Children under 11 can present a wide range of other food difficulties in addition to the classic eating disorders. These include:
- Food refusal
- Restrictive eating
- Selective eating
- Food phobia
- Food avoidance emotional disorder
These difficulties are not all well understood and are commonly misdiagnosed. It’s important also to remember that many children will experience difficulties that don’t fit neatly into one category or another, but these classifications will help you to gain some understanding of the range of behaviours you could encounter.
- Food refusal is commonly found in pre-school children, where the refusal of food can be used as a way to get other things.
- However, this can persist in slightly older children, where the main feature is an inconsistent refusal of food.
- These children will tend to eat their favourite foods without any problem at all.
- They may refuse food only when they are with particular people or in a particular situation – for example, refusing to eat at school but eating normally at home.
- Worry or unhappiness underlies the food refusal in many cases.
- These children are usually of normal weight and height, and this problem does not usually pose a threat to the child’s health.
- These children eat smaller amounts of food than they should do for their age.
- Their diet will be normal in terms of the range of food eaten and the nutrients that it contains.
- These children are often thin and their height tends to be low, but otherwise they generally seem healthy.
- It almost seems as if restrictive eaters are ‘programmed’ to eat less and to be thin but healthy.
- Often, other members of the family will have a history of the same pattern of food intake.
- The most obvious feature of this condition is the narrow range of food that is eaten. This can persist for months or even years.
- These children are very unwilling to try new types of food.
- The behaviour of these children is usually normal, unless they feel that they are being forced to eat a wider range of foods than they feel comfortable with.
- Problems may start to occur when the child is about eight years old because the selective eating causes difficulties over going to birthday parties or staying at a friend’s house.
- Children who eat only a restricted sugary diet may also have problems with their teeth.
- The weight of these children does not give much of an indication as to whether there is a problem – they may be of low, normal or high weight.
- These children are usually very resistant to eating and drinking, which can cause a great deal of concern.
- They may avoid foods that have certain textures because they are frightened of swallowing.
- They are usually frightened of choking, gagging or being sick, and some children say that eating and drinking hurts. This means that meals often turn into a battleground.
- Some children may be fearful and anxious of eating new or disliked foods.
- The majority of these children do, however, seem to grow and develop because the food and drink that they will have provide enough calories and nutrients.
Food Avoidance Emotional Disorder
- These children often wish that they could eat more and are concerned about being thin.
- The loss of appetite is usually associated with depression or anxiety.
- In food avoidance emotional disorder there is a more general disturbance in behaviour that does not centre on food and mealtimes.
- The child may experience a loss of appetite, problems with sleeping, poor concentration, tearfulness and a general sense of hopelessness.
- These children may actually say that they feel sad, and this sadness can be seen in their posture, the way they move, their facial expression and their tone of voice.
- They also may avoid school and contact with their friends, and want to stay at home.
In addition to this, some under 11s will also suffer with one of the three major eating disorders – anorexia, bulimia or binge eating disorder. These are all very serious conditions which are worth understanding despite their relatively low prevalence with this age group as early intervention is key with these children to ensure they make a full and lasting recovery.
If you’d like further support, I can provide bespoke face to face training to help you sport and support eating difficulties in younger children. I can also provide one to one consultancy via telephone or skype. Email firstname.lastname@example.org or call 07590446791 for further information.
There is a whole language around eating disorders that sounds like Greek to a lot of us:
Pro-ana – website that promotes anorexia
Pro-mia – website that promotes bulimia
Thinspiration / Thinspo – images to inspire weight loss
Fitspiration / Fitspo – images to inspire exercise / body building
In this post we’re going to consider pro-ana and pro-mia sites, who uses them, why they’re dangerous and what parents and schools can do to decrease they’re impact on the young people in their care.
What are pro-ana and pro-mia sites?
Pro-ana and pro-mia sites are websites that promote anorexic and bulimic lifestyles. Set up by people with eating disorders looking to validate their illness and seeking suppo
rt to continue with their eating disorder from fellow sufferers these sites vary hugely in their precise content. They are often a forum for people to exchange pictures and weight loss or purging tips and to encourage one another’s weight loss.
Who uses pro-ana and pro-mia sites?
These sites are often a refuge for people suffering from eating disorders. It’s common for sufferers to feel quite isolated having pushed away their family and friends preferring to seek out like-minded individuals online. There are over 500 such sites and the latest studies predict that they attract more than 500,000 unique visitors a year of which the majority are teenage girls and one in five are aged between six and eleven. Read the rest of this entry »
If the school becomes aware of a pupil’s eating disorder before the parents then it’s important to invite parents on board to work with you to support their child’s recovery.
Once you have overcome any objections from the pupil, you should aim to organise a meeting with the parents as quickly as possible.
This post looks at how to organise the meeting and how to ensure it runs effectively
Think about location
With the help of the pupil, decide where the meeting should be held – at school, in their home or on neutral territory. You should do whatever you think will make the pupil, and their parents, feel most comfortable.
Who should attend?
Obviously the pupil and their parents should be present, the pupil may also like to bring a friend along for support and you might decide to have a couple of different members of staff present – for instance the head of pastoral care and the pupil’s form tutor. Again, you should check with the pupil about what they’ll feel comfortable with and try not to set up a scenario which will be too intimidating for the parent.
Read the rest of this entry »
This can be adapted to help you adopt the correct approach when talking to pupils recovering from bulimia or binge eating disorder as well. A great degree of sensitivity is needed when interacting with a young person recovering from any form of eating disorder. Their self-esteem is very low and they are in a very vulnerable position where they will believe and blow out of all proportion even the slightest negative comment (or even positive comments which they may reinterpret as negative). Here are some key flashpoints to avoid.
Avoid commenting on the pupil’s appearance
During the recovery process, it can be very easy for eating-disordered thoughts to be triggered by someone saying or doing the wrong thing, even if they mean well. Almost any comment on appearance can be reinterpreted by the pupil as, ‘You’re fat’.
Well-meaning comments such as. ‘You’re looking healthy’; ‘It’s great to see some colour in your cheeks’; ‘You must feel better now you have more energy’ are all open to misinterpretation. It’s best to avoid any comment at all on a pupil’s appearance.
Consider lesson content
It’s also important to be sensitive to tasks in class that may be difficult for the recovering pupil and to consider altering your scheme of work as necessary. Any tasks involving food, healthy eating and exercise, weighing or measuring the body in any way, or discussion of eating disorders are best avoided. If this is not possible, show the pupil all of the materials beforehand and allow them to opt out if they prefer. Read the rest of this entry »
There are a wide range of risk factors for eating disorders including social, personality and family factors that I’ve discussed before, but I’ve not discussed one of the most obvious ones. Weight loss. You might think that weight loss is a symptom of rather than a precursor to anorexia and in many cases you’d be absolutely right. But it is also not uncommon for healthy weight loss to go on to trigger an eating disorder.
Diets can go too far
As you’ll be well aware, it is very common for young people to diet. Occasionally a young person will successfully stick to a diet and may end up taking their diet too far which can result in the development of an eating disorder.
One of the reasons that diets occasionally get taken too far and go beyond healthy weight loss is because of the positive feedback that dieters receive. Particularly if they were noticeably overweight to start with they are likely to receive a large amount of positive feedback from family and peers about their new healthier appearance. Read the rest of this entry »
Parents and teachers of young people recovering from an eating disorder often find themselves in a situation where they want to offer support at mealtimes, but they don’t know how best to help. It will depend entirely on the individual and, as long as they are well enough, you should always be guided by the young person in question, but here are ten suggestions to help you on your way.
Think about meal timings and locations
The school lunch hall or cafeteria can be a difficult place for a recovering anorexic to spend time in. You should never insist that their meals are taken there, even if it is your school’s usual policy. Perhaps your school has more than one lunch sitting and the pupil would feel okay in the cafeteria at a time when their peers aren’t there, or perhaps you should find somewhere different altogether such as a classroom.
Trust them to keep their own food diary
Many recovering anorexics are expected to keep a food diary. It can be very tempting to complete this on their behalf because you know what they have eaten and are keen to ensure that it is recorded accurately. However, it can be an important show of trust to allow the pupil to complete their own food diary. Of course, if you have reason to suspect it is wildly inaccurate then consider again!
Read the rest of this entry »
It can be difficult to know what to say when you’re talking to someone with an eating disorder, especially if you’re discussing the eating disorder itself. Many of us fear that using the wrong words will make things worse and it’s common to shy away from saying much at all. But if you put yourself in the shoes of the sufferer you’ll realise that would make for a lonely existence. There are things that you can say that are useful. Here are a few…
“How can I help you?”
It’s really, really hard to know how to help someone with an eating disorder. Maybe you’ve been wracking your brain to no avail. Well here’s a secret… the best way to find out is to ask them. This can be a real conversation starter and you’ll be amazed at some of the suggestions you’ll get back, anything from, “Sit with me when I eat, but please don’t talk” to “Don’t pretend there’s nothing wrong with me” to “Just keep asking, it’s helpful to know you care.” Don’t ask unless you’re genuinely willing to help and support though. Read the rest of this entry »
If a young person chooses to talk to you about their eating disorder, it’s a real sign of trust and it demonstrates that they’re ready to be listened to. The most important thing you can do is provide them with the opportunity to talk. No one expects you to know all the answers, but simply by actively listening you’re doing a really important job.
This post gives you a few ideas to make sure you’re listening as effectively as possible.
Make sure there’s no time pressure
A pupil will have to build up quite a lot of courage to have a conversation with you about their eating disorder, so if you suddenly have to dash off to do lunch duty after five minutes it can really shake their confidence. Although you may legitimately need to be somewhere else, the eating disorder is likely to make the pupil interpret the situation negatively and assume that you aren’t interested in what they have to say or you don’t want to help them or are disgusted by them. Read the rest of this entry »
You wouldn’t ignore a broken leg – please don’t ignore eating disorders either
There are several reasons why it is advantageous to detect, support and treat eating disorders cases as early as possible and to help you understand them I’ll bring you back to my trusty broken leg analogy.
If a pupil had a broken leg and it went unnoticed and untreated, a few things would happen:
- The injury would cause pain and suffering in the short term
- The injury would prevent the pupil from participating in sport and athletics until it was treated
- The pain of the injury would distract the pupil from their academic work and make them less inclined to socialise
- The injury would worsen, perhaps healing incorrectly, meaning that there might be a need for more serious intervention in the long term such as an operation or a long course of physiotherapy
- The pupil may never fully recover from the injury, perhaps being prone to further breaks, or being left with a limp
And it’s almost exactly the same with an eating disorder. Like a broken leg, if it’s picked up right at the start and treated appropriately, the chances are that the pupil will make a fairly quick and full recovery, but left untreated, the impact of an eating disorder both short and long term worsens. Read the rest of this entry »
None of these warning signs on its own means that a young person has binge eating disorder but if they are exhibiting several of these signs then you are right to be concerned.
Rapid weight increase / weight fluctuation
Due to the vast amount of calories consumed during a binge, a binge eater will tend to gain weight very rapidly. As binge eating tends to be worse at periods when the sufferer is struggling, perhaps due to pressures at school or at home, their weight may plateau at times when they are finding things easier, then rapidly increase next time they go through a difficult patch and resort to binging.
Binge eaters can often feel very embarrassed about eating and may make an effort to eat alone. They are unable to control their urge to eat but are usually keenly aware that they are overweight and feel that they should be eating less, so they will often do it in private away from prying eyes which they often assume will be judging them. Read the rest of this entry »