Advice for parents and carers of young people with eating disorders
On this page you will find advice on how to best support your child and managing as a family.
For more general information on eating disorders, visit the Eating Disorders page in Good Advice.
For information on the services we offer, visit the CAMHS ED Services page.
How to tell if your child is developing an eating disorder
As a parent or a friend, you may notice that an individual is losing weight. However, an eating disorder can be hard to spot – the majority of those with eating disorders (particularly in adult life) are either normal weight, or overweight. Eating disorders can often go unnoticed for a long period – symptoms can be easy to hide and are frequently associated with secrecy and shame. An eating disorder is a serious illness which can affect males and females of any ethnicity or weight.
All young people are growing, so it is crucial that they eat regular nourishing meals to give them energy. If they are also doing a lot of activity, they will need to eat more to keep up with their energy needs.
The following signs may alert you to the possibility of an eating disorder
- Making excuses to avoid eating with you
- Becoming secretive about eating
- Skipping meals or eating very little at meals
- Packed lunches coming home uneaten
- Snack food disappearing from your cupboards, or spending lots of money on chocolates, sweets and junk food that you don’t see them eat
- Disappearing to the bathroom straight after meals
- Making negative comments about their appearance or feeling or looking “fat”
- “Checking” their body fat, e.g. pinching the skin on their waist or thighs
- Losing weight, or rapidly gaining weight
- Expressing fear of gaining weight
- Weighing themselves more often
- Exercising excessively (strenuous, compulsive exercise and feeling guilty if they miss sessions)
- Starting to wear baggy clothes
- Withdrawing from social activities, especially if food is involved
- Losing interest in things they previously enjoyed
- Getting angry or irritable
- Feeling the cold
- Missing or irregular periods
- Dental problems
- Dry skin around their mouth or callouses on their knuckles (these can be signs that they are making themselves vomit)
Social and family relationships
You may notice your young person becoming irritable, distressed or angry. This is common if he/she is beginning to develop an eating disorder. This might make you angry or distressed too, and it is easy for family relationships to deteriorate. It is important to try and understand what is behind their feelings and give them space to share what is going on for them. They may find it difficult to talk in which case you may need to simply reassure your son/daughter that you are there for them and want to help and support them.
When a young person begins to develop an eating disorder they may become increasingly preoccupied with food, weight and shape and it can affect their peer relationships too. They may become withdrawn from their peers, leaving them isolated and unhappy. It is important to encourage them to keep their relationships going even if they don’t feel like it. Friends can be supportive and a great help in the process of recovery.
Some of these signs, such as loss of weight, loss of interest in usual activities or becoming angry/irritable may indicate that the young person is suffering from stress, anxiety or depression rather than an eating disorder.
It may be helpful to check out whether their mood has gone down or whether they are worried about something. Young people with depression suffer low mood but may also go off their food and start to lose weight. They often find it very hard to sleep and may lose concentration. Young people with anxiety may be preoccupied with specific worries and may start to avoid things they are anxious about.
Sometimes it is very difficult to tell what the primary problem is. If you are not sure what is going on for the young person, it may be helpful to get them checked out by their GP.
What to do if your child has an eating disorder
The sooner you address an eating disorder the better, as habits can become entrenched. Eating disorders are very hard to fight alone: someone suffering from an eating problem will likely need you on their side against the illness. They need to know that you are there to keep them safe and well and that you want to help them stay healthy.
Make a relationship with your child unrelated to eating
- Take time to engage in activities that you both enjoy together
- Watch a film, listen to music together
- Be curious about your child’s interests and tastes
Make family meals a priority
- Encourage the young person to join in with family meals
- Make them fun/enjoyable
- Use the opportunity to discuss things as a family
- Take turns to cook for each other
- Sit with them after meals, as this can be a time when they feel stressed about what they have just eaten, and may be tempted to try to make themselves sick, or start exercising
Find out if there is anything worrying your child
- Concerns at school or work?
- Concerns with friends?
- Concerns in the family?
If appropriate, keep an eye on what your child is eating at home and at school
- Check if food is left on the plate or put in the bin
- Notice if your child is starting to avoid certain foods, particularly foods high in calories
- Notice if your child is cutting down portion sizes
Be aware of any physical problems
- If your child appears to be losing weight suggest they might go to the GP for a check-up
- Help book the appointment and go with them if at all possible
Read relevant books/websites
- B-eat has some useful information and helplines www.b-eat.co.uk
- Another useful website is www.feast-ed.org/family-guide-series
When and how to get help
It can be hard to know when to ask your GP or school nurse for help – maybe you worry you’d be wasting their time, or it would mean admitting that there is a problem. However, people are more likely to get better if they ask for help early so don’t hesitate to ask for help if you’re worried: eating disorders are serious illnesses and can be life-threatening.
Further advice for parents and carers
Supporting a healthy body image
Supporting a child with perfectionism
Resources for parents and carers
Eating disorder resources for parents
How you can get involved
Our parent forum meets every few months for an informal and relaxed meeting with two or three members of our staff, to canvass views on all aspects of the current service, discuss ideas for service development and hear your views on research. Learn more
Common questions family and friends ask
The questions below have been created collaboratively by clinicians and parents. These questions are ones we are typically asked most frequently. If you have a question that is not here, please ask your clinician at your next appointment or at your assessment if you are new to service.
How do I know if my child has an eating disorder?
Please read our What are Eating Disorders? page for more information on the signs and symptoms of eating disorders.
Should I force my child to eat?
We do not recommend force feeding. It is very important that your child eats and to achieve this, we use family-based treatment. At the start of treatment, parents take full control of food and eating and provide supervision and support at all meal times. It is important that parents set up an expectation that the food presented to the child must be eaten and eating is actively encouraged throughout the meal. A firm but compassionate approach typically achieves the best result. The eating disorder may push back during meal times but we strongly encourage parents to be ‘bigger’ than the eating disorder.
How can I support my other children?
We have a webpage dedicated to this topic called ‘Advice for parents supporting siblings’.
How should I handle comments during mealtimes such as: 'I feel full', 'I am bloated', 'I feel fat'?
Parents find it most helpful to use reassuring and empathetic comments such as ‘I can see this is difficult for you but you must keep eating’, ‘It’s OK, I’m here with you’. Families also find it helpful to use enjoyable activities during and after meals to help distract your child from difficult thoughts and feelings. These might include putting the television/radio on, playing a game, having a fiddle toy.
It is common for young people with eating disorders to feel full and bloated after eating because of a gastric delay. Please see our ‘body map’ to look at the side effects of undereating/being underweight. The feelings of fullness and bloating will reduce as eating increases and becomes more regular. Some young people find having a hot water bottle helpful in reducing these uncomfortable feelings.
What do I do if my child disappears to the toilet after mealtimes?
We would recommend that you ask your child to use the toilet before the meal so you are able to supervise your child for a period after the meal has finished. This is to prevent any self-induced vomiting or other methods of getting rid of the food.
How should I approach the problem of excessive exercising with my child?
Excessive exercising is a method that some young people may use to lose weight. The purpose of the exercise is not for enjoyment or fitness, but to burn calories. It can sabotage weight restoration and is an unhelpful behaviour that will maintain the eating disorder. Our recommendation would be to try to eliminate all excessive exercising through parental supervision and monitoring. Some parents have found employing an ‘open door’ policy helpful. This involves the child keeping their bedroom door open so exercising can be monitored. When your child’s eating and health has stabilized, our aim is to work towards getting your child back to enjoyable activity such as team sports or previously enjoyed exercise which are not driven by the eating disorder.
How do I handle refusal to eat ‘fear foods’?
All eating is likely to be feared by your child and the approach to fear foods should not be different to any other foods. There should not be any negotiation in avoiding whole food groups such as carbohydrates (potatoes, pasta, rice) or dairy (milk, cheese, yoghurt) as these are essential for a healthy, nutritional diet. It is unlikely that logical explanations of nutrition will be listened to during meal times. Therefore, it is more helpful to take on a reassuring, calm and compassionate approach that is encouraged in the FBT model. Parents should make decisions about their child’s eating and this should involve all foods that their child previously enjoyed.
What should I do if I suspect my child is not eating whilst at school?
This is something that can be discussed with your therapist in the sessions. If the child is finding eating very difficult and there are physical health concerns, parents often meet their child for lunch in the school or in the car. Some schools can offer support with eating lunch.
Should I let my child prepare their own food?
Having an eating disorder makes it difficult to make healthy decisions about food and eating. The first phase of the family-based treatment involves asking parents to take all responsibility in food preparation and serving. This is to help reduce the burden and distress from your child and to ensure an adequate diet is eaten. Stage 2 of FBT starts once your child has made progress in eating and physical health is stable. This stage involves appropriately and carefully handing responsibility of food and eating back to your child.
What support is there for parents?
In addition to the family-based treatment sessions (if this is the treatment your child is receiving), we also have:
- A monthly Parents and Carers group held in Oxford.
- A Carers Workshop held four times a year.
- The multi-family therapy (MFT) programme also running four times a year
Please speak to the clinicians at CAMHS for more information.
What can I expect from a parent group?
The eating disorder parent group meets on a monthly basis at Raglan House on a Monday evening 5.15pm to 6.30pm. It is an informal friendly group starting with a cup of coffee/tea and providing a forum for parents to discuss their difficulties and concerns and share ideas of what helps. It is facilitated by two members of the eating disorder team and usually starts with discussion of a specific topic (agreed in advance by the parents) as well as having time for informal discussion and support.
What if my child doesn’t feel they need help?
It is very common for young people to feel there is nothing wrong with them and that they don’t need help. The more you try to persuade them the less they will want to have help. However, if you are concerned about your child you will need to find a way of accessing help in order to give your child the best chance of recovery.
My child doesn’t want to come for appointments or even attend the assessment, what shall I do?
You will need to be clear with your child that it is important for them to attend and that the professionals will listen to them and take them seriously. If you are having great difficulty you may find it helpful to ring the ED team to get advice on what to do.
How long is treatment going to last?
This varies a lot, depending on how ill your child is at the start of treatment, how entrenched the eating disorder is and to what extent you and your child engage with the treatment. Generally, the family-based approach will take 20 sessions, with the last few sessions occurring at wider intervals. On average, the whole course of treatment will take around a year, however, some young people may recover well before this and others may take longer.
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Page last reviewed: 19 January, 2023