Insisting Children Eat Can Be Dangerous, Experts Warn

Mistakes to Avoid in Eating Disorders Anorexia nervosa, bulimia nervosa and binge eating disorder… The prevalence of the three most common eating disorders today is increasing during adolescence. According to research conducted, one in every 100 adolescents develops an eating disorder. The beauty criteria of 'the thinner you are, the more beautiful you are' playing a role in bringing the situation to this point, particularly creating significant effects on young girls. Eating disorders lead to serious health problems ranging from fatty liver to kidney failure, from hypotension to osteoporosis, from amenorrhea to cardiac arrhythmias, and can even threaten life. Therefore, early recognition and treatment are vital. Acıbadem Altunizade Hospital Department of Child and Adolescent Health - Child Health and Diseases Specialist Prof. Dr. Müjgan Alikaşifoğlu points out that parental support plays great importance in the success of treatment, saying, "Accept that your child is going through a difficult period in this process. Even if they are angry or accusatory towards you, do not forget how much they need your support. Talk about the illness, make them feel you will always be there and support them in attending treatment regularly." So what are the other behaviours parents should pay attention to in order to prevent negative effects on eating disorder treatment? Child Health and Diseases Specialist Prof. Dr. Müjgan Alikaşifoğlu explained 8 mistakes that parents must absolutely avoid and made important warnings.

Anorexia nervosa

Anorexia nervosa begins in early adolescence (ages 11-14). Rarely, it can also be seen at age 9. The desire to have a thin body, extreme fear of weight gain and disturbance in body image form the basic symptoms. Adolescents develop specific behavioural patterns to lose weight; some lose weight by drastically reducing all food intake, while others engage in intense exercise. Some young people follow strict diets, occasionally lose control and eat in binges, then purge what they have eaten by vomiting or use laxative or diuretic medications or teas. Mood disorders can be seen together with substance use and suicide attempts.

Bulimia nervosa

The typical onset of bulimia nervosa is in the late adolescent years (18-19). It is described as an eating disorder characterized by episodes of binge eating followed by vomiting. As in anorexia nervosa, there is fear of weight gain and distortion in body perception. "However, bulimics do not restrict food intake," says Prof. Dr. Müjgan Alikaşifoğlu and continues: "These young people eat in a binge manner, and when they finish eating they experience intense remorse and depressive feelings. They engage in various compensatory behaviours to avoid weight gain. The most common of these behaviours is self-induced vomiting. However, use of laxative medications or teas or engaging in excessive exercise can also be seen. In this presentation, unlike anorexia nervosa, the patient is slightly overweight or at normal body weight."

Binge eating disorder

Binge eating disorder is defined as eating unusually large portions at least once a week over a period of 3 months, without compensatory behaviours, and with stress and feeling a loss of control accompanying this situation. During adolescence, the frequency increases with age in girls (0.7% at age 14 rises to 4.1% at age 20), while it decreases in boys. It can be seen together with obesity, deterioration in social relationships, depressive symptoms, anxiety, emotional fluctuations, substance dependence and suicidal tendency. Prior to a binge episode, there is usually an excessive craving for food. Loss of control during eating is considered an important finding.

Do not attempt to increase weight, direct them to treatment

The approach of parents plays a key role in achieving successful results from treatment. If the correct approach is not taken, the long and laborious treatment process may be interrupted or unsuccessful. Prof. Dr. Müjgan Alikaşifoğlu expresses the behaviours parents should avoid as follows:

• In eating disorders, the adolescent's greatest concern is weight gain. Therefore, do not try to force-feed them to gain weight; instead, direct them to treatment.
• Avoid being accusatory or judgmental.
• Do not comment on their appearance, even positively.
• Do not discuss food, calories and portions.
• Do not eat low-calorie, diet foods or high-calorie, low-nutrition snacks in their presence, and do not keep such foods in the house.
• Do not sit at the table at different times. Pay special attention to being together during meal times and try to create a pleasant atmosphere at the dining table.
• During meals, do not focus too much on what or how they are eating; eat your own food and chat with them.
• Do not scatter to different places after eating; do an enjoyable activity together. This way you can prevent them from vomiting or exercising excessively after the meal.

Multidisciplinary approach is very important in treatment!

The treatment of the illness is a long-term process with ups and downs for both your child and you. The treatment of eating disorders should be managed by a specialist team consisting of a paediatrician specializing in this field and dealing with adolescent health, an adolescent psychiatry and illness specialist, a psychologist and a dietitian. Determining whether there is a life-threatening risk developing due to extreme weight loss, vomiting or binge eating, and eliminating it if present, constitutes the first step of treatment. Since eating disorder is essentially a psychiatric illness, psychiatric evaluation and psychotherapy support are very important in the treatment process.