Eating disorders in children and adolescents

Signs and symptoms

Individuals with eating disorders may try to manage them in various ways. Here are some common signs that could indicate someone is struggling and might need additional support:

• significant weight loss
• preoccupation with food
• recent changes in food preferences and attitudes
• avoiding meal times or refusal to eat with others
• excessively exercising, sometimes secretly
• excessive monitoring exercise, weight or calories
• hidden food or hidden empty food wrappers
• self-induced vomiting
• denying thinness
• wearing loose or bulky clothes to hide true shape
• not being truthful about food intake

Anorexia nervosa

Anorexia nervosa is a serious eating disorder characterised by significantly low body weight in relation to the individual’s height, age, and developmental stage. This is not caused by another health condition or a lack of food.

It involves persistent behaviours aimed at preventing normal weight restoration. These behaviours may include restricting food intake, purging behaviours (for example, self-induced vomiting, misuse of laxatives), or excessive exercise.

The person often has an intense fear of gaining weight. Their low body weight or shape becomes central to their self-evaluation and may be inaccurately perceived as normal or even excessively large.

Bulimia nervosa

Bulimia Nervosa is characterised by frequent, recurrent episodes of binge eating, for example, once a week or more over at least one month. A binge eating episode is a distinct period during which the individual feels a subjective loss of control over eating, consumes much more food than usual, and is unable to stop or limit the type or amount of food.

Binge eating is followed by repeated inappropriate compensatory behaviours aimed at preventing weight gain. These may include self-induced vomiting, misuse of laxatives or enemas, or excessive exercise. The individual is preoccupied with body shape or weight, which strongly influences self-evaluation.

Unlike anorexia nervosa, the individual is not significantly underweight, which is why they do not meet the diagnostic criteria for anorexia nervosa.

Binge eating disorder

Binge eating disorder is characterised by frequent, recurrent episodes of binge eating, for example, once a week or more over several months. A binge eating episode is a distinct period during which the individual feels a subjective loss of control over eating, consumes much more food than usual, and is unable to stop or limit the type or amount of food.

Binge eating is experienced as very distressing and is often accompanied by negative emotions such as guilt or disgust. Unlike Bulimia Nervosa, however, binge eating episodes are not followed by inappropriate compensatory behaviours aimed at preventing weight gain. These compensatory behaviours may include self-induced vomiting, misuse of laxatives or enemas, or excessive exercise.

Assessments

We aim to assess within 4 weeks of receiving a referral. The assessment involves multiple team members to determine if the young person has an eating disorder and whether our service is the right fit. If not, we will help find appropriate support elsewhere.

After the assessment, we will provide feedback and, if necessary, a diagnosis. If an Eating Disorder is identified, we will offer information and a care plan for recovery.

Our assessments cover eating behaviours, physical health, early development, and social, family, and education factors.

Interventions

We offer interventions for eating disorders. Recovery can be a long and challenging journey, and families play a key role in supporting or driving a young person’s recovery. Our first line treatment is often family-based, but we tailor our approach to each young person’s needs for the best chance of recovery.

We will monitor physical health throughout treatment, including weighing, checking blood pressure and pulse, and possibly requesting blood tests, depending on progress.

Types of interventions

When we apply these interventions

For anorexia we use:

• family based treatment and approach
• cognitive behavioural therapy
• adolescent focussed therapy

For bulimia we use:

• family based treatment and approach
• cognitive behavioural therapy

For binge eating disorder we us:

• guided self-help
• cognitive behavioural therapy

Dietetics

Young people and families referred to the community eating disorders service will have access to specialist dietetic advice.

This advice may include education on maintaining a balanced diet to support normal adolescent growth and development.

It will also provide guidance on nutrients that can optimise both physical and mental health, as well as help with normalising eating patterns and behaviours.

Parents and carer’s support group

This group is for parents and carers currently receiving treatment from the community eating disorders service. It provides a space to share experiences and learn from one another.

You are welcome to attend whenever you feel it would be helpful, alongside your child’s individual treatment plan. To attend, please inform your named clinician or call us on 01302 566 980.

Plan your journey

If you use public transport, the Traveline journey planner provides information about what services and times are available.

Page last reviewed: March 11, 2025
Next review due: March 11, 2026