Difficulties with weight, eating habits, or body shape

Everybody eats because it’s necessary for life! Eating is a time of nutrition and pleasure, but for some children and adolescents, the relationship with food and their own bodies becomes a source of concern and suffering. We start our days with meals, and many cultures end their days with meals, too. Eating times bring together caregivers and infants, families and friends, and colleagues. Food is essential for ensuring energy and healthy growth, but it also carries an important emotional and social dimension.

From infancy, children learn to eat with the support of their caregivers. Over time, they develop their own habits and preferences. Therefore, paying attention to how a child or adolescent eats can provide important clues about their physical and emotional health.

What is typical?

How children and teens eat is shaped by their personalities, health, development, surroundings, and parents’ habits.

• Some people eat three meals per day; others eat two or five.
• Children and teens love snacks and often have them between meals (and that is okay!). They are growing, so their bodies use up all the energy from meals faster than adults, making snacks important.
• Some children or teens are picky eaters. They do not like many things and may refuse to try new foods because of their texture, smell, or taste. This is also normal, even though it can be frustrating, as long as they eat enough of something.
• It is also common for a child’s appetite to change from one day to the next, depending on their activity level.
• It is normal for a child to not be hungry when they are sick, tired, or stressed.

The most important things to remember about typical eating in children and teens are:

• It means eating enough food to have energy for the day and to grow well.
• It should be balanced and include different types of food.
• They should relate to food in a healthy way, without fear, guilt or suffering.

Sometimes, when children or teens are really hungry, they may eat too much or too fast and end up with an upset stomach. In pre-adolescence and adolescence, as the body changes rapidly, it is natural for young people to pay more attention to the mirror, make comments about weight, or seek out fad diets. This can often be resolved with guidance on a balanced diet and healthy physical activity.

When should I be concerned?

Be concerned when children or teens often eat too much or too little, or when food starts to cause suffering or harm their physical health, growth, emotions, or relationships. Pay attention if these behaviors occur frequently, last for several weeks, or become more intense over time.

Here are some signs of eating problems:

In younger children (up to 12 years old):

• Eating too little and losing weight
• Eating things that are not food (like dirt, paper, or soap)
• Often eating too much to the point of physical discomfort
• Long times without eating or refusing almost all foods
• Strong dislike of certain foods because of how they look, smell, feel, taste, or their temperature, making basic eating difficult

In older children and teens:

• Eating too little, losing weight, or always seeming to be on a “diet”
• Going to the bathroom or bedroom right after meals, and possibly showing signs of vomiting (e.g., coughing sounds, smell of vomit, or taking excessive time in the bathroom)
• Often eating too much, sometimes in secret or very quickly, and feeling uncomfortable after
• Long times without eating even when food is available
• Throwing up without a medical reason
• Finding hidden food wrappers or food in their bedroom
• Being constipated without a medical reason
• Irregular periods or stopping menstruation in the case of girls without a medical reason
• Using medicine (like laxatives or weight loss pills) without a doctor’s okay
• Exercising too much, especially after eating too much

Other important signs can include: constant concern about weight gain, thinking a lot about food and calories, checking their body in the mirror or with a scale several times a day, feeling unhappy with their body shape, eating large amounts of food in a short time, eating alone, feeling guilty about eating, taking pills to control weight, making themselves throw up, restricting food types based on strict rules without medical guidance, or avoiding food due to fear of physical discomfort.

If these behaviors occur frequently, last more than two weeks, or worsen rapidly, seek help. The sooner you intervene, the lower the risks to their physical and emotional health.

What can I do to help?

As a caregiver, you know your child best. Here are some things you can try:

1. Talk and listen.Ask simple questions to understand how your child feels about eating. You might say, for example, “Is something bothering you when you eat?” or “Are you worried about your body?”
2. Be supportive.Let your child know you care and are there to help. Even if their behavior seems difficult to understand, avoid criticism or scolding. Say that you’re there to support them.
3. Stay calm.Avoid reacting with alarm or punishment when talking about their eating habits.
4. Keep a routine.Have regular family mealtimes without distractions like phones or TV. This creates a calmer, more connected time.
5. Offer a varied diet.Keep healthy food at home, but don’t overdo it with rules or prohibitions. Encourage children to try new foods, respecting their limits and preferences.
6. Avoid diet talk.Do not talk about diets or physical appearance in front of your child, as comments about weight, calories, or bodies—yours, others’, or your child’s—can increase insecurity.
7. Keep medicines safe.Store medicines, especially laxatives or appetite suppressants, out of your child’s reach. Do not use these types of products without medical advice.
8. Watch for changes in behavior.Be aware if your child begins avoiding meals, sneaking food, wearing baggy clothing, or frequently talking negatively about their body.

What kind of professional support can I seek out?

Some caregivers feel embarrassed or guilty if their child has eating problems. However, it’s crucial to remember that neither caregivers nor the children or adolescents themselves are to blame. Help is available.

Talk to your child’s pediatricianor family doctor. They can refer you to other specialists, such as mental health professionals. Mental health professionals can help both the child and the caregivers. They can work with you to support your child at home and in therapy.

You can also find free support through the Unified Health System (SUS). Care often begins at your local Basic Health Unit (UBS). Other services include Child and Adolescent Psychosocial Care Centers (CAPS i), specialty centers, and clinics at university hospitals.