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Eating disorders
Food is often the focus of family celebrations, and regular shared mealtimes are a well-known way to keep the family connected, so when a young person has an eating disorder, it can be difficult for the whole family.
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Understanding eating disorders
An eating disorder is a form of mental illness, not a fad or a diet gone wrong. With all eating disorders, food is used in some way to control or block out difficult thoughts and feelings. There is rarely one specific cause or trigger. Each case is unique and could be the result of different pressures such as bullying, family issues, worries at school, body image issues, friendship worries, and relationship difficulties.
Types of eating disorders
Anorexia nervosa
People with anorexia usually restrict what they eat or drink - either by skipping meals and/or drastically reducing food types and portions. Subsequent chemical changes that occur in the body affect the brain and distort thinking, making it almost impossible to think rationally about food.
Bulimia
Bulimia involves in a cycle of bingeing and purging - eating large amounts of food and then inducing vomiting or taking laxatives or diuretics. After an episode, which usually takes place in secret, people with bulimia may limit food intake, triggering extreme hunger before the cycle repeats.
Binge Eating Disorder (BED)
BED involves eating large amounts of food in a short period of time as a way of coping with difficult feelings and emotions. Unlike bulimia, there is no 'purging' phase so, if the disorder continues, it can lead to weight gain and obesity.
ARFID
Avoidant restrictive food intake disorder is a condition characterised by the person avoiding certain foods or types of food, having restricted intake in terms of overall amount eaten, or both. They might be very sensitive to the taste, texture, smell, or appearance of certain types of food, or only able to eat foods at a certain temperature. This can lead to sensory-based avoidance or restriction of intake.
Chew and spit
This describes a disorder when the sufferer spits out food rather than swallowing or eats items like paper tissues to fill up without consuming calories. These behaviours are more common than many people believe and sometimes exist alongside other symptoms, say Beat experts.
The four stages of recovery
There is no quick fix that we know of, no magic wand, and no miracle cure. Recovering from an eating disorder is not like getting over a cold. You will have ups and downs, but these are part of the process. Experts have pinpointed four vital stages that sufferers need to work through.
Stages of recovery
Stage 1: Pre-contemplation: Denying that there is a problem.
Stage 2: Contemplation: Recognising the damage the eating disorder is doing but being daunted by the thought of change. They are literally in two minds about whether they want to recover or not.
Stage 3: Determination and action: Ready to accept help and begin working towards recovery.
Stage 4: Maintenance: This is the most challenging stage of all as your child has to learn to manage life without their old coping strategy.
Recovery is a process, not an event. Moving from one stage to another can take a long time and your child may have to go through some or even all these stages several times before recovering fully. You cannot hurry or force your child through any of these stages. However, they do need to feel supported and strengthened by your love, encouragement and understanding.
Supporting your teen
Avoid offering bribes to encourage your child to eat or not binge. Treats and shared activities are an important part of normal family life, but they will not make your child's illness disappear. Teenagers will sense their parents’ desperation and this may increase their anxiety.
Try not to blame yourself for your child's disorder. Accept that you may never know what triggered it. Simply accept that your child has an illness and focus on recovery.
Work together as a family. Keep normal family routines, for example, pocket money, hobbies, spending time together. Carry on eating normally as a family. It's important that your child sees you and the family enjoying food and normal helpings. Your child needs consistency, and you need to prepare yourself for the fact that the eating disorder may lead them to lie about their behaviour or try to manipulate others.
There may be temper tantrums, accusations, resentment. Try to avoid falling into the 'good cop', bad cop scenario with your partner (one of you being lenient and the other strict).
Avoid unnecessary comments about food, appearance or weight. Ask open questions like: 'How are you feeling?' or 'How's your day been?' rather than closed, confrontational questions like: 'What did you eat for lunch?' or 'Have you just made yourself sick?'
Find out as much as you can about eating disorders. This will help you to understand your child’s behaviour, feelings and mood swings and accept that there are certain aspects of the illness that will seem illogical and hard to understand.
Keep including your child in family activities and social arrangements (even if they don't join in) and try to build up their self-esteem. Keep telling your child that you love them.
Getting help and support
Eating disorders are complex conditions - and recovery can be just as complex. It's not as simple as encouraging someone with anorexia to gain weight or forcibly preventing someone with bulimia from vomiting. First, the person with the eating disorder has to accept that there is a problem and want to make changes.
Whatever reaction you get, anger, disbelief, shock, amusement, denial, relief, or even complete silence - you've made a start. You may need to accept that your child isn't ready to admit to a problem yet. But let them know they can come to you when they are ready. In the meantime, gather information and research. Make an appointment with your GP - even if your child refuses to attend with you or admit there is a problem. Your GP may be able to help your child recognise that they need help.
Make a note of your main concerns and specific questions you want to ask, beforehand. Any child under 14 should be accompanied by a parent when visiting the GP. But if they specifically want to be treated alone, that confidentiality has to be respected. A child reluctant to talk to a GP might confide in a practice nurse or health visitor. But the GP will need to become involved eventually. Following an examination (which can include questions, being weighed and blood tests), your GP can make a diagnosis and referral for treatment - usually as an out-patient, close to home, in age-appropriate facilities. However, if your child is very ill or has a very low weight, hospital treatment may be needed.
Further resources
If you would like further support and advice, call our helpline on 0808 800 2222 or email us at askus@familylives.org.uk. You can talk to us online via our live chat service, which is open, Monday to Friday between 10.30am and 9pm. You may find it helps to find out how other parents and carers have coped with this on our online forums. We also have a range of free online parenting courses that can help through the ages and stages of parenting.
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