What are eating disorders and disordered eating?

Eating disorders are serious mental health conditions that also affect physical health.

These are the most common eating disorders:

• Anorexia nervosa – this is when someone has a fear of gaining weight, restricts the amount of food they eat, and has a distorted body image.
• Bulimia nervosa – this is when someone eats very large amounts of food and then gets rid of it – for example, by vomiting or using laxatives, diuretics or enemas.
• Avoidant restrictive food intake disorder (ARFID) – this is when someone eats only a small range or amount of food and doesn't get all the nutrients they need.
• Binge eating disorder – this is when someone eats very large amounts of food and feels distressed about their eating, but doesn’t try to get rid of the food.

Disordered eating is behaviour that isn’t as severe as the behaviour in anorexia nervosa, bulimia nervosa, ARFID or binge eating disorder. Disordered eating is still serious and can need treatment too. Someone with disordered eating might be at risk of developing an eating disorder.

Signs of eating disorders

Changes in your child’s eating habits, mood, behaviour, physical health and appearance can be signs of eating disorders.

Note that you don’t have to be ‘thin’ to have an eating disorder. In fact, rapid weight loss in pre-teens and teenagers of any size can be a sign of an eating disorder.

Food and eating habits
You might notice that your child:

• prepares food for others, but doesn’t eat it
• cuts down on portion sizes or shows other signs of highly limited eating and dieting
• cuts out ‘junk food’ or major food groups like meat or dairy
• eats large amounts of food in a relatively short period of time
• complains about the colour, smell, texture or taste of food.

Moods
You might notice that your child:

• seems anxious, angry or irritable, particularly around mealtimes
• feels ’out of control’ around food
• experiences shame, guilt and self-loathing in relation to food.

Behaviour
You might notice that your child:

• avoids social activities, particularly ones that involve food
• talks a lot about food but doesn’t seem interested in eating
• has rituals for preparing and/or eating food
• goes to the bathroom or toilet straight after meals
• wants to try different diets
• vomits or uses laxatives or diuretics
• exercises too much, goes for long walks or runs, or exercises alone in the bedroom
• wants to build muscles.

Friends, teachers or coaches might tell you that something doesn’t seem right with your child.

Physical health and appearance
You should also be concerned if you notice physical changes in your child, including:

• irregular periods or loss of periods
• constant tiredness or lack of energy
• rapid weight loss or gain
• complaints about being cold all the time, even in warm weather
• faintness or dizziness
• very dry skin
• constipation
• soft downy hair growing on your child’s face, arms or torso
• hot flushes or sweating episodes
• reflux, bloating, nausea or feelings of fullness
• hair loss from their head.

Swollen or puffy cheeks, damaged teeth or gums, and sores on the knuckles or hands might be signs that your child is making themselves vomit.

Pre-teens and teenagers of all genders can develop eating disorders.

Talking with pre-teens and teenagers about disordered eating and eating disorders

If you notice any of the signs above, you need to talk with your child and your GP as soon as you can. If you just think that something isn’t right about the way your child is eating or behaving around food, trust your judgment and talk with your child.

It’s important to be sensitive, caring and non-judgmental when you talk with your child about food, weight and body image, but it could be a difficult conversation.

You might feel worried, and your child might get angry and say that there isn’t a problem. Even if this happens, try to stay calm and send the message that you’re concerned about your child’s health and wellbeing, not your child’s weight and appearance. You might need to say that you think your child needs to see a health professional.

If you’re not sure how to talk with your child about these issues, you could ask your GP or a mental health professional for help. Contacting a support organisation for eating disorders is another option.

If your child has an eating disorder, your love and support will be very important in helping your child get better.

Getting help for eating disorders

If you’re worried about your child’s eating habits, it’s best to take your child to see a GP or mental health professional as soon as possible.

If possible, try to find a health professional who has experience in eating disorders. Your GP can refer your child if necessary.

Early intervention for disordered eating can stop problem eating turning into a more severe eating disorder. It might save your child from intensive treatment and a very long recovery. Also, it might be easier to get your child to see a health professional now rather than later.

Support services for eating disorders

For adolescent eating disorders support services in your state, contact your specialist children’s hospital or speak to your GP.

For information about support and treatment services for eating disorders, you can also contact:

• Butterfly Foundation, Australia’s national foundation for eating disorders
• InsideOut, Australia’s national institute for eating disorders
• National Eating Disorders Collaboration.

If you’re concerned about an eating disorder or body image issue, you can get free support from a qualified counsellor by calling Butterfly Foundation’s national helpline on 1800 334 673, 8 am-midnight, 7 days a week. You can also use Butterfly Foundation’s email helpline or Butterfly Foundation’s webchat service.

Why pre-teens and teenagers can be at risk of disordered eating and eating disorders

We don’t know why some children develop eating disorders. But adolescence is a risky time for pre-teens and teenagers treating their bodies in unhealthy ways.

During adolescence, your child’s body and your child’s brain grow and develop very quickly. There are many changes going on in the way your child thinks, feels and relates to people. Your child is more influenced by messages from media, school and other places. And many pre-teens and teenagers become more aware of body image.

At the same time, your child needs more of the right kinds of food. But it can be harder to keep up with teenage nutritional needs because they’re growing so fast.

Also, lifestyle and food habits might change as your child begins to eat more meals and snacks away from home.

So you might notice some changes in your child’s eating habits and attitudes towards food, including:

• eating at random times and/or skipping meals
• eating more convenience foods and high-energy sugary snacks and drinks
• being more aware of information about ‘healthy’ eating, body image and weight control
• experimenting with dieting, or deciding not to eat certain foods or food groups.

The combination of all these things can lead some pre-teens and teenagers to develop eating habits that aren’t good for their growing bodies.

Other risk factors for eating disorders

We can’t link eating disorders to a particular gene, environment or personality type. But there are some factors that can put pre-teens and teenagers at higher risk of developing an eating disorder.

These risk factors include:

• family history of eating disorders
• dieting
• perfectionism
• obsessive compulsiveness
• family history of overweight or obesity
• early puberty
• anxiety and depression
• low self-esteem.