Disordered eating

Earlier we recognised that sometimes children and young people can struggle to manage when feeling overwhelming and intense emotions, such as high levels of anxiety, depression, anger or fear, that often arise from difficult situations or experiences. Sometimes this can lead to engaging in unhelpful ways to cope or manage these feelings. An example of this can be seen in the development of disordered eating.

We know that having a healthy relationship with food positively contributes to our physical and mental health. However, sometimes children and young people can find it difficult to maintain this healthy relationship and develop unhelpful ‘disordered eating’ behaviours. We all sit somewhere along a spectrum or scale of eating behaviours and attitudes, ranging from experiencing a healthy relationship with food through to the development of an eating disorder. We can move up and down this scale at different times in our lives, influenced by a range of sources including changes in our mood, experience of unhelpful life events, and the impact and influence of others (such as through social media). It’s important to remember that many individuals, including children and young people who experience disordered eating will not go on to develop a diagnosable eating disorder.

In some cases, however, disordered eating can develop into more serious and persistent difficulties with eating and emotional wellbeing. So, it’s important we recognise possible signs of disordered eating and support the child or young person to return to a more balanced and healthier attitude and behaviours towards food. An eating disorder is classified as a mental health disorder and will require specialist mental health assessment and support as these difficulties are often difficult to overcome and can have a significantly detrimental impact upon the individual’s physical and emotional wellbeing. For many children and young people the experience of difficulties with eating is not simply about food intake, but is representative of more complex factors, often with the eating difficulties being the outward sign or possible strong feelings relating to control and a maladaptive coping style in response to stressors.

Somebody who has disordered eating, may:

• Not see or perceive their body shape and size the way others do
• Exercise and monitor their food intake carefully
• May feel anxious about eating, particularly in front of others
• Feel uncomfortable about eating certain foods
• Create and follow rules about how or what they eat.

How can we support children and young people who experience disordered eating?

Many children and young people with disordered eating will return to a healthier balanced relationship with food themselves over time and as their ability to cope and manage their feelings is strengthened and they become emotionally stronger. However, some children or young people often benefit from low level input from a supportive adult to:

• Help them to develop a healthier relationship with food (such as through making mealtimes less stressful and more enjoyable, involving the child or young person in making meals that are more attractive and nutritious, and balancing healthy eating patterns that are modelled within the family)
• Reduce the impact of unhelpful influences from social media (such as through spending less time online, and encouraging more time completing alternative activities that promote the child or young person’s interests and boosts their self-esteem and self-confidence)
• Strengthen quality night-time sleeping patterns and practice better sleep hygiene routines (as good sleep helps promote emotional wellbeing, such as reducing anxiety feelings, and builds more capacity for effective coping)
• Identify helpful apps that can be used to distract from unhelpful thinking patterns and resist engaging in negative behaviours (which can instead provide support and guidance to strengthen wellbeing)

When to seek specialist mental health or general health advice

As with most concerns about a child or young person’s wellbeing, always proactively seek advice through sharing your concerns within your team and with more specialist colleagues at your earliest opportunity. This is particularly the case if you are aware of:

• Notable changes in the child or young person’s behaviour which are of concern, including more restrictive or rigidity in behaviours linked to diet and exercise
• If difficulties are persisting despite low level interventions, and are beginning to occur more frequently or build in severity
• If these challenges are having an increasingly negative impact upon aspects of a child or young person’s life, such as upon their friendships or attendance and achievement in school
• You become aware of a decline in the child or young person’s physical or mental health (such as increase in tiredness, changes in weight, expressions of low self-esteem, body image self-consciousness, increase in irritability, social withdrawal and negative preoccupations).

You can find out more on this topic from this short video clip: How to manage your mood with food.