Eating disorders commonly develop from around the age of 14, a time when most children are naturally and steadily becoming more independent. That normal process of maturing does, however, give rise to a convergence of potential triggers, both practical and psychological - on the one hand, a greater desire for self-determination and less parental supervision and direction; and, on the other, a decrease in time spent in adults' company and in parents' control over what their child chooses to eat.



Most parents will testify that this developmental phase is characterised by moments of conflict interspersed with periods in which the child appears more distant and unmotivated by systems of reward or sanction they may have respected hitherto.

Such strains on the parent/child relationship are testing but no cause for alarm in themselves. However, parental concerns become exacerbated because it can often be quite difficult to accurately assess whether changes in your child's behaviour are the result of this normal teenage development or whether they indicate an eating disorder.

At its root, an eating disorder is about neither food nor weight. Eating disorders develop when a person is unable to cope with difficult feelings and emotions and becomes dependent upon food as a means of controlling their mood.

The two main types are anorexia and bulimia. Characteristically, anorexia sufferers severely restrict their food intake in order to lose weight. Yet their self-perception is altered such that they believe themselves to be fat and become profoundly and irrationally fearful of putting on weight. Bulimia sufferers typically indulge in binge eating, consuming large quantities of food in a short period of time, before deliberately inducing vomiting so that the body does not absorb the food. The average age for the onset of bulimia is 18.

Changes of mood may characterise the behaviour of any teenager. An eating disorder is likely to have a more marked effect, the child becoming more withdrawn and secretive, the mood swings more sudden. Parents should remember that eating disorders are complex conditions, expressed in behaviour, emotions and in a physical impact on the sufferer's body. Taken together, the presence of a combination of such physical, psychological and behavioural symptoms give parents a strong indication as to whether they have cause for concern.

Physical signs of anorexia may include sudden weight loss, difficulty sleeping, dizziness, stomach pains, feeling cold and constipation. Girls' menstrual cycles may be disrupted. Psychological signs may include intense fear of weight-gain, depressions and an obsession with diet as well as the mood swings and emotional outbursts mentioned earlier. Additional behavioural signs that may indicate anorexia are frequent wearing of baggy clothes to disguise weight loss, evasiveness about eating habits, over-exercise and difficulty in concentrating. A secretive and distant demeanour would be a further indication that there may be cause for concern.

Bulimia sufferers typically exhibit some of the same symptoms, such as sleeping difficulties, constipation, stomach pain, mood swings, secretive behaviour and irregular periods in girls. Additionally, they may have physical issues such as a sore throat, mouth infections and sensitive or damaged teeth. The ability to eat large quantities without gaining weight and frequent visits to the toilet immediately after meals may indicate deliberate vomiting. Psychologically, a sufferer is likely to exhibit signs of depression, anxiety, anger and guilt.