As promised some information about early warning signs of an eating disorder. Please feel free to circulate to your friends, family, your loved one’s school and anyone else that might be interested.

The reason for me circulating this now is that we have seen something of an epidemic of eating disorders coinciding with the COVID pandemic. As I mentioned in my Look Forward Not Back Email earlier a few days ago a survey was released by the Royal College of Paediatrics and Child Health suggesting that in some parts of Great Britain doctors have seen a three or four fold increase in eating disorder cases since last year. Dr Simon Chapman at the Maudsley acknowledged that he has never been so busy and this was his advice “ I would say to any parent or teacher, if they notice anything different about their young person and are worried they may be developing an eating disorder, talk early on to the GP about their concerns or reach out to their local eating disorders service for advice.”

As many of you have witnessed with your own loved ones, eating disorders can creep up on a young person without anybody noticing. Of course it is not just about weight loss, it can be around exercise, mood, obsessive behaviours or rituals around food and an array of other things, self harm, bingeing and purging in its different forms and more. Common features also include a perfectionist personality type, concerns over body image and going on some sort of diet. Fierce denial is common as is secrecy. In my capsules attached I urge carers to be aware of common warning signs and approach their loved one with compassion empathy and understanding.

I am attaching three capsules that can be read in conjunction with each other:

Early Warning Signs
Medical Risk Assessment
Orthorexia or Clean Eating

How to approach your loved one if you are concerned

So many parents have said to me that they wish they had acted earlier. They knew something wasn’t quite right but then either didn’t know what to say, or thought it was just a teenage passing phase.

If you notice signs that an eating disorder might be developing then try to be curious without showing any hint of judgement or criticism. If your loved one responds calmly and is happy to engage in a conversation about what you have noticed, then it is highly likely that you will be able to work together to help sort out any issues that your loved one is trying to cope with.

If, on the other hand, your loved one becomes defensive and tries to push you away, then it is important to try to keep lines of communication as open as possible. This is not easy as teenagers often push their parents away. The key is to keep calm and offer support. Useful phrases might be along the lines of:

I have noticed that ……………… (might be food restriction, compulsive exercise, rigid rules, body checking, low mood)

How are things/ how are you feeling? (open question to show you are interested and care. This might just be met with – I’m fine! At least you have shown you care)

What can I do to help? (open question conveying that you would like to help)

Would you like to talk? (can be answered with a NO, but does convey you are there if your loved one does want to talk)

You might be curious about the latest diet or exercise regime:

Help me understand the benefits of this vegan diet.

Help me understand your goals with your exercise regime.

If all your attempts at opening a conversation are falling on deaf ears it is a good idea to get a physical check up at the GP. At the very least this gives the GP baseline numbers if things do start to deteriorate. You might say:

“I have booked an appointment with the GP to do a physical check-up as I have noticed (you are tired/cold/ losing weight/ injured a lot etc) and it is always a good idea to check that your body is working properly and you don’t have any deficiencies that might be causing these symptoms.

Often young people are happy to be taken for a physical check-up, whilst they are not happy if you start suggesting they might be developing a mental health issue.

For some young people you might be able to say “I am worried you have an eating disorder and I am going to take you the GP”. In my experience most young people would simply tell you that you are mistaken. If an older sibling has had an eating disorder there might be more acceptance from a younger sibling if you are concerned. Every case is of course different.

The bottom line is that if an eating disorder is developing, early intervention leads to the best prognosis for a speedy recovery.

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