Image: Priory Group
Hospital admissions for eating disorders among young people have almost doubled in three years. Here, renowned behavioural care specialists Priory explains eating disorders and offers their advice on supporting your child's recovery.
Eating disorders explained
If you suspect your child has an eating disorder, you might be scared to mention anything, worried you will make it worse. However, the sooner you talk with them about it, the better. Once they accept they have a problem, the faster and the more likely it is that your child will be able to make a full recovery. Recovering from an eating disorder involves not just getting physically better but also regaining a healthy attitude towards eating and improving confidence and self-esteem.
Types of eating disorders
Anorexia is an eating disorder which focuses on starving the body, often causing the individual to become dangerously thin. It affects both genders, but is most common amongst young women between the ages of 14 and 25. You can read more about the symptoms and treatment of anorexia here.
Bulimia is an eating disorder characterised by binge eating, followed by dietary restriction and/or purging (often self-induced vomiting or taking laxatives) to try and avoid putting on weight. Anyone can suffer from bulimia, but it is most common in young women aged between 15 and 25. You can read more about bulimia here.
Atypical eating disorder
An atypical eating disorder is similar to anorexia nervosa or bulimia nervosa, but does not meet the exact diagnostic criteria of either eating disorder. For example, this may be because a sufferer’s weight or BMI does not meet the specific threshold for these disorders, or because menstruation still occurs. The symptoms and causes of atypical disorders may be very similar to anorexia or bulimia, but often individuals don’t have the full list of symptoms.
Children and adolescents often suffer from more atypical eating disorders. All eating disorders are serious mental health conditions, and atypical eating disorders should not be taken less seriously than anorexia or bulimia.
How common are eating disorders?
Over 725,000 men and women in the UK are affected by eating disorders. Although anyone can develop an eating disorder, young women are most likely to suffer, particularly in their teenage years. It’s important to remember that boys get eating disorders too – up to 10% of young people with eating disorders are male.
'The best advice I can give to anyone is to open up and tell someone straight away.'
Although serious, eating disorders can be treated and recovery is possible, eating disorders impact every area of life – physical, emotional and social. Young people’s development can be seriously affected and the impact on families is significant. The sooner people receive treatment, the better chance they have of recovery and preventing long term effect on their lives.
Why do people get eating disorders?
There is no single reason why someone develops an eating disorder. There doesn’t appear to be one gene responsible, but it does seem there is some biological vulnerability in people who develop these conditions. Many suffers also tend to be perfectionists, have problems with anxiety and struggle to manage strong emotions.
A world dominated by appearance
Teenagers live in a world dominated by appearance and often become more self-conscious around this time of life. Adolescence, with its many challenges, often prompts dieting which can sometimes lead to the development of an eating disorder. Causes vary, but school changes, family problems, peer pressure and bullying can all play a role.
People with eating disorders tend to have very low self-esteem and judge themselves very critically in terms of their body and shape. They become obsessed with food and weight, and day-to-day lives are usually led by thoughts, feelings and behaviours around food and eating. Sufferers use sometimes life-threatening behaviours like extreme dieting, vomiting, excessive exercise and binge eating as a way of coping with difficult thoughts and feelings. Many people feel very ashamed of their symptoms and can gradually distance themselves from friends and family.
'A part of you wants to cry out for help...you can’t because if you tell someone, then it’s all over, you’re not in control any more and you're going to end up fat again.'
Although people with eating disorders can sometimes recognise that what they are doing is unhealthy, because of the strong drive to manage food and weight they find it difficult to stop. Eating disorders are associated with a high incidence of other mental health conditions, like anxiety and depression.
What to do when you suspect your child has an eating disorder
It can be really upsetting to think your child might have an eating disorder. Parents are often concerned that they may be making too much of things and hope that if left it will go away. It’s uncommon to recover from an eating disorder without help, so although talking about it may be difficult, it is essential.
Steps to take:
- Start talking. Encouraging your child to discuss any worries and insecurities they may have will be useful in understanding the reasons that might have led them to feel badly about themselves. Establishing an open discussion about how to cope with anxieties and difficulties will be an important first step.
- Help with healthy eating habits. You should help encourage a healthy eating attitude and watch out to see if your child continues with disordered eating habits. Don’t wait too long before seeking advice if you are worried. It can be useful to discuss this with your child’s school as schools often notice the early signs of an eating disorder or may have heard from school friends who have concerns. Schools can also be useful partners in helping young people manage their eating during treatment (eg supervising meals, providing medical monitoring).
- Keep talking. Trying to talk to someone you suspect has an eating disorder can be a scary thought. Sometimes young people with eating disorders will be relieved that their problem has been noticed as they too can be frightened. Not uncommonly, though, they will avoid any discussion about what they are doing and deny that there is a problem. It can be a difficult tightrope to walk between trying to support a child whilst also insisting they need help. At times it can feel that any reference to food leads to an argument.
- Keep calm. The key is to communicate without being judgemental or argumentative. Think carefully about what to say beforehand, speak calmly and be careful not to criticise or get angry or overly emotional. Even if your child denies having a problem in the moment, given some time they may be able to acknowledge they have some difficulties and talk about these when they are ready.
Treatment and recovery
Your GP is the first person to contact about your concerns, even if your child is reluctant to attend. Do your best to arrange a visit and your GP will be able to talk to you about treatment and make any necessary referrals. You can read more about treatment for eating disorders here.
Love and support
People with eating disorders often become lonely and isolated, but those who recover say love and support from family and friends is vital in their recovery. It’s important for those close to someone with an eating disorder to get their own support, as they often feel helpless, confused, frustrated, despairing and angry. While families are not the cause of the eating disorder, they are crucial in the recovery.
'My parents were really supportive and still are...they made sure they kept talking about it to me, asking how I felt and making me feel like they understood.'
You should acknowledge what a challenge your child is facing whenever they are managing food in a positive way. There are times when as a parent you have to assume responsibility for making decisions around food to take away the guilt your child experiences when making food choices. Helping your child to develop coping skills, continue normal aspects of life and to find things outside of the eating disorder will all contribute towards building self-esteem.
Avoid talking about appearance
Think carefully about how to discuss things, because comments can be misunderstood. Saying ‘you look well’ or ‘you’re making progress’ can sound as if you’re saying ‘you’re getting fat’. The person struggling will most likely not feel any sense of achievement by managing to eat appropriately – instead they may feel extremely guilty and like a failure, so they are not likely to take your comments as positive. It is probably better to steer clear of references to appearance.
Don’t give up
Most importantly don’t give up. At times things may seem hopeless but with time and appropriate help, it is possible for young people to recover.
To read more on this subject from Priory, visit their blog.