If being a teenager wasn’t hard enough - coping with exam pressures, discovering who you are as well as trying to fit in - some kids may also develop an eating disorder, which can often be very difficult for a parent to detect.
This is because one of the classic symptoms of an eating disorder is that the sufferer will do his or her utmost to hide it from loved ones, making it a very lonely condition as well as being a debilitating and potentially life-threatening one in extreme cases.
Furthermore, the rise of social networking sites such as Facebook over the past few years has added another visual element into the equation. Children are now exposed to more media images in a day than their parents might have been exposed to in an entire adolescence, thus putting increased pressure on teens to brand themselves online and be accepted.
But what exactly is an eating disorder and how can parents address a situation if they believe their son or daughter might be at risk?
“An eating disorder is a serious mental health condition, primarily characterised by disturbances in eating behaviours. It’s about behaviours around food and diet and the medical complications that can arise because of those behaviours,” says Ruth ní Eidhin, communications officer at Bodywhys, the Eating Disorders Association of Ireland.
“Also, it’s about the emotional issues that are underlying the eating disorder.
“An eating disorder is a coping mechanism. It would be a way that the person has developed to manage or try to cope with an issue that they haven’t or can’t otherwise address.”
Parental concerns
If you are concerned that your child might have an eating disorder, Ní Eidhin says you should:
* Read all you can about eating disorders;
* Look for support groups; and
* Speak to your family doctor if you have specific medical concerns.
She also suggests that parents make a note of what’s been happening, recording specific incidences such as skipped meals, over-exercising and frequent bathroom trips.
“It’s important to think of it not in terms of the food, because it’s not about food,” says Ní Eidhin.
“It’s such an emotive situation, so you need to be able to approach it in as calm and measured way as possible.
“Sit down with your child and say, ‘Listen, I want to talk about what’s been going on with you’, noting these behaviours have been happening and not just asking, ‘Why aren’t you eating?’ Give them the space to talk about what feeling has developed in them to engage in these behaviours.”
But what if your child doesn’t want to talk?
“Ultimately, that is the top question we get from parents. The majority of people will not want to be confronted about an eating disorder,” she explains.
“This is because if you look at an eating disorder as a coping mechanism, your child’s first fear is you are going to take away their coping mechanism.”
Ní Eidhin says parents need to reassure their child that they are not asking them to change their behaviours immediately.
“But, you are saying that in the longer term you need to find a healthier coping mechanism and that you’re going to work with them.”
Treat your GP as a gateway
Your doctor is generally your first port of call, as he or she is a gateway to other treatment options.
Ní Eidhin advises: “The first thing is a full medical assessment - how much weight has the person lost, has the person stopped menstruating, have physical side-effects taken place. Blood tests will also be done.
“The other side is what type of supports the person may need in terms of counselling or psychotherapy, or maybe going to see a psychiatrist.
“In extreme cases, they may need an out- or an in-patient treatment option.”
Mental health condition
What makes an eating disorder complicated is that it’s a mental health condition, but it has physical effects as well, she says.
“In terms of a recovery process, you really need to make sure that both the physical and mental sides of the situation are being dealt with.
“The majority of people would work with their general practitioner and then maybe some form of talk therapy as well.”
For parents, Ní Eidhin says it’s vital to reassure your child as much as possible, telling them that recovery takes time, that they can get better and they will be supported in getting better.
Family supports
“If one person develops an eating disorder it is likely to affect the entire family. It is important to advise parents to get support for themselves,” says Ní Eidhin.
“And from your child’s perspective, as with any mental health issue, it’s so important that people feel they can talk about it.
“Having an eating disorder can be incredibly isolating, as the person will change their behaviours not just in terms of their food but also their overall mood and their activities. If the person is ready to move towards recovery, the first thing is to start talking, saying, ‘Yes, this is going on for me, I need to get help. I might not be ready to get the help yet, but I’ll allow you to tell someone that I need to get help.’ “
Types of eating disorders
They fall into three main categories:
* Anorexia nervosa: A person restricts their diet and doesn’t eat as much as their body needs. They may also over-exercise and use laxatives. Over time, they will lose a substantial amount of weight and they may feel weakened and develop poor circulation. Their heart can also be damaged over a long period.
* Bulimia nervosa: Twice as common as anorexia, bulimia is where a person will binge eat, ie eat more than their body needs at any one time. It involves eating very fast, usually consuming foods that are low in nutritional value. The person will usually binge eat alone, hiding their actions. They might sit down to their family meal as normal. To compensate for binge eating, the most common method they would use is to make themselves sick after a meal or after bingeing.
* Eating Disorder Not Otherwise Specified (EDNOS): About 50 percent of eating disorders fit into this category. It’s when a person has some but not all of the criteria for anorexia or bulimia so they are in a more grey area. Binge eating without purging is an example.
Eating disorders and teens
The majority of people who develop bulimia stay quite close to their normal weight, says Ruth ní Eidhin. “They may lose weight or they may even gain some weight.”
Some signs parents should watch out for with bulimia are swollen glands and calluses on their child’s hands if they are making themselves sick.
To get an exact diagnosis of anorexia, if you are female and you have started menstruating, your periods need to have stopped. You also have to have reached a particular low body weight (85 percent of your normal body weight and below).
With anorexia and bulimia, Ní Eidhin points to the short-term impact they have on your digestion system.
“There would also potentially be the longer-term problem when you purge in that way, as you are interfering with the balance of electrolytes in your body and that can have a real impact on the heart.”
And while we might often associate eating disorders with young women, Ní Eidhin says it’s a growing issue for young men.
“Boys are more inclined towards over-exercising as well as or instead of just restricting their diet - at the extreme level going to the gym even twice a day.
“It’s the idea of not so much losing weight but building up muscle. It becomes unhealthy and compulsive,” she adds. - Irish Independent