Helen O’Callaghan says parents need to realise that early intervention and professional support are vital when tackling an eating disorder.
The radical change in Annette’s youngest daughter happened just after she began secondary school.
From being very outgoing, sporty and with a large circle of friends, she started withdrawing.
“She’d spend lots of time in her room on the pretext of doing homework,” recalls the Ballincollig-based mum of three.
“She gave up all her sport. Her room used to be covered in posters —everything came down, the walls were bare. She hated pictures of herself —she took them down and hid them in drawers.”
The 14-year-old wasn’t eating with the family. She became very picky about food, as well as weight-conscious.
“What teenage girl isn’t? She’d also discovered boys and had started a relationship. We thought she was being a moody teen,” says Annette, who had enjoyed a close relationship with her daughter.
“We used to talk about everything under the sun. That started to break down. She was getting very down. Anytime we asked what was wrong, she’d clam up.”
Her parents noticed their daughter wrapping food in toilet paper and “shoving it under the mattress or putting it in her gear bag or wardrobe”.
Eventually, says Annette, it all “came tumbling out”, with her daughter getting extremely upset.
“She was screaming: ‘look at me! Look at the size of me! I’m enormous!’.”
Helpless, Annette could only respond: ‘What are you saying?’
“All I could see was this beautiful child sitting in front of me. She’d lost some weight. I couldn’t see what she was seeing.”
It took weeks to persuade her daughter to see a specialist and, when she did, it was a disaster, says Annette.
The clinician said ‘it’s not that you can’t eat — you’re just refusing to eat’. The teenager came away with massive guilt.
“On the car journey home, she sat silent and hunched and then took to her bed, saying she’d never talk to anyone again.”
Annette contacted the Eating Disorder Centre, Cork (EDCC). Her daughter began seeing a counsellor there.
“There was no eureka moment, but she started to feel better about herself. She started coming back to us.”
Now 16, she had her final session last September.
“She has a much healthier attitude to food. She eats with us, so I see her eating. She’s into exercise, big-time — when she lost the weight, she lost a lot of muscle. Now she wants to bulk up a bit in the gym,” reports her mum.
With Eating Disorder Awareness Week (February 27 to March 5) taking place next week, Trish Shiel, clinical manager at the EDCC, says early intervention is vital in tackling this life-threatening condition.
“Research indicates early identification and treatment improves speed of recovery, reduces symptoms to a greater extent and improves likelihood of staying free of the illness.”
According to the Health Research Board, 12% of all admissions for under 18s to Irish psychiatric units/hospitals in 2015 had a primary diagnosis of eating disorders.
Females accounted for 87% of all admissions of those affected by eating disorders. Shiel points to a frequent delay between symptom onset and treatment.
Parents need to be educated, she says, and so do teachers, doctors and dentists. Last year, the EDCC collaborated with UCC’s Department of Applied Social Sciences in a pilot study of GP knowledge of eating disorders.
It found 80% of GPs feel a need for more training of doctors around diagnosing these conditions.
Shiel urges parents to watch out for warning signs — change in behaviour around food/eating; child making lists of ‘good’/’bad’ foods or having lots of rules around what they can/can’t eat; dieting or a sudden interest in healthy eating.
“For somebody with a predisposition to an eating disorder, dieting is like the first sniff of cocaine.”
Alarm bells should sound if the child’s putting a lot of emphasis on body shape and size or withdrawing from friends.
“In their head, their relationship is with the eating disorder. It’s like a best friend at the beginning and becomes an obsession at the end. It’s a very negative voice in their head – their own voice putting them down,” says Shiel, adding that an eating disorder’s a tricky condition.
“It’s a coping tool — there’s a sense of ‘I don’t want anybody to know about this because they’ll take it away from me’.”
For anybody worried their child might be affected, Shiel urges them to get information (visit www.bodywhys.ie) and help — if in Munster, contact the EDCC, which offers a professional psychotherapy service.
It also runs a carers’ education programme.
“Many parents start off thinking ‘I’m going to get my child out of this’ — it’s very unlikely this will happen. You’re not a therapist and you can’t control this,” says Shiel.
The EDCC has developed a youth outreach programme, targeted at 12- to 14-year-olds, which they will take into schools and wider community venues. The aim is to educate about the internal experience of eating disorders and to deglamourise the condition.
Psychotherapist Emma Murphy, who specialises in eating disorders ( www.counsellingcarecork.com ), works mainly with adults and says many women report to her how their mother was ‘always on a diet’ or their parents were obsessive about body size/exercise or too strict about food and sweets.
Murphy believes if parents have a healthy, relaxed attitude towards food and weight, it goes a long way towards giving children the same relaxed attitude.
“If you [the parent] are always worried about your weight, always on a diet, always ‘starting again’, or saying things like ‘I shouldn’t have this’, what sort of message are you sending out?”
Ivan Sisk, a first-year arts student from Cork, was diagnosed with anorexia and bulimia but says he’s now the healthiest he’s ever been.
He started restricting food at the age of 12 but believes the problem began much earlier.
“I was overweight as a child. That definitely didn’t help. At eight or nine, I was very self-conscious about my body and weight — I didn’t realise then this was abnormal.
“When I went into secondary school, I began restricting my food intake, just not eating for hours of the day. At school, I’d throw away lunches in the bathroom bin. I’d do the same at home if my parents were at work and had left dinner for me.
“With an eating disorder, you’ve very good at hiding things and lying. I pretended and concealed a lot. For me, it turned into bulimia — restricting food all day and in the evening I’d binge and purge. Often with bulimia, you can be a little overweight and it’s not so obvious to the eye there’s a problem.
“Eventually, my parents started copping onto my lies and concealing. My mood was low. I was weak and tired. My mum brought me to the doctor.
"For me, psychotherapy was the most effective treatment. You realise it’s not about the food or eating but a lot to do with emotions and feelings that [you haven’t] brought into your conscious mind.
“I experienced anxiety and depression at a young age. The eating disorder was a mechanism to cope with those. You don’t realise you’re dulling the pain of your low mood — but what’s really going on is a huge other problem detrimental to your physical and emotional wellbeing.
“I’m good now. I’m the healthiest I’ve been. I’m in college, studying. I’m doing well with my food and my eating and I’m very glad I’ve achieved this level of recovery.”
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