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Winnipeg Free Press - PRINT EDITION

Doctors are seeing binging, purging in five-year-olds

By: Sharon Kirkey

Posted: 12/15/2008 1:00 AM | Comments: 0 (including replies)

Pediatricians across the country are being asked to report symptoms of binging and purging in children as young as five.

The survey by the Canadian Paediatric Surveillance Program is the first attempt to collect national data on bulimia nervosa in five- to 18-year-olds. It comes as doctors are seeing eating disorders at ever-younger ages, a phenomenon experts partly blame on a culture that idealizes thinness.

Researchers started out looking at restrictive eating disorders in children under 12 -- "kids in the anorexia nervosa range of eating symptoms," says principal investigator Dr. Leora Pinhas, psychiatric director of the eating disorders program at Toronto's Hospital for Sick Children.

"At the time, we didn't think that kids purged or binged, that there wouldn't be a lot of that." In fact, Pinhas says "about 10 per cent of them were actually throwing up."

The finding surprised researchers. "We just weren't expecting it in kids that young," she adds.

Bulimia most commonly occurs in older adolescents. It's thought one per cent of teens meet official diagnostic criteria, although as many as three to six per cent of adolescents have symptoms.

However, there are reports of purging in children who have not yet reached puberty.

Binging is defined as eating, in a two-hour period or less, more than what most people would normally eat, with a sense of feeling out of control.

"They just eat whatever is in the fridge, or the snack cupboard," Pinhas says. "They usually binge at home."

Parents realize large amounts of food are disappearing, or there might be food wrappers left lying around.

Most children who binge and purge fall into an average weight range, and often look physically normal. What's more, they can hide what they're doing.

"Kids are so smart," Pinhas says. "When kids are (vomiting) they will turn on the tap, they'll flush the toilet or do it in the shower so people can't hear them.

"If they have money, they might use their allowance to buy food at the store, and binge on that." Some children hide laxatives.

Most of the children in the earlier study who were binging and purging were 10 to 12 years old.

"But we did get cases in the first study as young as five," Pinhas says.

"We don't want to leave those kids out of it. If we're seeing kids as young as five, that's going to impact the kind of treatment we provide and how we understand what we need to do in the country to address this issue."

Pinhas says some children who lose a lot of weight don't have serious "wanting to lose weight thoughts."

-- Canwest News Service

Republished from the Winnipeg Free Press print edition December 15, 2008 A9

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