Eating Disorders Children And Young People

Overview

An eating disorder is a serious mental health condition where a young person's thoughts and behaviours around food, eating, weight or body shape become very fixed and distressing. It is not a diet or a phase, and it is not caused by bad parenting. Common types include anorexia (eating very little and often fearing weight gain), bulimia (eating large amounts and then trying to get rid of the food, for example by being sick), and binge eating (eating large amounts in a short time while feeling out of control). All of these are treatable, and getting help early makes a real difference.

Eating disorders are more common than many people realise. Around one in every fifty to one hundred young people is thought to be affected at some point, and anorexia and bulimia are among the more widely seen forms in this age group. Many cases go unnoticed for a long time because young people often feel ashamed or worried about telling anyone.

Eating disorders most often start between the ages of 13 and 17, though children as young as 6 or 7 can be affected. They affect girls more often than boys, but boys and young people of all genders get them too, and they are often missed in boys. They happen across all backgrounds and body sizes. Some young people are more at risk because of things like a family history, anxiety, perfectionism, or pressure around appearance, sport or social media.

Symptoms

Common symptoms

• Eating much less than usual, or cutting out whole food groups without a clear medical reason
• Eating in secret, hiding food, or avoiding meals with the family
• Going to the bathroom straight after meals, or signs of being sick
• Being very focused on weight, calories, body shape or 'clean' eating
• Weighing themselves often, or checking their body in mirrors repeatedly
• Wearing baggy clothes to hide their body
• Changes in mood — irritability, low mood, anxiety, or withdrawing from friends
• Tiredness, poor concentration, or falling behind at school
• Feeling cold all the time, dizziness, or feeling faint
• Constipation, stomach pain, or bloating

Symptoms in children

• Slowing or stopping of growth, or falling off their expected growth curve
• Not putting on weight at the rate expected for their age
• Fussiness about food becoming extreme, or refusing foods they used to eat
• Behaviour changes — being more clingy, tearful, withdrawn or quick to anger
• Losing interest in play, sport or schoolwork because of low energy
• Delayed puberty, or periods not starting
• In teenagers: periods stopping or becoming irregular

Symptoms in older adults

• This article focuses on children and young people, but eating disorders can continue into adulthood or start later in life
• In older teenagers and young adults, signs include ongoing strict food rules, over-exercise, and shame around eating
• Long-standing eating disorders can cause lasting effects such as weak bones, dental problems and fertility difficulties
• If you are an adult worried about your own eating, the same advice applies — speak to a doctor, as help is available at any age

Causes

Main causes

• There is no single cause. Eating disorders usually develop from a mix of factors.
• Genetics and family history — eating disorders can run in families
• Brain and personality factors such as anxiety, perfectionism, or being very self-critical
• Pressure around body image from social media, peers, sport or culture
• Difficult life events such as bullying, loss, illness, or big changes at home or school
• Dieting — strict dieting is one of the strongest known triggers in young people

Risk factors

• A close relative with an eating disorder
• Being a teenager, especially during puberty when the body changes quickly
• Anxiety, depression, obsessive traits, or low self-esteem
• Being bullied about weight or appearance
• Activities where weight or shape matters a lot, such as some sports, dance or modelling
• Type 1 diabetes, where food and weight can become a focus
• A stressful or traumatic event

When to see a doctor

See a doctor urgently if:

• You are worried the young person is losing weight quickly or eating almost nothing
• They are dizzy, faint, very tired, or feel cold all the time
• They are making themselves sick or taking laxatives
• They have stopped having periods, or puberty seems delayed
• They talk about hating their body or feel unable to eat in front of others
• You notice any of the emergency signs listed above — call your local emergency number

Book a routine appointment if:

• Food and eating have become a battleground at home and you are worried
• Your child seems overly focused on weight, calories or body shape
• You have noticed changes in mood, sleep or friendships alongside changes in eating
• Your child is falling off their growth curve at routine checks
• You are not sure whether this is a phase — it is fine to ask for advice

Diagnosis

There is no single blood test for an eating disorder. A doctor will usually start with a calm conversation with the young person and their family about eating, weight, body image, mood and how things are at home and school. They will also check physical health — height, weight and growth over time, blood pressure, pulse and temperature — because eating disorders can affect the body in ways that need monitoring. Some young people are referred to a specialist eating disorder team for a fuller assessment.

Tests that may be done

• Height and weight measured over time and compared with growth charts
• Blood pressure, pulse, temperature and breathing rate
• Blood tests to check salts, blood sugar, kidney and liver function
• A heart tracing (ECG) if there has been rapid weight loss or purging
• A urine test to look for dehydration
• Questions about mood, anxiety and thoughts of self-harm
• In some cases, a bone density scan if the eating disorder has lasted a long time

What to expect at your appointment

The first appointment is usually a conversation, not an exam. The doctor may ask to weigh the young person privately and may want to see them a few times to see how things change. You can ask for your child to be seen on their own for part of the visit, and you can also ask to speak to the doctor alone. If specialist help is needed, you should be told what happens next and roughly how long the wait may be — ask about this if it is not explained.

Treatment

Treatment works best when it involves the whole family and a team of professionals. Most young people are treated in the community rather than in hospital, and the main aim is to restore regular eating and healthy weight safely, while helping with the difficult thoughts and feelings underneath. Recovery takes time and often has ups and downs — that is normal, and it does not mean treatment is failing.

Self-care at home

• Keep regular meal and snack times as calm and predictable as possible
• Take the focus off weight and calories at home — talk about health, energy and enjoyment instead
• Keep the young person involved in normal life: friends, school, hobbies and rest
• Protect sleep — a regular bedtime routine helps mood and appetite
• Limit time on social media accounts that focus on weight, dieting or body comparison
• As a parent or carer, look after your own support needs too — this is hard work and you deserve help
• Keep a simple note of what you notice so you can share it with the doctor

Medical treatments

The main treatment for children and young people is family-based treatment, where parents and carers take charge of meals and snacks with guidance from a specialist team, gradually handing control back as the young person recovers. Other talking therapies, such as cognitive behavioural therapy adapted for eating disorders and supportive individual therapy, are also used. A dietitian may help with meal planning. Some young people need a short stay in hospital or a day programme if their physical health is at risk or if community treatment is not enough. Medication is not the main treatment for eating disorders, though doctors may sometimes prescribe it for related problems such as anxiety or depression — this is always decided case by case by a specialist. Always ask your own healthcare team what is right for your child; never start or stop any medicine without their advice.

When is surgery considered?

Surgery is not a treatment for eating disorders.

Living with this condition

Life with an eating disorder can feel exhausting for the whole family. It helps to treat meals as medicine — planned, expected and not up for negotiation — while keeping the rest of the day as normal and warm as possible. Expect difficult moments, and try to respond calmly and consistently rather than getting drawn into arguments. Small routines, clear roles for each carer, and regular check-ins with the treatment team make a real difference.

Lifestyle tips

• Stick to the meal and snack plan agreed with your team, including on weekends and holidays
• Plan ahead for tricky times like birthdays, holidays and eating out
• Keep up gentle social contact — time with friends is part of recovery, not a reward
• Agree together what to do about exercise, following advice from the treatment team
• Let school or college know so they can offer quiet, practical support
• Build in rest and fun that has nothing to do with food or weight

Diet and exercise

During recovery, food is part of the treatment, so the young person may need to eat more than feels natural at first, and this should be guided by their team rather than by diet rules. Try not to label foods as good or bad. Exercise may need to be paused or limited for a while if the young person is underweight or their heart needs protecting — the team will advise on this. As recovery progresses, a balanced, flexible relationship with food and movement is the goal, not strict rules.

Mental health and emotional wellbeing

An eating disorder is a mental health condition, and it is common to also feel anxious, low, irritable or ashamed. Many young people hide how they feel because they fear being a burden or being judged. It is important to ask directly how they are doing, to listen without rushing to fix things, and to take any talk of self-harm or suicide seriously. If at any point the young person is having thoughts of harming themselves or ending their life, get help straight away — contact your local emergency number or a crisis support service, and stay with them.

Prevention

There is no guaranteed way to prevent an eating disorder, but there are things that help. Creating a home where bodies are not criticised, where food is not labelled good or bad, and where a young person feels able to talk about worries makes a real difference. Avoid strict diets for children and teenagers, be mindful of weight-focused talk and social media, and treat early signs seriously rather than waiting to see if they pass. Schools that promote body confidence and tackle bullying also help.

Screening programmes

There is no routine screening programme for eating disorders. However, growth and weight are checked at routine child health reviews, and doctors are alert to early signs. If you have concerns, you do not need to wait for a screening invitation — you can ask for an appointment at any time.

Complications

If left untreated

• Slowed or stunted growth and delayed puberty
• Weak bones that can lead to fractures later in life
• Heart problems caused by low weight or by repeated purging
• Hormone changes, including periods stopping and fertility problems in later life
• Tooth damage and sore throats from repeated vomiting
• Stomach and bowel problems such as constipation and bloating
• Low mood, anxiety and social isolation, and difficulties at school
• In severe cases, life-threatening medical emergencies

Long-term outlook

The outlook is genuinely hopeful. Eating disorders are treatable, and most young people who get specialist help recover — many fully. Recovery is rarely a straight line, and setbacks do not mean going back to the start. Getting help early gives the best chance of a good recovery, and families play a powerful part in that. With the right support, young people go on to finish school, build friendships and live full lives.

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