With eating disorders affecting girls at ever-younger ages, a recent study found that a surprisingly simple tactic might help: Dine as a family.

Among 4,746 adolescents in the study, girls who ate five family meals per week had about one-fourth the risk for extreme weight control practices. Family dining helps parents model healthy eating habits to children and gives parents a chance to directly observe their child’s eating habits.

"A structured family meal that takes place in a positive environment can protect girls from destructive eating habits," said Twyala Smith, a registered dietitian and board certified specialist in pediatric nutrition at Children’s Medical Center Dallas. "If a child is just beginning to show symptoms, it may be as simple as talking to them about it."

According to the National Eating Disorders Association (NEDA), eating disorders such as anorexia nervosa and bulimia nervosa now affect nearly 10 million females and 1 million males, with diagnoses peaking among girls’ ages 11 to 13. Anorexia and bulimia can cause nutritional deficiencies, organ damage and, in rare cases, death.

Signs of anorexia:

• Fear of being fat or claiming to feel fat when obviously not overweight.
• Denying hunger and avoiding eating in front of others.
• Preoccupation with food and calories with compulsive weighing of food portions and then eating nothing at all, or very little.
• Frequent weighing before and after a meal.
• Exercising compulsively (more than two hours per day).
• Excessive use of condiments such as mustard or pepper on everything.
• Binge eating with "signal foods" (broccoli, yogurt, egg whites) — often claims a sudden conversion to vegetarianism.

Signs of bulimia:

• Bulimic children often do not look overly thin and may have average or above-average weights but show an excessive concern about their weight.
• Bulimic children eat huge amounts of food, then purge their bodies within hours by taking laxatives or vomiting.
• Strict dieting followed by binging on high-calorie, sweet foods, such as sweet cereals, cookies, pastas or bread.
• Making excuses to go to the bathroom after meals or disappearing after meals.
• Frequent overeating linked to emotional episodes or stress with expressed guilt or shame about eating.
• Often have pitted or eroded tooth enamel from stomach acid in the mouth after vomiting.
• May appear to have swollen cheeks from enlarged salivary glands.
• Withdrawing from social activities.

With the media-fed images of slim celebrities, the constant pressure to be skinny often has many girls turning to unhealthy ways of controlling their weight.

"Parents may need to model healthy eating habits and insist on face-to-face communication," Smith said. "Children with eating disorders often just want someone to listen — not tell them what to do. Intervention at an early stage works." 

If a parent gets concerned about a child’s weight loss or eating behavior and is not comfortable addressing the topic with the child, they should ask for help from a pediatrician or pediatric clinical registered dietitian.