I’m a psychotherapist – how to spot an eating disorder in your kid as cases soar

A PSYCHOTHERAPIST has shared how parents can spot signs of an eating disorder in their child, as the number of teenage girls suffering from one saw a ‘staggering rise’ during the Covid pandemic.

A study of anonymised GP records from 2020 and 2022 revealed higher than expected diagnoses of eating disorders such as anorexia and bulimia in teens.

Diagnoses of eating disorders in teens saw a sharp rise between 2020 and 2022

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Diagnoses of eating disorders in teens saw a sharp rise between 2020 and 2022

While experts anticipated around 2,700 diagnoses of eating disorders among 13-16-year-olds, they observed 3,862 – 42 per cent more than the expected figure.

The research team also noted that cases of self-harm were 38 per cent higher than expected for the same group.

Eating disorders rose above expectations for 17 to 19 year-olds too.

Tom Quinn, director of external affairs at eating disorder charity Beat, called the rise in diagnoses “shocking but sadly not surprising”.

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“During the height of the pandemic we saw demand for our Helpline services spike by 300 per cent and it is still remaining high,” he said.

“We also know that the NHS is treating more children and young people than ever before, with healthcare professionals under huge amounts of strain.”

The study – published in the Lancet Child And Adolescent Health journal – also found diagnoses were highest among girls living in wealthier areas, raising ‘questions around care inequality’, according to Beat.

Tom said: “The rise in diagnoses in less deprived areas cannot be attributed to any one cause, but in general people in those areas will have easier access to primary care, making it more likely that eating disorders will be spotted earlier.

“We know there is still a postcode lottery and these gaps must be addressed so that everyone can get the help they need as quickly as possible.”

Speaking to the Sun, Tom noted that eating disorders are “complex mental illnesses that affect 1.25 million people of all ages, genders and backgrounds in the UK”.

As as nobody will experience an eating disorder in the same way, he acknowledged it can feel difficult to know which warning signs to look out for.

But he outlined a few key symptoms parents might notice in their kids that could indicate they are struggling.

Kerrie Jones, CEO and founder of eating disorder treatment clinic Orri, also offered the Sun her expertise on what signs of eating disorders parents can look out for.

1. Preoccupation with food and anxiety at meal times

According to Kerrie, a psychotherapist specialising in the treatment of eating disorders, preoccupation with food and eating is a very common sign.

“This may appear as someone becoming hyper-focused on food and the nutritional content, counting calories, categorising foods as strictly ‘good’ or ‘bad’,” she explained.

“Your child may appear very anxious at mealtimes, struggle to eat certain foods, or eat in front of others.

“They may request to prepare the food themselves or develop rigid food “rituals”, i.e. methodical and repeated behaviours to help them feel in control,” Kerrie went on.

She gave the examples of a child cutting their food into very small pieces and taking a very long time to eat a meal.

Tom, meanwhile, said parents should be on the lookout for “strict dieting, avoiding particular foods or exercising more often” as signs that their child “has become fixated on diet or is experiencing sensory issues”.

“Hiding food or food unexplainably going missing could indicate that your loved one is struggling with binge eating,” he added.

Binge eating refers to when people feel out of control and eat a large quantity of food in a short space of time, the charity director said.

But these signs might also indicate that your child is fixating on particular foods, according to Tom.

“Other warning signs include frequently going to the bathroom after mealtimes, which could indicate they are making themselves sick,” he added.

2. Physical changes

If your child is suffering from an eating disorder, they might undergo some physical changes, though that doesn’t necessarily mean a change in weight.

Kerrie said: “Someone might struggle with physical activity, become light-headed from regular daily movements like getting off the sofa.

“You may notice them looking pale and tired, struggling with digestive issues and feeling cold, no matter how warm the environment is.

“Some people may notice their menstrual cycles stop from the stress their body is under and dental issues can also arise in someone who is purging by vomiting.”

“A significant change in weight is important to take notice of,” the psychotherapist added.

Tom said your child might start “wearing loose clothing to hide their body”.

But he emphasised that not all people who have an eating disorder will undergo changes to their appearance.

“While there can be physical warning signs, such as weight loss, tiredness or stomach pains, eating disorders are mental illnesses and you cannot tell if someone has an eating disorder just by looking at them.”

3. Negative and disordered body image

Kerrie said you might notice your loved one frequently checking and making negative comments about their body weight or shape.

“When looking in the mirror you may notice them grasping or touching parts of their body,” she said.

This is called “body checking”.

“For some, how they see their body in the mirror may be completely different to who you see in front of you,” Kerrie noted.

4. Fear of gaining weight or preoccupation with thinness

A common red flag to watch out for is a fear of gaining weight or ‘pursuing thinness’, according to Kerrie.

Your kid “may adopt new diets, cut out certain foods or adopt veganism or vegetarianism in an attempt to remove ‘fear foods’ in a socially acceptable manner”, she said.

“You may also notice over-exercising as a way to compensate for eating, or taking frequent trips to the bathroom to purge any food eaten,” the psychotherapist went on.

5. Low self-esteem and social withdrawing

Kerrie noted that it’s important to pay attention to your child’s emotional state.

“Often, as someone’s eating disorder develops their sense of self-worth and mood can rapidly deteriorate,” she explained.

“You may notice your child becoming progressively self-critical, anxious or depressed with a drop in self-esteem and self-confidence.

“They may seem to be more introverted, distancing themselves from others or increasingly angry and aggressive, as a means of defending the eating disorder from challenge.”

What should I do if I think my child has an eating disorder?

If you suspect your loved one is suffering from an eating disorder, it’s important to check in with them and provide support – but the way you go about it crucial.

Tom said: “If parents are worried that their child or teenager may have an eating disorder, we’d urge them to speak to their loved one as soon as possible.”

Meanwhile, Kerrie noted that “eating disorders thrive in isolation, so it is critical to remain connected so that people can talk when and if they need to”.

“There can be a lot of shame and secrecy surrounding eating disorders, so it might take a while for someone to admit that they have a problem,” she explained.

Kerrie advised you pick a time to talk when the person appears open and receptive and be gentle addressing your concerns.

It’s best to talk to your child outside of mealtimes, according to Tom, “as your loved one may be particularly stressed during these times”.

It’s important that you focus on your child’s emotional state rather than the symptoms of the eating disorder, Kerrie emphasised, and stay calm if they begin to feel resistant or defensive.

Tom suggested: “Remind them that you are there to support them, for instance by asking open-ended questions like “You don’t seem yourself lately, do you want to talk about it?”.”

Both experts emphasised that it probably won’t be a ‘one and done’ conversation.

“You may need to return to the conversation multiple times and reaching out for support to have these conversations can be beneficial,” Kerrie said.

And if your child says they’re, Tom you recommend still keep an eye on them and regularly check in.

How to get specialist support

According to Kerrie, eating disorders so require professional intervention, whether that’s from specialist psychotherapist, psychologist, or clinic specialising in eating disorders.

Help from a dietitian can also guide your child towards recovery.

“Remember, self-care is critical for you too,” she added.

Tom urged parents to make an appointment with your GP as soon as possible if your child says they’re struggling, as they’ll be able signpost them to the help they need.

“Beat is also available 365 days a year, supporting people with eating disorders but also parents, families and carers to help guide their loved one towards recovery.

“The sooner somebody starts treatment for an eating disorder, the better their chances of recovery, and we’d like to reassure people that support is available.”

Recovery is possible

Most of all, Kerrie emphasised that recovery – although a unique journey for everyone – is a real and achievable goal.

“We know it is possible because we see it happen every day at Orri,” she said.

“It may be interspersed with ups and downs, but maintaining hope during the most challenging times can light the way to a successful recovery journey.”

She also noted that misconceptions about eating disorders can make things confusing for both parents and kids, advising parents to educate themselves about the intricacies of them to better support their loved ones.

What are the most common eating disorders?

Eating disorders are serious mental illnesses that can affect anyone.

People with eating disorders use disordered eating behaviour as a way to cope with difficult situations or feelings.

This can include limiting the amount of food eaten, eating very large quantities of food at once, getting rid of food eaten through unhealthy means (e.g. making themselves sick, misusing laxatives, fasting, or excessive exercise), or a combination of these behaviours.

  • Anorexia nervosa – it involves limiting how much you eat, doing lots of exercise, make yourself sick, or misusing laxatives to get rid of food eaten
  • Bulimia nervosa – sufferers tend to be caught in a cycle of eating large quantities of food (bingeing) and then trying to compensate by vomiting, taking laxatives or diuretics, fasting, or exercising excessively (called purging)
  • Binge eating disorder – eating large portions of food without feeling like you’re control of what you’re doing

If you think you or your child have an eating disorder, you should see a doctor as soon as possible.

Charities can also offer help and advice.

In the UK, BeatTalk ED and Health for Teens are good places to start.

The BBC spoke to teenagers Sophie Rowland, 18, and Annabelle, 19, both of who developed eating disorders as pandemic lockdowns took a toll on their mental health.

Annabelle – who received help in overcoming bulimia – described feeling like she had ‘very little control’ over her life.

As her GCSE’s were cancelled and movement and mingling was restricted, she began feeling like the only thing she could control was her appearance and what she ate.

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Meanwhile, Sophie began noticing she was obsessing about exercise and ‘couldn’t stop tracking calories’.

After confiding in her mum about her struggles, she received treatment for anorexia and received praise for documenting her recovery online.

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