January 25, 2022

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Fit And Go Forward

What parents need to know about the alarming rise in eating disorders among children

Eating disorder illustration  - PA
Eating disorder illustration – PA

Lockdown and the closure of schools has led to an unprecedented rise in eating disorders, according to NHS Digital. The number of children admitted to hospital with an eating disorder has risen by a fifth in two years, with 21,794 admissions last year. 

When schools closed in March, children not only lost social contact, but also access to the physical activities that gave them an outlet, such as sport and dance. At the same time, the country was encouraged to focus on eating healthily and getting their daily exercise, as protection against Covid and for respite from the challenges of lockdown. 

“It created a perfect storm,” says Dr Karen Street, consultant paediatrician at the Royal Devon and Exeter Hospital and officer for child mental health at the Royal College of Paediatrics and Child Health (RCPCH). “We were already seeing a background rise in eating disorders in children and young people. Then three or four months into lockdown we suddenly saw an increase among young people who had been happy in life, with no previous mental health problems who were high achieving.” 

There was another surge in September, when children went back to school and teachers noticed those who had lost a significant amount of weight. “It went under the radar because parents were seeing them every day,” says Dr Street. “It was only when they went back to school that alarm bells went off.” 

The new research has been compiled by the RCPCH to catch parents’ attention over the Christmas period. Dr Street explains that one way parents can notice if their child has developed an eating disorder is if their habits have changed during this time of indulgence. 

“Are children cutting out foods they would normally really enjoy at Christmas?” says Dr Street. “Do they find the normal Christmas routine makes them feel too guilty? Or are they being too rigid over what time they eat, how much, and the exercise they’re doing?” 

These are all signs that a child is shifting from normal behaviour to obsessive habits. Other signs include an unhealthy monitoring of calorie and fitness apps, and exercising more than once a day or in their bedroom. 

Dr Street advises parents who are concerned about their child to speak to them in the first instance. “Make clear this isn’t OK and that it’s heading down an unhealthy route,” she says. 

A popular approach to eating disorders in children is the Maudsley Method, which encourages parents to regain control over their child’s eating. For example, by telling them it isn’t healthy for them to go for a run before breakfast. Or explaining how their habits are becoming unhealthy. 

“If they look tired, thin, or constantly feel cold, parents should point that out to them,” says Dr Street. “If any of this leads to a child getting distressed or it causes conflict, then that’s a real sign it’s getting worse and they need to seek help.” 

The first place to go for professional help is to their GP. Parents should arrange a face to face appointment so the GP can conduct a health assessment and pick up on anything the child might be trying to hide, Dr Street adds. 

If a child has already lost a significant amount of weight they may require stabilisation in hospital. Parents can also go to Child and Adolescent Mental Health Services (CAMHS) and refer their child directly. 

There are a number of charities that offer help and guidance, including Beat and Young Minds. 

The period after Christmas is a time parents should be extra vigilant, adds Dr Street, because of the annual focus in January on dieting and resolutions. “Being left at home alone in front of screens, having indulged over Christmas, with messages of New Year’s resolutions and celebrities going on diets is the perfect nightmare for children developing eating disorders”. 

Once they become entrenched in someone’s behaviour, it can take more than a year or two to treat an eating disorder. “It’s not a transient thing,” says Dr Street. “Unless you catch it very early and stop it, there’s a risk of it becoming a long-term problem.” 

Eating disorders have a high mortality rate among mental health problems. If all the new cases develop into serious problems, then there could be “a very significant excess mortality of children and young people during the pandemic,” says Dr Street. 

In some extreme cases, children have stopped eating all together. “They almost presented like they were on hunger strike, as the only way to cope with the enormity of what was happening around them,” says Dr Street. 

There has also been a “rush” of young adults, those over-18, who have returned from their first term at university having lost an unhealthy amount of weight. “Most of them have been hidden behind closed doors for the university term,” says Dr Street. “They haven’t had sports clubs or lecturers where people can pick up on it. There are parents across the country who’ve been quite shocked at how their young person looks coming back to them.” 

Dr Street adds, “Sadly, there will be quite a lot of people who aren’t going to be able to go back for the second term.”

Eating disorders | Tips from Beat for approaching your child with your concerns
Eating disorders | Tips from Beat for approaching your child with your concerns

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