Guest blog: Dying to be thin?

Dr Sandeep Ranote

A guest blog by Dr Sandeep Ranote, consultant child & adolescent psychiatrist

As a mum of 3 I am only too familiar with the challenges of encouraging our children to have a balanced, nutritious diet, to try new foods and tastes and to do so without fear or developing obsessions. After all, to be a child should be about play, growth, learning, development and, above all, fun!

Even as an expert in the field it does feel like we are increasingly surrounded by the issues of ‘weight’ and ‘body image’, and that our global society’s preoccupation with these are becoming real challenges for our young people. Onepoll and Youngpoll (online survey companies) conducted a survey of 1500 young people aged 7-18 and found that over 40% of under 10s worried about their weight, with almost a quarter dieting and 44% being bullied because of their weight. Naturally this becomes a worry for parents and carers.

I am a great believer in education and awareness to empower our younger generation, increase their confidence and ultimately encourage responsibility, but I am not sure we have got this quite right yet in the area of food, nutrition, health and well-being. Has it been done too much, too vigorously, or with the wrong emphasis? There is a great deal of expertise amongst professionals, parents and young people and I am passionate about working in partnership to ensure we do get it right. What better a place and a tool than Eureka! to help us do this!

Worried about their weight or “dying to be thin”?

Both professionally and socially I’ve lost count of how many times young people have said “I’m dying to be thin”. It’s what young people seem to equate with beauty and success, and this has been blamed on the media and it’s influence – although it is a debate that continues and we currently lack strong evidence linking the media with causing actual eating disorders. The important thing is that we separate normal ‘ worries about weight’ from ‘eating disorders’.

Anorexia nervosa and bulimia nervosa are among a number of eating disorders that we see in our specialist clinics, and are two of the most common eating disorders seen in young people. These are real illnesses (neurobiological disorders) and are not the same as being ‘ worried about weight’ or ‘wanting to exercise’. This distinction is very important. About 1 in 150 young girls (under 18 years) have anorexia nervosa, and it is 10 times more common in girls than boys (according to the Royal College of Psychiatrists). Bulimia nervosa is more common than anorexia nervosa but tends to present in later teenage years and early twenties.

What triggers an eating disorder?

There is a genetic risk and certain personalities are at a higher risk of developing eating disorders like anorexia nervosa (sensitive, anxious and high achieving personalities). Traumatic life events can trigger an eating disorder and we are starting to learn more about how ‘disordered brain functions’ affects these illnesses. What we do know is that eating disorders have been around for hundreds of years but were simply not recognised as such, and that over the last 50 years there has been a huge increase in awareness, understanding, research and our ability to diagnose and treat. It is estimated that 60-70% of young people with anorexia nervosa can recover fully with treatment at the right time, so it is very important to access this from a specialist team.

What should we look our for?

I’m often asked what signs parents and carers should look for – what behaviours suggest that there might be a problem. Concerning signs of eating disorders can include:

  • Wearing baggier clothes
  • Excessive or rapid weight loss
  • Fluctuations in weight
  • Excessive exercising
  • Excessive self weighing
  • Secretive behaviour ( especially around eating or exercise)
  • Skipping meals, avoiding family mealtimes or refusing to go out to eat
  • Hiding or throwing away food
  • Craving or bingeing on foods
  • Vomiting after meals
  • Low mood, tearfulness, anxiety
  • Changes in behaviour ( e.g. becoming more isolative or socially withdrawn)

If you are concerned about someone you can visit your GP for advice or find out more on the Beat Eating Disoders (BEAT) website, where there is a wealth of advice and resources.

About Dr Sandeep Ranote

Dr Sandeep Ranote is a Consultant child and adolescent psychiatrist, Eating disorder lead and Associate medical director at 5 Boroughs Partnership NHS Foundation Trust. She established an adolescent eating disorder service there in 2005, continues to lead this and has been involved in research and service developments in eating disorders locally and nationally with the Department of health. She is currently on the National eating disorder executive committee at the Royal College of Psychiatrists and the National strategy group for arts and health and is an honorary senior lecturer at Edge Hill University. She is also a professional media contributor for the Royal College of Psychiatrists and BEAT.

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