First, don’t panic.
There’s a difference between picky eating and an eating disorder: many children have phases where mealtimes are tricky so it might be nothing. (See here for possible signs). Most kids who develop anorexia do so between the ages of 11 and 14 (although it can start as early as age 6), and there are many reasons why. However, go with your guts. If you suspect something is wrong, talk to your partner and talk to your child. If it’s nothing, then great. But if there is an issue, the earlier you catch it, the easier it is to get help.
Don’t waste time blaming yourself – you may never know what triggered it. Instead focus on what you can do and on opening up conversation with your child.
Pick a time when you won’t be distracted (not mealtimes) – a walk can be good, if face-to- face feels too confrontational. Let your child know that you are worried about their physical health and how they’re feeling. Encourage them to talk and don’t feel you have to mention eating disorders. For example: ‘I’ve noticed you’re quieter than usual and you haven’t been eating lunch. Can we talk about how you’re feeling?’
Be prepared for a range of reactions: anger, denial, shock, relief or nothing at all. If they do talk, listen carefully to what they say and take it seriously. Your child might not be ready to open up but whatever their response, you’ve made a start. Try not to take this personally. Make sure they know you are available to chat if and when they feel ready – and explain what the next steps would be to get help. In the meantime, make an appointment with your GP – even if your child refuses to attend with you. They may be able to provide support or to help your child see there’s a problem. Read about the issues or contact local/online support groups, for example: www.feast-ed.org. See also ‘Eating Disorders: Helping Your Child Recover’, published by beat, £15, www.b-eat.co.uk/Shop/Bookshop. You should also be aware of your child’s internet use: there are lots of pro-eating disorder websites under the tags ‘pro-ana’ or ‘pro-mia’.
Before you go to your GP, make a list of the things that are worrying you. For example: skipping meals, being anxious while eating and rituals such as dividing, weighing and playing with food, sudden changes in diet (eg; becoming vegetarian to avoid eating), going straight to the bathroom after meals. When did the behaviours start? What sort of physical and emotional changes have you noticed? How does your child talk about his or her body? Have others commented: for example, teachers or friends?
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.
Things that might help:
Don’t offer bribes or guilt-trip your child. It’s tempting, but it won’t help.
Try not to focus on appearance or body shape. Instead, emphasise your child’s inner qualities and tell them how much they are loved. (I’m sure you do this already, but at times of stress it’s especially important)
Have regular family mealtimes, (with normal portions) and keep normal family routines: for example, pocket money, hobbies, spending time together.
Pay attention to other siblings as they may feel side-lined or stressed.
If you’re working with professionals, be guided by them on meal-plans etc. It may be helpful to set meal times and menus in advance: talk to your child about this and allow them to be part of the process, but don’t let them dictate it. If they try to get involved whilst preparing a meal, gently but firmly give them a task such as setting the table or washing up.
Work as a family team. Don’t play good cop, bad cop. Be consistent, support each other and be prepared for lies and emotional outbursts.
Get as much help as you can from friends, professionals and church family. Don’t be afraid to suggest how others can pray or help: they want to, but might need direction on how. Ask for help.
Be aware of the messages you send your child about appearance and weight. Avoid talking about “good foods” and “bad foods”, dieting or making negative comments about your own body.
Avoid unnecessary comments about food, appearance or weight. Ask open questions like: ‘How are you feeling?’ or ‘How’s your day been?’ rather than ‘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. You won’t agree with them: but you can understand.
Keep including your child in family activities and social arrangements (even if they don’t join in). Encourage them to take part in things that aren’t focused around food or the body. Consider gentle family activities after meals that may help distract your child from purging or dwelling on what they’ve eaten.
Go a day at a time. Don’t blame yourself. Remember: help is available for you and your child. You are not on your own – and you can get through this.