When young people are experiencing an eating problem, they may stop spending time with their friends and withdraw from social situations. Disordered eating can be a way that young people try to cope with social situations and it can also result in young people becoming overwhelmed by constant thoughts about food.

They may have difficulty recognising and expressing emotions making it hard to interact with others and accurately judge social cues.

Young people may avoid spending time with friends, or avoid family events and cultural celebrations, as it may be more difficult to restrict their food intake or manage their eating. They may become less interested in hobbies and social activities.

This can affect their relationships with people and can disrupt the important social development that happens during this phase.

Young people with eating and body image problems may experience difficulty regulating and managing strong emotions such as guilt, anger and frustration. A young person experiencing strong emotions may act in uncharacteristic ways and parents may notice their child displaying difficult and distressing behaviours. In addition, malnutrition can exacerbate some existing personality traits like anxiety, sensitivity, impulsivity and obsessive and perfectionistic tendencies.

“I should have taken more notice of my daughter’s first anxiety attack, I feel she then channelled all future anxiety into an eating disorder”

-Parent of a young person with an eating disorder

Intense emotions can potentially lead to extremely disturbing situations where young people may intentionally engage in self-harm (also known as deliberate self-injury) or have suicidal thoughts. Parents may need to take measures to minimise any potential harm to their child or other family members. This may inlcude ‘safety proofing’ the house by removing any potentially dangerous items. Mental Health FIrst Aid Australia has developed guidelines on how to manage non-suicidal self-injury and suicidal thoughts and behaviours.

The full ‘Mental Health First Aid: Non-Suicidal Self-Injury First Aid Guidelines’ and the ‘Mental Health First Aid: Suicidal Thought & Behaviours First Aid Guidelines’ can be accessed in FYI Resources.

It is important to address these issues immediately and seek professional mental health support. Mental health teams are able to support parents to develop an individualised risk management plan to help keep their child safe while they receive the help they need to recover.

It can be difficult talking with someone about their eating or body image problems.

Communicating in a calm, compassionate, caring and consistent way is helpful. Young people with eating and body image problems generally do not respond well to logic, criticism or anger.

The ‘Mental Health First Aid: Eating Disorders First Aid Guidelines’ is a document that provides valuable advice about how to approach, communicate with and support someone who is experiencing eating and body image problems and may be developing an eating disorder. Below is some advice taken directly from this document that may help parents communicate more effectively with their child who is experiencing eating and body image problems. The full document can be accessed in FYI Resources.

It is better to approach the young person alone, because having the whole family or a number of people confront the person at the same time could be overwhelming. Be aware that the person may respond negatively no matter how sensitively you approach them.

Try to use ‘I’ statements that are not accusing, such as “I am worried about you”, rather than ‘you’ statements such as “You are making me worried”.

In order to be supportive, it is important to avoid doing or saying things that might make the young person feel ashamed or guilty. For instance, you should avoid:

• Being critical of the person
• Giving simple solutions to overcoming the person’s problems, such as saying things like “all you have to do is eat”
• Making generalisations such as ‘never’ and ‘always’ (e.g. “you’re always moody” or “you never do anything but exercise”)

As a parent, remember that it is your right to ensure that your child is safe and healthy. Do not let the child’s refusal, tears or tantrums stop you from getting help. Be prepared to take responsibility for getting professional help for your child.

Understand that any resistance to eating, seeking treatment or gaining weight is motivated by fear and anxiety rather than a desire to be difficult. Always be clear and honest with your child about what to expect from any professional treatment you seek for them.

Do not let empathy for your child inadvertently lead you to support their eating and body image problems. For instance, you should not let your child be the one to decide when, what and where the family will eat, as this may make their problem worse.

If you attend an appointment and are worried that the professional is ignoring your child’s condition, or has not correctly diagnosed an eating disorder, then you should seek a second opinion.

The full ‘Mental Health First Aid: Eating Disorders First Aid Guidelines’ document can be accessed in FYI Resources.

It can be helpful for parents to view the eating and body image behaviours as something outside of their child. This reduces the likelihood of situations where a young person feels blamed or guilty, further contributing to their low self-esteem, low mood and anxiety that may be driving the problems in the first place. For example, parents may say to their child ‘I can see there is something going on and it is making it really hard for you to eat’. It may also be useful for parents to reframe their thoughts this way, without saying anything to their child. For instance, a parent may recognise that the strong urge for their child to go to the bathroom and vomit after a meal is because of the eating and body image problem, not because their child is ‘being difficult’ or misbehaving.

By changing the way you think about the problems affecting your child, it can make it easier to intervene and try to help solve the problem.

Eating and body image problems can develop very gradually, so it can be easy for parents not to notice the changes immediately.

Because of this, sometimes the family routine unconsciously changes to accomodate the ‘new’ needs of the young person. Families may find themselves doing things such as preparing ‘special’ meals that a young person will eat, or complimenting the young person on their dedication to exercise. It is important to be aware of this because it is unhelpful to encourage these behaviours instead of addressing them directly.