Eating disorders can emerge much earlier than you might expect. As the concepts of body image, self-confidence and identity begin to evolve, young people compare themselves to others and “ideal” images portrayed online in the media. In today’s hyper-connected society, children and pre-teens are conditioned to believe that certain body types and appearances are more acceptable than others.

The need to fit in and belong is inherently human, but children and pre-teens are more likely to validate themselves based on others’ approval. Those who are overweight or don’t fit a certain image may be bullied at school or online, which only reinforces the idea that who they are is not good enough. Being liked becomes equal to being pretty or fit, and children can start to develop the beliefs that lead to eating disorder behaviors early.

If you are concerned that your child or pre-teen may have an eating disorder, here are some telltale warning signs to look out for.

Avoiding Food or Eating Non-food Substances

In children under 12, one of the most common expressions of an eating disorder are food aversion. Children may frequently complain of a stomach ache, claim to be ill, or flat-out refuse to eat.

Children in this age may also begin to eat substances like dirt or soap, a condition known as pica. This behavior typically falls outside of their developmental stage, e.g. a 10-year-old eating chalk or paper vs. a 2-year-old curiously sampling a handful of dirt.

Digestive Problems

If your child or pre-teen uses the bathroom excessively or frequently complains of stomach aches related to constipation, they may be malnourished. These symptoms are also associated with changes in appetite or food consumption. This undernourishment may be because they are not eating enough or because they are purging what they do eat.

You should speak to your child and their doctor about these changes immediately. Early intervention is the most important factor of recovery in eating disorders. Eating disorder treatment facilities for children can help stop the progression of anorexia and bulimia into life-threatening stages.

Hoarding Food

Some children will hide food in their rooms or somewhere else so that they eat later. Others may try to conceal their lunches or other meals to convince parents they’re eating more than they actually are. Some children will restrict their consumption to virtually nothing while others fast for periods of time only to binge large portions later. They may make themselves sick afterward and attempt to “clean” their body of the food they’ve eaten.

Closely monitor your child’s food consumption and comfort levels when eating. Are they claiming to eat regular meals despite losing weight? Some children, especially pre-teens, can be quite crafty about disguising their eating disorders. parents have to do a bit of investigative work to truly get to the bottom of their behavior.

Being Overly Concerned With Their Appearance

Children begin to compare themselves physically to their peers around age 7. Pre-teens are even more worried about looking “cool” and fitting in with their classmates. However, if your child is extremely worried about appearing fat or thin, they may be struggling with an eating disorder. Keep in mind that beliefs precede behaviors; early anxieties can and often do turn into harmful behaviors when left untreated.

Remember to approach your child with love and concern. Do not force them to eat or scold them for their feelings. They are just as confused and pained by the experience as you. Eating disorders are not a choice, and they are not something that can be resolved by simply eating more or dieting. The best thing you can do in this situation is to reach out to your child’s doctor and a licensed psychologist right away.