Eating Disorders in Children and Adolescents

Support with Anorexia in Teenagers and Children

If you are concerned that your child or teenager may be suffering from anorexia, or if they have been diagnosed with an eating disorder and you are looking for professional support, we can help.

What is anorexia?

Anorexia is a serious mental health condition characterised by an extreme preoccupation for pursuing as low a body weight as possible.

Children and adolescents with anorexia may:

• Restrict their food intake
• Exercise excessively
• Purge
• Abuse laxatives
• Use combinations of all of these

The disorder is characterised by an intense fear of gaining weight or becoming fat and often sufferers perceive themselves to be fat even when dangerously thin.

For young people with anorexia, their weight and shape influence their identity and self-evaluation to a disproportionate degree, to the point where many sufferers can become completely lost in the disorder.

What causes anorexia in teenagers and children?

Eating disorders are complex conditions, with a combination of biological, psychological, and social causes. Factors ranging from children’s genetic makeup to their life experiences create a unique set of vulnerabilities which may make them vulnerable to the development of anorexia.

As such, it is inaccurate and often very unhelpful to attribute the illness to a single cause. In particular, the common myth that families are responsible for their children developing eating disorders is not supported by research evidence and can be highly counterproductive for sufferers and carers alike.

Anorexia most commonly develops during adolescence.

1. Biological causes of anorexia
   Increased production of sex hormones during adolescence, such as oestrogen, affects the levels of serotonin and dopamine in a teenagers’ brain, and abnormal levels of these neurotransmitters responsible for many aspects of physiological and emotional regulations have been linked to eating disorders. Puberty also affects how our genetic data is expressed and this change could be part of the reason why adolescence is a key time for the onset of eating disorders¹.
2. Social causes of anorexia
   Much has been reported about the possible risks that social media has on our children’s likelihood to develop an eating disorder. For some, social media leads to a lowering of self-esteem, higher rates of depression and body image dissatisfaction (a key trait in anorexics).

Child and teenage brains are not fully developed until they are in their 20’s, and in the quest to develop their own sense of identity young people can be very susceptible to the opinions of others.

Symptoms of anorexia in teenagers

The following are some of the most common signs that an eating disorder, such as anorexia, may be developing or has developed. If you are concerned about your child or teen’s eating habits, weight loss, mood, or behaviours we would also recommend seeking expert help as quickly as possible.

• Weight loss
• Looking frail or gaunt
• Being tired all the time
• Becoming more secretive, especially around food
• Reluctance or refusal to eat in front of others
• Being more restrictive in the foods they will eat
• Wearing baggy clothes
• Hair loss
• Growth of fine, downy hair on body
• Stomach complaints
• Feeling cold all the time
• Becoming socially withdrawn
• Scrutinising self in mirror
• Taking a long time to eat meals, not finishing their food
• Going to the bathroom immediately after a meal
• Exercising more or in secret
• Depression, low mood, tearfulness, self-harm
• Bingeing and / or purging behaviour
• Drug or alcohol abuse

Not all children and teenagers with anorexia will show all these signs, and as anorexia is notoriously a very secretive illness, it can be hard to really know what is going on for your child. However, if you suspect something is wrong, then it is always advisable to seek professional advice.

What should I do if I think my child or teenager has anorexia?

Identifying whether your child or teenager has an eating disorder and broaching the subject with them can be very challenging. Many teenagers, especially teenage girls, engage in dieting behaviours and express dissatisfaction with their weight even when they are slim. It’s hard for parents to know when their child’s eating behaviours become a significant issue, but research shows that early intervention is the best way to determine a full recovery.

Helping your child to see that he or she may have a problem and to agree to an appointment for further professional evaluation is a difficult and important first step in eating disorder recovery. It is very common for young people to become hostile and defensive when loved ones raise concern about their eating, not least if problems really are developing.

Many young people with anorexia are simultaneously in denial about having eating difficulties and believe that the condition benefits them in some way (e.g., helps them focus, evidence self-control and determination). Be prepared for your loved one to state that they don’t have any difficulties or even to say that you are the one with a problem for suggesting as much!

Tips for discussing your child’s eating with them:

• Note down the things that your child is doing that are causing you concern, being as specific as you can.
• Try to find a quiet moment outside of mealtimes to raise these concerns in a calm and non-confrontational way.
• Do not place undue pressure on yourself to persuade your child of the need for help in a single conversation. Instead think of it as an opening, so that you and your children can keep returning to the topic, over time talk more openly and ultimately consider seeking further, professional support.

 

Talk with a qualified professional

A free, confidential call could quickly put you on the path to regaining control. All calls are answered by a trained assistant psychologist who will listen and ask questions, before suggesting the most appropriate treatment.

 

Call us today:

Bulimia in Teenagers and Children

If you are concerned that your child or teenager may be suffering from bulimia, or if they have been diagnosed with an eating disorder and you are looking for professional support, we can help.

What is bulimia?

Bulimia Nervosa, most known as bulimia, is a serious mental health condition that involves consuming large quantities of food (bingeing) compensated by purging behaviours, such as self-induced vomiting, laxative, diuretic or enema usage, excessive exercise or fasting.

The binge and purge cycle are then repeated – this may be several times a month or even as often as several times a day.

What causes bulimia in teenagers and children?
Eating disorders in children and teenagers can be extremely complex – and research has suggested that they are caused by several factors including biological, genetic and environmental.

It is thought that as much as 60% to 80% of our risk in developing an eating disorder could be genetic.

Hormonal changes during puberty have been shown to be linked to an increased risk in developing eating disorders like anorexia and bulimia – it seems that hormones such as oestrogen have a role to play in how the genes that have been linked to eating disorders are expressed .

Some children may become bulimic as a way of managing difficult emotions. Bingeing on food is a way some people cope with overwhelming emotions, perhaps stress or anxiety about school performance or difficulties with relationships. The purging (most commonly in the form of self-induced vomiting) is then used to rid the body of calories ingested.

Bulimia is a complex mental health disorder – the earlier treatment is sought, the more likely a full recovery can be made.

Symptoms of bulimia in teenagers and children

Bulimia is a progressive illness, meaning it often gets worse over time.

The following are some of the most common signs that an eating disorder, such as bulimia, may be developing or has developed.

• Obsessional thoughts about weight / thinness
• Being tired all the time
• Becoming secretive, especially around food
• Reluctance or refusal to eat in front of others
• Going to the bathroom immediately after a meal
• Scars or marks on back of knuckles (from inducing vomiting)
• Stomach complaints
• Dental issues, such as enamel erosion
• Sore throat / enlarged salivary glands
• Becoming socially withdrawn
• Scrutinising self in mirror
• Exercising more or, you suspect, in secret
• Depression, low mood, tearfulness, self-harm
• Bingeing and / or purging behaviour
• Drug or alcohol abuse

Not all children and teenagers with bulimia will show all these signs, and as eating disorders are notoriously a very secretive illness, it can be hard to really know what is going on for your child.

If you are concerned about your child or teen’s eating habits, weight loss, mood, or behaviours we would also recommend seeking expert help as quickly as possible.

What should I do if I think my child or teenager has bulimia?

Identifying whether your child or teenager has an eating disorder and broaching the subject with them can be very challenging. Bulimia is an incredibly secretive disorder – surrounded by a great deal of shame and embarrassment and your child may get very defensive when talking about it.

It’s hard for parents to know when their child’s eating behaviours become a significant issue, but research shows that early intervention is the best way to determine a full recovery.

Many young people with bulimia are simultaneously in denial about having eating difficulties and believe that the condition benefits them in some way (e.g., helps them focus, evidence self-control and determination). Be prepared for your loved one to state that they don’t have any difficulties or even to say that you are the one with a problem for suggesting as much!

Tips for discussing your child’s eating with them:

• Note down the things that your child is doing that are causing you concern, being as specific as you can.
• Try to find a quiet moment outside of mealtimes to raise these concerns in a calm and non-confrontational way.
• Do not place undue pressure on yourself to persuade your child of the need for help in a single conversation. Instead think of it as an opening, so that you and your children can keep returning to the topic, over time talk more openly and ultimately consider seeking further, professional support.

Talk with a qualified professional

A free, confidential call could quickly put you on the path to regaining control. All calls are answered by a trained assistant psychologist who will listen and ask questions, before suggesting the most appropriate treatment.

 

Call us today: 0333 3390115

 

 

Avoidant Restrictive food intake disorder in children and teenagers

Avoidant / restrictive food intake disorder (more commonly known as ARFID) used to be known as ‘Selective Eating Disorder’ until a few years ago – it can have serious long term health impacts, so treatment is always advised. We can help.

What is ARFID?

ARFID is an eating disorder in which those who have the illness restrict what they are eating or avoid certain food groups completely.

It is different to anorexia as weight loss is not the primary reason for restricting food intake, however, some people will go on to develop another eating disorder like anorexia or orthorexia if it is untreated.

There are three main types of ARFID:

1. Avoidant ARFID - certain foods are exclude because of sensory issues such as smell, taste or texture
2. Aversive ARFID - eating all or certain foods is very distressing, normally because of a traumatic event such as choking or serious illness associated with that food)
3. Restrictive ARFID – the person doesn’t feel hungry in the same way, or the person is easily distracted from the task of eating

Any of the three types of ARFID can develop from or into another eating disorder like anorexia, where the symptoms described above are accompanied by a wish to lose weight and low body image.

Causes of ARFID

The diagnosis of ARFID is relatively new, so there is limited research on what causes it to occur, however it is likely to be a complex interplay between several factors – such as a genetic predisposition triggered by some sort of biological, social, or environmental set of circumstances.

We know ARFID affects younger children more than those who are in adolescence or adulthood, and we know that boys are more likely to be affected than girls¹. We know there are strong links to neurodevelopmental disorders such as Autism or ADHD, to learning disabilities and to anxiety disorders including OCD.

We also know there are some circumstances that might trigger ARFID to develop. Choking and swallowing issues are very common (as much as a quarter of those with ARFID).

Anxiety disorders such as Generalised anxiety disorder (GAD) or OCD are also much more common in ARFID than for other eating disorders – around 75% of ARFID sufferers will have an anxiety disorder compared to 37% of anorexics².

Symptoms of ARFID

It’s very normal for children to develop some degree of pickiness as to what they do and don’t like to eat around the age of 6 or 7 (for instance - it’s thought carbohydrate rich foods are preferred to help growth spurts).

For most, by the time a child reaches puberty, their repertoire of food will have increased, and they will no longer be as picky about what they eat. It’s understandable therefore, that ARFID can be confused with picky eating however, ARFID is a diagnosable mental health condition that often is visible in very young children, and which they won’t grow out of naturally.

There are both physical and behavioural signs that someone might be suffering with ARFID.

Behavioural symptoms

• Fear of eating – anxiety around mealtimes
• Refusal to eat some or all food
• Difficulty eating in front of others
• No or very reduced appetite
• Forgetting to eat
• Limited amount of ‘ok’ foods

Physical symptoms

• Delayed growth against expectations
• Stomach complaints
• Vomiting, choking, or gagging when eating

Talk with a qualified professional

A free, confidential call could quickly put you on the path to regaining control. All calls are answered by a trained assistant psychologist who will listen and ask questions, before suggesting the most appropriate treatment.

 

Call us today: 0333 3390115

Eating Disorder Treatment

Finding the right treatment plan for your child or teenager to help them with their eating disorder is key to them making a full recovery.

What treatment is right for me?

There are various treatment routes that can be used effectively to help treat eating disorders like anorexia and bulimia. Finding the right treatment for your child will depend on a few factors including:

1. Your child’s BMI – those with a very low BMI (15 or less) are likely to need inpatient care. We always advise seeking care for your child as quickly as possible if they have a low BMI).
2. Outpatient care – if your child’s BMI is above 15 (and stable), attending regular therapy sessions may be an appropriate treatment route. The therapeutic approach will depend on your child’s individual requirements.
3. Psychiatrist assessment – it’s very common for people with an eating disorder to also have another co-current mental health condition like anxiety, OCD or depression. A full and thorough assessment, by a specialist Child and Adolescent Psychiatrist will identify if your child has a comorbid condition that needs treating before or alongside their eating issues.

Even when they feel motivated and committed to recovery, the entrenched thoughts and anxiety, guilt, shame and other strong emotions that come with an eating disorder can make change slow and difficult.

Research repeatedly shows that early intervention is one of the key factors in ensuring recovery from an eating disorder. We know it is often incredibly hard for parents to know what to do if the suspect or know their child has disordered eating behaviours – if your child will not engage in treatment themselves, you may wish to have an appointment on your own with a psychiatrist or Psychologist to talk about what can be done.

When is the right time to get help?

It can take huge courage to seek help for an eating disorder. It’s common for children and teenagers to say it is just a phase and that they will get better once they have overcome a period of stress. As a parent, we don’t want to push our children or upset them but getting help early on really does make a huge difference. Eating disorders are incredibly powerful, so getting the right support to help your child can make all the difference.

We also know that the sooner treatment begins following an individual coming forward to ask for help, the better the outcome – it’s very common for eating disorders to become a lot worse whilst on a waiting list to start treatment¹.

How can we help?

We believe in treating the individual.
It’s vitally important for your child or teenager that they receive personalised care and that is why we make sure that the treatment plan is personalised to their individual needs.

The most effective treatment plans will consider:

• Individuals’ needs and preferences
• Family, social and work circumstances
• Other mental health conditions
• Previous experiences

They will provide some flexibility in their approach, as recovery from eating disorders isn’t a standardised or linear process.

1. The first thing that will happen when you call us is that you will speak to one of our triage team. They are all trained mental health experts and understand eating disorders well. Their job is to make sure that the service our clinicians can offer is right for you or your loved one. If we don’t think we can help, or that another organisation would be better, we will tell you.
2. The triage team will ask you some questions about the concerns you have for your child.
3. If you and the triage team decide that we are the right organisation for you, we will arrange an appointment for your child or teen to meet with a senior Psychologist who specialises in eating disorders. You will need to be present for some or all this appointment – the Psychologist will advise you on this.
4. You may decide, following our advice, that an appointment with a psychiatrist is the first step – this can be particularly important if your child is struggling with other conditions or you suspect they have ASD or ADHD.
5. The Psychologist / Psychiatrist will advise on what therapeutic approach and treatment might be best, based on your individual needs. 
   This might include;
   - Therapy – for example CBT or DBT
   - Family therapy
   - Psychiatry
   - Nutrition advice
6. Once you have agreed with the Psychologist that you wish to continue treatment, we will arrange for your child to meet regularly with your therapist or psychologist (weekly, fortnightly, or monthly appointments are available).

 

Talk with a qualified professional

A free, confidential call could quickly put you on the path to regaining control. All calls are answered by a trained assistant psychologist who will listen and ask questions, before suggesting the most appropriate treatment.