Sydney Forbis seems like an ordinary teenager: She wears skin-tight clothing, worries about her figure and painstakingly picks out each new outfit when she goes shopping with her mother.
The extraordinary thing about Sydney is that she is only 6 years old.
"I think sweatpants make my legs look fat," she said on ABCNEWS' Good Morning America. Even though she is thin, the little girl said she runs to keep her weight down. "I don't want the fat to spread all over my body."
Eating disorder experts say prepubescent girls are developing eating disorders as young as 5 and 6 years old. They may be getting their obsession from parents who are preoccupied with their own body images, and media images of skinny pop stars like Christina Aguilera and Britney Spears, the experts say.
Spotting Eating Disorder Symptoms
Dr. Ira Sacker, an anorexia specialist who founded the organization Helping to End Eating Disorders, or HEED, told Good Morning America he has been treating a lot of very young girls for eating disorders.
One of Sacker's young patients, Justine Gallagher, started eating paper when she was 5, because she worried that she was as chubby as she had been in her baby pictures. Gallagher ate as many as 10 pieces of paper a day, believing that filling up on paper — rather than food — would help her lose weight.
"I thought if I ate my regular meals that I would get heavy and people would make fun of me," Justine said.
Her teachers noticed that pages from her books were missing, and at home her mother found that she was also eating the cotton from Q-tips. Her mother, Yvonne Gallagher, then took Justine to three separate pediatricians, but they all told her it was just a phase that Justine would grow out of.
One night Gallagher walked into her daughter's bedroom and found her running laps with a timer. "She said, 'I ate too much today. I have to exercise.' That was really the breaking point," Gallagher said.
She took Justine to Sacker, who recognized that the 5-year-old had an eating disorder.
Rather than force-feed his patients, Sacker tries to help them build up their self-esteem. During Justine's treatment, he discovered that she loved horseback riding, and began using that activity as a way to help her replace the dieting obsession with healthy activities. She could only ride the horse if she got rid of a piece of paper each day. Now 10, Justine has recovered from the disorder, and is participating in a school play.
Dieting Just Like Mom
The onset of anorexia nervosa has two peaks, one at ages 10 to 13, and the other at ages 13 to 18, said Dr. Gene Beresin, an associate professor of psychiatry at Harvard Medical School. Only 6 percent of those affected are men. Researchers say the causes range from genetics and family problems, to lack of self-esteem and the media's portrayal of thin women as ideal. But the underlying emotions are the same.
"The hallmark of the disorder is fear of getting fat and a gross distortion of body image," said Beresin, who is also the director of child and adolescent psychiatry training at Massachusetts General Hospital in Boston.
Experts say the children who develop eating disorders are mostly girls who are often following examples set by their mothers.
"The majority of the young children we see or hear about who are over concerned about their weight, interested in dieting, or who have already developed a distorted body image have mothers who are preoccupied with their own bodies," said Susan Willard, director of the Eating Disorders Treatment Center at River Oaks Hospital in New Orleans, and a professor of psychiatry and pediatrics at the Tulane University School of Medicine.
The mothers, she said, "devote a great deal of time and energy to dieting, exercising, counting calories and fat grams, and expressing their own displeasure with their bodies."
Is Barbie to Blame?
Any child watching prime-time TV is also exposed to ultra-thin women. "How many adults talk about dieting, looking greater as they become thinner and thinner?" Beresin said.
According to recent studies, many fifth- and sixth-grade girls have tried to lose weight, Beresin said. It doesn't mean that they will develop anorexia nervosa, but it does mean that they are feeling the crush of cultural and social pressure, he said.
"As an example, look at the figure of Barbie. Her figure is an impossibility for any young girl or woman to achieve, and yet it is the image of beauty," Beresin said. "How many girls yearn to look like her, or other dolls of the same image?"
Part of the solution lies in changing how we, as a culture, portray images of men and women and how we treat people who are overweight, he said.
"There is no doubt that our culture, and especially upper- and upper-middle-class cultures promote this disorder," Beresin said.