Eating Disorders and Primary School Children

Last week the Herald Sun reported that children as young as seven are being hospitalised with eating disorders. Equally as alarming, The Children’s Hospital at Westmead’s eating disorders clinic, which specialises in working with people aged seven to 17, has experienced a 270 per cent increase in admissions since 2000.

The crew at Kerri-anne asked me to come on and discuss this worrying trend with viewers yesterday. I asked for Melinda Hutchings — an eating disorders survivor, ambassador for The Butterfly Foundation and author of the incredible Why Can’t I Look The Way I Want?: Overcoming Eating Issues to accompany me to offer her personal insights.

As is always the case with live breakfast television, there wasn’t enough time to offer all the insights we would like, so I have asked Melinda to be my guest blogger this week.

image001 A study published in the Medical Journal of Australia in 2009 found that between July 2002 and June 2005, 101 children aged from five to 13 years old were newly diagnosed with an eating disorder. About two-thirds were affected by anorexia nervosa; the rest were experiencing “food avoidant emotional disorder”, a condition unique to children, which involves extreme weight loss driven by high anxiety levels, rather than wanting to be thin.

And according to a 2003 study of 135 South Australian children conducted by Professor Marika Tiggemann, of the School of Psychology, Flinders University, two-thirds of girls in year 1 believed that being thin would make them more popular. Even more believed weight gain would attract teasing.

Children spend much of their early lives at school, an environment that can be competitive, with hierarchies often based on physical appearances. A negative fixation on weight and size potentially lends itself to self-destructive thoughts and behaviours, which can be triggered by situations, comments or events that bring up feelings of anxiety and worthlessness. These include family arguments related to eating (e.g. “You’re not leaving the table until you’ve eaten everything on your plate”), feelings of being misunderstood, rejection by peers (e.g. “Go away, we don’t want to play with you”) or feeling like a misfit.

Negative emotions can lead to unhealthy thought processes and feelings of insecurity around body image. If left undetected, these feelings can lead to the onset of an eating disorder.

In my book Why Can’t I Look the Way I Want?: Overcoming Eating Issues, there is a chapter dedicated to the early warning signs. These signs are often subtle and can be passed off as “normal” behaviour – unless you know what to look for. Common warning signs include avoiding eating in front of others, making excuses to avoid family meal times, obsession with food preparation and a change in attitude towards food, e.g. becoming vegan or cutting out entire food groups under the guise of wanting to be “healthy”. In addition, ritualistic behaviour when eating, such as cutting food into tiny pieces, insisting that meals are eaten at a particular time each day or obsessive use of the same crockery and cutlery is cause for concern.

There are also warning signs before the warning signs. If a child is constantly complaining of headaches and tiredness, or appears to have trouble coping at school, this could indicate there is something deeper going on. Emotional issues, including feelings of inadequacy, often manifest as physical ailments, so stay aware of any symptoms that persist or behaviour that indicates difficulty coping, such as falling behind in class.

Becoming vigilant about the early warning signs means there is a very real chance of catching the behaviour before it spirals from an eating issue into an eating disorder.

Here are five tips for parents and carers:

1. Eat with your child as often as you can so that you become familiar with their eating habits.

2. Watch for changes in those habits, especially anything that appears unusually strict and lasts for several weeks.

3. Listen to the language your child uses around food. If they start talking about diets or calorie contents, or complain that they are fat (when they’re not) this is a red flag.

4. Watch for a change in disposition. If your child displays hostility around meal times, they could be experiencing internal conflict towards food.

5. If your child eats large amounts of food constantly but doesn’t realise how much they are eating and/or aren’t enjoying it, especially during times of stress, this could indicate obsessive eating.

In the event your child begins to display an aversion towards food and changes in their eating patterns, seek medical advice as soon as possible so that they get the right treatment without delay. Early intervention is critical in reframing the mindset before it becomes entrenched.
Melinda Hutchings

7 thoughts on “Eating Disorders and Primary School Children

  1. Leann Hall says:

    Thank you Melinda! I have no doubt that your personal journey has inspired so many… are one courageous young woman!!

    My research into Eating Disorders follows the work of Professor Patrick McGorry and Professor Ian Hickie here at the BMRI – specifically testing a theoretical framework known as the “clinical staging model”. In line with this theory, is the concept of illness staging – which allows us to follow the trajectory of an illness, with an aim to develop better early detection methods and early intervention treatment models. My colleagues and I hypothesise that what is typically referred to as “risk factors” are actually early forms of the disorder. Personally, I would like to eventually see a radical overhaul of the diagnostic criteria to reflect not only this, but the fact that symptoms in children are fundamentally different to those seen in young adults. The current diagnostic criteria apply only to more entrenched forms of the disorder…and no not include many of the behavioural symptoms often seen in children such as food refusal, tantrums etc… This is why the so called prevalence rates for eating disorders are so low. Interesting because according to Mission Australia, their 2010 screen of young people indicated that “body image” is the issue of most concern to young Australians!!

    Anyway…..clearly this is something I am very passionate about! Right now, I think I am going to order your book Melinda!!!!

  2. Kym says:

    Hi Melinda.
    I am Mum to a 9 year old “beautiful”girl who I’m worried about.
    The first signs of a problem to me were
    *when I saw here squeezing the skin in her belly (when she thought I wasn’t looking) because she thought she was getting fat.
    *when she told me not to “make her chin look fat”when I was taking her photo.
    *when she said that she needed to go on a diet before getting her tongue-tie cut “because I will get fat just eating ice-cream & jelly”.
    *after seeing a girl on tv bloated she went around the corner pulled up her shirt and ran her hand over her tummy.
    *and the latest is her worry about being hairy (coz someone at school told her she is).
    She has never ever been a good eater. Mealtimes are an arguement even though I swore to myself that I wouldn’t do that. But it is so hard to just let her not eat.
    She has no weight to spare.
    I need help but at the same time I’m worried about making a huge issue of something that may pass.
    How do I know she won’t just grow out of it?
    I didn’t eat much at all (never felt hungry) until I hit puberty.
    I feel quite lost & alone in this battle.
    I tried to speak to the school but didn’t get a lot if interest and that then makes me think I’m worrying about nothing.
    I have a friend who is a personal trainer and she is trying to find me help. In fact, I think she has contacted “The Butterfly Effect” to see if someone can help at the school.
    But for my daughter & I personally….
    what do I do?

  3. Melinda Hutchings says:

    Hi Kym

    I’m sorry that you are going through this feeling lost and alone. I would suggest calling The Butterfly Foundation on 1800 33 4673 as they have health professionals who will talk you through your concerns and provide support and advice. They can also refer you to a child counsellor in your area. Also my book is an excellent resource and has an entire section about the warning signs and as well as helping someone you love, including what not to say:

    Kym, I commend you for being vigilant in terms of your daughter’s behaviour. Early intervention is so important so that unhealthy behaviours can be dealt with and resolved before a full blown eating disorder takes hold. When it comes to eating issues and eating disorders, being armed with information will help you navigate the path ahead.

  4. Melinda L says:

    This post is very helpful, thanks so much for writing it Melinda. Fantastic name by the way. 😉

    I think it is so helpful for people to know about the early warning signs of an eating disorder. I was never diagnosed with an eating disorder, but I did engage in very extreme dieting as a young girl. ‘Becoming vegetarian’ was something I did as it allowed me to cut out the calories of an entire food group and eliminate the possibility of fast food. But I told everyone it was for ‘health.’

    Great to see you both you and Danni sharing these insights on Kerri-anne.

  5. Ella says:

    Thank you SO much for not having images at low weights and numbers of low weights, etc. Thank you Kerri-Anne, Danni and Melinda. I was waiting for it….just because the media jumps on it and I’m SO pleased that I didn’t find it.

    Kerri-Anne – Obesity is NOT a mental illness. It is a clinical tool to describe a person’s weight. ED-NOS (binge eating tenancies) is an eating disorder. You also need to focus less on anorexia and more on bulimia and EDNOS – all mortality rates are on par with each other, pretty much. Anorexia 20%, bulimia 19% and stats for EDNOS are varying – but between 5%-25%. Yep. They’re killers and if they don’t kill you, they’ll destroy your life. You can’t say one is more serious than the other, although anorexia is by far the most visually graphic and sensationalistic.

    I developed anorexia at 12, bulimia from 14-19 and at 19 was hospitalised after losing, very similar to Melinda, 1/3 of my body weight very rapidly. I should have died and I absolutely would have if I hadn’t had a very responsible flat-mate. I spent 4 months in hospital recovering from that bout; but I’m still not “well”. My last hospital admission for eating disorder complications was February. You know what the cruel irony of all of this is? I’m not underweight. I don’t ‘look’ like I have a problem. It’s a mental illness that delves so much deeper than image. It truly is about fears and perfection and feelings and thoughts and anger and sadness and anxiety and depression. It hasn’t got anything to do with food; that’s just the outlet for it. The term ‘eating disorder’ is a bit misleading really.

    I used to be one of the ‘best and brightest’ (I write that with a sinking sense and a strong emphasis on ‘used to be’ because I’m only just getting my life back on track and it’s no where near as brilliant, bright and shiny as I imagined it to be) and I remember the most cutting remark my mum made when I was in treatment at 18 “you’re a smart girl who makes very, very stupid decisions”. It is so hard for families to understand. Especially well educated families from ‘nice’ neighbourhoods, with ‘nice’ children who go to ‘nice schools’, etc. etc. etc. My family had to remortgage their house to send me to treatment when I was 18 and living in a regional area, because I was dying under their noses and there was nothing they, or anyone else, could do about it. There were no services that would treat me; I wasn’t underweight enough to be in an ‘anorexia program’ and I was too sick and non-functional to be in the ‘bulimia program’ which meant I fell through ‘the gap’ (of which there are many).

    I lost a treatment friend at 18 – she was 17. 17 years old and her light got extinguished because she couldn’t access inpatient treatment in time. Maybe it wouldn’t have made a difference to the final outcome. Maybe it would have. I don’t know. But I do know that my friend wanted to live. Her heart stopped. I guess after years of abusing her body, it just didn’t trust her that she really wanted recovery this time.

    I am sad and glad to say that this is the first time I’ve seen eating disorders discussed on breakfast television that has been reported responsibly. Let this segment be a role model to further media. THIS is how we should report eating disorders.

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