For parents and carers who are concerned that a boy in their care is developing anorexia:
- Make sure you and your son understand how much an active teenage boy needs to eat in order to grow. Your son may need to consume between 3,000 and 4,000 calories a day if he is particularly active.
- Encourage your son to eat a healthy diet including a good balance of carbohydrate, protein, fruit and vegetables, and at least some fats and sugar. However don’t be hard on yourself if he doesn’t respond. Anorexia can take over a child’s previously rational mind incredibly quickly.
- Weigh your son as soon as you feel concerned. You need to try and monitor how his weight is changing over a period of time. If he stops gaining weight over a three month period (teenage boys should be gaining between 4 and 6 kg each year, or 1 to 1.5 kg every three months) that should ring alarm bells. If he starts to lose weight you should be extremely concerned.
The weight chart shows how quickly Joe’s weight fell from the 75th centile to under the 9th centile. This was caused both by a reduction in his calorie intake and a dramatic increase in his exercise levels.
- Monitor his exercise routine. A sudden increase in sports training and repetitive exercise can be a major cause for concern. Even if your son appears to be eating well at home, he may be restricting his diet at school. A small decrease in food intake and increase in exercise can lead to weight loss. The chief medical officer recommends children should have at least 60 minutes moderate exercise every day. Several hours of punishing exercise can use up a huge amount of calories in a teenage boy and might even lead to muscle damage.
- Watch out for other behavioural changes. Some could be normal changes due to puberty, but dramatic mood swings and the appearance of rituals should ring alarm bells
- Write down everything you observe about his weight, exercise and other habits. This may be invaluable in helping a GP or pediatrician to make a speedy diagnosis.
- If you can, speak to your son’s teachers or sports coach. They may pick up on things at school that you haven’t observed at home. Other mothers of boys at school might also have picked up on changes in behaviour at school from your son’s friends.
- Seek professional help sooner rather than later, and as a matter of urgency if your son’s weight is dropping. An active boy who is restricting his diet can easily lose 1 kg a week and soon become dangerously emaciated. In addition the quicker an eating disorder is identified, the quicker and more complete the recovery is likely to be.
- If you decide to take your son to the GP, go prepared, armed with all the facts you have been writing down. It is incredibly difficult for a GP to recognise anorexia in boys so you need to give him all the assistance you can. There is no tangible indicator in boys (girls are likely to stop their periods) and many very healthy teenage boys go through very skinny phases.
- The UK government (through the NICE guidelines) has advised GPs that if a parent is worried then his/her fears should be taken very seriously. However many GPs still fail to recognise anorexia in their young patients. If your GP takes a “watch and wait” approach don’t be put off. If your son continues to fail to gain weight keep going back every week, and do not be afraid to ask for a referral to a pediatrician or child psychiatrist.
- A problem shared is a problem halved! beat (The Eating Disorders Association) can provide a huge amount of support. There are telephone helplines and beat can send you a wealth of useful information. There is also a considerable self help network consisting of volunteers who have experience of an eating disorder. You can write to volunteers by post or e-mail, there are phone volunteers and there are many self help groups around the country. Information on any of these can be obtained by calling the helpline on 0845 634 1414, e-mailing firstname.lastname@example.org , or looking on the website www.b-eat.co.uk
- Try to learn as much about eating disorders as you can and try to ensure the rest of the family do as well. If your son has an eating disorder you will be much better equipped to help him if you have a good knowledge of his illness. beat can provide lots of helpful information and has a recommended reading list.
- Try to keep calm and be consistent with your son over what is acceptable behaviour and what is not within your family setting. This can be extremely difficult when your son is being irrational and shouting at you, but keeping calm can help diffuse an incredibly emotional situation. Being consistent can help provide boundaries for your son who may be feeling very frightened and out of control.
- Anorexia is a terrifying experience for any family to go through, but remember:
- boys can get anorexia too
- anorexia can be beaten
- look forward not back
- never give up hope
And most importantly, you are not alone.