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Let's face it...raising kids is hard. The sleepless nights, the endless worry, the multitude of decisions that have to be made each day. It is no wonder that we sometimes let the little, apparently harmless quirks that our kids pick up, go unnoticed. When it comes to your child's eating habits, it can be very difficult to know when to worry. Kids are notorious for being picky eaters, therefore when your daughter suddenly decides she doesn't like or won't eat yet another food you may not even notice. On top of natural pickiness, pre-teen and teen years are a time of exploring your individuality and finding out your likes and dislikes. Your daughter might decide one day that she is going to be a vegetarian. The next day she may decide that she wants to be on a high protein, low carbohydrate diet. It is normal for teens to be concerned and self-conscious about their appearance.

Puberty is a time when hormones are raging, bodies are changing, and it becomes more and more important to avoid standing out from the crowd. Additionally, interest boys begins to take more of a front stage, and concern about whether or not they will be interested in her becomes critical. Unfortunately, this normal concern can start to be an obsessive quest for a perfection that is not only unrealistic, but unattainable.

Knowing this, then, how do you decide when to worry about your teen's unusual eating habits? Following are a few notable signs that you may want to intervene in your child's behaviors.

● One key sign is a fluctuation in weight. Excessive dieting, binging, and purging will all take their toll on a growing child. Disruptive eating patterns will lead to weight loss and weight gain.

● A drop in energy level that affect physical stamina can also be a clue that not enough calories are being consumed.

● Amenorrhea, or loss of menstrual periods, may be a result of excessive fat loss.

● Avoidance of social situations where food is the main attraction. Teens who are afraid of eating *too much* or eating *bad foods* may avoid socializing when food is the main focus such as barbecues, eating out, parties, etc.

● Refusal to eat in front of other people. This may be a sign that your child isn't eating, period. It may also mean that she is embarrassed about having other people see her eat. Either way, it is not a positive reaction to food.

● Cutting food up into tiny bites before eating it. This prolongs the eating process, allowing others to finish up and leave the room. The uneaten food can then be disposed of without people noticing.

● Pushing food around the plate to make it appear as if she has eaten more than she has. Additionally, this also prolongs the eating process, thereby making it seem that she has eaten more than she has.

● Continual dieting, even though the teen is within a normal weight range.

● Comments about feeling or being fat. While it is normal for a teenage girl to lament about being too fat, usually one or two comments are made and the girl, knowing that she isn't really fat, doesn't say much more about it. However a normal weight child who comments continually about her weight may be bordering on an eating disorder.

● A preoccupation with food, nutrition, and caloric content. While there is nothing wrong with your teen discovering an enjoyment of cooking, this may signal a problem. As the eating disorder develops, food becomes a larger than life object in the teens life. Because of this, she may want to learn more about cooking and, because of her hunger, will surround herself with food while still avoiding eating it and/or purging after binging on it. In addition to this, an eating disorder may be developing if the teen knows the calorie content and nutritional values of seemingly every morsel she puts into her mouth.

● If your child's sudden decision to become a vegetarian is accompanied by a sudden increase in the amount of exercise she does, there may be cause for concern. It can be particularly hard to recognize this sign in teens who are already involved in sports that may emphasize body size. It is more common to see eating disorders develop in sports such as gymnastics, swimming, ballet, etc. as the teen strives for a better suited physique.

● Insomnia, irritability, and changes in personality can also signal an eating disorder. Unfortunately, these are also pretty normal side effects of hormonal changes and growing up in general. Knowing your child and maintaining a close relationship with her will help you to decipher whether or not her irritability is unusual or just normal teenage angst.

While the above behaviors can be telling signs of an eating disorder, there are some behaviors that are more common among those developing Bulimia. These may include:

● Excessive eating. You might notice that the goodies you bought at the grocery store are completely gone the next day. You may find a large stash of food wrappers in the garbage. Uncontrolled, excessive eating or binging is a warning sign of bulimia.

● Purging. This can be in the form of a rigid diet, particularly after a binging episode. Other methods of purging include self induced vomiting and abuse of laxatives or diuretics. If your daughter frequently uses the bathroom right after meals you may want to watch carefully for other signs of possible purging. Generally reddened, scratched fingers will indicate self-induced vomiting. Less noticeable would be swollen cheeks or swollen glands. Foul smelling breath from the vomit as well as from the disruption of normal stomach acids are also indicative.

The behaviors mentioned above can all be signs of an eating disorder. There are many other behavioral clues that may indicate an eating disorder. Girls who are dealing with eating disorder often have other emotional and behavioral issues that they are dealing with. They may be prone to other addictive behaviors such as alcoholism or drug abuse. They may become more withdrawn, depressed, and possibly suicidal.

If you suspect your daughter's behavior is caused by an eating disorder, it is extremely important to get help as quickly as possible. Redirecting negative behaviors and thought patterns as soon as possible greatly increases the chance of a full recovery from an eating disorder. Your first line of defense is discussing your concerns with your daughter in a non-confrontational manner. That said, it can be very hard to get a person dealing with an eating disorder to recognize that there is, in fact, a problem. If your daughter is under legal age, you can take it into your own hands to require her to seek medical care. Visiting a doctor for a physical exam will give you a baseline from which to work. Your doctor can advise you on what steps should be taken to treat the eating disorder. There are many options available. These include out-patient treatment and counseling, consultation with a registered dietician, possible medication usage and, in some instances, in-patient treatment.

Which decision is right for your child will be based upon a multitude of factors and will be best discussed with your health care provider.

The first line of defense is to try to prevent a distorted way of thinking about body image and food. Build your child's self-esteem. Let her know that her worth is not based on her weight. Make sure that your child understands that the media images that bombard us each day are just that, images. Nobody is perfect and, with the proper lighting, make-up and photo editing programs we could all look like super models!