Changed eating: the danger signs and what might help

Despite that definition above, what I"m interested most in here is how changed eating habits can raise a red flag with parents for different reasons. We’ve all heard of 

• the ongoing rise in eating disorders at an ever-younger age, 
• an increase in overweight children and 
• the dangers of online influencers who pretend there’s only one way to look.

Your child can get seriously anxious about all this stuff about eating/looks/acceptability – especially when they spend so many hours online.

So it’s not surprising if a child suddenly decides to limit what they eat. Or start eating when they’re not hungry. Or refuse to eat in front of people. Or stuff themselves with food because something else in their life is not fulfilling a need (interesting word, that).  

Food suddenly becomes anxiety-provoking. Is this okay? Am I okay? Should I diet? Am I fat?

The result can move towards the definition of an eating disorder that we have above: not being able to manage feelings and so controlling food instead. But it stems from a slightly different starting point.

By the way, I've written about disordered eating as opposed to an eating disorder in the blog.

So what are the danger signs about changed eating?

Your child has grown noticeably anxious about food. 

Of course, children will get picky quite often. Some children will hate a particular texture. But serious anxiety about food – changed eating patterns – will show up in other ways, such as: 

• rejecting food regularly despite being hungry and despite it being varied.

• being obviously worried about weight or looks (looking in the mirror, altering their online avatars and posts with filters to enhance their image etc) – this sounds teenager-ish behaviour but it’s come down the age range rapidly, turning into "serious and face-saving" instead of fun.

• wanting to eat anything and everything all the time despite clearly not being hungry, and instead of doing their usual activities.

• trying to make themselves sick or saying the food will make them sick. This one is interesting because an over-anxious child will often feel sick or vomit and that will often link in their minds to avoiding food intake. Make a judgement call and talk with them about their anxiety.

One thing to note is that children on the autistic spectrum may well have texture and consistency problems, and specific preferences, with food all the time – and you’ll bear this in mind when assessing your child and their changed eating if you know they're on that spectrum.

However, my professional opinion is this: if your child’s eating has already changed significantly and become a serious problem, then you need to access medical help now. At the very least, consult your doctor. 

Yes, I know CAMHS referrals are currently difficult because the thresholds for entry are so high. But don’t be put off from asking. Your child’s health matters.

There are also excellent websites about eating disorders – not to frighten you but to inform you. Here are a couple of good ones:

Beat Eating Disorders has lots of information, telephone lines and email support for youngsters and also for parents and carers.

Young Minds has a page of help and a downloadable parents’ guide.

When you’ve read the information on those sites, you may find things haven’t got that far after all. 

But failure to get professional help for your child’s changed eating that’s out of hand can lead to malnutrition (whether over- or under-eating), possibly seriously low weight and a failure to thrive generally (after all, you need energy to thrive). And all this can lead to hospitalisation.

A note about the rise of type 2 diabetes in children

You may have noticed this alarming fact in the news recently.

Yes, it's concerning. Changed eating is always worrying. The onset of diabetes type 2 mostly affects overweight children, not underweight ones.

And comfort eating may well be contributing to a child slowly, almost imperceptibly, gaining weight you wouldn't want them to carry.

So just be aware that the latest available figures from the Royal College of Paediatrics and Child health (RCPCH) say that there were 790 under-18s receiving treatment for type 2 diabetes from a paediatrician in England and Wales in 2018/19 – and that's 340 more than in 2013/14.

It will have increased again by the time today's figures become available.

But even more worrying is that children as young as six have been diagnosed, and the number of 13-14 year olds with the condition has jumped 39% between 2017/18 and 2018/19.

That's why we're looking at changed eating and the underlying possible anxiety that's fuelling it.

It can't be ignored. Apparently medicines used by adults for type 2 rarely work for children after five years. So they're now talking about surgery to insert gastric bands.

Anxiety and changed eating patterns – the low self-esteem problem

If your child’s anxiety has grown recently and started to affect their eating, the key is to listen to them and help them understand what’s going on. 

It’s likely that, in general, their self-esteem is taking a blow somewhere. Anxiety about what they look like, what their friends think of them and how they’ll come across on social media is important to them. Maybe other compulsory activities also make them feel rubbish.

Many sensitive children simply cannot cope. Their life is lived in public 24/7 these days. If they don’t join in, they miss out and become outsiders to the “in” conversation.

Changed eating is not a good way of dealing with it. Growing your child’s self-esteem is much better. 

That way, they feel good about themselves and their abilities and can be less worried about not belonging to the crowd and not fitting in. 

Of course, every child needs to fit in, but they will find ways to do it that are healthier than tinkering with their weight and looks.

Some reading suggestions

My very best suggestion for a book that doesn’t feel hard work at all is Jenny Alexander’s 70 Ways to Boost your Self-Esteem, published by Five Lanes Press.

It has 10 tasks on each of 7 days, offering a rotating series of choices to undertake till they're all ticked off. They’re fun, whacky and sometimes weird. I’ve used the previous version of this book many times with children and they love it.

(This is an Amazon link but I do not get any income from you clicking on it.)

There's also research evidence that tackling self-esteem is a very safe way to avoid changed eating patterns and eating problems. If you like research write-ups, you can download a PDF by Jennifer A O’Dea here, published by BrunnerRoutledge/Taylor & Francis health sciences.

A super book to read about self-esteem with younger children is Margot Sunderland’s Ruby and the Rubbish Bin. It’s illustrated by Nicky Morgan and published by Routledge (and equally relevant to children who are bullied into silence). 

Ruby finds her voice! Your child will have lots to discuss if you read it together.

Ways to help your child feel involved in healthy nutrition – instead of changing their eating when anxious

I reckon it’s never too early to start involving your child in healthy eating in a very practical way by: 

• talking with them about food types, colours and choices, 
• helping them grow food on the window ledge, 
• arranging family menus with you and 
• helping with buying food, looking at labels etc.

This approach will stand your child in good stead when the onslaught of social media starts. This is because:

It empowers them to have experienced so much about nutrition and good eating that they will not automatically fall into the dangers of eating disorders. They will know it's not the answer.

And being empowered about food gives their self-esteem a boost.

So here are some ideas…

…to capture your child’s interest in food. "Changed eating" should involve adding variety and interest, not starving or bingeing!

I understand many of us will have different ideas about what we should or shouldn’t eat, so please take these suggestions and make them your own to suit your own household lifestyle.

1 Help you child understand about food colours – we should eat a rainbow. Maybe make a chart together that pictures food in a pizza-style diagram with the various foods of each colour in their own “slice”. Help them to choose ones in each section to tick off for you all to eat. 

You could ask them to take another look every so often and add in a food for the family to try. You don’t have to spend a fortune – you can share a small amount of a new food, just to keep interest and motivation at the forefront, and their food knowledge growing.

2 Help your child grow cress or other microgreens on damp kitchen roll on a saucer. You cut them off when the first leaves appear and put them in a sandwich, for instance. 

Totally nutritious – the seed, like an egg, has all the nutrients it needs to grow. Find out how to grow microgreens on paper towels here.  

You can find the 10 easiest veggies for children to grow like that here.

3 Mushrooms are weird and wonderful things to watch growing. Two weeks after starting to water the kit I recommend, you'll have oyster mushrooms to harvest.

Your child will be captivated by their growth. It’s like Triffids coming out to get you, doubling in size each day! Discuss how they could be cooked. They will then agree to try some. You could look into buying this home kit that gives you up to three harvests. 

4 How about asking your child to arrange the menus with you? Talk about them, write them down. Then let them help with the preparing and cooking as much as possible, all the way from start to finish.

However old or young they are, there’s something they can do: 

• Get veg out and put it on the counter. 
• Find the right knife and put it ready – teach them how to be careful with sharp things. 
• Set a timer on the microwave or elsewhere. 
• Set the table. (Yes, I know families tend not to eat at a table or together. Maybe try it at weekends or work out another way of helping!)
• All sorts of other things when they're older, to help and feel proud of their achievement. 

5 Allow your child to find the food in the shop that you’ve both chosen and to look at labels and see the nutrition value.

Food isn’t good or bad on the whole. It’s about “how much and how often” that really matters when you include some of the more processed things. 

You don’t want them to think food is good or bad, especially in these anxious times of social media influence. That leads to changed eating patterns, sometimes serious ones. You want them to gradually understand more and more as they get older and feel confident in themselves where food is concerned.

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The grip of social media can easily lead to changed eating patterns.

If you can put into practice even some of these suggestions – or your own home-grown (sorry!) versions – you’re warding off future trouble. 

You don’t want even a sign of an eating disorder to develop. It's best to help your child to deal with their anxiety and self-esteem first. 

And if you get your child confident and empowered about food, healthy eating, and being comfortable in their worth as young people, food won’t become their weapon of choice when difficulties arise.

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TAKEAWAY

• It's important to recognise that changed eating is an anxiety signal in children.
• Eating disorders and disordered eating are a coping mechanism more than a food issue.
• Signs of changed eating include: rejecting food, weight concerns, randomly eating without hunger.
• Seek medical guidance for serious patterns, but always support self-esteem as the first line of attack so your child can start coping with issues more easily.

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ALWAYS:

Trust your instincts,
use your judgement, protect the spirit
of your child