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Anxiety, eating issues in kids

Dear Mayo Clinic: My 9-year-old daughter always has been small for her age and never has much of an appetite. She's also an anxious child. During her last doctor's appointment, the pediatrician suggested we see a therapist about her eating habits. Could her anxiety be why she won't eat much? Does this mean she has an eating disorder?

A: The situation you describe is, unfortunately, a common one. Anxiety and eating issues often go hand in hand, and the symptoms have a tendency to reinforce one another. It's not possible to say if your daughter has an eating disorder, based on your description alone. But it sounds like she may be at high risk for one, and an assessment of her condition would be strongly recommended.

A big part of anxiety is excessive worry and fear. That worry and fear can trigger physical symptoms, such as fatigue, irritability and sleep problems. In children, feelings of anxiety also frequently cause stomach upset. That can lead to a lack of appetite and a decrease in the amount of food a child eats.

If, over time, low food intake leads to low body weight or failure to gain the weight a child needs for healthy growth and development, that can become dangerous. In addition, low body weight and insufficient food intake can make anxiety symptoms worse. If an anxious child always has been low in weight, like your daughter, that means she is even more at risk for falling below the developmental curve and for her eating to become a factor in her mental health. Studies have shown that, even if weight loss or restrictive eating starts for another reason other than body image concerns, any person can develop an eating disorder if he or she loses enough weight.

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