Eating disorders are serious mental illnesses that involve a person’s behaviour towards food and eating.
Eating disorders can cause serious harm and can even be fatal. In fact, anorexia has the highest mortality rate of all mental illnesses.
A child or young person with an eating disorder will typically restrict the amount of food they eat or eat large amounts of food they later get rid of by unhealthy means, e.g. making themselves sick, using laxatives or doing excessive exercise.
It’s not always obvious that a young person has an eating disorder; however, sufferers will often avoid eating with others and become unnaturally fixated on weight loss, dieting and food. Post-puberty, girls who become unnaturally thin will stop menstruating.
Why do young people develop eating disorders
Developing an eating disorder is not a lifestyle choice and sufferers should not be thought of as extreme dieters. The most common types of eating disorder are anorexia, bulimia, and binge-eating disorder, but a young person’s symptoms will vary and there is frequently an overlap.
Eating disorders can develop at any age, but the risk is highest for young men and women between 13 and 17. There are many more girls than boys affected.
The eating disorders charity Beat explains, “It’s important to remember that eating disorders are not all about food itself, but about feelings. The way the person interacts with food may make them feel more able to cope, or may make them feel in control.”
Anorexia nervosa is characterised by the strict control of food intake by individuals with a fear of putting on weight. Despite eating very little, sufferers often weigh constantly and go to great lengths to rid their body of any calories consumed.
People suffering from anorexia often have a distorted image of their body, seeing themselves as fat when they are, in fact, dangerously thin.
Things to look out for include:
- extreme thinness, accompanied by denial
- extremely restricted eating
- an intense fear of gaining weight
- dry skin, and brittle hair and nails
- constantly tired and cold.
Young people with bulimia nervosa are caught in a cycle of overeating and ‘purging’, i.e. getting rid of the food they’ve eaten by forced vomiting, laxatives and diuretics, fasting or excessive exercise (and often a combination of these).
A bulimic will have episodes of uncontrolled binge-eating during which they eat very quickly and consume huge amounts. Afterwards, they will be distressed by what they feel is their ‘lack of control’ and so the binge/purge cycle continues.
Unlike anorexia, someone with bulimia will often maintain a healthy weight, making the illness hard to spot.
Things to look out for include:
- noticeable fluctuations in weight, both up and down
- evidence of binge eating, e.g. large amounts of food disappearing, lots of empty wrappers
- evidence of purging behaviour, e.g. signs of vomiting, packs of laxatives
- bathroom trips after meals
- discoloured teeth, cuts or calluses on finger joints
- the frequent use of mouthwash, mints and chewing gum.
Binge-eating disorder (BED)
People with binge-eating disorder lose control over their eating and eat large quantities of food over a short time. Binge-eating is less common in younger people but it can develop from or into anorexia or bulimia.
Binges are usually planned in advance and take place in private. Unlike bulimia, they are not usually followed by purging.
After a binge, the sufferer experiences disgust and self-loathing; however, they find it difficult to stop their bingeing even if they want to.
Binge-eating can be hard to spot, but things to look out for include:
- frequent dieting, often without weight loss
- weight gain
- eating until uncomfortably full
- eating alone or in secret.
Treating eating disorders
Eating disorders are serious but they can be treated with good results. Many sufferers make a full recovery and go on to have a normal relationship with food.
The important thing is to get an early diagnosis so the young person can get the treatment they need as soon as possible.
Your GP will get the ball rolling. After an initial assessment, the young person will referred to a community-based, eating disorder service for further assessment or treatment.