By Lara Hyde
Brenda Smith’s* daughter, Leslie, was 13 when she told her parents she was swearing off candy — something she loved and regularly consumed with abandon. That same year, Leslie also informed her parents of her plans to become a vegetarian. Smith recalls thinking both decisions were seemingly normal and to be expected from a health-conscious child on the fast track for adulthood, but looking back she recognizes that they were the first indicators of her daughter’s bizarre and unhealthy eating restrictions driven by her desire to lose weight.
She’s far from alone. In fact, more teens and young adults than ever before are seeking treatment for eating disorders — anorexia, bulimia and binge eating among them — with 75 per cent of the sufferers female and 25 per cent male, says the Canadian Medical Association Journal. While many are quick to point fingers at the media for the continual growth and cite its unrealistic images of what defines beauty, for many sufferers, the roots of their disorder(s) are far more complex than simply a desire to be model thin.
The warning signs
Eating disorders aren’t always easy to diagnose; they don’t necessarily manifest themselves in a way that is obvious, which makes it critical for parents to trust their gut when they suspect their child may have a problem.
“Eating disorders often have their root in anxiety disorders, which frequently occur alongside an eating disorder, and in many cases, occur first,” says Kim Ewing, a registered couples and family therapist practicing in Kelowna, BC. The most common form of anxiety to be linked with an eating disorder is obsessivecompulsive disorder (OCD), which can present itself as fears of eating in public, fear of food and weight gain, or compulsive rituals, such as weighing bits of food or cutting it into tiny pieces.
Although eating disorders typically start between ages 13 and 24, studies have shown signs of body dissatisfaction in girls as young as five. Though it’s rarer for boys to suffer from them, experts say those who do are less likely to seek help due to feelings of shame and embarrassment.
“These disorders are very serious, and concerned parents should be watching for warning signs,” says Merryl Bear, director of the National Eating Disorder Information Centre (www.nedic.ca) based in Toronto. To put into perspective just how serious, The Renfrew Centre Foundation for Eating Disorders reports that a staggering 20 per cent of people suffering from anorexia will prematurely die from related complications, including suicide and heart problems.
For Brenda and her husband, who live in Western Massachusetts, Internet research prompted them to reach out to a local therapist. “The problem was, when we asked about the symptoms we found, we were told that Leslie didn’t meet the classic eating disorder criteria and therefore ‘didn’t have an eating disorder,’ so we didn’t pursue treatment at the time,” she says. It was only after Leslie reached a crisis point and returned emaciated and listless from a two-week camp that they began to act.
Thankfully, they were referred to a local pediatrician who was also an eating disorder specialist, and Leslie was hospitalized for medical stabilization. The family then began the grueling process of treating their daughter at home, using a family-based treatment [see Getting Professional Help].
How you can help
“Early intervention is vital because it can help prevent the development of a full-blown eating disorder, minimizing issues such as anxiety, depression, transitional difficulties, perfectionism and body image before they become more complex and difficult to treat,” says Ewing.
Parents can get involved by paying attention to the changes in their child’s mood or social activities. “If your child starts to see their friends less or seems to show decreases in normal functioning at school or in terms of their personality, these may be signs of a problem,” says Bear.
Should you suspect your child has an eating disorder, education and action are paramount, she adds, but cautions that parents should be prepared for a potential fight. “It’s best to anticipate a fairly negative, often aggressive response,” she says. “Eating disorders often develop as a coping mechanism and may be providing your child with a sense of comfort. Any threat of being separated from this source of comfort and control will be met with hostility.”
Bear also emphasizes the importance of not becoming discouraged by their denial, or any hostility projected. “If you need to, communicate your understanding and concern and tell them you will revisit the conversation in three days. Then make sure you do.”
Next, book an appointment to have your child seen by an expert. “Many doctors don’t know enough about eating disorders, and it is recommended that you tell the doctor what you suspect based on your research and observances,” says Bear.
Finally, trust your instincts. “If something feels wrong, then something is wrong,” Smith says. “If your doctor tries to minimize your concerns, ask for others who are more familiar with eating disorders. My daughter isn’t fully recovered yet, but she’s living a full and happy life while finishing her treatment. Early intervention helped make a world of difference for her.”
*Not her real name
Getting Professional Help
Treatment options for eating disorders are varied and case-specific. Unfortunately, the increase in those seeking treatment means long wait lists and a lack of appropriate treatment available for those who desperately need it. If you’re concerned, talk to your doctor about hospital-based programs, private treatment centres, dietitian or nutritionist support, individual therapy with a specialized professional and family-based therapy, such as the Maudsley Approach. (This is an intensive outpatient treatment that can prevent hospitalization, provided parents are seen as a resource and take on an active role in treatment by working with their child to bring his or her weight back to normal levels.) In certain cases, when approved by a physician, SSRI s (antidepressants) may also be effective at regulating behaviours, particularly when the eating disorder co-occurs with another psychiatric disorder.