The 12 things your child says to hide their eating disorder
FUSSY eating, a change in fashion or new-found love for running.
When are these symptoms “normal”, and when are they a warning sign your child or teenager is controlling their food, and may even have an eating disorder?
There are an estimated 1.25 million people in the UK with an eating disorder, according to BEAT, which includes anorexia, bulimia, and a dozen other less-known types.
The UK’s leading eating disorder charity says the pandemic deepened the eating disorder crisis in the UK.
Cases were already soaring in youngsters pre-Covid, with admissions to hospital in under 18s surging from 1,700 in 2010 to 4,500 in 2018.
To mark Eating Disorders Awareness Week, we spoke to , who has been helping people with eating disorders for over a decade.
As the Lead Psychological Therapist at - a day treatment service for those with an eating disorder - she knows all the classic signs someone is either hiding one an eating disorder, or in denial about one.
Speaking to The Sun, Dr Joanna said: “Unfortunately, these days eating disorders can start very young. Typically they start in teenage years, but it’s never too early to look out for it.”
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Dr Joanna said children and teens may justify eating less food or avoid it by telling their parents they “had a big lunch”, or “are eating out with friends later”.
A list of common signs of denial, or excuses for disordered eating, are:
- What I'm doing is totally normal
- It's good to eat healthily
- I had a really big lunch so I don't need to have dinner
- I hate my body, I want to lose some weight
- I need to go to the toilet after the meal - indicative of vomiting
- I don't like this food (one they used to love)
- Can you tell me where we're going for dinner? (to look up a menu)
- I don’t want to wear this anymore
- I'm going out to eat with my friends (and you know they haven't eaten with their friends)
- I need to go to the gym (or go for a run/workout) to burn calories
- I don't want to eat past [a certain time]
- Carbs are bad for me (or other "bad" foods avoided)
Signs of an eating disorder in kids
Dr Joanna said physical signs of an eating disorder aren’t just weight loss, although this is the most obvious.
Sometimes a person can be a normal weight and still have disordered eating habits.
Signs of a problem at the dinner table are eating slowly, cutting food into small pieces, avoiding certain food groups or asking to prepare their dinner themselves.
A child may appear very anxious at mealtimes or prefer to eat by themselves or in their bedroom out of fear of eating in front of others’ scrutiny.
Claiming that “carbs are bad” or that they “don’t want to eat past a certain time” can also signal a child is making rules for themselves around food choices.
Dr Joanna said: “In very young children, it might be avoiding food, so it might start off with them being very picky eaters.
“Being a fussy eater as a child is not uncommon. But it may be that their repertoire becomes less and less, less.”
Dr Joanna warned parents to look out for a general change in behaviour.
She said: “They may seem quieter and say less in general, and become more withdrawn or secretive.
“Isolation serves a purpose to keep the eating disorder from being un-challenged.
“Sometimes you can get very good, honest children, and once the eating disorder kicks in, they tell blatant lies, such as ‘I’m going out to eat with my friends’ - but they don’t end up eating with their friends.”
A person with an eating disorder may become increasingly anxious, depressed or have a rapidly changing mood, Dr Joanna said.
“They may become angry or aggressive as a means of defending the eating disorder from challenge.
“They might change their clothing. If they feel ashamed of their bodies, and want to hide it, they may wear baggy clothes because they feel really fat.
“But sometimes, people in the early stages can be proud of their body, and proud that they've lost weight, may always want to show it off.”
Excuses made by adults
The signs and symptoms of eating disorders are generally the same across all ages, dependent on the form of the mental illness.
With adults, however, it may be easier to hide.
Common signs of denial, or excuses for disordered eating, are:
- I don't have an eating disorder, I'm just clean eating
- I'm too busy to eat
- I've just eaten
- Exercise makes me feel good, it's good to exercise
- I'm just losing a few pounds
- I'm looking after myself as I get older
- I can’t tolerate that food/I don’t feel good after eating that food (things like bread)
- I’ve been very naughty today/I need to be more good/I let myself go today
Dr Joanna said adults may try to lose weight under the guise of “health”. For example they may go vegan or vegetarian in an attempt to remove “fear foods” in a socially acceptable manner.
She said: “People will often say I can't eat X Y Z because I can't tolerate that food, for example I’m intolerant to bread.
“Often they are not intolerant, they just don't like that feeling of the bread [in their stomach].”
Dr Joanna said a very common sign your loved one has an eating disorder is if they are “hyper-focused” on food.
She said: “They might say something like, ‘I've been very naughty today’. Which again, is quite a common thing to say. But if they're thinking of food in very kind of black and white terms, of ‘good' and ‘bad’, that could be a sign.”
Counting calories, planning food in advance or appearing increasingly concerned about the preparation of food - which can show up on social media as well - are all frequent signs.
While a person may at first feel good about their weight loss, their sense of self-worth and mood can rapidly deteriorate.
How to help a child or adult
Dr Joanna said: “The first thing is to talk to them and to be patient. You may need to talk to them on separate occasions.
“It can sometimes take several attempts to even get them to acknowledge and admit they have an eating disorder. Even in treatment, it’s normal to see motivation fluctuate.
“I'd always suggest being very gentle with the person and making sure that they don't feel criticised, perhaps just commenting that they seem a little bit different or have got a little bit quieter. [Use] really open questions and validate them.
“It doesn't necessarily need to be sit down formal chat. Sometimes these kinds of conversations are better when you're just in the car or walking somewhere.
“The best thing is to collaborate with them, and say what do we think the next step would be? Let's come up with a plan together. The more the young person feels involved, the better.
“BEAT - which is the UK’s eating disorder charity - they've got a lot of good resources and that can be a really good place to start becoming informed.
"Anorexia Bulimia Care, MaleVoicED and First Steps (in Derbyshire) also offer free support services."
When is it time to see a doctor?
Dr Joanna said: “Especially if it's a child, a GP is always a really good place to start in terms of the first port of call, and then if they think it's a problem, they can refer you onwards.
“But I wouldn't sit and wait. The earlier you convene, the better the prognosis.”
“After three years, the brain really changes. I'm not saying that you can't get better, but the more rigid someone becomes, the harder it is.”
There may be cases where someone is desperately unwell, in which case Dr Joanna said someone else needs to take control of the situation.
“If someone has lost a lot of weight quickly, or is underweight, you'd want to be moving faster,” she said.
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“If someone is fainting, or is unable to concentrate, they're in medical danger and you would have to act even if you haven't got them on side.
“If you're living with someone and you're clear that they're vomiting eight times a day for example, that would be a complication and you'd want to get them seen to.”