More young people than ever before are receiving treatment for eating disorders according to the latest figures, the NHS said today.
Almost 10,000 children and young people started treatment between April and December with record demand for services – an increase of a quarter compared to the same period last year and up by almost two thirds since before the pandemic.
NHS chiefs today said that young people and their families should seek help without delay if they were concerned, with community services now available in every part of the country.
Professor Prathiba Chitsabesan, NHS Associate Clinical Director for Children and Young People’s Mental Health and psychiatrist advised young people and their loved ones to use trusted online resources if they had concerns and wanted to seek help.
Professor Chitsabesan added that some of the signs to look out for included behaviours such as making rules about what or how they eat, eating a restricted range of foods or having a negative self-image about their weight and appearance. Young people’s problems with food can begin as a coping strategy or a way of feeling in control but may lead to more restrictive patterns of eating and behaviours. The rise could be attributed to the unpredictability of the COVID-19 pandemic, feeling isolated, disruption to routines and experiences of loss and uncertainty.
The NHS is investing an additional £79 million into children’s mental health services because of increased demand during the pandemic, with funding being used to ensure at least 2,000 more children and young people start eating disorder treatment.
Mental health services, including eating disorder services, are being backed by an additional £2.3 billion every year in additional funding until 2023/24 as part of the NHS Long Term Plan’s commitment to improving mental health services.
Claire Murdoch, NHS Mental Health Director said: “NHS services remained open throughout the pandemic as hard-working mental health staff worked to deliver care to more people than ever before.
“The NHS continues to see record-high numbers of young people for eating disorders and it is vital anybody who might need care comes forward as quickly as possible so the NHS can get you any care you may need.
“Parents can find information on potential symptoms, such as binge eating, feeling guilty after eating, and negative self-image, and other signs of a potential eating disorder are available on the NHS website and they should not hesitate to contact the NHS if they think their child might need some support”.
One of the people that the NHS has helped is Alice who was 17 years of age when her mother referred her to NHS eating disorder services, with an initial conversation with the NHS taking place the day after referral.
Alice said: “I felt so anxious when my Mum had made the referral as I didn’t know if I could be helped – those fears soon disappeared after speaking to my clinician over the phone only a day after the referral was made. If it wasn’t for the call so soon after, I don’t know if I would have answered my phone; I would have probably tried to pretend it wasn’t happening and disengage. The assessment was gentle and informative, I felt understood by my clinician. It wasn’t so scary after all”.
Following the assessment, it was determined cognitive behavioural therapy was the best way forward for Alice who says she is now doing much better.
Alice said: “I couldn’t believe that my treatment began only six days after my assessment. I was expecting to wait weeks or even months. I truly believe that if it wasn’t for the rapid intervention so soon after referral, I would be in a very different position. Thankfully, with the support from my clinician, I can report that I am doing much better. I was hesitant to seek support but I’m glad I did, I would say to anyone else in a similar position to take that step as it could save your life”.
In the guidance, Professor Chitsabesan recommends helpful support from charities doing important work in this area including BEAT which has designated pages to help young people who may be struggling with an eating problem, including an eating disorder, and provide advice.
The signs and symptoms of eating problems can vary from person to person. However, a combination of the below symptoms could be a sign that a child might need additional support:
- preoccupation with checking calorie or other ingredient content in food
- eating a restricted amount or range of foods
- binge eating
- more controlling behaviours such as rules about eating, insisting on making their own meals or only using certain utensils and cutlery
- negative self-image about their weight and/or appearance
- secretiveness or avoiding eating with others
- feeling guilty after eating
- repeatedly weighing themselves
- vomiting after eating, or going to the toilet immediately after eating
- compulsive or excessive exercising
- abnormally low or high weight or changes in weight or body shape
- long-term weight stagnation or failure to grow
- complaining of poor concentration, dizziness, tiredness or feeling cold
- getting stressed at mealtimes
- low mood, anxiety or irritability
- social withdrawal.
Professor Prathiba Chitsabesan advised parents over the pandemic on steps they can take to support their child which includes:
- Take time to talk to with the child or young person you care for: young people may find it difficult to accept that they have a problem or that they may need help. Some young people may find it easier to talk while doing something together such as playing a board game or engaging in a craft or other activity. Find a time when you will not be disturbed and both of you feel calm. If they find it difficult to talk to you, encourage them to talk to another trusted adult such as a family member, teacher or GP.
- Make time to listen to them: create a calm safe space where they can communicate how they are feeling without judgement. Try to avoid saying things that could feel accusatory, critical or dismissive.
- Try to understand the problems and provide reassurance that you have heard them and are there to help: ask how they are feeling rather than focussing all the conversation on their eating or weight as this can often be more productive. Complimenting them on things other than their appearance can help the young person feel valued and is less likely to be interpreted negatively.
- Encourage regular mealtimes as a family: sitting down together for regular mealtimes as a family can help encourage social and healthy eating behaviours and help monitor any concerns about eating problems. Keep the conversation neutral.
- Keep an eye on the young person you care for. Consider if eating problems persist, deteriorate and/or are impacting on the young person’s day to day living: seek specialist health advice and support and increase vigilance, including checking if the young person is losing weight, developing secondary physical health symptoms (see list above) or accessing websites/social media content that is pro-eating disorders.
- Help the child or young person you care for do positive activities which means they aren’t isolating themselves: positive activities including safe contact with family and friends can provide a distraction from negative and intrusive thoughts and may help the young person open up about their feelings.
- Provide structure and routine (including for sleep): frequent changes to routine and restrictions can cause some children and young people to feel more anxious and upset. Many children and young people may also experience difficulties with their sleep. Providing structure through the development of daily and weekly timetables, including bedtime routines can be helpful in providing some predictability for young people in this unsettled time and distraction from negative thoughts.
- Support children and young people with disabilities: children and young people with disabilities including those with autism spectrum disorder or learning disabilities may find the impact of COVID-19 particularly difficult to manage. It is important to explain change and manage any anxiety and distress they may be experiencing as this may impact on their eating behaviours including restrictive patterns of eating or overeating. Seek advice if they are already in contact with specialist health and social care services or contact your GP. The National Autistic Society have helpful advice on their website on how to deal with this uncertain time.
- Seek specialist advice and support quickly if you think the young person you care for has physical symptoms secondary to weight loss, suicidal thoughts or are self-harming: It is important that you do not ignore these and that you speak to a GP or crisis mental health help line urgently to get the right help and support – or contact some of the services detailed below.
- Finally, as a parent or carer, look after your own mental health too: this will help you to best support yourself and those you care about. Remember to talk to your family and friends about how you are feeling and seek help for yourself from the NHS and other support services if it’s all getting too much.