Supporting children and young people with anorexia

What is anorexia?

Anorexia Nervosa is an eating disorder where you try to control your body weight in a way that becomes obsessive or unhealthy. Symptoms may include losing weight quickly, counting calories in food, exercising too much and a fixation with body image. It can also cause symptoms such as trouble sleeping, growing a thin layer of hair all over your body, feeling irritable and not having periods.  

Although many see this as something that only women experience, 20% of people with anorexia are male, and men should equally seek support and treatment for it. A person can still have an eating disorder at any weight, they do not need to be underweight to be struggling. This is because it is more about the relationship they have with food in their mind; extreme weight loss is a common symptom but not the disorder itself.  

Signs that a child or young person may be affected by anorexia 

Signs include missing meals, eating very little and avoiding foods that are considered fattening. They may lie about what they have eaten and have strict rules about when and what they eat. They may avoid eating meals with other people or, if they do, they may cut their food up into very small pieces and eat very slowly. Other behaviours may also include excessive exercising and taking medicine to reduce hunger or for slimming purposes.  

It is likely they will be occupied with weighing themselves, feeling positive about losing lots of weight and adamantly believing they are fat when at a healthy weight. They may wear baggy clothing to hide their figure.  

Physical signs of anorexia include headaches, feeling dizzy, dry skin and hair loss. Common signs in young children include delays in growth, lack of weight gain and periods stopping or not beginning in younger girls.  

This is not a diagnosis tool for anorexia, simply common issues which a parent may have to contend with if the disorder is present.  If you are worried that your child has developed an unhealthy relationship with food, it is important to visit your GP for further help and support.

Common issues parents or carers may contend with 

Your child may lie about their food or avoid conversations concerning mealtimes. This is difficult as they may be aggressive or uncommunicative when trying to talk about it. Their secrecy causes difficulties for parents and carers to notice or attempt to help their child deal with them.  

Anorexia can occur alongside depression and anxiety, so it is important to be aware of the additional conditions the individual may be experiencing. Furthermore, irrational behaviour and mood swings are common, which must be dealt with in a patient and understanding way. 

How to support a child or young person with anorexia nervosa

It is important to try to talk to a child or young person openly about their eating habits. This may seem scary and a risk that it would make it worse. However, the earlier their eating behaviour is discussed the better, it may help them become more aware of their habits.  

It may at times feel that any conversation about food or eating leads to an argument or denial. Keeping calm is important and planning what you want to say in advance can be helpful. It is key to come across as understanding and non-judgemental. This allows the individual the opportunity to think and acknowledge their eating habits. Then it is a case of giving them time to talk about it when they are ready to do so.  

If worried about the signs, encouraging them to seek help from their GP is important. If they are younger, offering to go with them or helping them book appointments may be helpful for them.  

The individual is likely to feel low, lonely and may have isolated themselves from friends and family. It is vital to support them, assuring them that you are there for them and willing to help. This will help with discovery and steps towards recovery.  

Things to avoid discussing include talking about appearance. Any comments relating to their physical appearance could easily be misinterpreted or misunderstood. Specifically comments about their weight as this is likely to seem negative to the individual. Instead, it is better to acknowledge the challenge your child is facing and help with coping skills.  

What to say to schools or colleges

Schools can be a useful help during this time. If they are informed of the student’s situation they can offer support however it is important to talk to your child about what you may share. Your child is likely to generally have high anxiety levels and the extra stress of school or colleges may become too much. Teachers can be made aware so they can adapt the classes, so the student feels comfortable and safe. They may offer extended deadlines to reduce stress concerning homework.  

You could ask for your child to be supervised during mealtime to support them during lunchtime and ask for information to be fed back over how much they ate.  

It is important to advise the school to be somewhat lenient and flexible towards the student. They may be delayed to lessens after break or lunch due to difficult lunch or snack times. Additionally, they may be upset after a therapy or counselling session causing delays to lessons.  

What to say to siblings 

Siblings often feel left out due to the attention of their sibling. It is important to give the siblings time at home where the focus is not on the eating disorder and give them the space to spend time with the family and ask questions about it.  You may provide them with some information about anorexia so they understand.

As with yourself, it is important to talk to siblings about what to and what not to say. Talk about comments on eating, weight or appearance, suggesting for them to be avoided. Furthermore, anorexia can lead to mood swings, irrational behaviour and personality changes, and their siblings need to be aware and patient during this time.  They must understand what changes will occur in the household set up, for example, more focus on family mealtimes.  

All siblings argue and fight at times. There is a possibility that, in an argument, the sibling may feel they have said something which has caused the eating disorder. It is key to reassure them that eating disorders are complex and one comment will not have caused it. If they feel guilty, you could help them to talk to their sibling about this, or even write a note to them if easier.

One thing to be careful of is that siblings may also struggle over their weight and eating due to the environment at home. Discussing thoughts and emotions with them during this time is important. It may be that you, as parent or carer, are not the easiest person for them to speak to though there may be an older friend, family member or counsellor they feel comfortable to talk to. 

What to say to extended family 

Talking to the extended family depends on how close they are to the individual with anorexia. If they regularly visit the house it is important to be aware. Before they arrive, they should be informed of potential mood swings and irrational behaviour. Additionally, as with siblings, it is key to tell them to avoid comments about appearance, food and weight. With all this information it is important to not scare them off and discuss that the more normal the environment the better for everyone.  

Support for parents and carers is important too, so if you feel you are struggling through this difficult time it may be good to speak to extended family. They can offer support for you, being someone to talk to who is outside of the situation.  You may also find support groups where you can share your experience openly with other parents and carers who have or are going through a similar situation, which may help you talk openly without fear of being judged, feeling shame or lack of understanding from those you are confiding in.

Additional support for parents or carers

• Beat – Advice if worried someone has an eating disorder 

• Anorexia and Bulimia Care – Support for parents