Warning signs of eating disorders

Eating disorders are serious but treatable illnesses – and the earlier they're recognised, the better the chances. Anorexia usually begins in puberty, bulimia often in late adolescence and binge eating disorder frequently not until young adulthood; avoidant/restrictive food intake disorder (ARFID) can appear as early as childhood. In the KiGGS study by the Robert Koch Institute, about one in five young people aged 11 to 17 showed signs of disordered eating in a questionnaire – not yet a diagnosis, but a warning sign. Girls are affected more often, but boys can develop eating disorders too.

Warning signs that parents should take seriously when several occur together: skipping meals or eating in secret; strict rules, calorie counting, lists of forbidden foods; cutting food into tiny pieces, sorting it, eating very slowly; going straight to the bathroom after eating; excessive, compulsive exercise; withdrawing from friends and family meals; feeling very cold, tiredness, dizziness; in girls, periods stopping; rapid weight change up or down – and in growing children, a weight that stops keeping pace with growth; mood swings and constant preoccupation with body and weight. Important: you can't tell an eating disorder from someone's weight – many people affected are a normal weight.

What you can do: start a conversation, calmly and without reproach (“I'm worried about you”), don't argue about food or figure, no diets in the house, no policing at the table – and get professional help early. The first port of call is your child's paediatrician; they'll know local counselling services and treatment options.

Help is available quickly and anonymously: the German Federal Institute for Public Health (BIÖG, formerly BZgA) runs an eating disorders helpline on 0221 892031 and provides information for those affected and their families. The “Nummer gegen Kummer” helpline is free and anonymous: for children and young people on 116 111, for parents on 0800 111 0 550. In an acute emergency – fainting, a racing heart, self-harm – call 112.

And for you as a parent: it's not your fault, and you're not alone. Eating disorders arise from many factors – predisposition, pressure, perfectionism, body ideals – not from a mistake at the family table. But the family is an important part of recovery.