{"id":189790,"date":"2018-08-31T18:49:23","date_gmt":"2018-08-31T17:49:23","guid":{"rendered":"http:\/\/ohnhs.uk\/camhs\/?page_id=189424"},"modified":"2025-03-12T09:46:50","modified_gmt":"2025-03-12T09:46:50","slug":"ed","status":"publish","type":"page","link":"https:\/\/oxfordhealth.nhs.uk\/camhs\/carers\/ed\/","title":{"rendered":"Advice for parents and carers of young people with eating disorders"},"content":{"rendered":"<p>On this page you will find advice on how to best support your child and managing as a family.<\/p>\n<p>For more general information on eating disorders, visit the <a href=\"https:\/\/oxfordhealth.nhs.uk\/camhs\/self-care\/ed\/\">Eating Disorders<\/a> page in Good Advice.<\/p>\n<p>For information on the services we offer, visit the<a href=\"https:\/\/oxfordhealth.nhs.uk\/camhs\/ed\/service\"> CAMHS ED Services<\/a> page.<\/p>\n<h2>How to tell if your child is developing an eating disorder<\/h2>\n<p>As a parent or a friend, you may notice that an individual is losing weight.\u00a0 However, an eating disorder can be hard to spot \u2013 the majority of those with eating disorders (particularly in adult life) are either normal weight, or overweight.\u00a0 Eating disorders can often go unnoticed for a long period \u2013 symptoms can be easy to hide and are frequently associated with secrecy and shame.\u00a0 An eating disorder is a serious illness which can affect males and females of any ethnicity or weight.<\/p>\n<p>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.<\/p>\n<p>The following signs may alert you to the possibility of an eating disorder<\/p>\n<div id=\"15\" class=\"tabbed\">\n                            <ul><li><a href=\"#section-eating-habits\">Eating habits<\/a><\/li><li><a href=\"#section-weight\">Weight<\/a><\/li><li><a href=\"#section-behaviour\">Behaviour<\/a><\/li><li><a href=\"#section-physical-signs\">Physical signs<\/a><\/li><\/ul>\n<div class=\"ohft-tab-content\" id=\"section-eating-habits\">\n<ul>\n<li>Making excuses to avoid eating with you<\/li>\n<li>Becoming secretive about eating<\/li>\n<li>Skipping meals or eating very little at meals<\/li>\n<li>Packed lunches coming home uneaten<\/li>\n<li>Snack food disappearing from your cupboards, or spending lots of money on chocolates, sweets and junk food that you don\u2019t see them eat<\/li>\n<li>Disappearing to the bathroom straight after meals<\/li>\n<\/ul>\n<\/div>\n<div class=\"ohft-tab-content\" id=\"section-weight\">\n<ul>\n<li>Making negative comments about their appearance or feeling or looking \u201cfat\u201d<\/li>\n<li>\u201cChecking\u201d their body fat, e.g. pinching the skin on their waist or thighs<\/li>\n<li>Losing weight, or rapidly gaining weight<\/li>\n<li>Expressing fear of gaining weight<\/li>\n<li>Weighing themselves more often<\/li>\n<\/ul>\n<\/div>\n<div class=\"ohft-tab-content\" id=\"section-behaviour\">\n<ul>\n<li>Exercising excessively (strenuous, compulsive exercise and feeling guilty if they miss sessions)<\/li>\n<li>Starting to wear baggy clothes<\/li>\n<li>Withdrawing from social activities, especially if food is involved<\/li>\n<li>Losing interest in things they previously enjoyed<\/li>\n<li>Getting angry or irritable<\/li>\n<li>Feeling the cold<\/li>\n<\/ul>\n<\/div>\n<div class=\"ohft-tab-content\" id=\"section-physical-signs\">\n<ul>\n<li>Missing or irregular periods<\/li>\n<li>Dental problems<\/li>\n<li>Dry skin around their mouth or callouses on their knuckles (these can be signs that they are making themselves vomit)<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<h3>Social and family relationships<\/h3>\n<p>You may notice your young person becoming irritable, distressed or angry.\u00a0\u00a0 This is common if he\/she is beginning to develop an eating disorder.\u00a0 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.<\/p>\n<p>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.\u00a0 They may become withdrawn from their peers, leaving them isolated and unhappy.\u00a0 It is important to encourage them to keep their relationships going even if they don\u2019t feel like it.\u00a0 Friends can be supportive and a great help in the process of recovery.<\/p>\n<div class=\"ohft-box gray\">\n<h3>Note<\/h3>\n<p>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.<\/p>\n<p>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.<\/p>\n<p>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.<\/p>\n<\/div>\n<h2>What to do if your child has an eating disorder<\/h2>\n<p>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.<\/p>\n<details class=\"nhsuk-details nhsuk-expander\">\n                    <summary class=\"nhsuk-details__summary\">\n                        <span class=\"nhsuk-details__summary-text\">Make a relationship with your child unrelated to eating<\/span>\n                    <\/summary>\n                    <div class=\"nhsuk-details__text\">\n<ul>\n<li>Take time to engage in activities that you both enjoy together<\/li>\n<li>Watch a film, listen to music together<\/li>\n<li>Be curious about your child\u2019s interests and tastes<\/li>\n<\/ul>\n<\/div>\n                <\/details>\n<details class=\"nhsuk-details nhsuk-expander\">\n                    <summary class=\"nhsuk-details__summary\">\n                        <span class=\"nhsuk-details__summary-text\">Make family meals a priority<\/span>\n                    <\/summary>\n                    <div class=\"nhsuk-details__text\">\n<ul>\n<li>Encourage the young person to join in with family meals<\/li>\n<li>Make them fun\/enjoyable<\/li>\n<li>Use the opportunity to discuss things as a family<\/li>\n<li>Take turns to cook for each other<\/li>\n<li>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<\/li>\n<\/ul>\n<\/div>\n                <\/details>\n<details class=\"nhsuk-details nhsuk-expander\">\n                    <summary class=\"nhsuk-details__summary\">\n                        <span class=\"nhsuk-details__summary-text\">Find out if there is anything worrying your child<\/span>\n                    <\/summary>\n                    <div class=\"nhsuk-details__text\">\n<ul>\n<li>Concerns at school or work?<\/li>\n<li>Concerns with friends?<\/li>\n<li>Concerns in the family?<\/li>\n<\/ul>\n<\/div>\n                <\/details>\n<details class=\"nhsuk-details nhsuk-expander\">\n                    <summary class=\"nhsuk-details__summary\">\n                        <span class=\"nhsuk-details__summary-text\">If appropriate, keep an eye on what your child is eating at home and at school<\/span>\n                    <\/summary>\n                    <div class=\"nhsuk-details__text\">\n<ul>\n<li>Check if food is left on the plate or put in the bin<\/li>\n<li>Notice if your child is starting to avoid certain foods, particularly foods high in calories<\/li>\n<li>Notice if your child is cutting down portion sizes<\/li>\n<\/ul>\n<\/div>\n                <\/details>\n<details class=\"nhsuk-details nhsuk-expander\">\n                    <summary class=\"nhsuk-details__summary\">\n                        <span class=\"nhsuk-details__summary-text\">Be aware of any physical problems<\/span>\n                    <\/summary>\n                    <div class=\"nhsuk-details__text\">\n<ul>\n<li>If your child appears to be losing weight suggest they might go to the GP for a check-up<\/li>\n<li>Help book the appointment and go with them if at all possible<\/li>\n<\/ul>\n<\/div>\n                <\/details>\n<details class=\"nhsuk-details nhsuk-expander\">\n                    <summary class=\"nhsuk-details__summary\">\n                        <span class=\"nhsuk-details__summary-text\">Read relevant books\/websites<\/span>\n                    <\/summary>\n                    <div class=\"nhsuk-details__text\">\n<ul>\n<li>B-eat has some useful information and helplines\u00a0<a href=\"https:\/\/www.b-eat.co.uk\/\">www.b-eat.co.uk<\/a><\/li>\n<li>Another useful website is <a href=\"https:\/\/www.feast-ed.org\/family-guide-series\/\" target=\"_blank\" rel=\"noopener noreferrer\">www.feast-ed.org\/family-guide-series<\/a><\/li>\n<\/ul>\n<\/div>\n                <\/details>\n<h2>When and how to get help<\/h2>\n<p>It can be hard to know when to ask your GP or school nurse for help \u2013 maybe you worry you\u2019d 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\u2019t hesitate to ask for help if you\u2019re worried: eating disorders are serious illnesses and can be life-threatening.<\/p>\n<div class=\"nhsuk-action-link\"><a class=\"nhsuk-action-link__link\" href=\"https:\/\/oxfordhealth.nhs.uk\/camhs\/carers\/ed\/when-to-get-help\/\" target=\"_self\"><span class=\"nhsuk-action-link__text\">When to get help<\/span><\/a><\/div>\n<div class=\"nhsuk-action-link\"><a class=\"nhsuk-action-link__link\" href=\"https:\/\/oxfordhealth.nhs.uk\/camhs\/carers\/ed\/getting-help\/\" target=\"_self\"><span class=\"nhsuk-action-link__text\">How to get help<\/span><\/a><\/div>\n<h2>Further advice for parents and carers<\/h2>\n<p><a href=\"https:\/\/oxfordhealth.nhs.uk\/camhs\/carers\/ed\/how-to-help\/\">How to help the young person<\/a><\/p>\n<p><a href=\"https:\/\/oxfordhealth.nhs.uk\/camhs\/carers\/ed\/helping-a-young-person-to-eat\/\">Helping a young person to eat<\/a><\/p>\n<p><a href=\"https:\/\/oxfordhealth.nhs.uk\/camhs\/carers\/ed\/body-image\/\">Supporting a healthy body image<\/a><\/p>\n<p><a href=\"https:\/\/oxfordhealth.nhs.uk\/camhs\/carers\/ed\/perfectionism\/\">Supporting a child with perfectionism<\/a><\/p>\n<p><a href=\"https:\/\/oxfordhealth.nhs.uk\/camhs\/carers\/ed\/social-media\/\">Using social media<\/a><\/p>\n<p><a href=\"https:\/\/oxfordhealth.nhs.uk\/camhs\/carers\/ed\/parents-supporting-siblings\/\">Supporting siblings<\/a><\/p>\n<h2>General mental health resources for parents and carers<\/h2>\n<p><a href=\"https:\/\/oxfordhealth.nhs.uk\/camhs\/carers\/ed\/resources\/\">Eating disorder resources for parents<\/a><\/p>\n<p><a href=\"https:\/\/oxfordhealth.nhs.uk\/camhs\/carers\/ed\/support\/\">Carer support<\/a><\/p>\n<a href=\"https:\/\/oxfordhealth.nhs.uk\/camhs\/carers\/\" class=\"ohft-button \" target=\"_self\" title=\"Visit Site\" >\n                <span class=\"ohft-button-inner\">Parents and carers homepage<\/span>\n            <\/a>\n<h2>Common questions family and friends ask<\/h2>\n<p>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.<\/p>\n<p>&nbsp;<\/p>\n<details class=\"nhsuk-details nhsuk-expander\" id=\"Enter ID\">\n                    <summary class=\"nhsuk-details__summary\">\n                        <span class=\"nhsuk-details__summary-text\">How do I know if my child has an eating disorder?<\/span>\n                    <\/summary>\n                    <div class=\"nhsuk-details__text\">Please read our\u00a0<strong><a href=\"https:\/\/oxfordhealth.nhs.uk\/camhs\/self-care\/ed\">What are Eating Disorders?<\/a><\/strong>\u00a0page for more information on the signs and symptoms of eating disorders.<\/div>\n                <\/details>\n<details class=\"nhsuk-details nhsuk-expander\" id=\"Enter ID\">\n                    <summary class=\"nhsuk-details__summary\">\n                        <span class=\"nhsuk-details__summary-text\">Should I force my child to eat?<\/span>\n                    <\/summary>\n                    <div class=\"nhsuk-details__text\">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 \u2018bigger\u2019 than the eating disorder.<\/div>\n                <\/details>\n<details class=\"nhsuk-details nhsuk-expander\" id=\"Enter ID\">\n                    <summary class=\"nhsuk-details__summary\">\n                        <span class=\"nhsuk-details__summary-text\">How can I support my other children?<\/span>\n                    <\/summary>\n                    <div class=\"nhsuk-details__text\">We have a webpage dedicated to this topic called \u2018<a href=\"https:\/\/oxfordhealth.nhs.uk\/camhs\/carers\/ed\/parents-supporting-siblings\/\">Advice for parents supporting siblings<\/a>\u2019.<\/div>\n                <\/details>\n<details class=\"nhsuk-details nhsuk-expander\" id=\"Enter ID\">\n                    <summary class=\"nhsuk-details__summary\">\n                        <span class=\"nhsuk-details__summary-text\">How should I handle comments during mealtimes such as: &#039;I feel full&#039;, &#039;I am bloated&#039;, &#039;I feel fat&#039;?<\/span>\n                    <\/summary>\n                    <div class=\"nhsuk-details__text\">Parents find it most helpful to use reassuring and empathetic comments such as \u2018I can see this is difficult for you but you must keep eating\u2019, \u2018It\u2019s OK, I\u2019m here with you\u2019. 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 \u2018body map\u2019 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.<\/div>\n                <\/details>\n<details class=\"nhsuk-details nhsuk-expander\" id=\"Enter ID\">\n                    <summary class=\"nhsuk-details__summary\">\n                        <span class=\"nhsuk-details__summary-text\">What do I do if my child disappears to the toilet after mealtimes?<\/span>\n                    <\/summary>\n                    <div class=\"nhsuk-details__text\">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.<\/div>\n                <\/details>\n<details class=\"nhsuk-details nhsuk-expander\" id=\"Enter ID\">\n                    <summary class=\"nhsuk-details__summary\">\n                        <span class=\"nhsuk-details__summary-text\">How should I approach the problem of excessive exercising with my child?<\/span>\n                    <\/summary>\n                    <div class=\"nhsuk-details__text\">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 \u2018open door\u2019 policy helpful. This involves the child keeping their bedroom door open so exercising can be monitored. When your child\u2019s 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.<\/div>\n                <\/details>\n<details class=\"nhsuk-details nhsuk-expander\" id=\"Enter ID\">\n                    <summary class=\"nhsuk-details__summary\">\n                        <span class=\"nhsuk-details__summary-text\">How do I handle refusal to eat \u2018fear foods\u2019?<\/span>\n                    <\/summary>\n                    <div class=\"nhsuk-details__text\">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\u2019s eating and this should involve all foods that their child previously enjoyed.<\/div>\n                <\/details>\n<details class=\"nhsuk-details nhsuk-expander\" id=\"Enter ID\">\n                    <summary class=\"nhsuk-details__summary\">\n                        <span class=\"nhsuk-details__summary-text\">What should I do if I suspect my child is not eating whilst at school?<\/span>\n                    <\/summary>\n                    <div class=\"nhsuk-details__text\">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<\/div>\n                <\/details>\n<details class=\"nhsuk-details nhsuk-expander\" id=\"Enter ID\">\n                    <summary class=\"nhsuk-details__summary\">\n                        <span class=\"nhsuk-details__summary-text\">Should I let my child prepare their own food?<\/span>\n                    <\/summary>\n                    <div class=\"nhsuk-details__text\">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.<\/div>\n                <\/details>\n<details class=\"nhsuk-details nhsuk-expander\" id=\"Enter ID\">\n                    <summary class=\"nhsuk-details__summary\">\n                        <span class=\"nhsuk-details__summary-text\">What support is there for parents?<\/span>\n                    <\/summary>\n                    <div class=\"nhsuk-details__text\">Please see our support for parent\/carers page <a href=\"https:\/\/oxfordhealth.nhs.uk\/camhs\/carers\/ed\/support\/\">here<\/a>.<\/div>\n                <\/details>\n<details class=\"nhsuk-details nhsuk-expander\" id=\"Enter ID\">\n                    <summary class=\"nhsuk-details__summary\">\n                        <span class=\"nhsuk-details__summary-text\">What if my child doesn\u2019t feel they need help?<\/span>\n                    <\/summary>\n                    <div class=\"nhsuk-details__text\">It is very common for young people to feel there is nothing wrong with them and that they don\u2019t 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.<\/div>\n                <\/details>\n<details class=\"nhsuk-details nhsuk-expander\" id=\"Enter ID\">\n                    <summary class=\"nhsuk-details__summary\">\n                        <span class=\"nhsuk-details__summary-text\">My child doesn\u2019t want to come for appointments or even attend the assessment, what shall I do?<\/span>\n                    <\/summary>\n                    <div class=\"nhsuk-details__text\">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.<\/div>\n                <\/details>\n<details class=\"nhsuk-details nhsuk-expander\" id=\"Enter ID\">\n                    <summary class=\"nhsuk-details__summary\">\n                        <span class=\"nhsuk-details__summary-text\">How long is treatment going to last?<\/span>\n                    <\/summary>\n                    <div class=\"nhsuk-details__text\">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.<\/div>\n                <\/details>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>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 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":1373,"parent":192065,"menu_order":22,"comment_status":"closed","ping_status":"closed","template":"template-infopage.php","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"class_list":["post-189790","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/oxfordhealth.nhs.uk\/camhs\/wp-json\/wp\/v2\/pages\/189790","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/oxfordhealth.nhs.uk\/camhs\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/oxfordhealth.nhs.uk\/camhs\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/oxfordhealth.nhs.uk\/camhs\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/oxfordhealth.nhs.uk\/camhs\/wp-json\/wp\/v2\/comments?post=189790"}],"version-history":[{"count":35,"href":"https:\/\/oxfordhealth.nhs.uk\/camhs\/wp-json\/wp\/v2\/pages\/189790\/revisions"}],"predecessor-version":[{"id":196400,"href":"https:\/\/oxfordhealth.nhs.uk\/camhs\/wp-json\/wp\/v2\/pages\/189790\/revisions\/196400"}],"up":[{"embeddable":true,"href":"https:\/\/oxfordhealth.nhs.uk\/camhs\/wp-json\/wp\/v2\/pages\/192065"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/oxfordhealth.nhs.uk\/camhs\/wp-json\/wp\/v2\/media\/1373"}],"wp:attachment":[{"href":"https:\/\/oxfordhealth.nhs.uk\/camhs\/wp-json\/wp\/v2\/media?parent=189790"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}