Grey skin, violent outbursts & suicide attempts – the shock rise & devastating impact of childhood eating disorders

SEEING her daughter dragged kicking and screaming from the family home, Donna feared she’d lost 13-year-old Maddie* forever.

The schoolgirl was fighting a losing battle with anorexia and, by the time she was sectioned in July 2022, she was surviving on two sips of water a day. Painfully thin, Maddie refused even to shower, fearing she’d inhale calories.

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“At the hospital, she had to be tube-fed and was confined to a wheelchair,” says Donna, 41, who lives in Yorkshire.

“She was given a special mattress as her bones were protruding through her skin, causing sores. Truthfully, I thought she’d die there.”

Maddie is just one of a rising number of children with an eating disorder in the UK.

NHS data shows the number of kids being treated has doubled in eight years, from 5,240 in 2016/17 to 10,606 in the last school year.

Despite guidelines that state children should not wait longer than four weeks for treatment, or one week after an urgent referral, many are waiting over a year. Experts agree the pandemic has fuelled the rise.

“When Covid hit, we saw an explosion in the number of people calling our helpline, with around four times as many calls,” says Tom Quinn of the eating disorder charity Beat.

“Eating disorders thrive in isolation, and the lockdowns in 2020 and 2021 provided the perfect breeding ground.”

It was Christmas 2021 when Donna first noticed something wasn’t right with Maddie, a shy, sporty girl who had lots of friends.

“It wasn’t the weight loss we noticed, as she was covering herself with baggy clothes. But her skin was turning grey,” Donna recalls.

“She really felt the cold. Then she began suffering fractures while playing netball. At Easter, I took her to the GP, thinking she might need calcium tablets.

“When the nurse told Maddie she was going to weigh her, she got very angry. It was as if we’d uncovered her secret.

“I later found out that, although she’d been eating a meal with us, she hadn’t been eating anything else all day.”

Half of the time she was my daughter, the other half she was controlled by the eating disorder

Referred to hospital, Maddie was sent home with a meal plan after just a few hours.

“After that, she started hurting herself. She felt so guilty for eating food, she’d hit herself,” Donna says.

“We ended up in hospital again a week later. This time, the consultant witnessed her being violent and fast-tracked her to CAMHS [Child and Adolescent Mental Health Service] for help.”

Donna remained positive that specialist help would get her daughter better, but weekly appointments at a mental health clinic didn’t prove enough.

“She was surviving on fruit smoothies,” Donna recalls. “Half of the time she was my daughter, and the other half she was controlled by the eating disorder. As the months went on, the eating disorder fully controlled Maddie.

“She was very aggressive and would throw food at me at mealtimes. Towards the end, she wouldn’t even be in the same room as food, believing she was inhaling calories.

“We’d drive past Rowntree’s chocolate factory and she used to hold her breath, thinking she’d put weight on.

“Family life was hard. I have two other daughters, now aged 11 and 17, and I’m saddened by the impact it had on them. If Maddie gets upset even now, my youngest will ask how long it will last ‘this time’. Her sisters are very tuned into her feelings.

“My husband Paul, 49, and I run our own business and he took over so I could care for Maddie full-time, but it was so tough. She tried to take her own life many times. Our lives were falling apart.”

Desperate, Donna contacted her local MP, who put pressure on CAMHS, and Maddie was admitted to hospital in June 2022. She was violent when she was on the ward, didn’t eat and threw her food. But still, after three days, she was discharged.

“I asked why they couldn’t give her a bed and they said she wasn’t ready yet,” Donna says.

“I took her home and phoned our MP again. I felt that they’d sent her home to die. Two hours later, my phone rang and it was a highly specialised clinical psychologist, who said he was taking over Maddie’s care.

“She was then sectioned and admitted to a special unit in a different hospital. He saved her life.”

Some children say the trigger stemmed from healthy-eating messages at school

Now, Beat is calling for more intensive community therapies to help children like Maddie before they reach the point that they need to go to hospital.

“It takes a long time for people to get help, and that help can be quite limited, sometimes just one or two sessions a week,” Tom says.

“It’s useful, but for many people, that just isn’t enough. They become even more poorly and end up in hospital, which can be highly traumatic.

“Often it is far away and parents can only visit at weekends. Giving children better outpatient care is in everyone’s best interests.”

As well as lockdown, there are several other factors that may have contributed to the rise in childhood eating disorders.

“Some children say the trigger stemmed from healthy-eating messages at school, which is very concerning,” says Tom.

“It’s too simplistic to say this would cause an eating disorder, but in children who are susceptible, the kind of black-and-white thinking that says foods are ‘good’ or ‘bad’ could be damaging.

“Others say social media added fuel to the fire. The Online Safety Act requires social media companies to protect children from harmful content, but there is still work to do in defining exactly what is safe and what is not.

“As a society, we place too much importance on achieving a certain look and people feel under pressure to fit in.

“I’d urge parents to be careful about how they talk about their own bodies, too. It can be easy to be self-deprecating, but you have to think about how your child might interpret that. We need to focus on what is healthy, rather than some unnatural ideal.”

Calls to the Beat helpline have reduced since the pandemic ended, but are still significantly higher than they were pre-Covid – and the children calling are getting younger.

One of the biggest reasons for younger children receiving treatment is a rise in ARFID, or Avoidant Restrictive Food Intake Disorder, often diagnosed in children as young as four or five.

It’s a relatively new condition, and statistics show the number of children with it has risen sevenfold in five years. Beat received 295 calls about ARFID in 2018 and 2,054 calls last year – one in 10 of all its requests for help.

“Although we don’t know the exact reasons why someone might develop ARFID, there are some factors that will make it more likely, such as being neurodiverse,” says Tom.

“When someone has ARFID, they don’t have concerns about their weight, but they may restrict food due to sensory issues, or they may have previously had a distressing experience while eating, such as choking.

“There’s no evidence to suggest it can lead to further eating disorders, but there are health risks, such as malnutrition. It can also affect growth in children and young people.”

Natalie’s son Jack* was six when he was diagnosed with ARFID.

“He was a healthy, chunky baby who loved his food and milk, but by four, he wouldn’t put so much as a grape in his mouth,” says Natalie, 48, a freelance copywriter, who lives in Hertfordshire with Jack and his 15-year-old sister.

“Everything had to be puréed and eaten with a spoon. His ‘safe foods’ could be counted on one hand – bread, peanut butter, pasta, pizza and chicken nuggets.”

Family members wrote Jack off as a fussy eater, but Natalie knew there was more to it.

“He’d refuse anything that he didn’t associate with his safe foods. Children’s parties always triggered my own anxiety. I’d have to be well-organised and pack food for him so he’d eat.

“Holidays were a nightmare, too. I remember a trip to Greece when he was a toddler when he refused to eat anything except Nutella crepes.

“He ended up being bitten badly by mosquitoes, as I guess his blood tasted so sweet, and I had to get an appointment with a skin specialist when we got home.”

Natalie took him to the GP but, as Jack wasn’t losing weight, she wasn’t offered any medical help. After extensive research online, in 2019 she sought help from a specialist child psychologist, who diagnosed ARFID.

They suggested privately funded hypnotherapy – and it was this that finally made a difference.

“After one session, Jack successfully ate tiny pieces of apple, carrots and cheese, and tried his first burger,” Natalie says. “I could hardly believe my eyes.”

Since then, Jack, now 11, has added a few more meals to his repertoire.

“I still can’t get him to eat anything green, but I hope one day this might change,” says Natalie.

“He started secondary school in September and he is loving the not-so-healthy options in the canteen, such as slushies, doughnuts and waffles.

“It’s a slow process, but we have come a long way. I’d love to revisit therapy in his teen years – my wish is that this doesn’t affect his adult life.”

Dr Lorna Richards is a consultant psychiatrist at Priory and Life Works. She says it’s not fully understood why eating disorders develop, but they can run in families, so genetics may play a part in developing the disease.

“Also, any sort of difficulties, trauma or disruption can increase the risk,” she says. “It may develop as a coping mechanism if someone is in a big melting pot of stress, which many of us were in 2020.”

Children may become withdrawn, stressed, unhappy or secretive

Dr Richards

Getting help early is vital, and there are signs parents can watch for.

“Often children become withdrawn,” Dr Richards says.

“They might appear stressed or unhappy and secretive. Watch for any change in eating habits – not just restrictive eating, but secret eating, hidden food or wrappers at the bottom of their school bags.

“They might leave the table more often during their meal or they might ask to be involved in cooking, but suggest leaving bits out.

“Watch for any change in exercising or if they’re step-counting. They might complain of bloating, abdominal pain, constipation, feeling cold, tired or dizzy.

“Girls’ periods may become irregular or stop. Weight loss or slowing growth is always a concern.”

Beat runs support groups that families can access if they are waiting for NHS help, and Tom says parents should keep pestering their GP, especially if they feel their child is deteriorating.

“An eating disorder can really take a hold. People often talk about hearing an eating disorder ‘voice’ in their head and the power it has over them.

“They can’t see how recovery is possible. But there is help out there and the sooner you seek it, the better the chances,” he says.

After eight months in the specialist unit, Maddie returned home. Now 16, she is still haunted by the scars of her anorexia.

“Although she looks great and leads a normal life, we know she is still battling her mental health and that might never go away,” Donna says.

“It’s hard to put into words how evil this illness is. It’s like a monster takes over your child and you are left to fight it alone. For now, I just count my blessings that she is with her family, at home.”