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Helping kids develop a healthy relationship with food – and warning signs for eating disorders

Young patient with back to camera gets hear heart listened to by a doctor in a clinic room.

During the COVID-19 pandemic, many children and teens are more isolated, anxious, stressed and have a sense of loss of control. They may have reduced access to activities and friends which help them cope. These factors can add to other potential risk factors for developing eating disorders like bulimia, anorexia and others. While the pandemic may create additional vulnerability for eating disorders, it’s important to recognize it is not the cause. The following are some tips for parents to promote good health and positive body image, in addition to some general information about eating disorders and warnings signs to watch for in children.

Tips for parents: Promoting healthy living

Parents play a key role in prevention and developing positive body image and good nutritional habits at home. Here are some ways to help children learn about healthy lifestyles:

  • Keep open communication. Encourage discussion of good health, eating habits and body image in a positive and non-judgmental way. Also talk about the messages children see on social media and TV and evaluate if it impacts your child’s mood in a negative way.
  • Avoid diet culture. Stay away from forcing children to eat everything on their plate or limiting food. Instead, you can talk about if your tummy is full, or still hungry. You can discuss the importance of nutrition for growing and keeping energy levels up. Avoid labeling foods as “good” or “bad.” All foods can be included in a healthy, balanced diet, including treats. Model good eating habits by serving and eating a balanced variety of foods. When possible, have family meals together.
  • Encourage positive self-esteem and a healthy body image. Find qualities in your child to compliment, like their determination, gentleness or a characteristic other than their appearance to help promote self-esteem. Remind children they are still growing and people come in all different sizes and shapes. Model acceptance of diverse body types. Parents should avoid critical comments about their own bodies, as children observe and may question whether their own body is OK.
  • Get professional help. Ask your child’s primary care provider for support or resources if you have concerns that your is child struggling with eating and or expresses negative body image. There are many levels of support available to help each child.

While the goal is for all children to have a healthy relationship with food, we know that is not always possible. Here’s some information about eating disorders and some warning signs to look for if you think your child might be suffering.

What are eating disorders? 

Eating disorders are not a choice. They are complex biopsychosocial illnesses that can be fatal if not treated. Eating disorders can develop in children and teens of any race, gender and from any background. The body and brain need proper nutrition to grow and function. Malnutrition from an eating disorder affects all organ systems in the child, as well as mental and emotional functioning and growth.

Common eating disorders include anorexia, involves restriction of food intake and may result in significant weight loss or failure to gain during a period when children are expected to grow. Body image issues and fears of weight gain are typical. Bulimia includes episodes of overeating along with attempting to purge the food with laxatives, diuretics, vomiting, fasting or exercise. It is important to note children of any weight may have an eating disorder.   

What causes eating disorders?

Parents do not cause eating disorders. While it’s common for parents to blame themselves, eating disorders are complex and several factors are typically involved for each child. Genetics play a part: people with siblings or parents with an eating disorder may be more likely to develop one also. Social-cultural factors like pressure from social media, peer bullying or media images reflecting an ideal of thinness also influence eating disorders.

Certain groups are more vulnerable for developing an eating disorder: athletes who participate in “body-conscious” sports such as gymnasts, ice skaters, swimmers, dancers, wrestlers, bodybuilding and football players, among others may be more at risk. Children and teens with significant anxiety and depression, or those with a history of trauma may also be more at risk.

Warning signs

It’s important to watch for warning signs of eating disorders and find help as soon as possible. If a child is struggling, they may show one or more of these signs.

  • Significant weight loss or gain. A child does not have to be thin to have a serious eating disorder, however.
  • Child with over-focus on food, eating habits and/or body weight.
  • Skipping meals, restricting intake, or eating large amounts of food in one sitting.
  • Increased or rigid patterns of exercising.
  • Forced vomiting or use of medications like laxatives and diuretics. Children frequently using the bathroom during or right after meals.
  • Food missing from the pantry, evidence of secretive eating, such as wrappers or hidden food.
  • Comments about being fat, or negative body image.


Full recovery from an eating disorder is possible with multi-disciplinary, specialized care. Parents play a key role in the recovery of their child and should be included into all intervention plans. At Children’s Mercy Eating Disorders Center evaluation and treatment is customized for your child and includes a medical provider, psychologist or social worker and a dietitian as the core team. Psychiatry and family therapy may also be appropriate and is also available in the center.

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Child Psychology

Director, Eating Disorders Center; Associate Professor of Pediatrics, University of Missouri-Kansas City School of Medicine