Why the disorder develops and how to help a child cope with it: a clinical psychologist explains
More than 14 million people worldwide suffer from an eating disorder (ED), and 3 million of them are adolescents and children.
Research on families facing the problem of eating disorders shows that it is difficult for parents to accept the fact that their child has a disorder for several reasons:
- feelings of guilt and the feeling of not being a good enough parent interfere;
- it is difficult to overcome mistrust of doctors and give up responsibility for your child;
- It is difficult to cope with the shame and judgment that parents face in medical settings.
And often parents simply consider the behavior of their children with eating disorders to be whims and do not realize the seriousness of the situation.
What are the types of eating disorders?
According to the International Classification of Diseases, 11th revision, eating disorders are a group of diseases that include:
- Anorexia nervosa is a disorder characterized by low body weight that is not explained by another health disorder. People often come to this condition because they are afraid of becoming fat and consciously refuse to eat.
- Nervous bulimia – a person with this disease loses control over their eating behavior, begins to eat significantly more than usual, and after eating tries to get rid of what they have eaten – induces vomiting, uses laxatives or enemas, performs intense physical exercise .
- Binge eating disorder. The person has periods of severe overeating, feeling unable to stop eating, or limiting the type or amount of food they eat. Unlike people with bulimia, patients with binge eating disorder do not try to purge what they have eaten.
- Pathological selective-restrictive food consumption – a person eats extremely selectively, limiting himself in many foods, because of which he can lose weight and experience nutrient deficiencies.
Why Eating Disorders Occur
Mental disorders always have a complex nature – doctors take into account biological, psychological and social factors.
Biological factors:
- Genetics, family history. If people have a mental disorder, it does not mean that their offspring will have it by default. It means that children have a predisposition and are at higher risk of getting sick than those who do not have such a disease in their family history.
- Emotional dysregulation, increased emotional mobility can lead to eating disorders: teenagers may begin to eat away their worries or, conversely, eat little due to stress.
- Early puberty, when at 10-11 years old teenage girls’ figures begin to change, they stand out among their peers and are embarrassed by this, and hatred of their bodies can develop.
- High body weight of a child is a biological risk factor for the development of eating disorders in modern culture.
- Unintentional weight loss: As a result of a somatic illness, a child may lose appetite, which leads to weight loss, and then a fear of gaining weight develops.
Psychological factors:
- Perfectionism. Often, teenagers with nervous anorexia are girls who are medalists and excellent students. Physical perfectionism is worth mentioning separately, when a child wants to look perfect. This is often found in models, athletes, dancers – in those teenagers whose activities are related to body image.
- Increased anxiety causes one to worry excessively about one’s appearance and relationships with peers.
- Bullying at school or in other groups, experiencing violence – physical or sexual – disrupts a teenager’s healthy body image and relationships with others.
Social factor: visual media that convey extreme thinness as the norm.
Can Eating Disorders Be Fatal?
According to research from international databases, eating disorders are the most deadly of all mental disorders.
Here are the main reasons:
- If a person induces vomiting for a long time, the balance of sodium and potassium in the body is disrupted, and this can lead to heart failure.
- Inducing vomiting can cause bleeding in the esophagus, rupture of the esophagus or stomach, and pieces of vomit can enter the lungs and cause lung infections and pneumonia.
- Malnutrition causes osteoporosis (brittle bones)
- Taking large amounts of laxatives can impair kidney function, leading to the need for hemodialysis.
- Due to food restrictions, people become more irritable, isolated, anxious, and constantly haunted by thoughts about food.
- People with eating disorders sometimes resort to self-harm and may unintentionally cause fatal harm to themselves.
- The risk of developing depression and suicide increases.
How can parents understand that their child has an eating disorder?
- A teenager talks a lot about his weight or figure, he is unhappy with the way he looks. This is a signal that you need to clarify the situation and understand what is happening. This is not necessarily a sign of a disorder, but it is definitely a reason for a confidential conversation.
- Changing the usual portion size, refusing a number of products: fats or carbohydrates, flour, sweets. If parents offer some food that the child considers harmful, he may start crying, get angry, he may even have a tantrum.
- Active and constant calorie counting: the teenager installed an app and constantly spends a long time looking at food packaging.
- The child may isolate himself from the common table and start eating in his room in order to hide changes in his eating behavior.
- He makes himself vomit.
- There are expenses for pharmaceutical drugs: laxatives, diuretics.
- The child does a lot of sports every day, especially after meals.
- Girls have irregular menstrual cycles. This happens due to exhaustion – you need to pay attention.
- The child has a lot of subscriptions to public pages about weight loss – this can be tracked on social networks.
- The child has started wearing oversized clothes all the time to hide his figure from others. This point is especially important if the teenager has not worn such things before.
- Withdrawal: the child has stopped communicating with other children, with parents, and does not make contact.
- The child looks tired, lethargic, is constantly cold, and wraps himself in a blanket even when it is warm.
What should parents do? How to talk to a teenager about eating disorders?
Psychologists from the Association of Eating Disorders Informed Professionals advise doing the following.
Discuss the problem
It is important for parents not to hush up this topic, but to talk honestly with their child about what they see. To speak openly in approximately the following form:
- Name what they observe. For example: “I see that you refuse to eat, constantly count calories, walk around very lethargic, stopped communicating with me, with friends.”
- Name the emotions they experience in this situation. For example: “This worries me, it disturbs me, I don’t understand what’s happening.”
- Ask, “Can you tell me why you do this?” and listen without judgment or criticism.
- Offer help, for example, contact a psychologist.
If you see that your child has lost a lot of weight, emotional problems are noticeable, it is important to contact a specialist, even if the teenager does not want it. Often people with eating disorders refuse help because they are ashamed to admit the existence of the problem.
Support the child
Because of physiological changes, changes in character are also possible. Teenagers with eating disorders may be emotionally unstable: rude, crying. It is important to remember that these reactions do not occur intentionally to anger parents, and these are not whims. The child is anxious, he feels bad, he is sick. Many teenagers can only understand how unpleasantly they behaved after recovery and regret it.
Support yourself too
Don’t blame yourself for your child’s disorder – as we wrote above, there can be many reasons. It’s important to acknowledge the situation and seek support – for example, by contacting other parents. There are groups where parents can get support – for example, this one .
How to Find a Professional to Help a Teenager with an Eating Disorder
- You need a psychiatrist or a clinical psychologist. Clinical because they specialize in disorders, not general psychological problems.
- It is important that the doctor has education, experience and specialization in eating disorders. This information is usually indicated on the websites of clinics or on the personal professional pages of specialists.
The most evidence-based psychological approach to working with eating disorders is cognitive behavioral therapy and the cognitive behavioral approach in general. The best place to seek help is through the Association of Eating Disorders-Informed Professionals.