What are eating disorders?
Eating disorders in children and adolescents are serious mental health conditions that can have a significant impact on their physical and emotional well-being. For a person with an eating disorder, thoughts and behaviors around food can be extremely complex and distressing. These individuals often have a difficult relationship with food and related attitudes and behaviors.
The thoughts of a person with an eating disorder can sometimes relate to feelings of fear, guilt, and shame around eating. The way this presents can be different for each child; for example, they may have an extreme fear of gaining weight or might fear choking or becoming ill from eating. Additionally, they may also engage in emotional eating as a coping mechanism for their underlying feelings of anxiety, depression, or low self-esteem.
Behaviors around food can be equally varied and still indicate an eating disorder. For example, they may engage in restrictive eating patterns, binge eating, or purging behaviors such as self-induced vomiting or excessive exercise. They may also avoid social situations that involve food, resulting in isolation and withdrawal from friends and family.
Overall, the thoughts and behaviors around food for a person with an eating disorder can be all-consuming and debilitating, affecting their physical, emotional, and social well-being.
What causes an eating disorder?
There are several factors that can contribute to the development of eating disorders in children and adolescents. These can include genetic predisposition, societal pressures to be thin, low self-esteem, anxiety, and depression. Additionally, traumatic experiences such as bullying, abuse, or a major life change can also increase the likelihood of developing an eating disorder. It's important to note that these risk factors can interact with each other, and the development of an eating disorder is often the result of a combination of factors.
What are some of the common misconceptions about eating disorders?
Eating disorders are unfortunately heavily stigmatized. This is a result of misinformation, cultural norms around body image, media portrayals, and the physical visibility of some eating disorders. Because of this, there are some common and unhelpful stereotypes held by society about eating disorders.
“Eating disorders only affect girls and young women”. In reality, boys and young men can also develop eating disorders, but the stigma and shame surrounding these conditions can make it difficult for them to seek help.
“Eating disorders are solely a result of vanity or a desire to be thin”. This oversimplification disregards the complex psychological and environmental factors that contribute to the development of an eating disorder.
“Individuals with eating disorders can simply ‘snap out of it’ if they just tried harder”. This leads to feelings of guilt and shame for those struggling with the condition.
Those with eating disorders are "attention-seeking" or "just going through a phase", which can further hinder their ability to seek and receive appropriate treatment.
How do these stereotypes impact care?
Unhelpful stereotypes surrounding eating disorders can have a significant impact on the treatment and support received by children and adolescents with these conditions. When individuals hold stereotypes about eating disorders, they may not take the condition as seriously, or they may make assumptions about the causes or characteristics of the disorder that are not accurate. This can lead to a lack of understanding and empathy for those struggling with an eating disorder, and can result in ineffective or harmful treatment and support.
For example, if people hold the stereotype that eating disorders only affect young, white, affluent girls, they may not recognize the signs of an eating disorder in a child or adolescent who does not fit this stereotype. This could lead to the condition going untreated or undiagnosed, which can be harmful to the individual's physical and mental health.
Additionally, if healthcare providers, educators, or family members believe that eating disorders are solely caused by a desire for thinness, they may overlook underlying psychological or emotional factors that contribute to the disorder, and may focus exclusively on changing the individual's eating habits rather than addressing the root causes of the condition.
Furthermore, stereotypes about eating disorders can also affect the way children and adolescents with these conditions are treated by their peers and the broader community. This can lead to social isolation, bullying, and a lack of support from friends and family members, which can exacerbate the individual's struggles with their eating disorder.
What are the signs that a child may developing an eating disorder?
Here are some indicators to watch for:
Change in Eating Habits: Suddenly becoming very picky, skipping meals frequently, or developing new rituals around eating can be early signs of disordered eating.
Preoccupation with Weight and Body Shape: Expressing dissatisfaction with their body or showing an intense fear of gaining weight, even if they are not overweight, can be a red flag.
Weight Fluctuations: Unexplained weight loss or gain could be evidence of an eating disorder, indicating either restricted eating or binge-eating behaviors.
Food Focus: An unusual focus on food, whether it's an increased interest in cooking and nutrition without eating the food, or talking about calories and dieting excessively, can indicate a preoccupation with food control.
Alteration in Appearance and Health: Signs like hair thinning, dental erosion, brittle nails, dry skin, or the growth of fine hair all over the body (lanugo) can be physical manifestations of an eating disorder.
Social Withdrawal: If your child starts avoiding meals with the family or social events, especially those involving food, it might be a cause for concern.
Unusual Behaviors: Visiting the bathroom immediately after meals, using laxatives or diet pills, or the discovery of food hoards can be associated with eating disorders.
Exercise Excess: An obsessive or compulsive approach to exercise, particularly if it's coupled with negative comments about their own body, could indicate an issue.
Mood Changes: Significant changes in mood, such as increased irritability, depression, or anxiety around meal times, can be associated with eating disorders.
Clothing Changes: Wearing baggy clothes to hide their body could signify body dissatisfaction or an attempt to conceal weight loss or other physical changes.
Menstrual Irregularities: In girls, missed periods or mention of menstrual irregularities can be a result of an eating disorder.
If you observe one or several of these signs, it's important to approach the subject with empathy and concern rather than judgment. Remember, eating disorders are serious mental health conditions that require professional intervention.
How might an eating disorder be treated?
The treatment of eating disorders in children and adolescents involves a multidisciplinary approach that typically includes medical, nutritional, and psychological interventions. Research indicates that treatment for eating disorders is more likely to be effective if support is sought early.
Treatment varies depending on diagnosis and level of need, but some common forms of psychological therapy include:
- 1-1 psychotherapy such as Cognitive Behavioral Therapy (CBT)
- Family Based Therapy such as the Maudsley Approach
- Specialist group therapy
Is an assessment right for my child?
There are many reasons why a young person may struggle with eating, and the ways in which it impacts people's lives can be very different. Because of this, a comprehensive overall assessment of a young person is done first to get a full understanding of the current difficulties, triggers, and maintenance factors.
During the initial assessment, the clinician will gather information about the child's history, observed behaviors, and gain an understanding of how symptoms impact a child's day-to-day life. This preliminary assessment may involve both the young person and parent or caregivers.
A report will be written summarizing the assessment, outlining the outcome, and providing recommendations for intervention and support. This could be recommendations for school or home, support sessions for parents, liaison with schools, as well as individual therapeutic sessions with young people and, in some cases, medication treatments.
How can I find out more, speak to someone about my child or book an initial consultation?