If you know or suspect a child in your care has an eating disorder, you may feel concerned and powerless to help, but there are steps you can take to support a young person with an eating disorder.
Around 1.25 million people in the UK suffer from eating disorders, many in secret. Like most illnesses, eating disorders to not discriminate - those who suffer with EDs come from all sorts of backgrounds and may be any age or gender.
Eating disorders include bulimia, binge eating disorder, avoidant/restrictive food intake disorder (ARFID), other specified feeding or eating disorder (OSFED), and anorexia, which tragically has the highest mortality rate of any mental illness, though all eating disorders can be deadly.
In this blog, we will discuss how you can talk to a child with an eating disorder and support them with their recovery.
What can cause an eating disorder?
It is useful to know that an eating problem is usually symptomatic and suggests there is an underlying problem that needs to be identified, understood and treated.
Eating disorders can develop from unhealthy thoughts, beliefs or emotions around food, with common pivotal causes being:
Trauma
Stress
Poor self-esteem or body image
Bullying
Overconsumption of media showing extreme habits and diets
Fluctuations in weight due to development
Obsessive tendencies relating to previous trauma or disorder
As individuals, we all have our own positive and negative relationships with food and eating, and these can change over time.
Children’s attitudes to eating are affected by the people and things happening around them, including the attitudes and behaviours of parents and peers towards food, nutrition and body image, trauma, stress, and bullying. It is not uncommon for looked-after children to have experienced trauma, or have experience living in a home that does not support healthy eating habits.
During their development, a child’s appetite and eating habits are likely to change naturally as they grow and become more conscious of how they look and what they eat compared to others.
Younger children often refuse to eat certain foods and teenagers may try 'fad diets'. Many of us have our own experience with different types of diets well into adulthood, whether our goal is to lose or gain weight, improve our appearance, improve our health or just try new foods. These changes amongst children are not typically cause for concern, but issues can become more prevalent if a young person feels under pressure to eat or look a certain way.
What are the signs of an eating disorder?
Much like when adults are stressed, a child may lose their appetite or turn to food for comfort. If an individual is unhappy with how their body looks and are lacking in self-esteem, they may change their eating habits. Problems with food can begin when it is used to help cope with painful situations or feelings, or to relieve stress, perhaps without even realising it.
There are lots of different types of eating disorders, too, which are characterised by their own distinctive symptoms.
Some of the behavioural symptoms of an eating disorder can include:
Mood fluctuations
Often talking about food, diets, weight changes or body image
Preoccupation with nutritional content
Refusal to eat certain foods, such as carbs or fats
Avoiding mealtimes or eating in front of others
Denying that being under or overweight is a problem
Being reclusive
Some of the physical symptoms of an eating disorder:
Significant or sudden changes in weight
Chapped lips and grey skin
Fainting spells from malnutrition and dehydration
Low energy, sleeping often or for long periods of time
Hair loss
Irregular or absent menstrual cycles
Injuries and pain from excessive exercise
Dental problems from self-induced vomiting
Constipation, acid reflux and other stomach problems
Significantly low blood pressure and pulse
Frequent respiratory infections
Overall poor health
Some of these signs alone may not be cause for concern, for example, a sudden weight change if a child has a growth spurt is not uncommon, and many teenagers are known for sleeping for prolonged amounts of time. If a few of these symptoms are present in combination, however, this could be a sign of an eating disorder.
It is important to speak to the child’s support worker and their GP about your concerns and potentially seek a diagnosis before intervening further. Once you are aware of the problem, there are things you can do to help.
If you are a Red Kite carer, get in touch with a member of the team to learn more about the support available to you.
How can I help a child with an eating disorder?
Ultimately, the goal of a parent or foster carer is to help and support a young person who is struggling. There are a few things you can do if you’re supporting someone to recover from an eating disorder:
Talk about it
Change the language you use
Make changes at mealtime
Show you care and want to help
Manage your own feelings
Talk about it
Strong emotions and withdrawal can make it difficult to talk to a young person who is struggling, especially if they are unable to accept that they have problems with food.
However, these conversations are important for their recovery, so gentle persistence is key. Emotional responses such as aggression and anger can sometimes be signs of fear, insecurity, or a lack of trust.
Our blog on having difficult conversations with young people can help you find a positive way to approach the topic.
Change the language you use
As we discussed earlier, a person's perspective on food can be heavily influenced by those around, which is why it is important to be conscious of your own attitudes to food and how you talk about health and body image.
Try to avoid talking about their appearance, even if you believe you are paying them a compliment or telling them what you think they’d like to hear. It’s important to avoid focusing on how their body looks, as this can enforce the pressure they may feel around body image. Similarly, discussing your own or others’ diets, bodies and eating habits should be avoided and this should be reflected by others in the household and those that have regular contact with the child.
Make changes at mealtime
Mealtimes can be sensitive for a child with an eating disorder, so it’s important that the household agrees to avoid talking about portion sizes, calories or anything else about the meal. Ideally, avoid eating low-calorie or diet foods in front of them or having them in the house.
Even if you are worried, try to stay positive and enjoy mealtimes as you otherwise would, perhaps have an activity planned after the meal to prevent the young person from being tempted to purge or exercise immediately after eating.
If the young person is older and is normally involved in cooking, gently suggest that they participate in setting the table or washing up instead, so that they are not tempted to control the meal. These changes can be difficult to implement, so be patient and remind yourself that it’s okay if positive change isn’t immediate.
Show you care and want to help
Don’t underestimate the value of your love and support - phrases that reflect your own thoughts and feelings can show that you genuinely care, such as “I’m worried because…” or “I miss seeing you happy…”. Try to be honest about your own feelings, as this will encourage them to do the same.
Aim to keep informed and use any helpful resources available to you. Remind the young person you care for that you love them and will always be there for them, and if they are not ready or prepared to speak to you, there is other support available.
Suggest activities that you could do together, or that they can do alone or with friends, such as hobbies and getting outside. Or you can simply ask them what you can do to help.
Manage your own feelings
Try not to feel hurt if they do not open up immediately or lie, as this is part of their illness. If the young person you care for has had a formal diagnosis and is receiving help from a treatment team, they should be able to offer you support and advice. It is also important to speak to your family support worker, the child’s social worker and your own friends and family - it is a tough experience for both you and them, so remember you are not alone.
Ensure you manage your own eating and exercising habits to a healthy level for both your health and to set a good example.
Who can help support a child with an eating disorder?
The most helpful thing to remember is that you and they are not alone. There are many parents and carers who lived experience caring for children who have eating disorders or problems, as well as specialists who can offer their support and guidance.
You and other carers
The household
The child's friends and peers
The child's social worker
Your family support worker
The child's treatment team
The following organisations and helplines also offer advice online:
TalkED - a national, peer-led charity supporting anyone affected by any eating disorder or eating distress
Beat - a UK national helpline and service to inform and support people who are suffering with an eating disorder
Family Lives - support for families on a range of topics
Young Minds - support for young people, parents and carers for a range of mental health issues including eating problems
You can also ask your GP about support groups for parents and carers who are caring for someone with an eating disorder.