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The past year has taken its toll on the mental health of many young people, and there has been a significant rise in the number presenting to clinical services with Eating Disorders. For parents there can be little more terrifying than watching a child you have spent years nurturing, harming themselves by starving, bingeing or purging.
Eating disorders are serious and complex mental health conditions; Anorexia Nervosa has the highest mortality rate of all mental illnesses. People with an eating disorder will have thoughts and behaviours centred around food, weight and body shape but it is important to understand that these are a coping strategy which they have developed to help them manage difficult feelings such as anxiety, self-loathing, depression and shame. The majority of people with an Eating Disorder will recover but, early intervention is vital, and most patients will require a team including their GP, a psychiatrist, a psychotherapist and a nutritionist to support their recovery.
Whether or not someone will develop an eating disorder is determined by a variety of factors including their personality, biology, social environment, what is culturally prized and levels of psychological stress. It is often mooted that eating disorders are the preserve of the adolescent girl, but this is simply not true, a quarter of all clinical cases are male and, whilst they most often start in adolescence they can affect anybody, at any time.
You cannot tell if someone has an eating disorder just by looking at them. While it is true that some sufferers of anorexia are severely emaciated, some are not, and the majority of eating disorder sufferers do not have anorexia (BEAT Eating Disorders, 2022). Those suffering from bulimia may be within the normal weight range or may be overweight, while those with binge eating disorder are often overweight.
Professor John Morgan at Leeds Partnership NHS Foundation Trust designed the SCOFF screening tool to indicate a possible eating disorder. A score of two or more positive answers is a positive screen. If you’re concerned that you’re child might have an eating disorder, encourage them to consider these questions:
SCOFF questionnaire
In terms of prevention there is a lot we can do as parents to minimise the likelihood of our children developing an eating disorder. We can teach them healthy ways to manage their feelings. We can build their self-esteem and help them connect with who they really are. We can help them focus on the journey to any goal rather than the goal itself to minimise any pressure they might feel. We can encourage them not to put too much pressure on themselves. We can model the importance of living life in balance. We can give them the time, space, permission and opportunity to talk to us about anything that might be worrying them. We can show that we take their concerns seriously no matter how trivial they might seem to us. We can check that the school environments we choose for them are suited to their personality and are pastorally proactive, and we can give them the social skills to be able to create and maintain healthy relationships.
We can do all of these things and more but there are times when an eating disorder develops despite our best efforts and then we need to know what to do. You know your child, if you are worried that they are not ok then the chances are you are right, so trust your instincts. Think through when, where and how you can most sensitively broach the subject. Try to stay calm and focus on feelings rather than behaviour because there is always a lot of shame and secrecy around the behaviours attached to eating disorders which, when confronted, can result in them becoming too angry or upset for rational discussion. Your child needs to know that you love and accept them for who they are; that you are robust enough to discuss painful emotions so they don’t need to protect you; that you will support them in any way you can, and that there are experts who can and will help them get better.
Lastly I think it is important to recognise that supporting someone with an eating disorder can be extremely stressful. Find support for you and the rest of your family because you will all be affected by this most distressing of illnesses.
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