Body image concerns and dieting fads are an increasingly common problem among children, especially girls. Throughout childhood, it is normal for children to be concerned about the way they look, their weight, and the type of food they consume. However, when a child begins to become obsessed with food, their shape or weight, and develops physical problems, it is possible that the child may have a mental health issue.

Children who have an eating or body image issue may hide their behavior and concerns about weight from friends and family.

Signs and Symptoms of an Eating or Body Image Concern

Your child may have an eating or body image concern if they:

• Fear gaining weight or becoming fat
• Are extremely dissatisfied with body shape or size, including feeling fat even if they are of normal weight or are underweight
• Have unexplained weight change greater than 10 pounds
• Change size in clothing
• Have irregular menstrual periods or no longer have periods
• Develop a low sense of self-esteem
• Feel worthless because of their weight
• Have a poor appetite
• Are constantly dieting even though they are not overweight
• Eat very little and are obviously avoiding fatty foods
• Eat and then vomit to get rid of the food, including binge eating
• Eat and then exercise much more than is typical
• Over-exercise or have an obsessive attitude about physical activity
• Become increasingly isolated from friends and family and have difficulty eating foods in front of others
• Prepare food as if carrying out a ritual (for example, they may cut food up into tiny pieces)
• Eat irregularly with wide variations in how much
• Have unexplained constipation or diarrhea
• Have fainting episodes or frequent lightheadedness

Possible Mental Health Diagnoses

Possible mental health diagnoses within this symptom cluster include:

• Body dysmorphic disorder (BDD)
• Eating disorders

A child with the symptoms listed above could also have a medical problem related to eating. Talk to your child’s pediatrician about your child’s symptoms.