It’s no surprise that eating disorders in children and young people have risen throughout the pandemic. Psychotherapist Noel McDermott is helping children, families, and communities to spot the signs and to get professional help as soon as possible. Eating disorders are particularly worrying because they have among the highest mortality rates of any psychological disorder. There are many reasons for this, but they include lack of early diagnosis, lack of early intervention, and lack of specialist services.
Eating disorders were on the rise before the pandemic and there were calls for improved access to services prior to 2020 and COVID-19. The rise has continued for the past 18 months, for example, recent news reports from NHS Digital showed the number of under-20s admitted to hospital over the past year was nearly 50% higher than in 2019–20. Coronavirus and the subsequent lockdowns have had a massive impact on vulnerable young people, increasing anxiety and isolation issues, sadly leading to more eating disorders.
Overview of eating disorders
Eating disorders can be grouped into four main categories:
- Anorexia and avoidant restrictive food intake disorder: avoiding and restricting around food, leading to being unhealthily underweight and lacking sufficient nutrition for daily living, often use of purging behaviours.
- Bulimia: where weight may be within normal ranges, but eating and exercising habits are being unhealthy and damaging, such as bingeing (overeating compulsively) and purging (sometimes vomiting up food recently eaten, sometimes using laxatives to get rid of food, sometimes using excessive water to purge food or excessive exercise to burn/purge the calories consumed).
- Binge eating disorder: involving compulsive binge eating and often being obese.
- Other specified feeding or eating disorders: where someone doesn’t fit into the categories above because they don’t do all the specified behaviours of the diagnosis but have disordered eating or feeding issues that impinge on healthy functioning.
Psychotherapist, Noel McDermott, comments: ‘Eating disorders are classified as anxiety-based disorders and issues around food and appetite are standard diagnostic tools for assessing any mental health problem. Changes to appetite or eating patterns are generally a sign that someone is having problems. In children, it is often one of the first signs of psychological distress. Other signs include changes in socialisation habits (suddenly changing to withdrawing or suddenly becoming risk-taking and outgoing in social situations from having been reserved) or significant changes in mood and outlook.’
Signs of eating disorders include:
- spending a lot of time worrying about weight and body shape
- avoiding socialising when food will be involved
- eating very little food
- deliberately making oneself sick or taking laxatives after eating
- exercising too much
- having very strict habits or routines around food
- changes in mood
You may also notice physical signs, including:
- feeling cold, tired, or dizzy
- problems with digestion
- weight being very high or very low for someone of their age and height
- lack of periods
Treatment for eating disorders
Eating disorders are treatable and people recover with proper treatment. Noel stresses that, despite what the headlines might suggest, we don’t need more hospital beds for young people who have eating disorders. Hospital is the last resort for those seriously ill and we need to intervene in communities and families prior to that level of crisis. All major psychological disorders are more effectively treated in home and community settings, and a hospital is only of use if there is a significant risk of harm to self or others. Treatment can be very successful but, as with all mental health issues, the earlier it is sought the better.
Family treatment approaches
Treatment involves help with diet plans and exercise plans, medical help, psychological therapy for sufferers and families, psychosocial training for sufferers and families, and use of specialist support groups. The use of family approaches is not to blame the family, but to recognise that family members living together in relationships of emotional and practical dependency operate as a psychological unit or system, more than say a group of friends sharing a house. The whole family unit or system can be affected by significant psychological dysfunction and adapt to that ’normal’ and may well need help to adapt into something more helpful for recovery.
Noel McDermott is a psychotherapist with over 25 years’ experience in health, social care, and education, with a range of online therapy resources to help clients.