Anorexia nervosa in children and young people

Disclaimer: This fact sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

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What is anorexia nervosa?

Anorexia nervosa is a mental illness in which there is a disturbance in the way a person experiences their body shape or weight as well as unhappiness with their body. Overall, Anorexia nervosa occurs more commonly in females than males, but in the younger age group the proportion of boys affected is higher than in older age groups.

The young person may experience intense fear of gaining weight, attempt to lose weight, and/or refuse to maintain a healthy body weight for their age and development. Anorexia affects an individual’s thoughts, feelings and behaviours. The first things that parents and carers may notice in the young person might include change in eating habits, eating less, exercising more, weight-loss, and changes in mood and irritability.

Why is anorexia nervosa dangerous?

Anorexia nervosa has serious psychological, medical, and social consequences. Of all psychiatric illnesses, Anorexia has the highest mortality rate and is a leading cause of death for females aged 15-24 years. Almost all systems in the body can be affected, including effects on the heart and circulation, liver and kidney function, brain function, growth delay, long term effects on bone density, loss of monthly menstrual periods and inability to have children later in life. You may notice the young person feeling cold more easily, a loss of energy, high levels of physical activity, social withdrawal or difficulty concentrating. Psychological effects of Anorexia include high levels of distress, irritability, excessive worry, depression, anger and behavioural changes which may include lashing out at others, self-harm, and suicide attempts.

How do I know if my young person has an eating disorder?

Some early warning signs of an eating disorder include:

  • Food restriction and hiding foods (can start with becoming ‘healthy’ or vegetarian)
  • Food obsessions/unusual food habits
  • Calorie counting and obsessive reading of nutritional information on food items
  • Rigid and irrational ideas about food
  • Interested in food, recipes and cooking but not interested in eating
  • Excessive exercise
  • Vomiting/laxative use
  • Excessive time in bathroom after meals
  • Rapid and or excessive weight loss

What can we do if we are concerned?

If you are concerned that your young person may have an eating disorder you should see your family doctor immediately and explain your concerns. Your doctor will need to examine the young person and carry out physical observations such as weight, height, blood pressure, and heart rate. They may also conduct blood tests. Your local doctor should be able to advise you if additional services are needed. These may include further psychiatric or psychological assistance which can be provided by your local community health centre, psychiatrist, an eating disorders service, paediatrician, adolescent medicine team, or nearest Children’s Hospital.

Treatment may include outpatient medical and psychological therapies, admission to a day hospital program or admission to hospital. Admission to hospital may be needed if a young person is physically or psychologically unwell. At times the young person may be so starved that they may need hospitalisation without the young person’s permission. Hospitalisation is aimed at saving a young person from starvation, but ongoing outpatient treatment will be necessary for complete recovery. Day hospital treatment may be required if more intense psychological support is required than outpatient treatment can offer. Outpatient treatment usually consists of Family Therapy with close support from mental health and medical staff. Outpatient treatment aims to help parents re-feed their child in the home environment and achieve return to physical health and normal activity as soon as possible.

As a parent, how do I support treatment?

Parent involvement in treatment is crucial. While it is expected that a young person will become very upset and may obstruct attempts at treatment, it is very important to have regular family meetings with your health professional to be kept informed about the health of your young person. In the initial stages of refeeding and weight gain, the focus will be on establishing a healthy weight.

Recovery

While the illness can last for several years, early recognition and commencement of treatment as well as family involvement improves recovery.

What can we do when our children need help and we don’t have the answers?

  • Call the Transcultural Mental Health Centre for advice in your language.
  • Talk to your family doctor for advice about local professionals such as child psychologists, paediatricians and community child and adolescent mental health services. 
  • In an emergency, go to your local hospital Emergency Department

The following organisations offer useful information:

  • The NSW Centre for Eating and Dieting Disorders website www.cedd.org.au
  • The Butterfly Foundation http://thebutterflyfoundation.org.au
  • Transcultural Mental Health Centre Tel: (02) 9840 3767 (during business hours) Freecall for rural and remote areas of NSW: 1800 64 8911
  • Kids Help Line Tel: 24hr 1800 55 1800 
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The Children's Hospital at Westmead
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Sydney Children's Hospital, Randwick
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Hunter New England Kids Health
www.hnekidshealth.nsw.gov.au

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