This Eating Disorders Awareness Week (1-8 March 2021) our Lead Paediatric Dietitian Caroline Culverwell advises what parents and carers can do if you're worried your child isn't eating enough:
Young people’s energy needs
Children and young people need a lot of food to grow and develop, and use energy throughout the day; walking to, from and around school, carrying heavy bags and doing physical and mental activity.
Most teenagers need significantly more food than their parents (unless a parent is particularly active). It is normal for teenagers to have pockets full of snack wrappers, or to be constantly grazing, or asking for snacks an hour after dinner.
What can change eating patterns?
Sometimes children and teenagers will go through periods of changing the amount they eat which can be very worrying for their families.
Anxiety can make them feel as though they have a lump in their throat or a knot in their stomach and can impact on their appetite.
Self-consciousness and puberty can lead to teens being concerned about their body shape, and this may be exacerbated by pressure from the media, peers and social media to look a ‘certain way’. This can lead to teens deliberately trying to reduce their food intake, or ‘diet’.
Rapid height growth, high physical activity levels and busy lifestyles can make it difficult for a young person to maintain an adequate food intake.
Ethical awareness can lead to teens deciding to reduce dairy intake, become vegetarian and even vegan, and whilst it is possible to achieve these changes whilst maintaining an age appropriate nutrient intake, it can be really difficult and therefore often results in unintentional reduction in food. The vegan society has information if you wish to support your child’s decision to follow a vegan diet.
Top diet tips to encourage healthy eating
- Provide your child with three meals (including two desserts) and three snacks to include a pint of whole or semi-skimmed milk daily.
- If avoiding cow’s milk it is important to use a fortified soya alternative as oat and nut milks do not contain equivalent amounts nutrients.
- Consider using a multivitamin and mineral supplement containing a wide range of vitamins and minerals and including iron and vitamin D.
- Keep portions modest but nutritious, this can help a young person from feeling overwhelmed by food.
- Try to include nutritious drinks (milk, juice, smoothies) as part of meals and snacks, these can be helpful if a young person is short on time or complains of feeling full.
- If your child can’t finish their meal then completing the carbohydrate and protein part of the meal may be more of a priority than the vegetables at the moment.
- Avoid using ‘diet’ products and think about the language used about food in the home, i.e. make it ‘positive’ - about taste, flavours and appearance, or being nourishing, rather than about any negative health or weight consequences.
- Try to avoid labelling food as ‘healthy or unhealthy’ – all food can be healthy depending on the requirements of the individual. There is no such thing as a ‘bad’ food.
What else can I do?
It is important that if you are worried that your child is losing weight or restricting their foods that their nutrition is prioritised.
Sometimes parents are concerned that if they ‘insist’ their child eats that it will do more harm than good.
We recommend a common sense; gentle and supportive boundary is placed around expectations for eating:
- Do not be afraid to insist your son or daughter has breakfast before leaving for school, and if they refuse snacks and meals at home it may not be appropriate to allow them to attend school the next day. Of course, this assumes that attending school is a motivator for your child.
- You may wish to speak to your child’s school to see if they are aware if your child is eating at school, and in some instances schools may be able to find a space for your child to eat if eating with others is feeling overwhelming and becoming problematic.
- Is your child fuelling themselves adequately for their activity level? If not do put in appropriate boundaries. For example, if they are refusing to eat snacks then it would be unwise to allow then to attend a dance class, go for a run or attend the gym.
- Is your child wanting to take over the food preparation at home, or dictating what and when you should eat?This is a warning sign, please remember you are in charge – helping out in the kitchen is great, dictating what products should be bought, taking over in the kitchen or criticising parents is not.
- If your child loves to bake and you are happy with that then this is acceptable, but if they are baking for others and not eating it themselves then this is concerning – please insist that they eat a portion of anything they make.
- Do discourage the use of apps or calorie counting, as again these behaviours can become obsessive. Do also discourage them from following posts on social media that increase their anxiety about eating or body image.
Should I check my child’s weight?
If you are concerned that your child is losing weight then it may be appropriate to monitor weight either at your GP surgery, in a local leisure centre or chemist or at home.
We do not recommend a child has regular access to scales as this can increase anxiety and lead to obsessive checking.
You should not weigh your child unless you are worried, and certainly no more frequently than once a fortnight unless you have been advised otherwise.
Girls weight can fluctuate according to where they are in their monthly cycle, so once a month may be a better indicator.
When to seek professional help
A child of normal or low weight should not be losing weight.
If, despite following the advice above, your child is losing weight, or if a teenage girl who was previously menstruating regularly misses two consecutive periods please see your GP.
Find out more
1. The CCI website includes self-help workbooks and information on disordered eating.
2. Kooth.com is an online mental health and wellbeing community for young people which is free to join.
3. Beat is one of the UK's leading eating disorder charities. Their website has some excellent information and support groups, including a focus on early intervention and prevention.