About this factsheet
This is one in a series of factsheets for
parents, teachers and young people entitled Mental Health and
Growing Up. The aims of these factsheets are to provide
practical, up-to-date information about mental health problems
(emotional, behavioural and psychiatric disorders) that can affect
children and young people. This factsheet discusses the causes of
eating disorders and how to recognise them, as well as giving
advice on how to cope with a child who has an eating disorder.
What are eating disorders?
Worries about weight, shape and eating are
common, especially among young girls. Being very overweight or
obese can cause a lot of problems, particularly with health. Quite
often, someone who is overweight can lose weight simply by eating
more healthily. It sounds easy, but they may need help to find a
way of doing this.
A lot of young people, many of whom are not
overweight in the first place, want to be thinner. They often try
to lose weight by dieting or skipping meals. For some, worries
about weight becomes an obsession. This can turn into a serious
eating disorder. This factsheet is about the most common eating
disorders – anorexia nervosa and bulimia
nervosa.
- Someone with anorexia
nervosa worries all the time about being fat (even if they
are skinny) and eats very little. They lose a lot of weight and
their periods become irregular or stop.
- Someone with bulimia nervosa
also worries a lot about weight. They alternate between eating next
to nothing, and then having binges when they gorge themselves. They
vomit or take laxatives to control their weight.
Both of these eating disorders are more common
in girls, but do occur in boys. They can happen in young people of
all backgrounds and cultures.
What are the signs of anorexia or
bulimia?
- Weight loss or unusual weight changes.
- Periods being irregular or stopping.
- Missing meals, eating very little and
avoiding ‘fattening’ foods.
- Avoiding eating in public, secret
eating.
- Large amounts of food disappearing from the
cupboards.
- Believing they are fat when underweight.
- Exercising excessively, often in secret.
- Becoming preoccupied with food, cooking for
other people, calorie counting and setting target weights.
- Going to the bathroom or toilet immediately
after meals.
- Using laxatives and vomiting to control
weight or sometimes other medications/herbal remedies to lose
weight.
It may be difficult for parents or teachers to
tell the difference between ordinary dieting in young people and a
more serious problem. If you are concerned about your child’s
weight and how they are eating, consult your GP.You can also seek
help and advice from other agencies (see sources of further
information at the end of this leaflet).
What effects can eating disorders have?
- Feeling excessively cold.
- Headaches and dizziness.
- Changes in hair and skin.
- Tiredness and difficulty with normal activities
- Damage to health, including stunting of
growth and damage to bones and internal organs.
- Loss of periods and risk of infertility.
- Anxiety and depression.
- Poor concentration, missing school, college
or work.
- Lack of confidence, withdrawal from
friends.
- Dependency or over-involvement with parents,
instead of developing independence.
It’s important to remember that, if allowed to
continue unchecked, both anorexia and bulimia can be
life-threatening conditions. Over time, they are harder to treat,
and the effects become more serious.
What causes eating disorders?
Eating disorders are caused by a number of
different things:
- Worry or stress may lead to
comfort eating. This may cause worries about getting fat.
- Dieting and missing meals lead to craving for
food, loss of control and over-eating.
- Anorexia or bulimia can develop as a
complication of more extreme dieting, perhaps triggered by an
upsetting event, such as family break-down, death or separation in
the family, bullying at school or abuse.
- Sometimes, anorexia and bulimia may be a way
of trying to feel in control if life feels stressful.
- More ordinary events, such as the loss of a
friend, a teasing remark or school exams, may also be the trigger
in a vulnerable person.
Risk factors
Risk factors include:
- being female
- being previously overweight
- lacking self-esteem
- being perfectionistic.
Obsessional behaviour is often seen in young
people with eating disorders.
Some people are more at risk than others.
Sensitive or anxious individuals, who are having difficulty
becoming independent from their families are also more at risk.
Eating disorders can also run in families. The families of young
people with eating disorders often find change or conflict
particularly difficult, and may be unusually close or
over-protective.
Where can I get help?
If you think a young person may be developing
an eating disorder, don’t be afraid to ask them if they are worried
about themselves. Quite often young people with eating disorders
are unable to acknowledge there may be a problem, and will not want
you to interfere and may become angry or upset.
However, you may still be worried and you can
seek advice from professionals in different agencies e.g.
GP, Child and Adolescent Mental
Health Services (CAMHS). It is important that you
feel supported and not alone.
These simple suggestions are useful to help
young people to maintain a healthy weight and avoid eating
disorders.
- Eat regular meals – The
British Dietetic
Association recommends eating regularly throughout the
day which usually means three main meals and three nutritious
snacks in between such as fruit, yogurt or nuts.Too many sugary or
high fat snacks should be avoided.
- Try to eat a ‘balanced’ diet – one that
contains all the types of food your body needs including
carbohydrate foods such as bread, rice, pasta or cereals with every
meal.
- Don’t miss meals – long gaps encourage
overeating.
- Take regular exercise.
- Try not to be influenced by other people
skipping meals or commenting on weight.
When professional help is needed
When eating problems make family meals
stressful, it is important to seek professional advice. Your GP
will be able to advise you about what specialist help is available
locally and will be able to arrange a referral. This will
usually be to the local CAMHS.
Working with the family is an important part of treatment
If the eating disorder causes physical ill health, it is
essential to get medical help quickly. If untreated,
there is a risk of infertility. thin bones (oesteoporosis),
stunted growth and even death, but if treated, most young
people get better.
Recommended reading
-
The Mind: A User's Guide: Editor Raj Persaud,
Bantam Press, 2007.
-
The Young Mind: An essential guide to mental health
for young adults, parents and teachers, Bantam Press, 2009.
- Anorexia Nervosa: a surival guide for families, friends and
sufferers by Janet Treasure.
- Parenting skills by Janet Treasure.
Sources of further information
B-EAT: Adult
Helpline 0845 634 1414; Youth Helpline 0845 634 7650; textphone
service 01603 753322;
YoungMinds
provides information and advice on child mental health issues.
Parents’ Information Service 0800 018 2138.
References
Carr, A. (ed.) (2000) What Works with
Children and Adolescents? A Critical Review of
Psychological Interventions with Children, Adolescents and
their
Families. London:
Brunner-Routledge.
Dana, M. & Lawrence, M. (1988) Woman’s
Secret Disorder: A New Understanding of Bulimia.
London: Grafton Books.
Palmer, R. L. (1989) Anorexia Nervosa: A
Guide for Sufferers and Their Families. London:
Penguin.
Rutter, M. & Taylor, E. (eds) (2002)
Child and Adolescent Psychiatry (4th edn).
London: Blackwell.
Scott, A., Shaw, M. & Joughin, C. (eds)
(2001) Finding the Evidence: A Gateway to the
Literature in Child and Adolescent Mental Health (2nd
edn). London: Gaskell.
Nice
Guideline (2004) – Core Interventions in the
treatment and management of Anorexia Nervosa, Bulimia Nervosa and
related eating disorders .
Series editor: Dr Mona Freeman
Expert Review: Dr Sandeep Ranote
Editorial Board: Child and Family Public
Education Editorial Board.
Revised: March 2010; next due for review: March
2012.
© [2004] Royal College of
Psychiatrists. This leaflet may be downloaded, printed out,
photocopied and distributed free of charge as long as the Royal
College of Psychiatrists is properly credited and no profit is
gained from its use. Permission to reproduce it in any other way
must be obtained from the Head
of Publications. The College does not allow reposting of its
leaflets on other sites, but allows them to be linked to
directly.
Please note that we are unable to offer advice on individual cases. Please see our FAQ for advice on getting help.
Please answer the following questions and press 'submit' to send your answers OR
E-mail your responses to dhart@rcpsych.ac.uk
On each line, click on the mark which most closely reflects how you feel about
the statement in the left hand column.
Your answers will help us to make this leaflet more useful - please try to rate
every item.
Did you look at this leaflet because you are a (maximum of 2 categories
please):
Age group (please tick correct box)