Understanding eating disorders - for friends and family

We all have times in their lives when we experience unhealthy eating habits. Some people may try the latest fad or detox diet to shed a few kilos, others might occasionally feel like they’ve eaten more than they needed to.

Not every person who experiences unhealthy eating behaviours will develop an eating disorder. For some people, disordered eating behaviours coupled with extreme concerns about weight, body shape, eating and body image can result in an eating disorder. This can have a significant impact on their physical and mental health.

Eating disorders are complex conditions. While they can often begin with dieting, a number of factors can increase the risk of a young person developing an eating disorder. These include family factors (such as a family history of eating disorders), individual factors (such as low self-esteem or wanting to do things perfectly all the time) and external factors (like the influence of the media and social pressures to look a certain way).

Eating disorders can be serious, damaging and at times even life-threatening, so if you think a young person may have signs of an eating disorder, it’s important to raise your concerns and support them to seek help.

Symptoms and warning signs

It can be hard to detect signs of an eating disorder in a young person, as they may try to hide, disguise or deny their behaviour. Some may not even realise that there is anything wrong.

Recognising the signs of an eating disorder is very important, as the earlier a problem is detected and treated, the better the outcomes for a young person. Here are some things to look out for in a young person who may be developing, or experiencing, an eating disorder:

Physical changes:

  • rapid weight loss or fluctuating weight changes

  • signs of tiredness and poor sleep

  • lethargy and low energy

  • fainting or dizziness

  • feeling cold most of the time, even in warm weather

  • signs of damage due to vomiting (swelling around the cheeks or jaw, calluses on knuckles, damage to teeth and bad breath)

  • loss or disturbance of menstruation in females and decreased libido in men.

Psychological changes:

  • preoccupation with eating, food, body shape and weight

  • signs of anxiety or irritability around meal times (e.g., avoidance of meals or wanting to eat alone)

  • behaviours indicating a sense of lack of control around food (e.g., eating high quantities of food in a short period of time)

  • rigid thoughts around particular foods being ‘bad’ or ‘good’

  • poor or distorted body image (e.g., negative self-talk about body)

  • intense fear of weight gain.

Behavioural changes:

  • dieting behaviour (e.g., fasting, counting calories, avoiding specific food groups such as fats or carbohydrates)

  • eating in private and avoiding places involving food

  • evidence of binge eating (e.g., disappearance and/or hoarding of food)

  • frequent trips to the bathroom during and/or after meals

  • changes in clothing styles (baggy clothes that hide weight loss)

  • compulsive or excessive exercise (e.g., exercising in bad weather or at odd hours, exercising despite sickness or injury, and excessive distress when unable to exercise)

  • sudden changes in food preferences

  • excessive body checking behaviours (e.g., repeatedly weighing self, pinching waist, excessive time spent looking in mirrors)

  • extreme sensitivity to feedback about body shape, weight, eating and exercise habits

  • continual denial of hunger

  • obsessive rituals around eating (e.g., cutting food into very small pieces, excessive chewing or playing with food)

  • excessive food preparation and planning (e.g., reading cookbooks, shopping for food, planning, preparing and cooking meals for others but not consuming anything themselves, taking control of the family meals).

Common types of eating disorders

There are four main types of eating disorders: 

  1. Anorexia nervosa: This condition involves food restriction resulting in significant weight loss, alongside distorted body image and intense fears of gaining weight.

  2. Bulimia nervosa: This condition involves a cycle of ‘binge’ eating (that is, eating a large amount of food quickly, in a way that feels uncontrolled) followed by actions to rid the body of food by vomiting, using laxatives, over-exercising or fasting. These experiences tend to be accompanied by intense feelings of guilt and shame.

  3. Binge eating disorder: This condition involves ‘binge’ eating behaviours that feel uncontrollable and are accompanied by feelings of distress, guilt, shame or disgust. Unlike bulimia nervosa, binge eating disorder does not involve taking actions to get rid of the food (such as vomiting or using laxatives).

  4. Other specified feeding and eating disorder: This condition involves disordered eating symptoms that do not completely reflect the other disorders, but cause a person significant distress and interfere with their daily life.

 

Related problems

Other mental health difficulties, such as anxiety, depression and substance use, are also common among people who experience eating disorders.

What to do if you notice these signs in a young person

Eating disorders can be complex and serious conditions, so it is encouraged that anyone who is experiencing symptoms of an eating disorder seeks professional support. If you think a young person is showing signs of an eating disorder, it is important that you raise your concerns and support them to access professional help. A GP or mental health professionals at headspace centres and eheadspace (online and phone support) can help.

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Alongside professional help, there are some things that you can do to help support your young person: 

Things you can do to support a young person

  • Talk to them and let them know about your concerns. Encourage them to talk about how they are feeling. Listen openly and ask questions to demonstrate your desire to understand their experiences. Avoid the temptation to try to solve your young person’s problems for them, or provide overly simplistic solutions such as ‘all you have to do is eat’.

  • Promote healthy eating patterns and positive body image by modelling these attitudes and behaviours yourself.

  • Encourage discussions about normal, daily parts of their life. Where possible, avoid being drawn into conversations about food, weight, shape or even just general appearance. Comments about appearance can be misinterpreted (for example, ‘you look well’ may be heard as ‘you look fat’). Provide compliments that focus on personal qualities, rather than looks.

  • Try to be patient. The recovery process through eating disorders can be lengthy and challenging. Changes in behaviour can take some time and it is a normal part of recovery to have set-backs. Try to maintain encouragement and reassure a young person that recovery is possible.

  • Help them maintain contact with their friends and usual daily activities. Young people experiencing eating disorders can feel very isolated and alone; they may avoid social settings for fear of judgement or to avoid eating. Encourage them to keep up their normal activities as much as possible.

  • Learn more about eating disorders: By learning more about eating disorders, you may be in a better position to understand and empathise with your young person, as well as have a greater understanding of how you can help them. You can learn more by visiting The Butterfly Foundation.

Looking after yourself

Supporting a young person with an eating disorder can be very challenging, so it’s important that you take care of yourself, while you are being a supportive carer.  Being at your best means that you can offer greater patience and a more considered approach to helping a young person. 

Ensure that you take care of your own physical and mental health by engaging in helpful behaviours such as getting good sleep, regular exercise, having a healthy diet, limiting alcohol consumption and maintaining engagement in enjoyable and relaxing activities. Looking after yourself in these ways will also encourage your young person to do the same.

Remember, professional support is available for both you and your young person. For more guidance on how you can best support your young person, contact eheadspace and talk to one of our family and friends specialists.

 

 

Other useful websites

In addition to professional help, it may be useful for your young person to seek support and guidance from the ED Hope Support Line, which provides phone, email, and live webchat support to people experiencing eating disorder concerns.

You may also consider encouraging your young person to access an online program called Overcoming Disordered Eating, which can be very useful to use alongside professional support.

 

The headspace Clinical Reference Group oversee and approve clinical resources made available on this website.

Last reviewed 26 June 2017 

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