How Monitoring Your Child's Growth Chart Could Help Prevent an Eating Disorder

Help Prevent an Eating Disorder

Hero Images, Getty Images

Hopefully at every well visit, your pediatrician documents your child’s growth on the CDC growth chart, which plots height, weight, and body mass index (BMI) against age-based averages.  Why?  Because the CDC growth chart is one of the best tools for early identification of eating disorders.

Eating disorders most often begin during adolescence, and they can become severe quickly.  Research shows that early intervention improves the chance for a full recovery.

   Unfortunately, most pediatricians are not trained in the early detection of eating disorders.  Furthermore, in the face of the current societal focus on obesity, doctors may be more sensitized to weight being over versus under what is expected and miss signs of anorexia.  So parental vigilance can make a big difference. 

Body weight and height are largely genetically determined.  Contrary to what commercial diet companies promise and what the war on fat implies, not every individual is meant to be average weight for their age and height.  Consider foot size, where there is a normal distribution.  While the average woman today has an 8 ½ shoe size, most do not – some will be size 5 and others will be size 10.  And so it is with body weight.  Not everyone is predestined to have a body weight in the 50th percentile – some will be heavier and some lighter.

During the first year of life, the curve along which a child grows to a significant degree reflects environmental factors for the baby as well as in the mother during pregnancy.

 By around the second year of life, a child starts to grow along a trend line that more accurately reflects their unique genetic growth potential.  In healthy children height and weight each increase along a fairly constant growth curve.  However, some children grow steadily along the 25th percentile while other children grow steadily along the 50th percentile and still others along the 95th percentile.

 Their height and weight percentages may be similar or different.  This may all be normal for that child.

Annual measurement is recommended so there’s adequate information to determine whether a child is falling off a growth trajectory in a dangerous way.  This is one of the reasons for yearly pediatric appointments.  If you change pediatricians, it is a good idea to have the growth records transferred so that a complete record is maintained. 

Of note, many children and adolescents who develop anorexia nervosa do not experience actual weight loss.  However, they are usually supposed to be growing at this age – it is common for children to gain 30 pounds as they go through puberty.  Failure to gain weight can be a sign of malnutrition and as dangerous as actual weight loss.  Malnutrition during puberty can lead to weak bones and permanently stunted height.  Failure to gain weight in a growing child should be a cause for concern.  It can mean an eating disorder or a multitude of other health issues.


Growth curves are also used by professionals in establishing target weights for recovery, and research shows these curves are the best method for determining an individual’s healthy body weight (more accurate than using BMI) when they are available (Harrison et al., 2013).  They can help a professional to accurately estimate the weight at which females will resume menses following amenorrhea due to malnutrition. 

Falling off the growth chart trendline for either height or weight can indicate a potential problem.  For example, if a child who has always tracked along the 75th percentile for either height or weight suddenly starts tracking along the 40th percentile, there is reason for curiosity and likely concern even if they are not technically underweight on a BMI chart.  Sometimes children with anorexia fall off their height curves before they fall off their weight curves, which is why it is important to track both. 

Parents can plot their child’s growth on the following charts, or obtain growth records from their child’s physician:

CDC Growth Chart for Girls Up to Age 20

CDC Growth Chart for Boys Up to Age 20

Parents can also plot growth curves electronically (for free) on My Growth Charts.

Helpful information on determining target weights for recovery are available here

An example of how to read a growth chart can be found here.

If you notice that your child has fallen off either their height or weight curves, ask your physician to conduct a careful history and physical.  There are many possible explanations for a failure to grow and eating disorders are only one of them.  Doctors may need to perform additional testing. 


Harrison, M., Obeid, N., Fu, M., & Norris, M. (2013).  A Descriptive Study of the Availability and Utility of Growth Curve Data in Adolescents With Eating Disorders.  BMC Family Practice.  

Continue Reading