Eating disorders in children: how to recognize them. Sukharev readings

He eats this, and then he doesn’t eat, he prefers only candy, he eats only sausage, you can’t put anything in your mouth at all... How to avoid similar problems and teach your child to eat properly?

Many people underestimate the role eating behavior. Just think, today I ate, tomorrow I don’t eat, today it’s like this, tomorrow it’s that way. Selective taste, limited menu - what's wrong with that? In fact, incorrectly formed eating behavior and, as a consequence, poor nutrition, lead to problems such as:

metabolic disorders due to a lack of certain elements in the diet;
lack of weight or overweight;
digestive problems, gastritis, colitis, abdominal pain;
food allergies;
decreased immunity, development chronic diseases etc.

That is why it is so important to teach your baby to eat right almost from birth. What does it mean to be correct and how to educate it?

First steps

It is difficult to realize this, but it is possible to instill certain eating behavior in a newborn. If you have discussed with other mothers how your children eat, you probably realized that they do it completely differently. Some weakly and for a long time, with breaks, some quickly, in large sips. Some people ask to eat more often, others less often.

The main rule for forming the foundation of eating behavior is to eat when you want, and as much as you want. That is, do not feed by the hour, rocking the baby with a pacifier until he turns blue, until the cuckoo announces that 4 hours have passed since the last meal. Do not breastfeed when you want the baby to shut up. And don’t allow the grandmother to pour another bottle of formula into her grandson’s mouth just because she thought he didn’t weigh enough. A newborn’s body undergoes fine tuning of all systems, and he knows better than anyone when it is or is not time to have a snack. Feeding by the hour, regardless of the child’s wishes, weaning from the breast before the child is full, and overfeeding can once and for all disrupt the natural connection “hunger-food-satiety.”

The second rule is: food is food. And not a means of calm, distraction, entertainment, games, etc. This is true for all children, except for breastfed newborns (for them, mother’s milk is both a sedative and a cure for pain). If the baby has already learned to actively express his desires or eats formula, it is worth making it clear to him: when it is offensive, painful, boring, or just in a bad mood, you can easily correct the situation by communicating with your mother and other relatives. Play, sing, dance, hug, lie next to each other. And you only need food when you are hungry.

Usually, by the time the mother is already able to distinguish what exactly is bothering the baby: hunger or something else, it becomes clear that the child has naturally arrived at a certain diet. So feeding on demand naturally turns into feeding by the hour, only without any violence against the baby.

We introduce complementary foods

Complementary feeding plays a major role in the development of eating behavior. If you want your baby to not be afraid to try new foods, to willingly eat what you offer him, and to eat well, use the following tips.

Complementary feeding should be introduced only when the child is ready for it, that is, he himself shows interest in any food other than milk or formula. On average, this occurs at the age of 6-8 months, but it can happen earlier or later. Typically, a baby who is ready to try complementary feeding already knows how to sit independently and can boast of his first teeth.
Start complementary feeding with unsweetened and unsalted foods. Purees made from hypoallergenic vegetables are ideal for this: zucchini, cauliflower, broccoli. Some doctors advise starting with dairy-free, unsweetened cereals or fermented milk products.
Complementary feeding should be given when the baby is hungry, but before milk or formula.
If the baby winces at the first spoon, do not insist and do not try to force complementary foods into him by any means. Give him time to get used to it: offer the same food for several days. If the child still does not show a desire to continue the meal, try with a different dish. If your baby refuses any complementary foods, stop trying for one to two weeks and then try again.
Under no circumstances try to distract the baby’s attention and shove a spoon at him. Reading books, parents singing and dancing, playing games and watching cartoons while eating is the worst thing you can think of. In this case, the child concentrates not on the food, its consistency and taste, not on his feelings (whether he is hungry or full), but on something extraneous, that is, there is no talk of any correct eating behavior.

Nutrition after a year

Perhaps the most difficult moment in the process of educating eating behavior is the one when the child begins to realize that he is not being fed what his parents eat. He demands your food, climbs into your plate, looks into your mouth with sad eyes... At the same time, he may refuse to chew pieces and agree only to puree. And after trying something really tasty (especially sweets), he will start asking for only this. What should I do?

Sit down at the table with the whole family. Who enjoys picking at a plate alone? It is much better when the whole family gathers around the table. Or at least part of the family. If you don’t want your baby to beg food from adults and refuse his own, create a schedule so that you have breakfast, lunch and dinner with your baby. This way he will be more willing to eat and will quickly learn to use cutlery. For the same reason, it is better to sit a grown-up toddler in a high chair behind big table, and not at the children's table.
Lead by example. It’s easy to guess that if parents eat only burgers and fries, the baby will not want to break away from the group and eat mashed vegetables alone. The only way teach your child to eat right - do it yourself. Eat with him what he can try: vegetables, fruits, meat, side dishes, cereals. In the end, since you care about the question proper nutrition baby, it means you don’t mind normalizing your diet. Moreover, it is extremely beneficial for health.
Say no to TV in the kitchen. Don’t let your child watch cartoons or read books while eating and don’t set a bad example yourself (phones and tablets are the same as TV).
Be careful with snacking. Having eaten between meals, the child may not have time to get hungry by the appointed hour. Especially if he snacked on a couple of sweet rolls or a piece of cake. Try to avoid snacking, and if your baby gets hungry ahead of time, offer him a drink, a small fruit or vegetable.
Buy your child his own dishes and cutlery for children - this will make it more interesting and enjoyable for him to try food.
Do not forbid to show independence. Many mothers try to spoon feed their babies longer so that they don’t get dirty and smear everything around them. Not only is this way of eating very boring, it also quickly becomes a habit. This means that with a high degree of probability such a child will ask to feed him at both 3 and 5 years old. Buy your baby a large apron with a pocket and encourage him to eat on his own. You will be surprised how willingly he will take up food that he previously refused to eat.
Pay attention to serving. A beautifully decorated dish is much more pleasant than a shapeless plop of something that looks like it’s already been chewed. How older child, the more demands he places on the type of food. And this is correct: normally, when a person is hungry, at the sight of an attractive dish, he begins to produce saliva and gastric juice, which makes it easier to digest. If your baby doesn't want to eat, try placing the food nicely on a plate. Cut the meat into cubes and the vegetables into strips so that they are easy to take and put in your mouth.
Develop a competent menu. After a year, the child begins to develop food addictions. Some people prefer porridge, some prefer vegetables, while others love cottage cheese. At the same time, it is, of course, wrong and impossible to feed the baby with one thing, the most favorite one, because the diet should be varied and complete. Eliminate from the menu what your child categorically refuses to eat and replace it with other, similar food (for example, it is absolutely normal to eat carrots and zucchini, but not pumpkin and cucumber).
Combine different products in one dish (your favorite with your least favorite), offer compromise solutions (your favorite zucchini after a piece of meat). Prepare the main course from what your baby will definitely eat. Offer your child several equivalent options to choose from (for example, rice or buckwheat, fish or cutlet) - this way he will feel that he has the right to decide what he will eat, which means he will eat with great pleasure.
And last important advice- do not feed your child fried, spicy, fatty foods, limit pickles and sweets. Firstly, it’s healthier for digestive system and the whole organism as a whole. Secondly, dishes with too strong a taste will force the baby to refuse other, more neutral ones. It is impossible not to consume salt and sugar at all, because the body needs them in small quantities, but it is important to know when to stop. And, of course, sweets should be given only after meals, and not instead of it.

Don’t worry if your child has already developed unhealthy eating behavior - it can and should be corrected at any stage. It all depends only on your patience and desire!

Moscow City Health Department
Scientific and Practical Center for Mental Health of Children and Adolescents named after. G.E. Sukhareva
Department of Psychiatry and Medical Psychology, Russian National Research Medical University named after. N.I. Pirogov
Department of Child Psychiatry and Psychotherapy RMANPO

II ALL-RUSSIAN SCIENTIFIC AND PRACTICAL CONFERENCE
with international participation

"SUKHAREV'S READINGS. EATING DISORDERS IN CHILDREN AND ADOLESCENTS"

Moscow, December 11-12, 2018

INFORMATION MAIL

Dear colleagues!

We invite you to take part in the II All-Russian Scientific and Practical Conference with international participation “Sukharev Readings. Eating disorders in children and adolescents”, which will take place on December 11-12, 2018 in Moscow.

End XX - beginning of XXI centuries were marked by a significant increase in mental illness, especially in childhood and adolescence. With children suffering mental disorders, doctors of various specialties encounter. Children and adolescents with eating disorders are among the most severe group of patients.

Today, eating disorders are a heterogeneous group consisting of various mental disorders and includes both classic anorexia nervosa and bulimia, as well as numerous syndromic eating disorders with different mental illness, including autism spectrum disorders, delayed mental development, endogenous diseases, etc.

High social significance, the relevance of this topic is due to the severe consequences of such conditions. Diagnosis, treatment, rehabilitation and prevention of eating disorders require an integrated multiprofessional approach with the participation of different specialists: psychiatrists, pediatricians, gastroenterologists, endocrinologists, cardiologists, nutritionists, crisis and family psychologists.

We invite all interested specialists, representatives of the parent community and public organizations take part in our conference.

List of main issues planned for discussion:

Eating disorders as a polynosological category;
Anorexia and bulimia: modern views on etiology, epidemiology, diagnosis, classification, pharmacotherapy and psychotherapy;
Features of eating behavior in children with various mental disorders: autism spectrum disorders and other developmental disorders, schizophrenia spectrum disorders, affective disorders and others. Modern approaches to etiology, phenomenology, diagnosis, pharmacotherapy and psychotherapy;
Somatic disorders in children and adolescents with eating disorders: modern approaches to diagnosis and treatment;
Eating disorders in the practice of a pediatrician, gastroenterologist, endocrinologist, gynecologist, nutritionist, cardiologist, pathologist and other specialists. Issues of professional interaction;
Organization of assistance and routing of children and adolescents with eating disorders;
Crisis and urgent states in children and adolescents with eating disorders;
Working with the family of a child suffering from eating disorders;
Assessment of the quality of service medical care children and adolescents with eating disorders;
Issues of undergraduate and postgraduate teaching of child psychiatry and related disciplines.

Goals and expected results Activities

The purpose of the event is to form a consolidated position on creating effective system prevention, diagnosis, treatment and rehabilitation of children and adolescents with eating disorders.

Expected results of the event

Development of new approaches to the classification of eating disorders;
identifying the main biological, psychological and social factors underlying various eating disorders in children and adolescents;
development of a set of measures to facilitate timely identification and further referral of children and adolescents with eating disorders;
formation unified system early detection, diagnosis, treatment and rehabilitation of children and adolescents with eating disorders;
development of a system of multiprofessional interaction with the participation of psychiatrists, pediatricians, gastroenterologists, endocrinologists, gynecologists, nutritionists, cardiologists, psychologists and other specialists, as well as representatives of the parent community for complex therapy and rehabilitation of children and adolescents with eating disorders.

The target audience: psychiatrists, psychotherapists, pediatricians, gastroenterologists, endocrinologists, gynecologists, nutritionists, cardiologists, pathologists, clinical psychologists and other specialists, as well as teachers, parents, journalists, representatives of public organizations.

Conference Chairman:

Bebchuk Marina Aleksandrovna, candidate medical sciences, Director of the State Budgetary Healthcare Institution “Scientific and Practical Center for Mental Health of Children and Adolescents named after. G.E. Sukhareva DZM".

Organising Committee:

Osmanov Ismail Magomedtagirovich, Doctor of Medical Sciences, Professor, Chief Freelance Specialist Pediatrician, chief physician Children's Clinical Hospital named after. Z.L. Bashlyaeva DZM, Director of the University Clinic of Pediatrics, State Budgetary Educational Institution of Higher Professional Education, Russian National Research Medical University named after. I.I. Pirogov Ministry of Health of the Russian Federation, Professor of the Department of Hospital Pediatrics No. 1, State Budgetary Educational Institution of Higher Professional Education, Russian National Research Medical University named after. N.I. Pirogov Ministry of Health of the Russian Federation;
Petryaykina Elena Efimovna, Doctor of Medical Sciences, Professor, Chief Freelance Specialist pediatric endocrinologist Department of Health of Moscow, Head of the Center for Pediatric Endocrinology, Chief Physician of the State Budgetary Institution "Morozov Children's City clinical Hospital DZM";
Shevchenko Yuri Stepanovich, Doctor of Medical Sciences, Professor, Head. Department of Child Psychiatry and Psychotherapy of the Federal State Budgetary Educational Institution RMAPE of the Ministry of Health of the Russian Federation;
Shmilovich Andrey Arkadevich, Candidate of Medical Sciences, Head. Department of Psychiatry and Medical Psychology, Federal State Budgetary Educational Institution of Russian National Research Medical University named after. N.I. Pirogov of the Russian Ministry of Health;
Zinchenko Yuri Petrovich, Doctor of Psychology, Professor, Dean of the Faculty of Psychology, Moscow State University. M.V. Lomonosov, head of the department of methodology of psychology, vice-president of the Russian Academy of Education, academician of the Russian Academy of Education;
Kholmogorova Alla Borisovna, Doctor of Psychological Sciences, Professor, Head. Department of the Faculty of Psychological Counseling, Moscow State University of Pedagogical University;
Portnova Anna Anatolyevna, Doctor of Medical Sciences, Head of the Department of Child and Adolescent Psychiatry of the Federal State Budgetary Institution "Federal Medical Research Center named after. V.P. Serbsky" of the Ministry of Health of Russia, Chief freelance child psychiatrist of the Department of Health;
Anna Yanovna Basova, Candidate of Medical Sciences, Deputy Director of the State Budgetary Healthcare Institution “Scientific and Practical Center for Public Health and Prevention named after. G.E. Sukhareva DZM" on scientific work.

Register to participate in the conference, apply for a speech and familiarize yourself with latest version You can visit the program on the website http://www.npc-pzdp.ru

Applications for performances accepted until November 1, 2018

General requirements for the acceptance and preparation of abstracts:

Acceptance of abstracts carried out before November 20, 2018 The organizing committee reserves the right to refuse publication of work that does not meet the quality criteria scientific research or not suitable for the topic.

Anorexia and bulimia are diseases that affect not only adults, but also children. The most susceptible to eating disorders are adolescents over 15 years of age and adults under 25 years of age. However, children younger age may also experience bulimia, binge eating, or anorexia. How can you tell if your child is suffering from an eating disorder?

According to a study, only 56% of children aged 3 to 12 years have normal weight. 18% of children are overweight, 13% are obese, and 13% are underweight.

Finally, 3 out of 10 children are overweight.

This is why it is so important to understand what category your child is in, monitor their weight as they develop, and pay attention if the indicator is above or below normal age limits.

Anorexia nervosa

When a child suffers from anorexia nervosa, they will severely limit their food intake or avoid eating it altogether, often to limit their water intake in order to keep their weight as low as possible. In addition to this, other methods are used to lose weight. This may be vomiting, exhaustion in gym or using medications such as laxatives and diuretics to “get rid of” excess calories.

Criteria for diagnosing anorexia

Inability to maintain body weight within a normal range based on gender and age.
Excessive fear of obesity.
Body image disturbance, e.g. the impression created primarily by teenagers that their body is plump, despite its low weight.

How to understand that a child suffers from anorexia?

Experts explain that although eating disorders are obvious, parents often ignore them because various reasons, for example, because there are other problems in the family, etc. In any case, the signs may be as follows:

Children suffering from anorexia continue to show miracles of remarkable endurance and can do everything they did before, such as ballet, gymnastics, etc.

Bulimia nervosa

Bulimia nervosa is associated with eating disorders and is considered the most common because the number of patients with bulimia nervosa is higher than with anorexia nervosa.

People suffering from bulimia have the following three main characteristics. They consume excessive amounts of food with overeating and regular intervals between them, and although they want to control the process of eating, they feel helpless. After eating, they either induce vomiting, drink laxatives, or use other methods to feel better. They are very concerned about their weight, they want to lose weight, and they are very unhappy with their reflection in the mirror.

Unlike patients suffering from anorexia, people with bulimia have a normal body weight compared to their age. Most cases begin during adolescence (13 to 19 years), and in last years there are cases in more at a young age. Research shows that bulimia is more common in female population and that up to 4.2% of women have bulimia at some point in their lives. Additionally, children suffering from bulimia are very active during the day and never lose weight.

Binge eating

Binge eating is a very common eating disorder in children, which is characterized by the child’s desire to constantly eat. The child experiences inexplicable nausea, eats secretly, hiding foods, and steals foods that most often fit into the “forbidden” category.

The child may overeat in front of his own, constantly gaining excess weight, or he may develop obsessions with food, worship or worry about some food.

Other symptoms of eating disorders:

There are eating disorders that are not classified in any of the above categories, but they do have some characteristic symptoms, which parents should note:

How to help your child

By according to psychologists, The first thing to do if any of the above symptoms are noticed is to understand what is happening to the child. In most cases, children with eating disorders suffer both physically and psychologically. Consider whether there is anything that may be affecting the child mentally or emotionally and talk to them.

Devote more time to your child than usual to be close to him, communicate, do common things and even cook together!

In any case, discuss your problems and observations with your pediatrician, who, if he deems it necessary, will recommend a nutritionist or a good psychologist who can help the child practically.

Don't be afraid and add me to

Nutrition - necessary element for physical and mental health of a person. This is a basic need, a special ritual that performs the function of sensory communication and interaction. In children it is associated with a feeling of security. often depends on psychological factors, reasons.

Eating disorders in children. Forms of manifestation

Occurs before age three and persists throughout life. There are two stages: the first is physical, the second is psychological. The first depends on general degree health of the body. A child's eating behavior may change due to physical illness. The second affects the individual perception of food and methods of consumption. This means that it can be affected by diseases of the body, congenital pathologies, psychogenic factors. In the absence of organic problems, the most probable cause- psychological. To a greater extent depends on the nature of the relationship with the mother.

Eating disorders in children- a group of diseases, the foundation of which is psychogenic factors. Displayed in relation to food, methods of intake. Examples of violations include refusal to eat food, excessive consumption, desire to consume inedible items, substances that form bad eating habits in later life. In young children it manifests itself in the form of refusal breastfeeding, food interest in “adults”, “forbidden foods”, selectivity.

Eating habits, formation features

From birth, eating habits are based genetic predisposition. They are unstable and can change throughout life. They are influenced by the children’s family environment and the characteristics of the members’ interactions with each other. Formation of eating behavior begins during breastfeeding. A newborn learns to distinguish between hunger and satiety, and learns to distinguish tastes. During this period, basic trust (distrust) in the world and the basis for interaction with the immediate environment are formed. This occurs through the emotional interaction of the child with the mother during the feeding process.

Correct habits can be formed in a baby only in a situation of full support and understanding of the child’s nutritional needs. The mother must know when he is hungry, he needs to be fed, feel when he is full, and fully accept the baby’s needs. Bad eating habits may occur due to improper introduction of complementary foods. Parents often try to feed their children according to a schedule (at a certain time - a certain amount of food), regardless of whether the child wants to eat or not. The main focus here is on the need to feed, and not on the real needs of the baby. This can lead to eating disorders. (feeding according to need) provides that the child can eat when he is hungry. The child learns to understand the feeling of hunger and satiety independently, and can control these states. He is able to feel his body and react to it. Parents only need to provide opportunity and access to food. From a physiological point of view, this is useful for digestion (the child eats as much as he needs, does not overeat), from a psychological point of view - he feels significant, feels, his feelings are accepted. This is important for the development of a harmonious personality.

According to statistics, more than thirty million people in the United States alone are faced with one or another eating disorder. Number of children suffering from similar diseases, gradually increases. Diagnosis of diseases has improved, attention to mental health now more detailed, so the stigma associated with such diseases is beginning to gradually disappear.

However, every child is exposed to a variety of messages about food from a variety of sources, so the dangers never go away. Parents need help dealing with eating disorders. First, you need to figure out what signs you can use to talk about the presence of an eating disorder. Let's look at the most obvious and common of these signs that every parent should watch for.

Abnormal weight changes

Children should gain weight on a fairly clear schedule. If your baby is not gaining weight or, more worryingly, losing weight, it may be a worrying sign. Eating disorders in both adolescents and adults are often diagnosed by noticeable weight loss, for which there is no medical reason. In children, weight loss may be slight, but weight loss relative to height will be noticeable. Any unexpected fluctuations in body weight (whether gain or loss) may reflect changes in eating behavior. Try to control the child’s body weight, but unobtrusively - increased attention weight gain can also trigger an eating disorder. You shouldn’t immediately sound the alarm, just calmly and openly discuss issues of weight and its changes with your child.

Avoiding family dinners together

Sharing meals encourages the development of healthy eating habits in children, but a child with eating disorder may make every possible effort to avoid them. Pay attention to the situation if the child claims that he has already eaten with friends or refuses to eat in the presence of other family members, does not eat food that was previously loved, or calls it unhealthy. In addition, some children begin to simply cut food rather than eat it. An alarming sign is also excessive attention to the method of cooking and portion control, as well as the habit of reading all labels. Pay attention to this behavior, but do not force the child to change habits immediately; try to gently find out the reason for them and support them at such a moment.

Switching to a specific diet

A child who suddenly shows interest in a popular diet or “healthy” eating plan may claim that he is not motivated by weight loss, but it can still be a warning sign. In addition, children may refuse certain categories of food. Often, children with conduct disorder assume that dieting involves skipping meals. Monitor sudden changes in diet and discuss their nature. Perhaps the point is really not at all in the eating disorder, but in the fact that the child is interested in certain products or his food preferences simply change with age.

Lost food in the house

Eating disorders manifest themselves in different ways. Children with bulimia and a tendency to overeat may hide food in their room and secretly eat it when no one is around. Overeating usually involves eating large portions of food quickly. Children usually overeat alone, so parents do not realize that weight gain is associated with bulimia. Other signs of bulimia include vomiting, laxative use, and feelings of guilt or shame associated with food. If you regularly notice that food goes missing somewhere, try to pay closer attention to how your child eats and how he behaves at the table. You may need to start fighting an eating disorder.

Increasing physical activity

Children who have an eating disorder may want to start exercising more. Craving for constant physical activity is not always associated with eating disorders, however, sometimes there is still a connection. If the child anorexia nervosa, increased activity may be a way to control weight. Over time, the sport becomes more and more intense. For young people with bulimia, exercise becomes a way to compensate for overeating. Try offering your child yoga classes, this good way do your physical fitness and at the same time raise self-esteem. The main thing is not to prohibit sports, since interest in it may be completely unrelated to eating disorders, and indeed, physical exercise very helpful. You just need to make sure that the exercises don't become too intense.

Increased attention to appearance

A child who spends too much time in front of the mirror and constantly weighs himself may be in danger. Often teenagers are not too confident in themselves and their appearance, they refuse pool parties, do not want to go to the beach, wear baggy things and associate their appearance with their own importance. All this could be a sign bigger problem. However, you should not criticize a child’s interest in his own appearance - this is normal at a certain age and often has nothing to do with eating disorders. Your negative attitude will only undermine your child's self-confidence even more.

Changes in behavior

Children who are constantly irritated or cannot concentrate on anything, isolate themselves from society, do not always suffer from an eating disorder, however, such changes often happen to those who are sick. Pay attention to sudden changes in mood, assessments, and relationships with others. For example, a child who was previously a good student may begin to get poor grades. A child who had many friends may begin to isolate himself from society and refuse invitations to visit. Children who were previously happy and carefree become anxious and sad. If you notice such a drastic change, think about what might be causing it.

Increased interest in cooking

It may seem strange for someone with an eating disorder to cook for others, but it is a common situation. This may be due to the need to control everything around, or it may be the consequences of the brain reminding a starving person to eat. One way or another, statistics have proven that interest in cooking is an extremely common sign of eating disorders. No matter what behavior is causing you concern, you need to discuss it with your child. The sooner he gets help, the better the result will be.