I always get nervous when a school-aged girl comes to see me when there is no clinical or medical reason for their visit, but rather that they want to lose weight or learn to eat more healthily. This is especially worrying when upon assessment it is found that their body composition is well within the normal range and that they have (at least on paper) impeccable eating habits. This is not to say that every girl falling into this category has an eating disorder but it does indicate a red flag.

 

Good eating habits and healthy choices should most definitely be encouraged and supported by parents, but there are signs to look out for that these thoughts or habits are becoming restrictive and unhealthy. Here they are:

Warning signs with regards to behaviour:

  • Dieting behaviour (e.g. awareness of calories/kilojoules, skipping meals, avoidance of certain food groups or types such as starches, meat or dairy, replacing meals with fluids)
  • Excessive or compulsive exercise patterns (e.g. exercising even when injured, or in bad weather, refusal to interrupt exercise for any reason; insistence on performing a certain number of repetitions of exercises, exhibiting distress if unable to exercise)
  • Evidence of binge eating
  • Evidence of vomiting, diuretic or laxative abuse (e.g. frequent trips to the bathroom during or shortly after meals)
  • Categorising (writing it down or verbalising) ‘good’ and ‘bad’ foods
  • Changes in food choices (e.g. refusing to eat certain foods, claiming to dislike foods previously enjoyed, sudden interest in ‘healthy eating’)
  • Development of patterns or obsessive rituals around food preparation and eating (e.g. insisting meals must always be at a certain time; only using certain utensils/cutlery)
  • Avoidance of all social situations involving food, for examples friend’s parties, and avoidance of meals (may say they have already eaten or have intolerances to certain foods)
  • Behaviours focused around food preparation and planning (e.g. shopping for food, planning, preparing and cooking meals for others but not consuming meals themselves; taking control of the family meals; reading cookbooks, recipes, nutritional guides)
  • Preoccupation with body shape and weight
  • Repetitive weighing or measuring of self
  • Avoidance of activities that she previously enjoyed.
  • Social withdrawal or isolation from friends, including avoidance of previously enjoyed activities
  • Deceptive behaviour around food, such as secretly throwing food out, eating in secret or lying about amount or type of food consumed
  • Eating very slowly, cutting food into small pieces, hiding food
  • Continual denial of hunger

 

Warning signs with regards to physical health

  • Sudden or rapid weight loss or changes in weight
  • Frequent changes in weight
  • Sensitivity to the cold (feeling cold most of the time, even in warm environments)
  • Loss of menstrual period
  • Signs of frequent vomiting - swollen cheeks/ jawline, calluses on knuckles, or damage to teeth
  • Fainting, dizziness
  • Fatigue - always feeling tired, unable to perform normal activities

 

Warning signs with regards to psychological health

  • Intense fear of gaining weight
  • Constant preoccupation with food or with activities relating to food
  • • Extreme body dissatisfaction/ negative body image
  • Distorted body image (e.g. complaining of being/feeling/looking fat when actually a healthy weight or underweight)
  • Heightened sensitivity to comments or criticism about body shape or weight, eating or exercise habits
  • Heightened anxiety around meal times
  • Depression, anxiety, moodiness or irritability
  • Low self-esteem
  • Rigid ‘black and white’ thinking (viewing everything as either ‘good’ or ‘bad’)
  • Feelings of life being ‘out of control’
  • Feelings of being unable to control behaviours around food

 

Should you identify your own child in any of these criteria, please do not hesitate to send me a message and I will do my best to guide you on the steps to take.  Many people struggle to understand an eating disorder. As a parent, you don't have to understand it to be able to offer your child the support they need to recover from it.