Eating disorders are notoriously secretive, which can make them very hard to spot. A lot of young people with disordered eating and/or poor body image may not realise that they are actually struggling with an eating disorder, instead just seeing themselves as “fat” or “greedy” or “ugly”. Others may feel too scared or ashamed to ask for help, whilst others may actually fear losing their eating disorder - feeling that it’s the only thing that gives them a way of managing their emotions or a sense of success or control in life. However, there are “silent signs” that parents can look out for:

• Abnormal weight changes

  Young people should be gaining weight as they grow and develop, so if they don’t gain weight, or more worryingly they start losing weight, this is a warning sign. Unexplained weight loss, plateauing or gain could reflect a change in eating behaviours.

• Avoidance of family meals

  Family meals encourage healthy eating behaviours in children, but young people with eating disorders will often do everything they can to avoid them - either due to food avoidance or due to discomfort about being seen to eat. Alternatively, young people may reject foods they used to enjoy, pick apart meals at the table, or say they feel full to avoid finishing meals.

• Sudden changes in diet

  A change in food preferences or an interest in “healthy eating” may be motivated by reasons other than weight loss. However, if young people start trying to diet or restricting certain food groups, this could be a warning sign.

• Missing food in the home

  Young people struggling with overeating or binge eating will often hide food in their rooms or find ways to eat in secret. However, it can be harder to identify an eating disorder when the disordered eating is done in secret and there are no obvious weight changes. Some other signs to look out for include self-induced vomiting, taking laxatives, increased physical activity, and feelings of shame or anxiety around eating.

• Increase in physical activity

  Some young people are very physically active, whilst others do little or no physical activity. For young people with eating disorders, exercise can become obsessive and/or compulsive. This could include exercising in their rooms/at night, or prioritising exercise over school work or time with friends. Exercise may start as a healthy activity, but become a way to lose weight or compensate for eating.

• Increased focus on appearance

  If a young person spends more time in front of the mirror, or becomes overly preoccupied with weighing themselves, this could be a warning sign that they are struggling with poor body image and/or an eating disorder. Whilst young people may feel self-conscious or dissatisfied with their appearance at times, some behaviours are more worrying. This could include avoidance of wearing clothes that are revealing/fitted (such as swimwear or shorts), avoidance of social events, or linking self-worth to appearance.

• Change in mood/personality

  Young people who become more withdrawn, irritable, anxious and/or low in mood are not necessarily hiding an eating disorder, but mood changes are common in eating disorders.

• Increased interest in cooking

  Whilst this may seem surprising, many young people with eating disorders develop an interest/obsession in food, and this may include an increased interest in cooking. This is particularly relevant if they are they reluctant to eat what they have cooked, or large amounts of the cooking goes missing.

If you are worried about any of these signs and symptoms, it is worth talking to your child and to a professional to get some guidance. Eating disorders are much more easily treated when they are caught early.

The London Centre offers a range of therapy approaches for people with eating disorders. However, we always offer family therapy as a first line treatment for any young people in our service as research has shown that it is the best and most effective treatment, and it is the NICE (National Institute for Clinical Excellence) recommended treatment for young people with an eating disorder. Having said that, some young people may want and benefit from individual therapy, either as a stand alone treatment or alongside family therapy. After meeting with your family, we will be able to provide a recommendation as to which treatment approach might work best for your child. Please download our information sheet for more details.

It is not uncommon for children and adolescents to be very reluctant to attend assessment/treatment. They will often express a strong desire to hold onto their eating disorder, or anxiety about talking openly to a professional about their difficulties. Young people (as well as parents) can have preconceived ideas about what treatment will involve or what seeing a psychologist will be like. This can often result in a fear that they will be told off, judged, misunderstood or talked down to. It is important that young people do not feel forced into attending therapy, and it can often help if they are told that if they do not like their therapist, they will not necessarily have to continue sessions with that therapist. That said, it is not uncommon to find attending therapy difficult at first, and young people should be encouraged to give it a few sessions to see how they feel.

Try talking to your child about any anxiety, preconceptions or fears they have about attending therapy before the first appointment. Try to show your child that you understand these fears and that they are common fears to have, but not necessarily a reason not to attend therapy. Explain to your child that therapy is a safe space to share their thoughts and feelings and reassure them that discussions which take place in the therapy room will be kept as secret as possible. During the first session, older children are usually seen with their parents (at least initially) and then on their own for part of the session. Younger children are usually seen with their parents unless they ask to see the therapist on their own at any point.

Whether your child is undergoing treatment with us or not, we are happy to provide information and support sessions for parents and other family members. This could be done as a single session or a series of sessions. Having a child with an eating disorder can be very distressing for the entire family, and parents often feel a mixture of helplessness, fear, guilt, distress, anger and frustration. Parents also tend to be very anxious about saying or doing the wrong thing and do not know how they should be dealing with their child’s eating disorder. Information and support sessions include psychoeducation to help parents better understand eating disorders and how to deal with them. These sessions also involve providing parents with support to help them cope with the distressing impact of having a child with an eating disorder. Please note that if your child is over the age of 18, specific information about your child’s difficulties/treatment will not be discussed unless your child has agreed to this beforehand.

If you are considering visiting us, you probably have lots of questions about what to expect and how to guide your child through the process. We have gathered all the key information into one handy guide. If there is anything further you want to know, please get in touch with us.