With the recent news reports that eating disorders in the UK are affecting a larger number of young children than ever before, I'm re-posting this article which originally appeared on the Brit Mums blog back in September last year.
While labelling children as young as five with eating disorders like anorexia might not actually be particularly helpful, clearly there are many children experiencing eating problems who need help and support, as do their families.
For families trying to cope with anorexia, here is some information based on my own experiences and also on the research I undertook when writing my book Anorexics on Anorexia, Jessica Kingsley Publishers.
Anorexia rarely stems from a single cause. Instead it results from a number of different factors, such as family problems, relationship problems, traumatic events, bereavement and exam pressures, which build up over time. Eventually the point is reached where the individual can no longer cope.
Although ‘anorexia’ means loss of appetite, those with the illness deny their appetite and severely restrict their food intake. They are often extremely hungry and preoccupied with food. They may also exercise vigorously, use laxatives or make themselves sick.
Controlling food is a way of expressing distress and a way of focusing thoughts away from other more painful issues. Starving and losing weight can become their only way of feeling safe and one of the few areas of life they are able to control. Ultimately the illness controls them.
Parents are advised to educate themselves about eating disorders and be aware of the early warning signs. These include cutting out high calorie foods, hiding food, claiming not to be hungry, as well as more noticeable signs such as weight loss.
But what do you do if you notice these things? Here are tips from my experience and research on how you can help your child.
Tips for helping your child
1. Early diagnosis is vital. The earlier medical treatment is offered, the less time there is for eating disordered behaviour to become deeply engrained. The first port of call is your GP who can refer on to specialist services. (Understanding of eating disorders among GPs varies, so if you do not get the referral you need, be extremely persistent or find another GP.) NHS services typically have long waiting lists. Seek professional advice on how to manage your child’s condition during this time. You may be required to monitor your child’s weight and food intake.
2. Investigate self-help organisations such as Beat (formerly the Eating Disorders Association) and Young Minds. Take advantage of their helplines, advice sheets and resources.
3. Despite how frustrated you may feel about your child’s eating behaviour, try to remain calm and understanding. Getting angry with your child simply won’t help.
4. Be aware of online activity. Pro-ana websites attract vulnerable children with eating disorders. They are unregulated and extremely dangerous. Explain to your child that the images and the nature of the discussions in these sites concern you. Discuss that they are communicating with people who are also unwell, who may be giving unhelpful advice and may not want to get better.
5. Eating disorders affect the whole family. Consider the needs of your remaining children and take time to talk to them about their feelings. Ensure your sick child is not the sole focus of your attention.
6. Don’t neglect your own needs and seek help to manage your own stress levels. Take up a hobby or activity outside the home, or get professional counselling if necessary.
7. Be inclusive. Parents need to work together when discussing their child’s treatment and care. Try to involve your child in any decisions made. It is important their opinions and feelings are heard and they do not feel you are plotting behind their back.
8. Involve your child’s school so they know what is going on and can offer help, if necessary, especially at meal times.
9. If family therapy is recommended, don’t be reluctant to attend for fear of being cross-examined. Research has shown it can be extremely effective in the treatment of eating disorders.
10. Remember that recovery takes time. Your child needs to be able to trust the professionals working with them and this does not always happen straightaway. It can also take time for professionals to find the best treatment package for your child.
11. Change tactics if you don’t see progress. If the situation isn’t improving after a reasonable period of time, it may be best to seek a different approach or different providers. Discuss your concerns with the clinical team. If your child’s condition is deteriorating, then the treatment they are receiving needs to be evaluated.
12. Consider whether hospitalisation is necessary. While the majority of people with eating disorders are able to recover without inpatient treatment, a period of hospitalisation may be necessary for those not responding or when their life is in danger. Admissions can be made voluntarily or under the Mental Health Act. No-one with anorexia would welcome being sectioned and treated against their will, but sometimes this is the only way a severally ill child is able to receive essential treatment. Many will thank you in the long run.
13. There has to be a willingness on the part of your child to get better and that can be difficult especially if your child is very depressed. Encourage them to mix with friends and take part on normal every day activities.
14. Try to be positive and upbeat about your child’s life and their future. Don’t make food battles the only conversation you have. Try to remember what they were like before they became ill because that person is still there.
With support, perseverance and professional help, anorexia nervosa can be overcome. Eating disorders take many years to manifest themselves and so recovery will take time too. Eating patterns need to be stabilised and a normal weight maintained, but long term recovery can only be achieved if the psychological problems causing the initial problem are effectively dealt with. Recovery is not easy, but it is certainly possible and extremely worthwhile.
Useful Resources
