School Breaks and Identifying Eating Disorders
It's that time of year again. The snow is falling, the holiday parties have started, and (yay!) your child is home for the holidays. At first it seems perfect - you pick him or her up from the airport and hear all about the classes and the friends at school. But, something feels different. Your experience is not unique. Many parents realize that their children are experiencing eating disorders (or other problems) during the time that they are home on breaks from school.
Here are some things to look for:
Weight Shift - Anytime that your child experiences a weight shift you should talk to him or her about this change and about what behaviors they are engaging in to provoke the change. Be sure to pay careful attention to kids who start out over-weight and not praise the weight loss without knowing how they have achieved it. Also, remember that a change in weight is not necessary for eating disorder behaviors - and actually most people who experience bulimia don't lose weight.
Increased Exercise - Be on the lookout not only for overt exercise (going to the gym, going for a run, etc) but also micro-exercise. If it feels like your child is using everything as an excuse to burn calories, that is a cause for concern. See my previous post about this topic here: http://www.claytonmentalhealth.com/#!single-post/cuoz/7AC27162-C2DF-4171-A823-A812A9D84E12
Increased Irritability or Moodiness - Anxiety and depression can go hand in hand with eating disorders, so be on the lookout if you find that you kid is overly stressed out or appears to be sad or withdrawn.
Frequent Bathroom Visits - Keep an eye out for trips to the bathroom in the hour or so after meals. Use your senses - Do I hear vomiting (or excessive noise that might be covering it, like water running)? Do I smell it? Do I see food particles in the toilet / shower / sink? Also look at your son or daughter's knuckles when they return - sometimes you will see tooth marks or blisters. Finally, notice if his or her cheeks appear puffy.
Changes in Eating Habits - You have a long history with your child and know the patterns that they tend to follow in eating. If it feels like their patterns have shifted it is important to talk about the change and the reasons behind it. For example, if your son or daughter has become a vegetarian, vegan or gluten-free or appears to be restricting or hoarding food.
Body Image Concerns - Notice if there is more time spent changing clothes, looking in mirrors, or complaining about certain body parts.
Mysteries around Food - Perhaps you walk into the kitchen and it feels like a lot of food is missing, yet no one is reporting having eaten it. Or, you are in a pattern of encouraging your child to join at a meal and they are stating that they ate earlier / are eating later outside of your presence. If it feels like you are always trying to solve a food based mystery, trust yourself in knowing that there is a problem.
If you are finding that your child is experiencing some or many of the above, here are some actions you can take
Talk to him or her! Don't expect that your child will immediately tell you everything. There is a lot of guilt and shame associated with eating disorders, and sometimes kids don't know how to tell their family members about the behaviors they are engaging in.
Make an appointment to see the Pediatrician / PCP - Be open and honest with the doctor about your specific concerns and provide as much detail as possible. Ask that they run labs to check on health status.
Make an appointment with a therapist and dietitian - Try to start working on getting help as soon as possible before the eating disorder takes a stronger hold of your child and his or her life.
Of course, feel free to contact me if I can provide help, support or guidance.
A wonderful resource is the NEDA Parent Toolkit: http://www.nationaleatingdisorders.org/sites/default/files/Toolkits/parenttoolkit/index.html