According to research compiled by the National Eating Disorder Association, 40 to 60 percent of elementary school girls are concerned about their weight. By age 10, 81 percent are afraid of being fat. And by adolescence, 32 to 57 percent of girls will have engaged in “crash dieting, fasting, self-induced vomiting, diet pills, or laxatives.”

I was 13 years old the first time I stuck my fingers down my throat. The irony is, no one had ever told me I was fat. And while I had gotten curves before most of my friends, my newly budding breasts seemed to be more a source of envy than something I was made to feel ashamed of.

It wasn’t about weight for me. At least, not in the beginning. It eventually became about that, but when it started, it was more about control. About trying to maintain a handle on something in my otherwise chaotic life.

In part, I can now see it was also about trying to get the attention of my parents, who were a bit caught up in their own issues at the time.

Unfortunately, by the time I was finally caught, I was 16 years old and this habit was so deeply engrained for me, it wasn’t something anyone could convince me to give up. It would be another 6 years (several of those spent as a very sick girl) before I would make strides towards any kind of real recovery.

I’ve often wondered what would have happened if the adults in my life would have spotted the signs sooner.

Of course, eating disorders are not simply a pre-teen or adolescent girl problem. While girls are the most often afflicted, approximately 10 to 15 percent of eating disorder patients are male. This can sometimes be even harder to spot because of the pre-conceived notions surrounding gender and eating disorders.

The differences between eating disorders can vary greatly as well (for instance, binging vs. restricting, over-exercising vs. purging, etc.). So I don’t necessarily blame anyone for not spotting mine sooner. The signs can be hard to see. For me, they mostly included over-eating and then jumping in the shower—I relied on the sound of running water to drown out the noise of me getting rid of my meals. But a lot of that also took place in private. I would wait until no one was home, or until everyone was already asleep, before I would go on my binging crusades.

And sometimes, I wouldn’t even binge at all. I would eat completely normal meals, and then throw those up just because I needed to feel empty.

The signs aren’t necessarily cut and dry. But if you are concerned your child may be suffering from an eating disorder, WebMD suggests these as potential symptoms you should be aware of:

  • Anxiety, depression, or perfectionism
  • An intense focus on dieting and weight
  • Excessive or compulsive exercising
  • Rapid weight loss or irregular menstruation
  • Strange eating habits—eating too much, not enough, avoiding meals, eating in secret, food disappearing, etc.
  • Sensitivity to cold
  • Use of laxatives
  • Mood swings
  • Overemphasis on physical appearance
  • Routinely heading to the bathroom after meals
  • Scarring on the knuckles from vomiting

Anorexia and bulimia can look very different, but they are often driven by the same base desires. I sometimes think that the people who have been there themselves are best at spotting it in others. I recently met an 11-year old girl who I immediately recognized the signs in. Looking at her knuckles was all I needed to confirm my suspicions.

The fact of the matter is, more kids are struggling with these issues than you might ever suspect. And even if you have worked hard to create a stable and supportive home for your children, they are receiving messages from outside forces every day that could contribute to the development of disordered eating or body image issues. The best way to help them combat that is to remain aware and ever-available. Don’t stop talking to your kids. Keep the lines of communication open, and consult your pediatrician if you have any concerns at all.

Addressing eating disorder issues early can sometimes be the key to helping your child combat them. But in order to do that, you have to spot the signs first.

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