Expert Answers: Girl’s attitude to food worries parent

There is an urgent need for services to recognise and treat eating disorders in young children, say doctors.

The first study of the scale of the problem in the UK has been published in the British Journal of Psychiatry.

The study of UK and Irish data suggests that three in every 100,000 children under the age of 13 – including children as young as six – have an eating disorder.

The charity, Beat, has called for more specialist treatment for young people as it could save lives.

The researchers from University College London used monitoring data, collect by the British Paediatric Surveillance Unit of the Royal College of Paedaitrics and Child Health, from between March 2005 and May 2006 in the UK and the Republic of Ireland.

They identified 208 cases of eating disorders in children between five and 13, with more than four in five cases being in girls.

Dr Dasha Nicholls, a consultant child and adolescent psychiatrist at Great Ormond Street Hospital, said there were huge developmental differences between children and adolescents and adults.

“Unfortunately, many eating disorder services are aimed specifically at adolescents,” she said.

“Our study shows there is an urgent need to consider the needs of children with eating disorders separately and not simply lower the age range of existing adolescent services.”

She added that it had been thought that puberty could be a trigger for eating disorders, but, that did not account for these cases.

A spokesperson for the charity, Beat ,said: “Beat welcomes this new research from UCL – and supports the call for improved diagnosis and specialist treatment for these young people.

“Although there is first-class treatment available in this country for adolescents and adults with eating disorders, there is very little for those under the age of 13.

“The earlier the intervention, the better the long-term prognosis for a full recovery to avoid these young lives being blighted or even lost to these serious conditions.”

* Beat’s website is at www.b-eat.co.uk. It has two helplines; one for young people (under 25) and a general one for those over 18. The general number is 0845 634 1414. The Youthline number is 0845 634 7650.

Paul Charlson

GP from Brough

If you suspect that your daughter has an eating disorder, I would strongly suggest you seek help from your GP in the first instance. Explain why you are doing this. Expect her to be resistant – denial is part of the disease and she may not want to let go of her behaviour. Stand firm; eating disorders are more easily treated in the early stages. It is important to remember that eating disorders are really not about food, they are about underlying emotional issues. For girls growing up in today’s society, weight and self-esteem are closely linked. Depression and low self-esteem are factor-linked to the development of an eating disorder. Attempting to respond helpfully to a young person whose eating behaviour is causing concern can evoke very strong feelings in a parent. These can range from a feeling of helplessness to a feeling of intense frustration. It is important that you don’t act in such a way which suggests that you are highly anxious or panicking about her refusal to eat; try to remain calm and supportive.

Elaine Douglas

A chartered psychologist who specialises in family and child relationships

It’s not easy to work out why girls in particular feel the need to control their food intake, and there are many theories why this happens. Certainly there is pressure from the media through images of models being ultra thin, but for some youngsters this striving to emulate their heroines can get out of hand. For some young women, it can be more to do with having control about one aspect of their lives, when perhaps they may not be able to influence things in other ways. For example, if they are not allowed to make decisions for themselves or have a say in family affairs. Some may be having a tough time at school, and restricting what they eat can help them to feel that there is something they can control. Unfortunately, they do not necessarily have the maturity to understand the harm they could do to their bodies in the long term. Talk to your GP and find out what support is available in your area. There are a number of websites that will give you information which you should share with your daughter. This may not be easy (as you have experienced), but if you can find a good counsellor as well to find out what drives her to do this, you may be more successful.

Cary Cooper

Professor of Organisational Psychology and Health at Lancaster University

I KNOW what you shouldn’t do, which is to continually draw attention to it or nag her. There will also be parents, of course, who say it is just a phase, all teenagers go through this, which may be the case, but I would want to proverbially nip it in the bud, to find out what is underpinning this behaviour. I think if were my child, I would tell her honestly that you are worried about her, and to try to encourage her to see her GP. If the GP is concerned about her weight and eating behaviour, he/she will be able to recommend that she see a nutritionalist or allergy specialist or psychologist depending on his/her diagnosis. If the GP felt it was bordering on anorexia, he/she would get her to see a counsellor or clinical psychologist who specialises in this condition.

Dr Carol Burniston

Consultant Clinical Child Psychologist

With the symptoms you describe, it is important to take your daughter to your doctor and ask for a referral to the local Child and Adolescent Mental Health Service. It isn’t unusual for teenagers to be reluctant to eat breakfast, but coupled with reductions in eating at other times, making herself sick and weight loss, this suggests that she may be developing an eating disorder and this requires treatment as soon as possible. The longer your daughter behaves in this way, the more difficult it will be to treat her successfully.Treatment is available and is usually offered to the young person individually and also to the whole family. You will be supported in helping your daughter to adopt a more normal attitude to her weight and eating. You will also be able to address any family conflicts which arise out of the problems you face. Very occasionally, young people need to be admitted to hospital to help them get back on the right track. You can obtain more information from Beat ,who specialise in support for families dealing with this difficult problem, www.b-eat.co.uk

DEFINITIONS OF THE DISORDERS

There are few reliable statistics but it is estimated that 1.6m people in the UK are affected by eating disorders; of these, 1.4m are female.

An eating disorder is a serious mental illness; it is not a passing fad, and should be treated as soon as possible.

There are officially three categories of eating disorders – anorexia, bulimia and an “eating disorder not otherwise specified” (EDNOS).

The charity, Beat, was set up to help people directly affected by eating disorders, their families and the professionals who treat them.