Awareness of eating disorders in children and teenagers
New research shows how the pandemic has raised awareness of eating disorders in children. Here you’ll find support, advice, and warning signs to look out for.
How the pandemic has fuelled a rise in eating disorders
Throughout the pandemic, many of us have turned to Google for our health worries or questions. We found that parents turned to Google for their concerns, especially eating disorder support. There has been a rise in searches on Google for eating disorder awareness, affecting children, teenagers and young people.
So we asked Bupa mental health advisers Harriet Finlayson and Danielle Panton their expert advice. On this page, they tell us the warning signs of an eating disorder and offer guidance for recovery and self-care. They also provide advice on how to talk to children about eating disorders.
You may have seen the impact of COVID-19 on your own family’s mental health, with heightened anxiety, stress, and worry. These are difficult times for everyone, but teenagers and children are particularly vulnerable because they’re still acquiring the coping skills and life experience they need to build resilience. Here’s what our own survey† about teenage reactions to the pandemic revealed:
46% of teens surveyed had altered their eating habits during lockdown
84% admitted to restricting food for a sense of control
41% of teens reported the same sense of control from eating more
Teenagers have turned to harmful coping mechanisms to manage their mental health during the pandemic, including controlling or restricting their food intake.
173%
173% increase in searches for eating disorder help’ in April 2021, compared to April 2020
125%
125% increase in searches for anorexia in children’ in April 2021, compared to April 2020
Types of eating disorders
While it’s normal to change your eating habits every now and again, it can become a problem if food and eating feel like they’re taking over: that’s when a disorder can develop.
Eating disorders are complex conditions that cause people to develop severely disrupted eating habits. For parents, it’s important to be aware of the different types of eating disorder because they’re most common in teenagers aged 13 to 17. There are lots of different eating disorders, each with unique symptoms. Some of the more common disorders are listed below.
Anorexia
A person who has anorexia nervosa will try to control their weight by not eating enough food and/or exercising excessively. Often, they have a distorted image of themselves, believing they are overweight when in fact they may be severely underweight.
Anorexia is a serious and complex mental health condition which requires expert professional help. It is the least common eating disorder, even though it may be one of the most widely recognised. Anorexia is most common in teenage girls and young women, and females are about four times more likely to be affected than males.
Binge eating disorder
Binge-eating is a common, serious but treatable eating disorder which can affect males and females, and usually starts in the late teens or early 20s. It involves recurring sessions of eating very large quantities of food, very rapidly.
Those who binge-eat may secretly hoard food, plan their sessions, and try to hide how much they’re eating. Unlike with bulimia, they don’t force themselves to be sick afterwards. During a binge they may feel distressed and out of control, while afterwards they may feel shame.
Bulimia
Bulimia nervosa is a serious mental health condition. It can be hard to spot because a person with bulimia may have a normal body weight, so the signs may be more around behaviour. Bulimia can affect anyone, male or female, but is most common in ages 13 to 17.
Bulimia shares similarities with some other eating disorders. As with anorexia, those with bulimia try to control their weight, may exercise excessively, and may have a distorted body image but bulimia means eating a lot, rather than very little. And like binge-eating, those with bulimia tend to eat a lot in a short time, usually secretively, although someone with bulimia will force themselves to be sick afterwards or may over-use laxatives.
Orthorexia
Orthorexia is a newly identified disorder in which the person develops an unhealthy obsession with healthy eating, or pure eating’. So unlike with anorexia or bulimia, for example, orthorexia is about the quality of the food, rather than the quantity.
Someone with orthorexia may be obsessive about researching foods or reading the ingredients in food. They may eliminate entire food groups and have a very restricted diet, which can lead to malnutrition. Orthorexia can interfere with daily life and cause anxiety in social settings that involve food.
Body dysmorphic disorder
A person with body dysmorphic disorder becomes so concerned about flaws in their appearance, however minimal or imaginary, that they feel real distress. It can have a significant impact on their daily life, and they may avoid going out or social occasions.
Body dysmorphic disorder can affect both males and females. Because it’s most common in teenagers and young adults, it can be difficult to spot. After all, this is an age when physical appearance can be especially important anyway. Warning signs could include obsessive behaviour around mirrors, grooming, or continually researching cosmetic procedures. It may involve constantly seeking reassurance about an aspect of appearance.
Many more people are searching for help with eating disorders
We compared how many people are using Google to look for support with eating disorders in April 2021, compared with April 2020.
50%
increase in Google searches for 'binge eating'
82%
more searches for 'orthorexia', an obsession with pure eating
22%
growth in searches for body 'dysmorphia' (anxiety about appearance)
122%
increase in searches for 'anorexia'
Why has there been an increase in eating disorders during COVID 19?
Our research shows a significant increase in Google searches relating to eating disorders this year, compared to 2020. Here are some of the reasons why food, and eating difficulties, have become more of an issue for children and young people during COVID-19.
- The pandemic has led to increased anxiety and stress. Some children and teenagers respond by eating more, or restricting their food intake.
- Huge changes to their usual routine have been very disruptive for children and young people.
- During lockdown, many children and teenagers have turned to social media to pass the time. Increased social media use puts them at risk from unhelpful and negative social media messages, which can fuel any existing mental health struggles.
- Lockdown has meant that those with existing disordered eating habits have constant access to food.
- If you’ve spent more time than usual with your child or teenager, you may have noticed eating habits that you hadn’t previously observed.
Eating disorder awareness: warning signs to watch out for
Whether you’re concerned about yourself or someone you love, it’s important to recognise the potential signs of an eating disorder. For a parent, seeing your child struggle with eating problems or disorders can be very upsetting.
Behavioural symptoms of an eating disorder
Unusual behaviours around food could suggest that someone is experiencing an eating disorder. For example, cutting food into small pieces, wanting to eat alone, going to the toilet after every meal, and repeated weighing.
Psychological signs of an eating disorder
You might be concerned if you notice these, or more often: low self esteem, intense mood swings, panic attacks, or self harm.
Physical signs of an eating disorder
There are physical symptoms which might suggest an eating disorder, such as a change in weight, fatigue, dizziness, and sensitive, discoloured or damaged teeth.
How to talk to your children about eating disorders
74%
74% of parents were sure their teen would come to them if they had a problem
33%
Our recent study found that 1/3 of teens found it difficult to talk about their feeling with parents
Validate their feelings
Even if you don’t understand what they’re going through, it’s important to validate your child’s feelings. Avoid advice or criticism, because that can close down the conversation and prevent your child from opening up. Simply let them know that they’re being heard.
When talking to your child about changes in their eating habits and behaviours, try to stick to the facts of what you’ve actually seen, rather than making assumptions. Don’t minimise their feelings or try to brush them off, either. Accept them for what they are. Saying something as simple as, 'I’m really sorry you don’t feel so good right now’ won’t change their symptoms - but it will remind your child that they’re cared for, and considered, and supported.
Listen without judgement
You could ask your child if there’s anything that’s making them feel anxious or stressed which could be affecting their eating habits. Opening up can take time, but it’s important to remain calm and listen without judgement, and only when they’re ready.
Try finding out why they’re having difficulties with food, and work with them to come up with possible solutions. You should do this with guidance from a doctor: they should be able to support you both and put you in touch with support groups.
Take good care of yourself, too
It’s a tough time for everyone, but it’s important to find time for yourself. You may feel frustrated that your child isn’t eating healthily, or feel worried that it’s because of something you’ve done, or feel like you’re not doing enough to help them get better.
Remember that your mental health is important, too, and you deserve your own support. If possible, take some time to do something you find relaxing. Reach out to friends and family if you can (respecting your child’s confidentiality), and be sure to contact your GP if you need advice and support.
Find a calm and quiet space
It can be a huge relief to open up and discuss a mental health problem with someone close. However, these conversations can be tricky, and not everyone’s comfortable talking about their feelings.
Your first step should be to create a safe space where your child feels able to talk. It doesn’t have to be face-to-face; that can be overwhelming and difficult. Instead, you could try a text message or a note. This offers your child greater control, and more time to consider how they want to respond.
Eating disorder recovery
With the right eating disorder support and guidance, it’s possible to regain health and wellbeing.
Find the right treatment
It’s crucial to find the treatment that works best for you, as it can help you develop healthy, balanced eating patterns in the long term.
An important part of finding suitable treatment is first speaking to your doctor. They may be able to refer you to specialist eating disorder support for both your child and your family.
There are specialist charities that can help. You can find details for Beat, the UK's eating disorder charity, at the bottom of this page. Young Minds, the mental health charity, also has lots of content around anorexia and other eating disorders.
Encourage a healthy relationship with food
Even though food itself isn’t the problem with an eating disorder, developing a healthier relationship with food is an important step to recovery. Here are our tips for reducing mealtime anxiety for everyone:
- Prepare for meals by letting the family know when food will be served.
- When you’re eating a meal, divert attention by talking about the events of the day, or what’s been on TV.
- Reduce added pressure on your child by taking greater control of their food; for example, by offering less choice.
- Distracting your child after eating could reduce the urge for excessive exercise or purging (vomiting or using laxatives). So plan to do something afterwards, like watching a moving, playing a board game or going out.
Watch out for triggers
It’s important that your child learns how to cope and manage any triggers that arise in their everyday life. As part of their support network, be mindful that topics around food, body image and dieting may naturally come up in conversation. Where you can, avoid talking about these topics at mealtimes.
It’s critical that your child finds a coping strategy to ease any discomfort. For example, if you can identify the events, people and situations that trigger negative emotions, you can help to avoid that trigger or prepare a way to handle it in future.
How Bupa can support you with eating disorders
If you have health insurance
If you have family health insurance with us, you’ll have support for almost every mental health condition there is, including eating disorders. If you’re struggling, just pick up the phone and call our Family Mental HealthLine. You can talk to an online doctor 24/7 with our Bupa Blua Health digital GP service,†† or simply call us on:
0345 609 0111^
If you don't have health insurance
We want to help everyone, whether you have health insurance with us or not. That’s why you’re welcome to all the expert advice on this page.
Our children's mental wellbeing page
Our teenage mental health page
And if you’d like to explore going private just for an eating disorder, you can simply pay as you go with Bupa.
Helpful external resources
Beat is the UK's eating disorder charity. If you’re concerned that someone you love might be suffering from an eating disorder, you can contact them online or by phone, 365 days a year. They also run support groups.
The Beat Adult Helpline is open to anyone over 18. Use his number if you think you might have an eating disorder, or if you’re concerned teacher or family member.
Helpline
0808 801 0677
Email
[email protected]
The Beat Youthline is open to anyone under 18. They offer a supportive, non-judgemental space for talking about feelings about food.
Helpline
0808 801 0711
Email
[email protected]
Eating disorder support and information from Bupa's experts
Thoughts are not facts: how CBT can help break the cycle of negative thinking
When it comes to eating disorders, CBT could help with worries about food, food intake and appearance
Self esteem and body image - a parent's guide
Our clinical lead for mental health explores children’s feelings of insecurity about how they look, and offers some practical suggestions.
Understanding changes in a child or teenager's behaviour
Behaviour can reveal much more than what’s actually said, according to our clinical lead for mental health.
Be kind… to yourself: 10 top tips
Being kind to others may come naturally, but being kind to yourself may not. Here are some very helpful tips from our associate clinical director.
^ Lines are open 8am - 8pm Monday to Friday, 8am-4pm Saturdays. We may record or monitor our calls.
† Teens Minds: Living Through a Pandemic and Beyond
Bupa-commissioned report by PCP Research, surveying 1,000 UK teenagers aged 13-19, and 1,000 of their parents, between 22 October and 3 November 2020.
†† Customers who live on the Isle of Man, or have a Bupa Standard, Bupa Premium or Bupa Your Choice policy, do not have access to Bupa Blua Health, but can access GP24 provided by HealthHero. Some corporate schemes don't include access to Bupa Blua Health or GP24, so please check your scheme documents or give us a call.
‡ NICE (National Institute for Health and Care Excellence)
https://cks.nice.org.uk/topics/eating-disorders/background-information/prevalence
Bupa Blua Health is provided by Bupa Insurance Services Limited, registered in England and Wales with number 3829851. Digital GP services are powered by Babylon Healthcare Services Limited, registered in England and Wales with number 09229684, registered office: 1 Knightsbridge Green, London SW1X 7QA.
