Teenage Mood Swings Could Conceal Underlying Eating Disorders
While some symptoms of eating disorders are obvious, others can be subtle, often leaving parents unaware of serious underlying issues. Distinguishing normal teenage behaviour from warning signs frequently comes down to observing shifts in behaviour patterns.
"The first signs of an eating disorder are often behavioural or psychological rather than physical," explains Tom Quinn, director of external affairs at Beat, the UK charity supporting those affected by eating disorders. "Whilst people often think of weight loss as the main symptom, there are many different types of eating disorders where someone's weight is likely to stay the same, such as bulimia."
With Eating Disorders Awareness Week scheduled for February 23 to March 1 this year, experts outline six key behavioural changes that may indicate a child is struggling.
1. Avoids Eating with the Family
"Through no fault of their own, people with eating disorders will often try to keep their illness a secret, so you might notice they are lying about when, where or how much they ate," Quinn details. "It's important to remember that eating disorders are never a choice and that behaviours around food are never intended maliciously."
Dr Caroline Fleming, head of psychology at Cygnet Hospital Ealing, adds: "Instead of having a meal at the table with the family, they might say, 'I want to do my work, so I'm going to eat in my room', and then get rid of that food. They might also leave the house more often than they usually do and say 'I've eaten elsewhere' or 'I'm not that hungry. I had a big lunch, so I don't need very much for dinner'."
2. Disappears to the Toilet During or After Meals
"They might look as though they're eating reasonably in front of the family but might then run to the bathroom really soon after eating," Fleming says. Quinn notes that this could indicate purging, which is more common in bulimia.
3. Tiredness and Difficulties Concentrating
"If they are not getting the nutrition they need, that's going to have an impact on how somebody is managing physically and in terms of their concentration, because the brain is a very hungry organ," Fleming observes. "It can also impact sleeping patterns, so they might feel really tired during the day."
4. Food Unexplainably Goes Missing
Quinn states this could signal binge eating. "Binge eating disorder is the most common eating disorder, with 1 in 50 experiencing this during their lifetime, where people eat large amounts of food in a short space of time. People often describe bingeing as going into 'autopilot' or feeling out of control, which can be very distressing. You can also experience binge eating as part of a different eating disorder like anorexia or bulimia."
5. Mood Changes
"You might notice distinctive changes to their personality and behaviour," Fleming explains. "They might experience big mood swings, look really cut off emotionally, or be really irritable. For example, any concerns or mentions about their behaviours and food might be met with a really snappy response."
6. Withdraws Socially
"A lot of socialising is around eating and drinking - such as going out for coffee with friends, going out for lunch, sitting in the canteen with your friends to have lunch etc - so someone struggling with an eating disorder might become increasingly socially isolated because they're not engaging in those things with their peers, family and friends," Fleming adds.
What Parents Can Do
Fleming advises against heavy-handed approaches. She explains that worries about eating behaviours are often met with anger or defensiveness, and pushing too hard can risk damaging the relationship.
"Concerns about eating behaviours can often be met with anger or rebuttal, so I would advise against a heavy-handed approach as that might lead to a breakdown in the relationship. Because it's such a secretive illness and can quickly become part of someone's identity, if you go in too hard and too quickly, it might feel like an attack," she cautions.
Instead, she recommends prioritising trust and starting conversations in a calm, gentle and supportive way to help keep communication open.
- Choose the right setting: "Choose a time and place where you both feel safe and won't be disturbed. Avoid immediately before or after meals, as this will be a stressful time," Quinn says.
- Ask open-ended questions: "Try not to back them into a corner," Quinn advises. "We'd recommend asking open-ended questions like 'I wondered if you'd like to talk about how you're feeling' as opposed to 'You need to get help'."
- Seek professional support: "You could put information leaflets around their room, or if you've got a really good relationship with them you might just want to gently express concern and say 'I'm worried about your physical health and I think we should go and see the GP'," Fleming suggests. "Getting support from outside the home is a really helpful start and the sooner you seek support, the better."
Parents or carers worried about their own or a child's health can contact Beat, the UK's eating disorder charity, at 0808 801 0677 or visit their website for more information.
