Eating Disorders and Problems | Parent Guide

What are eating disorders?

A boy sits on a park bench wearing a blue puffer jacket with his hands in his pockets. He is looking straight ahead as if deep in thought.

Eating disorders are serious mental health conditions that can have a huge impact on someone’s mental and physical health. They can affect anyone with any body shape or lifestyle – regardless of their gender, culture, age or ethnicity.

Lots of young people who develop an eating problem or disorder are also going through other mental health issues. This can include anxiety or stress, feeling low or depressed, or struggling with their self-esteem.

Young people can use their behaviour around food and eating to try to cope with these difficult thoughts, feelings and experiences. They might limit how much they eat, consume large quantities of food quickly, or use methods such as making themselves sick to get rid of food from their body.

While it can sometimes be hard to understand from the outside, doing these kinds of things might:

make someone feel they have a way of coping when things are difficult
make someone feel in control, or give them a way of reducing anxiety or panic when they’re overwhelmed
numb or reduce uncomfortable or distressing feelings

Over time, these kinds of thoughts and behaviours around food might become very fixed and difficult to change – and may start to take over daily life. When this happens, it can have a hugely negative effect on a young person’s social life and their relationships with friends and family. It can also lead to very serious physical health problems, and affect a young person’s physical growth and development. In very serious cases, and without the right kind of support and treatment, eating disorders can cause death.

But if someone gets the right professional help, the eating disorder can be treated and they can get better. The earlier they get help, the easier this will be. There are lots of common stereotypes about what someone with an eating disorder will look like. As a parent or carer, it’s important to understand that a young person’s weight or appearance does not determine whether they have a problem. Whatever’s going on, it’s important to find help as soon as you notice behaviours around food that are concerning. The sooner they get support, the easier it will be for the young person to change their behaviour and find other ways of coping. Getting help early can also prevent physical health problems from developing.

Different types of eating disorders

Some eating problems develop or fit into a certain type of eating disorder. But if your child has an eating problem that’s affecting their day-to-day life, they still need professional help to find out what’s going on – even if you’re not sure that they have an eating disorder. These are some common eating disorder diagnoses.

People with anorexia generally try to keep their weight low by limiting how much food they eat or doing lots of exercise, or both. They may have “rules” about what they eat, or when and where they eat. And they may think they are bigger than they are, and feel very scared about gaining weight.

Some people with anorexia also try to ‘get rid’ of food from their body, for example by making themselves sick or using laxatives.
Without support, anorexia can lead to serious physical health problems – so it’s important to get help as early as possible.

ARFID stands for ‘avoidant/restrictive food intake disorder’. This used to be known as selective eating disorder.

People with ARFID avoid certain foods or types of food, restrict the amount of food they eat, or both. Unlike with anorexia, people with ARFID don’t necessarily do this to lose weight.

Common reasons people with ARFID may limit their food intake include:

sensory sensitivity to the appearance, smell, texture, temperature or taste of certain foods
feeling scared about eating if they have had a frightening experience with choking or vomiting after eating
having a limited interest in food, including not realising when they feel hungry

People with bulimia “binge-eat” or over-eat, and then "purge" to get rid of the food. They might do this by making themselves sick, using laxatives or over-exercising. They may feel guilty about what they have eaten and want to remove the food from their body. Or, completing a cycle of bingeing and purging might feel like it’s giving them a sense of control when things are difficult.

Bulimia can cause serious damage to someone’s body, so it's important to get help as early as possible.

People with binge-eating disorder regularly eat large quantities of food in a short time. They feel like they are not in control of this, or that they are unable to stop. In a binge-eating episode, people may eat a lot faster than usual or eat when they’re not hungry, and feel embarrassment or shame afterwards.

Unlike with bulimia, people with binge-eating disorder do not usually “purge” afterwards (try to get rid of food in their body).

OSFED stands for ‘other specified feeding or eating disorder’. This is the diagnosis often given to someone if their symptoms do not fit with anorexia, bulimia or binge-eating disorder. This is the most common eating disorder in the UK.

People with OSFED may experience a range of different symptoms. Some examples of what OSFED might look like include:

Atypical anorexia – where someone is experiencing all the symptoms of anorexia, but their weight remains in a “normal” range.
Lower frequency binge-eating disorder – where someone experiences the symptoms of binge eating disorder, but episodes of binge eating do not happen as often.
Lower frequency bulimia – where someone experiences the symptoms of bulimia, but the cycles of bingeing and purging do not happen as often.
Night eating syndrome – where someone eats a lot at night or after dinner, or wakes up in the night to eat.
Purging disorder – where someone purges, as with bulimia, but it is not part of a binge/purge cycle.

Pica involves experiencing cravings to consume things that are not for eating, or feeling like you cannot stop yourself from eating these things. This can include substances such as soap, chalk or dirt. Sometimes, the person may feel urges to consume substances that are dangerous, so it’s important to get help as early as possible.

You can find out more about each of these conditions on the Beat website.

If you'd like to hear from other parents and carers who have supported their child with an eating disorder, and personal stories from those who have struggled with them, you might like to listen to this BBC podcast. Please keep in mind that this podcast discusses some very serious experiences - only listen if it's helpful for you, and at a time that's right for you.

A mother comforts her sad looking daughter outdoors

If I’ve learned anything from this journey, it’s to trust my instincts as a parent. If something doesn’t feel right, it’s worth fighting for answers. ARFID is often misunderstood, especially in children with autism, and getting the right diagnosis can make all the difference.

Dealing with an ARFID diagnosis

Signs that your child might be developing an eating problem or disorder

Every child and young person will show, or not show, what’s going on in different ways. The signs that they’re struggling might also look different depending on what type of eating problem they have.

While it’s not always easy to tell, some early signs that your child is developing an eating problem or disorder might include:

becoming more controlling or limiting about what, how much or when they eat – including avoiding eating with other people
obsessing about their body shape, having an inaccurate view of their body shape, or feeling afraid of putting on weight
leaving the table quickly after meals (for example to hide food or be sick)
exercising a lot, or much more than they used to
seeming different in themselves – including seeming more tired than usual, or finding it difficult to concentrate
wearing loose or baggy clothes to hide their weight loss
losing or gaining weight

As a parent or carer, it’s not always easy to know what’s going on – and a young person with an eating problem may try to hide what they’re doing. But you know your child, and you know when something is wrong.

If you’ve noticed changes that are worrying you, the next steps are to open up a conversation with your child and to get professional advice. You don’t need to wait for your child to lose or gain weight before getting professional help – ask for advice now.

Getting help and treatment

1. Making an appointment with a GP

If you’re worried that your child is developing an unhealthy relationship with food, it’s important to make an appointment with a GP. This is the first step to getting them the right help.

Make a list before the appointment of the concerning behaviours you have noticed. Or, if your child wants to go by themselves, encourage them to make a list of the things they’re experiencing. The more honest and specific you can be, the easier it will be to get the right help.

Beat have a really useful resource on seeking GP treatment that you can both use to help you prepare for the appointment. They also have a binge-eating disorder leaflet you can take to the GP if your child is struggling with binge-eating problems.

People with eating disorders can find it hard to see they have a problem. Be clear about the fact that you’re concerned and that you can see they need some help.

If your child will not go to an appointment at the moment, you can still speak to the GP yourself to get advice about what to do next.

For more advice, see our guide to getting help from the GP.

Getting support from the GP

Seeing your GP as quickly as possible, and asking for support for your child is essential. Early intervention is key to your child’s recovery. If your GP does not take your concerns seriously, keep persisting in asking for a referral to an eating disorders team.

2. Getting a GP referral for specialist help

After talking to your child, the GP can make a referral for a specialist assessment. Depending on where you live and your child’s age, this is usually done by one of the following services:

CAMHS, which is the NHS mental health service for children and young people
your local adult NHS mental health service
a specialist eating disorder unit

Professionals working in one of these teams will talk to your child to find out what the problem is. They will then decide what kind of treatment will help. While this is happening, the GP may also refer your child to a paediatrician for a physical health assessment.

The National Institute for Health and Care Excellence (NICE) provides guidelines for NHS treatments. They very clearly recommend that GPs should make a referral for specialist assessments if there is any concern that a young person has an eating disorder. The NICE guidelines specifically state that they should not wait to see whether things get worse before doing this.

Parent sits with their arm around their child to reassure them.

This is because getting early help can make a big difference – and because it’s important to get help before an eating disorder starts to affect a young person’s physical development.

If you do not think the GP is taking enough action, you can always ask the surgery to make you an appointment with a different doctor. You can also outline what the NICE guidelines say.

Depending on where you live, your child may be able to contact CAMHS or adult mental health services directly. You may also be able to refer them as their parent or carer. You can find this information online, or ask your GP surgery how things work in your area.

3. Receiving specialist treatment

The type of support and treatment your child has will depend on the type of eating disorder they have been diagnosed with. It may include:

family therapy
individual therapy developed specifically for eating disorders
group therapy developed specially for eating disorders

Your child’s physical health may also be monitored during and after treatment.

Your child may receive treatment locally while they’re at home. Or, if their symptoms are more serious, they may go into hospital to get treatment and support.

If you are worried about your child’s physical health or they become very unwell, for example if they are experiencing chest pains or feeling faint, they need to see a doctor straightaway.

Take them straight to A&E or call 999 for an ambulance.
You can also call 111 if you’re concerned but they do not need to be seen immediately.

If your child needs urgent mental health support, for example if you are worried that they are feeling suicidal or experiencing a mental health crisis, you can find advice on our urgent help page.

My child needs urgent help

Educate yourself around eating disorders, this will enable you to give your child the best possible support. Charities such as Beat offer peer support and online development for carers on similar journeys to those you are facing.

How can I support my child?

Getting professional advice as early as you can is one of the most important things you can do to support your child. Eating disorders are complex mental health conditions that need specialist treatment – and the earlier your child gets support, the easier it will be for them to change their thinking and behaviour.

Alongside getting professional help, there are also things you can do to support your child at home.

Beat have a really useful resource to help you start a conversation if you’re worried about your child.

Young people who have been through this say it helps when parents:

show they are able to talk about it and do not shy away from the issue
remember that this might be a difficult conversation for their child to have
are open minded and focus on finding out what it’s like for their child
avoid making assumptions about why their child is behaving in this way
address what they want to talk about directly and use ‘I’ statements - for example, you could say, ‘I’ve noticed that …’, or ‘I’m really concerned because …’, and then ask, ‘can we have a chat about it?’

You can find some simple tips on things you can do to help your child to feel understood in our blog on how to really listen to your child.

I found it helpful to separate the eating disorder from my child. The eating disorder thoughts were very strong and controlling at times – totally dominating her behaviour, thoughts and feelings. It was helpful for her to be able to talk over these thoughts and feelings with me. I listened in a calm and measured way and reassured her that these feelings were the eating disorder thoughts, and that recovery was possible.

It is important to remember the illness is about difficult and challenging thoughts and feelings. So empathy, calmness and being able to listen are key in supporting your child. 'I can hear what you are saying' and 'I can see that it is tough' can be useful phrases.

It’s completely understandable if things feel all-consuming at times. But try to keep your focus on the person your child is, rather than just seeing the eating disorder. Talk about other things and spend quality time together doing activities you both enjoy. Keep normal routines and family life going as much as possible. This might feel hard sometimes, but young people who have been through this say just how important it is.

Certain points of the day, such as meal times, might feel really challenging. This is understandable, but if things feel tense, it can be more anxiety-provoking for your child.

It can help to:

give yourself permission to step away for a moment if you feel yourself becoming stressed, and come back when you’re calmer
think about activities you could do during meals, such as playing a game together or watching TV, which can help to take the pressure off everyone
avoid having serious conversations during mealtimes or other family activities, so that your child can enjoy the social time too

Activities before, during and after eating often act as distractions. This can be very useful in challenging the eating disorder thoughts and feelings, which will be at their height at mealtimes.

There are stories of recovery on social media that can be positive for young people to see. But some social media content promotes disordered eating and can be damaging for young people with eating problems. This is often called ‘pro-anorexia’ (or ‘pro-ana’) and ‘pro-bulimia’ (or ‘pro-mia’) content. Social media will also advertise things like weight loss programmes that can be harmful to see.

Talk to your child about what they’re seeing online, and about how they can make sure it’s having a positive influence on them. Your child can use our advice on creating a positive social media community in our young person's guide to social media and mental health. Or they could try finding an online community at Beat (their online chat spaces are fully moderated).

It’s really important that young people feel able to socialise with friends and family. But it can be difficult when social events often revolve around food. Think together about events such as big family meals or trips with friends ahead of time.

Young people who have been through this say it can be helpful to:

decide what they are going to eat beforehand, for example if they are going to a restaurant with friends
plan in downtime around social events to help them cope with stress
have a back-up plan if things feel too difficult - for example, eating in a separate room just with you if eating with everyone together is too much
allow themselves to enjoy the event and socialise too, without the occasion being all about what they’re eating

My child found routine and pre-planning particularly useful. This eased her anxiety and calmed her eating disorder thoughts. I agreed a range of suitable meal options with her, which she ate at regular intervals during the day. Later, when she was able to start eating out at social occasions/restaurants, we looked at menus and discussed prior to the event what she would eat.

When things feel tough, remind yourself that your child is not choosing to do this and cannot simply decide to stop. Eating disorders are complex mental health conditions and it does take time for things to get better. Try not to take their behaviour personally and remember to see yourselves as a team working together.

The steps will be very small at first but it is important to remember that every small step is a success. Praise your child for their achievement.

My child found it helpful to keep a diary to write down her challenging thoughts and feelings, and to acknowledge her successes. The path may not always be linear and there may be setback, but your child needs your support.

Getting support at Beat

Beat can help you and your child through:
- Their Helpline service, which provides information and advice for people with eating problems, and their parents or carers.
- Their weekly online support groups for people struggling with eating disorders, and for their families and carers.
- Their daily online chat space, where anyone struggling with an eating disorder can connect with others.
- Their resource packs and their online learning and sharing space for anyone supporting someone with an eating disorder.

Find support with BEAT

Looking after yourself

This can be an incredibly tough, or in some cases traumatic, thing for parents and carers to go through. You may be feeling really worried about your child’s mental and physical health. When the situation is very serious, some parents tell us they feel like they’re firefighting all the time. This is exhausting, and can start to affect your wellbeing too.

It's also important to think about how your other children might be affected by the situation. Remember to check-in with them about how they’re doing, and to make space for quality time together.

Here are some ways you can get support for you:

Lean on trusted friends and family, and say ‘yes’ to offers of help.
Take a moment for yourself. Even if it’s something simple like watching a TV programme or doing a short activity you enjoy, it’s so important to be able to recharge.
Connect with other parents and carers going through similar things at one of Beat’s online support groups.
Speak to the professionals supporting your child to share your worries or concerns if they’re receiving treatment at the moment.
Call the Samaritans anytime on 116 123 if you need to talk.
Make an appointment with a GP to get help with your own mental health.

It is essential that the carer takes good care of their own mental health, and that other family members do too. Reach out to friends and family members who are willing to listen and to offer support.

Useful helplines and websites

While we take care to ensure that the organisations we signpost to provide high quality information and advice, we cannot take responsibility for any specific pieces of advice they may offer. We encourage parents and carers to always explore the website of a linked service or organisation to understand who they are and what support they offer before engaging with them.

Beat

Offers information and support for anybody affected by eating disorders, and for their families and carers.

One-to-one web chat available. They also run a range of online support groups, which are all fully moderated and anonymous.

Enter your postcode in the HelpFinder to see what eating disorder support is available in your area.

Parents and carers in some parts of the UK can access peer mentoring, through which you can be supported by someone who's been through the same situation.

Find information on helpline accessibility and confidentiality.

Helpline is for anyone over 18.

Opening times:

365 days a year - weekdays (9am - 8pm); weekends (4pm - 8pm)

0808 801 0677

help@beateatingdisorders.org.uk

Beat
ARFID Awareness

Provides information, advice and support to people experiencing ARFID, and to their parents and carers.

ARFID Awareness
PEACE Pathway

Information and advice for autistic people who are experiencing an eating disorder, and for their parents and carers.

PEACE Pathway
National Autistic Society

Offers support to autistic people and their families. They have a a wide range of information about autism – from what autism is, to diagnosis, to socialising and relationships.

National Autistic Society

Please note:

This form is not a mental health support service. We cannot reply to this. If you or your child are at immediate risk of harm, call 999 and ask for an ambulance or go to your nearest A&E. If you are worried about your child’s mental health, call our Parents Helpline on 0808 802 5544, Mon-Fri, 9:30am – 4pm. If you are struggling with your own mental health, call Samaritans on 116 123.

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