How do I know if my kid is worrying about food and their body too much?

A child doing more exercise or choosing healthier foods can be normal and even positive.

Yet these are also actions taken by young people who develop an eating disorder - the serious mental health condition characterised by a persistent, unhealthy relationship with food, eating and body image.

So how can you tell if your kid is at risk? Here’s what to look out for, and what to do if you’re worried.

Along with disordered eating – problematic behaviours around food without a diagnosed disorder – eating disorders are on the rise among young Kiwis, with LGBTQIA+ youth at particularly high risk.

All eating disorders, including anorexia nervosa, bulimia nervosa and binge eating disorder, are linked to a higher risk of dying early.

And we know that noticing and intervening early is key to stopping a disorder from developing.

Research has identified some of the most common early warning signs of eating disorders in children. Any one of these is cause for concern.

This means exercise beyond physical activity guidelines for young people. Your child may want to exercise even when injured, or may retreat to their bedroom to exercise secretly. They may be unable to sit still, jiggling body parts to use up calories.

Young people should be increasing in weight as they grow in height, unless medically supervised otherwise. This supports optimal development of major body organs, including the brain. But parents often miss these physical changes, as young people can become very skilled at hiding weight loss by wearing multiple layers or baggy clothes.

You might notice your child spending more time talking about food and eating, wanting to know what is in every meal so they can count calories, and seeking reassurance about how much they’ve eaten.

"Clean" eating and veganism can be popular among young people. But dieting is a strong risk factor for developing an eating disorder. You may notice your child increasingly restricts their diet or is often distressed about what is an “acceptable” food to eat.

Does your child always find a reason to avoid eating with other people? Does a lot of food go missing from the pantry? Having dinner as a family is a protective factor – it normalises eating and helps you see what and how your child eats. This can also be why your child wants to avoid it. This is why eating regularly together is often an important component of recovery.

Occasionally making negative comments about your appearance is relatively normal in adolescence, but needs to be handled with care. Problems can emerge where your child makes frequent and sustained negative remarks about their body weight and/or shape.

This could look like cutting food into tiny pieces, or having to eat food in a certain order or using the same crockery or cutlery every time. When rituals are disrupted, the child becomes distressed.

Know what to look for and act quickly if you’re concerned. The Feed Your Instinct website helps you document what you’ve observed before discussing your concerns with your child or GP. You can also call Eating Disorders Association of New Zealand (EDANZ) on 0800 2 EDANZ / 0800 2 33269 or (09) 5222 679.

Gently express concern, without judgment. You might try:

You haven’t seemed yourself lately. Is everything OK?

You’ve lost a lot of weight. I’m worried about you.

Acknowledge the challenges and offer unconditional love and support. Anxiety is a major driving force of many eating disorders. Let your child know you care deeply about them and that you’re there to help and act in their best interest.

Stay calm and be patient. It might take time for your child to acknowledge the issue. You may need to get them treatment, regardless of how willing they are.

Starvation in a young brain can cause rapid and catastrophic physical deterioration. It can lead to a vicious cycle of depression and black-and-white thinking that locks in disordered eating.

Being proactive and intervening early is key and can help avoid physical and mental health issues down the track.

Tracey Wade is a Professor of Psychology at Flinders University.

Feed Your Instinct has a behaviour checklist for people concerned that someone they love might be developing concerning relationships with food, weight and body image.

You can contact the Eating Disorders Association of New Zealand (EDANZ) helpline on 0800 2 EDANZ / 0800 2 33269 or (09) 5222 679.