When eating is used to manage difficult situations, thoughts and feelings it can sometimes develop into an eating disorder. The most common types of eating disorder are bulimia nervosa and anorexia nervosa. Anyone can have an eating disorder regardless of their age, sex, ethnicity, or background.
Eating disorders are not all about the food itself. Setting strict ‘rules’ around food and eating, being pre-occupied with weight, shape, food and developing rituals around food and eating are way of coping with difficult situations, thoughts and feelings. The way the person treats food may make them feel more able to cope, or feel more in control, but they might not be aware of the purpose this behaviour is serving.
There is no one cause of an eating disorder. Young people who develop eating difficulties and disorders often tell us that eating or not eating can be a way of coping with feelings of sadness, worry and stress. Sometimes life stressors such as exams, bullying, friendship or family relationship difficulties and bereavement or loss may play a part in how someone copes or feels about themselves. There are also some personal factors such as having low self-esteem, experiencing anxiety or depression, setting high standards and being perfectionistic and identifying as LGBT (Lesbian, Gay, Bisexual or Transsexual) are sometimes associated with people who develop eating disorders. However, experiencing any one of these things does not necessarily mean that someone will develop an eating disorder or difficulty.
Most young people worry at some time about how they look and can become unhappy with their weight or shape. Some will ‘diet’ and / or exercise as a way of losing weight. This is different from an eating disorder, which is an extreme and unhelpful focus on eating, weight and shape.
An eating disorder can quicky take over a person’s life and make them very unwell. Eating disorders can involve eating too much or far too little. Worries about things like their weight and shape get tied up with feelings of self-worth and can become extreme. People with eating disorders also experience a deep fear of gaining weight, and will usually challenge the idea that they should. People with eating disorders can develop a distorted body image that does not fit with how others see them. Eating disorder behaviour can impact on physical health, education and general daily living, such as hanging out with friends, spending time with family, going out and taking part in activities.
There are many different types of eating disorders, with bulimia and anorexia nervosa being the most common, and all of them are serious. All eating disorders are treatable and a full recovery is possible. Getting help and advice as soon as possible improves the chances of a full recovery.
Here are some signs that there might be a problem and it’s time to get help;
Not everyone who has an eating disorder will experience all the signs and symptoms. Also, if you are experiencing some of these signs and symptoms this does not necessarily mean that you have an eating disorder, but it is important to get help and advice.
It is common for people with eating difficulties to not see that there is a real problem. You may not understand why others are concerned or you might disagree that there is a problem altogether. This may make you feel angry and frustrated.
Calmly support them to open up about how they are feeling and what they are struggling with. The quicker they can get help for your difficulties, the better the outcome.
Take things one day at a time, each meal at a time. If they have a difficult meal or snack, start the next one afresh.
Find things that will motivate them to maintain healthy eating when things are hard; such as being able to go out with friends, do sports and activities and achieve goals that they have set.
Have a look at these helpful, downloadable workbooks and self-help materials:
If you live in Hampshire and you are concerned that your child may have an eating disorder and you’d like help or advice, please contact the Hampshire CAMHS Specialist Eating Disorder Team on 0300 304 0062 Monday-Friday, 9am-5pm or if you live in Dorset you can call Young People’s Eating Disorder Service (YPEDS) on 01202 492415. For those living on the Isle of Wight you can call IOW CAMHS on 01983 523602 between Monday-Friday 8:30am-5pm (answerphone out of hours).
Many young people go through phases of dieting and not eating enough. Sometimes this can tip into developing an eating disorder. Here’s a guide to help you know how best to support your young person if they are experiencing eating difficulties. This is not an exhaustive list; young people may experience symptoms which may not be included on this guide:
Coping / needs support; These are experiences that most young people will have from time to time
Type and nature of distress
It is common for children and young people to experience eating difficulties during childhood and adolescence. These tend to be short term, have no impact on physical health or daily functioning (e.g., going to school, seeing friends, taking part in hobbies or activities) and can be managed with clear boundaries combined with the love and support of parents/ carers.
What you might see or what a young person might report
Things to try, support and next steps
If someone is developing an eating disorder, often changes in behaviour are noticeable before changes to physical appearance. Signs include:
See your GP (ask for physical health observations to be done- height, weight, blood pressure, pulse)
Inform your child’s school to share concerns and ask if they have noticed any other concerns
Needs help; These are challenges that some young people experience and may need some support with
The degree to which a young person experiences eating difficulties may cause the young person distress or might have some mild impact on their ability to cope with everyday life such as going to or coping at school, seeing friends, or taking part in leisure activities. The family may also be experiencing a degree of stress characterised by more arguments or disagreements around food/ mealtimes, exercise levels/known or suspected vomiting. Other people may be commenting or noticing there is a difficulty or noticing change in weight. These difficulties may have been going on for a few weeks.
Dieting/ restricting food intake
Exercising/ increased activity
Purging (self-induced vomiting)
Eating excessive amounts/ bingeing/ constantly seeking food; gaining weight
Behavioural signs can include:
YP section- eating difficulties, anxiety, depression (see downloads)
Podcasts and Videos Section on www.hampshirecamhs.nhs.uk
How to support a young person with an eating difficulty here: https://youtu.be/-ApfAzKOy60
How to support a young person with anxiety: https://youtu.be/LMFQHABnH1M
How to support a young person with depression/ in crisis/ who engages in self-harm: https://youtu.be/qBAZQVjSmQU
Other Useful resources:
Needs Specialist Treatment or a Crisis Response; These are difficulties that cause a significant impact and a young person may need specialist support.
The degree to which a young person experiences eating difficulties may cause the young person distress or might have an impact on their ability to cope with everyday life such as going to or coping at school, seeing friends or taking part in leisure activities. The family may also be experiencing a degree of stress characterised by; more arguments or disagreements around food/ mealtimes or exercise levels/known or suspected vomiting. Other people may be commenting or noticing there is a difficulty or noticing change in weight.
The difficulties may have had a sudden onset at a significant level of concern or may have been deteriorating gradually over a long period of time.
What you might see, or what a young person might report
Emergency symptoms – seek immediate medical advice
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