Expert explains the subtle signs of an eating disorder that parents might miss

While some eating disorder signs immediately alarm parents, others are often obscured by the conditions' secrecy and complexity.

Distinguishing these serious issues from typical teenage angst demands careful observation of behavioural shifts.

“The first signs of an eating disorder are often behavioural or psychological rather than physical,” highlights Tom Quinn, director of external affairs at Beat, the UK’s leading charity supporting those affected by eating disorders.

“Whilst people often think of weight loss as the main symptom, there are many different types of eating disorders where someone’s weight is likely to stay the same, such as bulimia.”

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Eating Disorders Awareness Week is set to take place this year between February 23 and March 1, and while eating disorders are mental illnesses that can affect everyone differently, here are six common behavioural changes to look out for and some expert-backed advice about what to do if you are concerned about your child…

“Through no fault of their own, people with eating disorders will often try to keep their illness a secret, so you might notice they are lying about when, where or how much they ate,” says Quinn. “It’s important to remember that eating disorders are never a choice and that behaviours around food are never intended maliciously.”

Dr Caroline Fleming, head of psychology at Cygnet Hospital Ealing, agrees and says this behaviour is common.

“Instead of having a meal at the table with the family, they might say ‘I want to do my work, so I’m going eat in my room’, and then get rid of that food,” says Fleming. “They might also leave the house more often than they usually do and say ‘I’ve eaten elsewhere’ or ‘I’m not that hungry. I had a big lunch, so I don’t need very much for dinner’.”

“They might look as though they’re eating reasonably in front of the family, but might then run to the bathroom really soon after eating,” says Fleming.

Quinn adds: “This could mean they are purging by vomiting, which is more common in bulimia.”

“If they are not getting the nutrition they need, that’s going to have an impact on how somebody is managing physically and in terms of their concentration, because the brain is a very hungry organ,” says Fleming.

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“It can also impact sleeping patterns, so they might feel really tired during the day.”

“If you notice food going missing, this could mean that they’re struggling with binge eating,” says Quinn. “Binge eating disorder is the most common eating disorder, with 1 in 50 experiencing this during their lifetime, where people eat large amounts of food in a short space of time.

“People often describe binging as going into ‘autopilot’ or feeling out of control, which can be very distressing. You can also experience binge eating as part of a different eating disorder like anorexia or bulimia.”

“You might notice distinctive changes to their personality and behaviour,” says Fleming. “They might experience big mood swings, look really cut off emotionally, or be really irritable. For example, any concerns or mentions about their behaviours and food might be met with a really snappy response.”

“A lot of socialising is around eating and drinking – such as going out for coffee with friends, going out for lunch, sitting in the canteen with your friends to have lunch etc – so someone struggling with an eating disorder might become increasingly socially isolated because they’re not engaging in those things with their peers, family and friends,” says Fleming.

“Concerns about eating behaviours can often be met with anger or rebuttal, so I would advise against a heavy-handed approach as that might lead to a breakdown in the relationship,” says Fleming. “Because it’s such a secretive illness, and can quickly become part of someone’s identity, if you go in too hard and too quickly it might feel like an attack.

“You want to do as much as you can to maintain that relationship with them, so I would recommend starting these conversations very gently.”

Choosing the right setting can be a good starting point.

“Choose a time and place where you both feel safe and won’t be disturbed,” recommends Quinn. “Avoid immediately before or after meals as this will be a stressful time.”

Quinn also recommends asking open-ended questions so they can express how they are feeling.

“Try not to back them into a corner,” advises Quinn. “We’d recommend asking open-ended questions like ‘I wondered if you’d like to talk about how you’re feeling’ as opposed to ‘You need to get help’.”

“You could put information leaflets around their room, or if you’ve got a really good relationship with them you might just want to gently express concern and say ‘I’m worried about your physical health, and I think we should go and see the GP’,” suggests Fleming.

“Getting support from outside the home is a really helpful start and the sooner you seek support, the better.”

If you’re worried about your own or someone else’s health, you can contact Beat, the UK’s eating disorder charity, on 0808 801 0677 or beateatingdisorders.org.uk