Colman Noctor: Eating disorders on the rise among young children
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I recently took part in an online seminar with Bodywhys, the Irish support organisation for eating disorders.
Bodywhys training and development manager Harriett Parsons spoke about a notable rise in the number of fifth and sixth-class primary school children displaying disordered eating behaviours compared to previous years.
This increase is reflected in my clinical experience. Before, I would have typically seen young people beginning to show signs of eating problems and body image concerns in second or third year of secondary school, but now it is occurring much earlier.
In the past, parents mediated their child’s exposure to adult content by keeping a watchful eye on what they read, watched or listened to. But now that many children have unfettered access to multiple social media platforms, surveillance of what they view is almost impossible.
An eating disorder is best understood as a solution to a problem rather than a problem in itself. When people feel they have little or no control over their lives, hyper-controlled eating can seem like an appealing antidote for a complex emotional problem. They often believe that when you ‘eat less and move more’, you are ‘good’, while eating more and moving less means you are ‘bad’.
In the early days of an eating disorder, it seems to make the person’s life better. Concentrating on something you can control, like your weight, is easier than being preoccupied by things you cannot control, such as academic pressure, friendship fallout or low self-worth.
They often describe how friends and adults they meet praise their efforts to restrict their intake and increase their exercise. Comments like ‘I would love to have your willpower’ or ‘you’ve got a great figure, I wish I looked like you, what’s your secret’ are common. I have heard of such comments being made even when a child is so underweight they are medically compromised. It’s a sad indictment of how we glorify weight loss.
It is not only the societal glorification of thinness that promotes disordered eating — many online platforms, particularly social media, inadvertently contribute to the normalisation or promotion of unhealthy body image ideals.
More worryingly are ‘Pro-Ana’ sites with content promoting extreme thinness or unhealthy weight loss methods as aspirational goals, including images, quotes, or tips that reinforce disordered eating behaviours.
While many of these may not explicitly promote eating disorders, they contribute to a culture of undue emphasis on thinness and perpetuates harmful dieting behaviours, especially to impressionable child viewers.
A 2023 study published in the International Journal of Environmental Research and Public Health found that excessive or obsessive social media use can be a risk factor for body image dissatisfaction and associated eating disorders. Another study published in the same journal in March 2021 showed that widespread use of social media among children and teenagers could increase body dissatisfaction as well as their drive for thinness, rendering them more vulnerable to eating disorders.
Before social media, body-image comparison was restricted to celebrities and stick-thin catwalk models in glossy magazines. But social media platforms foster a more intense culture of comparison, with users constantly comparing their bodies and lifestyles, not only to airbrushed models and celebrities but to influencers and, in some cases, even their peers.
Where adults may have the life experience to dispel some of this messaging as nonsense, young children and emerging teens do not have such a filter, contributing to their feelings of inadequacy and convincing them of the need to pursue unhealthy behaviours in pursuit of an unrealistic ideal.
A recent example is social media hashtag #LeggingLegs, promoting a ‘thigh gap’. Many users have slammed this trend and, as a result, it has been taken down by TikTok. But such unreasonable and unhealthy fads crop up like a game of ‘whack-a-mole’ where another is created as soon as one is shut down.
Trends like Legging Legs are dangerous and harmful, especially to youngsters who naively interpret the often unrealistic goals as something they ‘need’ to pursue.
With more and more children owning smartphones at younger ages, it has become increasingly important for adults to provide them with a counter-narrative to the dieting culture.
Online misinformation about nutrition, exercise, and weight loss is widespread. Exposure to this poorly informed content can lead children to adopt unhealthy eating habits or extreme dieting practices based on faulty information they are not mature enough to question. Parents and schools need to address media literacy and encourage children to be critical of these messages.
While I appreciate the need to provide education about healthy eating, this approach can also run the risk of demonising certain foods and making some children hyper-conscious of calories and fats. The militant practice of inspecting school lunch boxes for anything resembling a ‘treat food’ feeds into this problem too. The narrative of ‘good’ and ‘bad’ foods needs to be revisited.
Beyond schools and parents stepping in, online platforms must take the necessary steps to combat the promotion of content that promotes eating-disordered behaviours. This may involve implementing policies to remove harmful content, providing resources for individuals struggling with eating disorders, and promoting body-positive content and messages.
If you are concerned about your child developing an eating disorder, Bodywhys runs a successful online PiLAR programme which many parents have attended in recent years. It can serve as crucial support to parents when children have to wait for unreasonably long periods for a mental health assessment.
In the meantime, alongside promoting balanced, healthy attitudes to food, weight and shape, we have a duty to ensure our children are getting reliable information about the steps they need to take to remain fit and healthy. We also have to be acutely aware of the risk of children as young as ten or 11 engaging in any dieting behaviour.
With current trends suggesting that eating disorders are growing in younger children, we must be vigilant about the content they are viewing and be proactive if they start to restrict their diet. Parents must also be aware of the messages they give their children about weight and role model body positivity.
- Eating Disorders Awareness Week runs from February 26 to March 3
- Dr Colman Noctor is a child psychotherapist