Top Docs: Kids and eating disorders

Though eating disorders such as anorexia or bulimia generally start in the teenage years, health experts now know that younger children aren't exempt and urge parents to be on the lookout for telltale signs. Here's what you need to know:

1. EATING DISORDERS CAN AFFECT THE VERY YOUNG

"Most people think of it as an adolescent or college-age problem," said Dr. Marc S. Jacobson, director of pediatric metabolic medicine at ProHealth Care Associates in Lake Success. However, he said, "over time, we're seeing it appear in younger and younger people."

The U.S. Centers for Disease Control and Prevention estimates that one in 1,000 youths 8 to 11 years old have an eating disorder, as do one in 500 age 12 to 15. Males develop the condition, too, but to a much lesser extent than females.

2. EATING DISORDERS CAN BE HARD TO DETECT

Bulimia -- a condition in which a person binges on food and then purges, often through vomiting or laxatives -- can be difficult to detect. Some bulimics are able hide their disorder, said Dr. Morton Levy, a Roslyn Heights pediatrician affiliated with North Shore University Hospital in Manhasset. Still, they may show signs of weight loss.

Anorexia, in which people try desperately to lose weight, is easier to detect because the person often exercises frequently, usually seven days a week, Levy said. And among females who've started menstruating, their cycle is generally disrupted, he said.

Overall, though, "children are very good at concealing eating disorders," Jacobson said. "If they really want to lose weight, they don't want anyone interfering."

What to watch for? Children with an eating disorder may try to hide weight loss by wearing several layers of clothing. They also might do so to keep warm, Jacobson said, because in severe cases, "they start having trouble maintaining their body temperature."

3. WATCH FOR RED-FLAG BEHAVIORS

"Red flags for an eating disorder need to be taken seriously and addressed as early as possible -- weight loss, preoccupation with food or weight, excessive exercise, self-induced vomiting, use of diet pills and use of laxatives or diuretics," said Dr. Clifford Nerwen, medical director of the division of general pediatrics at Cohen Children's Medical Center of New York in New Hyde Park.

Jacobson recommended watching to see if children try to avoid certain foods or talk about friends who are overly interested in food. For example, he said, "Sometimes, your daughter will come home and say the girls at the lunch table said, 'Don't eat XYZ anymore' or 'Don't eat anything too fatty.' "

4. A TEAM APPROACH MAY BE NEEDED TO TREAT A CHILD

"Therapy must be individually directed, depending upon the particular child's circumstances and degree of illness," Nerwen said. "Mild cases may be appropriately taken care of in the hands of a pediatrician and a nutritionist. As patients become more complicated and symptoms more persistent, physicians and mental health workers with expertise in treating adolescents with eating disorders -- psychiatrists, psychologists or social workers -- may become involved."

In the most severe cases, a child with an eating disorder may require day treatment or hospitalization, Nerwen said. And, according to Jacobsen, psychiatric medications may be prescribed.

5. IT'S NOT CLEAR WHY EATING DISORDERS OCCUR

The cause of eating disorders remains a mystery, Jacobson noted, although it appears to be a blend of genetic predisposition and environment. "They do tend to run in families and exist with other psychiatric conditions that run in families, like depression," he said.

Pediatrics and adolescent medicine

PEDIATRICS

Dr. Andrew Adesman

1983 Marcus Ave.

Ste. 130

New Hyde Park; 516-802-6100

Dr. Harvey E. Bernstein

Smithtown Pediatric Group

260 Middle Country Rd., Ste. 107

Smithtown; 631-979-7222

Dr. Lev Chernobilsky

269-D E. Main St.

Smithtown; 631-361-2121

Dr. Maurice J. Chianese

ProHealthCare Associates, LLP

Div. of Pediatrics

7 Vermont Dr.

Lake Success; 516-622-7337

Dr. Seymour M. Cooper

1101 Stewart Ave.

Ste. 306

Garden City; 516-746-2299

Dr. Barbara Cusumano

325 Meeting House Lane

Southampton; 631-283-7733

Dr. Robert S. Festa

270 Union Ave.

Holbrook; 631-588-4442

Dr. Eugene B. Friedman

271 Jericho Tpke.

Floral Park; 516-354-7575

Dr. Lawrence Galinkin

700 Old Bethpage Rd.

Old Bethpage; 516-293-0666

Dr. Lynda Frances Gerberg

200 Middle Neck Rd.

Great Neck; 516-466-3311

Dr. Eric Gould

225 Community Dr., Ste. 105

Great Neck; 516-829-9409

Dr. Abraham I. Green

115 Franklin Place

Woodmere; 516-295-1200

Dr. Jacob Grijnsztein

107 Northern Blvd.

Ste. 201

Great Neck; 516-487-6565

Dr. Dorie Hankin

173 Mineola Blvd., Ste. 301

Mineola; 516-739-1936

Dr. Martin Kaplan

12 Medical Dr.

Port Jefferson Station

631-331-1710

Dr. Harvey A. Kolker

111 Sylvan Ave.

Miller Place; 631-928-4888

Dr. Lee A. Kurfist

205 E. Main St., Ste. 2-8

Huntington; 631-424-1741

Dr. Jill Leavens-Maurer

Winthrop Pediatrics Assocs.

222 Station Plaza N., Ste. 611

Mineola; 516-663-2532

Dr. Morton G. Levy

133 Andover Rd.

Roslyn Heights;

516-621-9360

Dr. Richard E. Manners

Mid-Suffolk Pediatrics

1770 Motor Pkwy.

Islandia; 631-434-1770

Dr. Ronald Marino

222 Station Plaza N., Ste. 611

Mineola; 516-663-2532

Dr. Ruth Milanaik

1983 Marcus Ave.

Bldg. 1, Fl. 1, Ste. 130

Lake Success; 516-802-6100

Dr. Clifford Nerwen

Steven & Alexandra Cohen Children's Medical Center

Dept. Pediatrics

410 Lakeville Rd., Ste. 108

New Hyde Park; 516-465-4377

Dr. James G. Parles

260 Middle Country Rd., Ste. 107

Smithtown; 631-979-7222

Dr. Joseph B. Quinn

325 Meeting House Ln., Bldg. 2

Southampton; 631-283-7733

Dr. Morris Rabinowicz

995 Old Country Rd.

Plainview; 516-935-7333

Dr. Marvin Resmovits

107 NE Northern Blvd., Ste 201

Great Neck; 516-487-6565

Dr. Richard Sosulski

269 E. Main St., D Bldg.

Smithtown; 631-361-2121

ADOLESCENT MEDICINE

Dr. Martha Arden

2001 Marcus Ave., Ste. N204

New Hyde Park; 347-882-1321

Dr. Martin M. Fisher

410 Lakeville Rd., Ste. 108

New Hyde Park; 516-465-3270

Dr. Marc S. Jacobson

1300 Union Turnpike, Ste. 301

New Hyde Park; 516-829-8600

Dr. Linda Levin Carmine

Steven & Alexandra Cohen Children's Medical Center

Adolescent Medicine

410 Lakeville Rd., Ste. 108

New Hyde Park; 516-465-3270

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