very thin—hence it was originally called “reverse anorexia.” It manifests as excessive exercise, strict dieting, use of supplements (e.g., steroids), and avoidance of social activities due to rigid training routines.

Why is early recognition in children and adolescents crucial?

Eating disorders in young people can lead to slowed growth and development; hormonal imbalances; heart, digestive, and bone problems; depression, anxiety, and social withdrawal; as well as significantly lowered self-esteem and increased risk of self-harm. Early intervention allows for faster recovery, fewer physical complications, greater family involvement in treatment, and a better long-term prognosis.