Associate Professor Kimberly Sheffield Hello,  my name is Kim Sheffield, and I’m a Clinical   Psychologist, specialising in the treatment of  paediatric eating disorders. My video today will   cover some tips for how to identify and  talk about eating disorders with youth,   and provide pes – specific tips for parents,  educators, Social or Youth Workers and peers.   I also provide some context on the impact of  social media on the development and maintenance   of eating disorders, as well as how parents  can begin to monitor and limit their children’s   social media access. Finally, I’ll cover some  tips on where to get help and more information,   in a – if a child in your life is  struggling with an eating disorder. Section 1 early signs of difficulty. There are  several early signs of eating disorders that you   may observe in a child or adolescent.  Some of the most common include, one,   obsession with body weight and shape. Youth  with eating disorders may become fixated on   their bodies, frequently weighing or  measuring themselves. They may also   constantly compare themselves to others,  and feel like they never measure up. Second preoccupation with food. Youth with eating  disorders may become overly concerned with what   they are eating, how much they are eating, and  when they are eating. They may also develop strict   rules around food, such as only eating certain  types of food, or avoiding entire food groups. Any   sudden adoption of virgin diets or fads, such as  eliminating sugar, cutting carbs, becoming vegan,   may be indicative of a budding eating disorder.  Youth may also show an increased interest in food,   such as wanting to grocery shop and cook for the  family, but then not eating their own creations. Third changes in eating habits. Youth  with eating disorders may start to eat   significantly less or more than usual. They  may also skip meals, eat in secret, or make   excuses for not eating. Or emotional changes,  youth with eating disorders may become moody,   irritable or anxious; they may also withdraw  from social activities and relationships. And,   also, physical symptoms, so youth with eating  disorders may experience physical symptoms,   such as fatigue, dizziness, constipation,  frequent stomach aches, and many more. If you’re concerned a child in your life  may be developing an eating disorder,   start by observing their actions more  closely. One way that parents and carers   can begin observing youth more closely is to  institute family meal times in the home. This   may only be feasible for dinner or breakfast,  but even this level of observation will begin   to give you information on your child’s eating  behaviours. You can also begin to note patterns   of bathroom use. For example, if your child  is always going to the bathroom after eating,   or maybe spending longer periods of time in the  bathroom, looking in the mirror or body checking. Note that it may not be helpful to  confront your child with the findings of   your observations. Youth with eating disorders  are often secretive around their behaviours,   and will likely deny the problem, especially at  first. It is critical that you do not wait for   your child to ask for help in these situations.  If you suspect they may have an eating disorder,   please seek out further evaluation with  their primary care provider or a Therapist. It is important to know that eating disorders  can affect anyone, regardless of age, gender,   or background. However, certain factors may  increase a youth’s risk of developing an   eating disorder. One is genetics. So, research  suggests that genetics may play a role in the   development of an eating disorder. If  a family member has an eating disorder,   you may be more likely to develop one, as well. Second is environmental factors, so cultural  and societal pressures can contribute to   the development of eating disorders. For  example, the idealisation of thinness in   the media can lead to body dissatisfaction  and unhealthy weight control behaviours. Third, psychological factors. So people with  eating disorders often struggle with low   self-esteem, perfectionism, and anxiety.  They may also have difficulty regulating   their emotions or coping with stress. Fourth, life transitions and stressors.   Eating disorders may develop in response to major  life transitions, such as moving to a new place,   onset of puberty, or starting college. Stressful  life events, such as trauma or loss, can also   trigger eating disorder symptoms. It’s important  to note that eating disorders are not a choice   or a lifestyle. They are serious mental health  conditions that require professional treatment. Section 2 how to talk about it. Talking to your  child about their eating disorder can be difficult   and sensitive, but it’s important to approach the  conversation in a supportive and non-judgmental   way. Here are some tips for talking to your  child about their potential eating disorder. First, choose a private and comfortable  setting. Make sure that you choose a quiet   and private place where you and your child  can have an open and honest conversation. Second, be supportive, and non-judgmental. Your  child may feel ashamed or embarrassed about their   eating disorder. So it’s important to approach the  conversation with compassion and understanding. Third, listen to their perspective.  Allow your child to express their   thoughts and feelings about their  eating disorder. Listen carefully   to what they have to say and try to  understand where they’re coming from. Fourth, express your concerns. Let your  child know that you are worried about   their health and wellbeing. Be specific  about the behaviours you have noticed,   and the impact they may have on their health. Fifth, offer support and help. Let  your child know that you are there   to support them and that you want to  help them get the treatment they need. Sixth, avoid blame or criticism.  It’s important to avoid blaming   or criticising your child for their eating  disorder. Remember that eating disorders   are complex mental health conditions  that require professional treatment. And seventh, follow-up. After this first  conversation, make sure to follow-up with your   child and check in on their progress. Let them  know that you are there to support them through   their recovery journey. Remember that talking  to your child about their eating disorder can be   challenging and emotional. If you feel overwhelmed  or unsure about how to approach the conversation,   consider reaching out to a mental health  professional for guidance and support. One trick I like to share with parents,  to begin reducing criticism and blame,   is to externalise the eating disorder from  your child. Externalising the eating disorder   means separating the child from their eating  disorder and viewing it as a separate entity,   or a problem to be solved. Here are  some ways to externalise the eating   disorder from your child. Use language that  separates the child from the eating disorder.   Instead of saying, “You are anorexic,” or,  “You have a problem with food,” you could say,   “The eating disorder is causing you to have  trouble eating,” or, “The eating disorder   is making it hard for you to be healthy.”  Talk about the eating disorder as a separate   entity. Encourage your child to name their eating  disorder, such as “Ed,” or “The Voice.” This can   help them to separate themselves from the eating  disorder and see it as a problem to be solved. Encourage the child to  challenge the eating disorder.   Help your child to recognise that the eating  disorder is not their fault and that they have   the power to challenge it. Encourage them to  identify the negative thoughts and behaviours   associated with their eating disorder and to  replace them with positive and healthy ones.   Focus on your child’s strengths and abilities.  Remind your child of their other strengths and   abilities. Encourage them to use these to  challenge the eating disorder. For example,   if your child is artistic, encourage them  to express their emotions through art. Seek professional help. Eating disorders  are serious and can require professional   treatment. Connect your child with a qualified  healthcare provider, who can provide them support   to overcome their eating disorder. Ideally, this  treatment will have a strong family component and   actively engage you as parents in the journey  of recovery. Remember that externalising the   eating disorder from your child is just one  part of the recovery process. It’s important   to provide your child with love, support, and  understanding as they work towards recovery Section 3 social media impact.  There is currently a lot of buzz   around the role of social media in the  development of mental health conditions,   including eating disorders in youth. I want  to be clear that there is not one singular   thing responsible for the development  of an eating disorder. It requires   the perfect storm of genetic predisposition,  personality factors, and societal influences. I also want to be clear that media, even before  the advent of social media, has played a role in   eating disorders. Diet culture refers to a set of  beliefs that values thinness, appearance and shape   above health and wellbeing. Food is given moral  value, with language assigning certain foods as   “good, clean, pure,” and other foods as “bad”  or “sinful.” As humans, we then internalise   this information and begin to label our eating  behaviours as “good” or “bad.” Food morality   leads to advertising around guilt-free desserts  and diets that still allow you to eat junk food. Similarly, the media tells us that  certain body shapes and sizes are   desirable above others. We are bombarded  with images of tall, thin, often White,   celebrities as the ideal of personhood.  By making us feel bad about our bodies,   advertisers can then sell us products, diet  pills, anti-ageing lotion, fitness machines,   that promise to make us better. Social media  has magnified toxic diet culture, replacing   traditional commercials with influencer accounts,  which, similarly, peddle a certain version of   health or goodness. Recent data indicates that  more than 90% of teens interact with one or more   of social media platforms daily, with around  20% reporting almost constant use. Teens are   often accessing these sites on smartphones,  with minimal supervision from their parents. One aspect of social media that makes it  particularly impactful is that much of the   communication is done through photos and  videos. Youth are bombarded with images,   like weight lost supplements and teas, fitness  routines, guilt-free recipes, and more. Popular   searches include influencer videos about “what I  eat in a day,” or “before and after weight loss.” Aside from celebrities and influencers,  youth are also presenting curated versions   of their own lives on these platforms.  They may post edited or filtered images   of themselves, and then closely track the  number of likes and comments as a measure of   self-worth. This search for external validation  may lead to engagement in certain behaviours to   achieve the most worthy body. Further, social  media naturally encourages comparisons. Youth   are judging themselves against each other.  They may see people of having more happiness,   or other markers of success, and relate  this to their appearance. They imagine   that losing weight or gaining muscle will lead  to more friends, or invites to parties, etc. Another layer of this phenomenon is that social  media algorithms contribute to the singular focus   on appearance. A teen may start by searching  for one thing, and then the app suggests related   posts. For example, an initial search for “healthy  snacking” can lead to “take this diet pill.” In   extreme corners of different platforms, there are  even pro-eating disorder groups. These persist,   morphing over time, in response to regulatory  efforts to shut them down. These groups often   involve posts from people suffering with their own  eating disorders. They talk about their symptoms   as “lifestyle choices,” instead of a mental  illness, stating “anorexia is a lifestyle, not   a disease.” Post reference tips and techniques,  and even lead youth to coach each other at how to   be better at their eating disorder. They provide  a sense of acceptance and belonging to struggling   youth. Parents should be aware of these groups’  existence, and make sure they know their key   terms like, “thinspiration,” or “thinspo,”  “pro-ana,” “pro-mia,” and “fitspiration.” Unfortunately, the answer probably isn’t to  restrict all access to these sites. Teens are   endlessly creative in their ability to hide things  from their parents. I have seen teens making   Instagram – masking Instagram with what looks like  a calculator app. So if we’re going to be forced   to embrace social media, at least partially,  how can we make it a safer experience for teens?  First, I encourage all parents to regularly check  their children’s accounts and make them – and make   sure they know what they’re following. Parents  can then help their teen unfollow accounts that   make them feel worse about themselves and could  be triggering. Further, parents can set limits   on how late their children can have access to  their phones, taking away their phone at night,   or turning it off before bedtime, can limit some  of the more harmful use. Gently reminding your   child that you pay for the phone can help with  limit setting; you give them access to that phone. Another key to promoting health or soci  – healthier social media use is to engage   your child in open communication, so they feel  comfortable coming to you if there’s an issue.   Parents can strive to be non-judgmental, and  even talk about how they may feel negatively   after looking at their own social media.  Some apps even have parental controls built   in that can help regulate use. In some,  social media can be problematic for kids   with eating disorders. Parents can support  their teens by monitoring and limiting use. Section 4 tips for parents. If your child  had been diagnosed with an eating disorder,   here are some tips that may helpful for  you. First, educate yourself. Learn as   much as you can about your child’s eating  disorder. This will help you to understand   what your child is going through  and how you can best support them. Second, seek professional help. Eating disorders  are complex and require professional treatment.   Work with your child’s healthcare provider  to develop a treatment plan that meets their   specific needs. Advocate to be involved in  your child’s treatment, as they will benefit   greatly from your support, and often need  their parents to help fight this illness. Be patient. Recovery from an eating  disorder can be a long and difficult   process. Be patient with your child and offer  them support and encouragement throughout   their recovery journey. Avoiding judgement  and criticism. It’s so important to avoid   criticising or judging your child for their  eating disorder. Remember, eating disorders   are not a choice and your child needs you, both  your love and support to overcome this illness.  By creating a safe space, you are a huge  part of their journey. This can involve   just a positive home environment, where you avoid  commenting on your child’s weight or appearance,   and instead focus on their strengths  and accomplishments. And encourage open   communication in your home. Encourage your child  to talk openly with you about their feelings   and struggles. Create a space where they feel  comfortable sharing their thoughts and emotions,   even the ones that may feel shameful or  embarrassing. Remember that recovery from   an eating disorder is possible, with  the right treatment and support. By   working closely with your child’s healthcare  provider, and offering them love and support,   you can help them to overcome their eating  disorder, and live a healthy, fulfilling life. Section 5 tips for educators. If you are  an educator working with a child who has an   eating disorder, here are some tips that  may be helpful. First, educate yourself,   learn about eating disorders and their symptoms,   as well as the impact they can have on a child’s  academic performance and broader mental health. Second, work to create a safe and  supportive classroom environment.   Create a classroom that is safe for all  students, avoiding comments on a student’s   weight or appearance, focusing on  their strengths and achievements,   being mindful of comments made by other  students in the classroom, as well. Develop a plan with the student’s healthcare team.  You can work with the student’s healthcare team   to develop a plan on how to support their  academic needs while they are in recovery.   They may be missing assignments, having to  make classes at time, and can benefit from   support. Encourage open communication with you  as their educator. Encourage them to talk to   you about struggles and feelings and stresses  that may occur during the school day. Try to   create a space where they feel comfortable  sharing their thoughts without judgement. Offer accommodation that may be helpful to the  student managing their eating disorder. This   might involve them being allowed to take breaks  during class to eat snacks or receive supplements,   considering reductions in workload,  and support for missed assignments,   due to appointments. This would invo – this  requires you to be flexible and understanding.   Eating disorders can be unpredictable, and the  student may need extra support and flexibility   from time-to-time. Even as things appear to  be getting better, there can be setbacks. And maintain confidentiality. Respect  the student’s privacy and maintain their   confidentiality about the eating disorder,  unless there is a concern for their safety   and you need to involve others in getting them  the help they need. Remember that recovery   from an eating disorder is possible,  with the right treatment and support,   and working closely with the student’s broader  healthcare team and offering them a safe learning   environment, you can help the student to overcome  their eating disorder and succeed academically. Section 6 tips for Social and Youth  Workers. If you are a Social Worker   working with children who have eating disorders,  here are some tips that may be helpful. First,   understand that individual child’s needs, and  eating disorders can have a significant impact   on a child’s mental and physical health,  as well as their family and social life.   Understand the child’s needs and the impact of  their eating disorder on their overall wellbeing. Second, collaborate closely with  the child’s healthcare team,   to develop a comprehensive treatment  plan that addresses their physical   and mental health needs, as well  as their family and social needs. Third, address family dynamics. Eating  disorders can have a significant impact   on the family. Work with the child’s family  to address any issues that may be either   contributing to the eating disorder, or arise as a  result of the eating disorder’s impact on others. Fourth, prevent support for parents and  caregivers. They may be overwhelmed and   struggling to cope with their child’s eating  disorder. Providing support and resources to   help them better understand the disorder  can be so critical to their recovery. Fifth, address co-occurring mental health issues.  Eating disorders are often co-occurring with   other issues, such as anxiety, depression  or trauma. Make sure that these issues are   being addressed in a supportive manner, as  this is essential for the child’s recovery.  Sixth, encourage positive body image.  Encourage the child to develop a positive   body image and healthy relationship with  food. Promote self-care, and self-acceptance,   and avoid negative or critical comments  about their weight or appearance. Seventh, advocate for the child. Be their advocate  with their family and their team. Ensure that   they have access to the resources and support  they need to achieve and maintain recovery. Section 7 tips for friends or peers of  those with an eating disorder. If you are   a peer of a child with an eating disorder,  here are some quick tips that may be helpful   in supporting your friend. First, learn about  eating disorders and their impact on physical   and mental health. Don’t ask your friend  who might be suffering with the illness   to educate you. Take the time to do your  learning on your own. This will then help   you understand what your friend is going  through and how you can best support them. Be supportive. Offer your friend encouragement  and support throughout the recovery journey.   Let them know that you are there for them and  that you care about their wellbeing. Be aware   of avoiding judgement and criticism. Eating  disorders are not a choice, and your friend   needs your support and understanding. Avoiding  criticising or judging your friend about their   eating disorder, and instead, focus on  offering them support and encouragement   and highlighting other aspects of their life and  maybe shared interests. Avoid talking about food,   weight or appearance. So talking about food or  weight or appearance can be triggering for someone   with an eating disorder. Try to avoid making those  comments and, instead, focus on other interests,   other aspects of their personality, things that  you have previously enjoyed doing with them. Being a good listener is so critical. Give  your friend space to express their thoughts   and feelings, without judgement. Let them know  you’re there, you support them and care about   them. Balance this, though, with not pressing  for too much information, or asking for them   to share if they do not feel comfortable  talking with you about what is going on. Section 8 where to get help or get more  information. If you believe that your   child has an eating disorder, it is important to  seek professional help as soon as possible. Here   are some steps you can take to get your child  the help they need. The first step is getting   your child to talk to their healthcare provider.  They can assess your child’s physical and mental   health and refer them to appropriate treatment  resources. Request to be part of this appointment,   as your child may not be forthcoming with  their eating behaviours or negative thoughts. Second, seek out a specialist. Eating disorders  require specialised treatment. Find a specialist   who is either a Psychiatrist, Psychologist  or other licenced mental health provider,   and has experience in treating eating disorders.  Evidence-based treatments, including family-based   treatment, enhanced cognitive behavioural  therapy, has the strongest research support.   Consider an eating disorder treatment centre. In  some cases a more intensive treatment programme   may be necessary. If that is true, you may need  to consider an eating disorder treatment centre   that offers inpatient, partial hospitalisation,  or intensive outpatient treatment programmes. You can involve family members. Eating disorders  truly do have a huge impact on the family.   By involving additional family  members in the treatment process,   and even seeking out family therapy to  address family issues, you can go a long   way in helping to treat this disorder. Being  patient and supportive, recovery is a complex   process that takes time and requires patience  and support. Encourage your child to seek   treatment and be there to offer them support  and encouragement throughout their journey.   Remember that early intervention is key when it  comes to treating eating disorders. By seeking   professional help for your child and providing  them with support and encouragement, you can   help them to overcome their eating disorder  and achieve a healthy and fulfilling life. There are several resources available for  more information on eating disorders. Here   are a few places to start. The National Eating  Disorders Association, NEDA, is a non-profit   that provides information, support and resources  for individuals and families affected by eating   disorders. Their website offers information  on different types of eating disorders,   treatment options, and recovery resources.  The Academy for Eating Disorders, AED, is a   professional organisation dedicated to providing  research, education and treatment for eating   disorders. Their website offers information on  eating disorder research, treatment and advocacy. Eating Disorder Hope. Eating Disorder  Hope is a website that offers information   on different types of eating disorders,  treatment options, recovery resources and   support groups that may be available. And  the National Institute of Mental Health,   NIMH is a federal agency within the United States  that conducts research on mental health disorders,   including eating disorders. Their website  offers information on the signs and symptoms   of eating disorders, treatment options,  and research studies that are ongoing. Thank you so much for taking the time to  listen to me talk about paediatric eating   disorders and how you can help those who  are suffering with these complex illnesses.