Worries about weight and eating problems: information for young people

Most of us, at some time in our lives, feel unhappy about the way we look and try to change it. Being smaller, shorter, or less well-developed than friends or brothers and sisters can make us feel anxious and lacking in confidence. So can being teased about size and weight. Many of us have an idea of the size and shape we would like to be.

Our ideas about what looks good are strongly influenced by fashion and friends. You might compare yourself with the pictures in magazines. The models in these magazines are often unhealthily thin. You may then worry that you are fat, even if your weight is normal for your age and height.

There are a variety of sizes and shapes that are within the normal, healthy range. If you’re interested, there are tables showing normal height and weight. Ask your school nurse, GP or library. Your weight, like your height and looks, depends a lot on your build, your genes and your diet.

Our bodies need a healthy diet which should include all the things you need to develop normally – proteins, carbohydrates, fats, minerals and vitamins. Cutting out things you might see as fattening, such as carbohydrates or fats, can stop your body from developing normally.

There are some simple rules that can help you to stay a healthy weight. They sound quite easy, but might be more difficult to put into practice. You can ask your family and friends to help you to stick to these rules – and it might even help them to be a bit more healthy!

• Eat regular meals – breakfast, lunch and dinner. Include carbohydrate foods such as bread, potatoes, rice or pasta with every meal.
• Try to eat at the same times each day. Long gaps between meals can make you so hungry that you eventually eat far more than you need to.
• Get enough sleep.
• Avoid sugary or high-fat foods and junk foods. If you have a lunch of crisps, chocolate and a soft drink, it doesn’t feel as if you’re eating much, but it will pile on the pounds. A sandwich with fruit and milk or juice will fill you up, but you are much less likely to put on weight – and it’s better for your skin.
• Take regular exercise. Cycling, walking or swimming are all good ways of staying fit without going over the top.
• Try not to pay too much attention to other people who skip meals or talk about their weight.

If you follow these suggestions, you will find it easier to control your weight, and you won’t find yourself wanting sweet foods all the time.

There seems to be a new one of these almost every week. Sadly, they often do more harm than good.

• Crash diets don’t help you to keep your weight down. In fact, they might make you put on weight after a while. At worst, they can be dangerous.
• Exercise helps, but it’s got to be regular and increased only gradually. Too much exercise, or too much too soon, can damage your body.
• Laxatives might help you feel less guilty and bloated. Unfortunately, they don’t reduce weight and can upset your body chemistry.
• ‘Slimming pills’ can’t make you thinner. They might make you feel a bit less hungry, but unfortunately, they can also harm your health.

Problems or pressures at school, with friends, or at home, are common. Your appetite can be affected by stress, pressure, worry or tiredness.

Some people turn to food for comfort. This can lead to eating more than we need, and can make us put on weight.

It’s easy to start worrying about getting fat and we find ourselves eating even more to comfort ourselves. It becomes a vicious circle. ‘Comfort foods’ often contain a lot of fat or sugar – sweets, biscuits, chocolate, cakes and pastries. It can be helpful to keep a diary of what you eat to make sure that you don’t slip into this.

If you are unhappy or stressed, it can be easy to focus on your weight and eating habits instead of the things that are bothering you. If this goes on for long enough, you might develop an eating disorder. The most common eating disorder is becoming overweight (obesity). Other eating disorders are less common. Anorexia nervosa and bulimia occur most often among girls but can occur in boys.

When you have an eating disorder you may notice some signs.

If you suffer from anorexia:

• you may be exercising a lot more than usual to lose weight
• you feel afraid of putting on weight
• you don’t feel good about yourself and the way you look
• if you are female your periods may be irregular or may have stopped
• you may have noticed changes in your physical health
• you will feel you are fat and will avoid eating, even though you aren’t actually overweight
• you feel guilty when you eat
• you avoid food, lose a lot of weight and become extremely thin.

Strangely, the thinner you get, the fatter you feel! We don’t fully understand why this happens, but it makes the eating disorder harder to overcome.

People with anorexia usually remain very active - and say they are well - even though they become so thin that they avoid undressing in front of others or wear loose clothes to hide their size.

Anorexia nervosa can be dangerous if it gets out of control. If you are a girl, and your periods have stopped, this is a danger sign that means you need help right away (this won’t happen if you are on the pill – so if you are, don’t wait for this).

If you don’t eat much, you can feel like you are starving! You may then find yourself bingeing – eating lots of food very quickly. Bingeing also happens in an eating disorder known as bulimia.

If you have bulimia:

• you avoid foods like chocolates, cakes or biscuits, except when you binge
• you feel fat, guilty and ashamed when you binge
• you try to get rid of the food by being sick or using laxatives. It usually doesn’t make much difference to your weight, but can damage your health and take up a lot of time and energy.

Some people have both anorexic and bulimic symptoms.

If you are worried about your weight or feel you might have an eating disorder, you should get some help. Talk to:

• a member of the family
• a teacher or school nurse
• a counsellor or social worker
• your general practitioner.
• a B-EAT professional.

Your GP or practice nurse is the best person for basic information and advice on diet and weight.

If you need more specialist help, they can refer you to a specialist or suggest that you see a professional at your local child and adolescent mental health service.

This is a team of specialists including child and adolescent psychiatrists, psychologists, social workers, psychotherapists and specialist nurses.

They can help you to regain control of your eating and your weight. Most young people do get better with help.

"Two years ago it was my ‘best friend’ and now it’s my ‘enemy!' It no longer controls me or my family and together we’ve pushed it away. I couldn’t have done it alone. I wouldn’t have made it to uni if it wasn’t for my mum and the school nurse who convinced me to see a professional team….that took them 6 month! I was really pig-headed! I am talking about ANOREXIA.

It started when I was 15 and my friends and I tried the ‘South Beach Diet’…..most of them dropped out but I stuck with it…. I’ve always been competitive.

At home there was so much pressure to get ‘A’ grades; at last there was a different focus. I became obsessed with counting calories and even kept a food diary. I lost more weight but still felt huge and ‘ugly’ and wanted to lose more. My friends tried to stop me and said they were worried but I didn’t care.

Slowly, I stopped going out with them, preferring to stay in and do my sit-up regime. I thought about taking slimming pills but was too scared so I bought laxatives instead. I felt so driven to lose weight; the thought of putting on an ounce scared me to death. I remember feeling weepy and very tired. At its worst, my fingers and toes went blue!

Then, I agreed to see the child and family mental health service where I met a team of professionals including a nurse, psychiatrist, psychologist and family therapist.

They offered me individual therapy every week, to work through things and have my physical health monitored too. The family therapist was also able to offer us time as a family to work things out. This felt like the most important bit for a long time, especially for dad who found it hard to understand Anorexia. It was tough and sometimes we felt like throwing the towel in but the team supported us and we felt safe.

Even now some days are hard, but we got through it."

"I’m 16 now, but I think I started having a problem when I was 12. I became very worried about my weight and my body. I had put on a bit of weight and was very upset when a boy in my class called me fat. I remember feeling that even if I was doing very well in school, things weren’t quite right and I wasn’t quite good enough.

Gradually I ate less, lost masses of weight, but still believed that I was fat. Sometimes I “felt” fat and this made me feel very down. I stopped seeing most of my friends, and spent more and more time thinking about food and my body.

I was always checking the shape of my stomach and bottom – at 20 or 30 times a day, looking at them in great detail. I felt very cold at times, and found it harder and harder to find the energy to do things as I was eating less and less.

I also weighed myself at least 5 times a day, and if my weight had not gone down, I checked my stomach, and tried dieting even more. Sometimes I binged on cakes and chocolate. I felt very guilty afterwards and would usually be sick so that I could get rid of the food and loose some weight. It felt as if I was going round and round in circles, with no means of escape.

One of my teachers noticed that I wasn’t eating lunch and that I had become thin (or at least she thought I had). She spoke to my parents and I was taken to a clinic.

At first I didn’t want to know and I didn’t want to be helped. However, I started a treatment called Cognitive Behavioural Therapy (CBT). I learned to look at the links between my thoughts, feelings and behaviour, but more importantly, I learned that I could eat regularly - without putting on weight.

Gradually I put on some weight and worked on my checking and weighing behaviour. It wasn’t easy to get better. I slowly started to eat the foods that I used avoid. Sometimes I still find myself thinking the way I used to, but now I know I that this is only one way of thinking, one way of being, and most of the time to chose not to do this.

I love going out clubbing with my friends now and I don’t argue quite so much with my parents, well at least not about food anyway."

B-eat - Beat provides helplines, online support and a network of UK-wide self-help groups to help adults and young people in the UK beat their eating disorders. Youth Helpline: 0845 634 7050.

Epic friends - Mental health problems are common. This website is all about helping you to help your friends who might be struggling emotionally.

Young Minds - Website offers information to young people about mental health and emotional well-being.

Further reading

Changing Minds: A Multimedia CD-ROM about Mental Health is intended for 13–17 year olds; it talks about addiction, stress, eating disorders, depression, and schizophrenia and self-harm. 

Rutter, M. & Taylor, E. (eds) (2002) Child and Adolescent Psychiatry (4th edn). London: Blackwell.

NICE Guidance (2004) Core Interventions in the treatment and management of Anorexia Nervosa, Bulimia Nervosa and related eating disorders

Series editor: Dr Vasu Balaguru

This leaflet reflects the best available evidence at the time of writing.

© March 2012. Due for review March 2014. Royal College of Psychiatrists.