More boys are developing eating disorders, and children as young as 9 are being admitted to hospital with anorexia.
The increasing pressure on children and teens to be a certain shape and size had contributed to a rising number of young people battling eating disorders, Wellington Hospital adolescent physician Anganette Hall said.
On top of striving to look like skinny celebrities on magazine covers, there was a growing fear about obesity that was impacting on relationships with food.
"What's portrayed in the media is not reality," Hall said. Other factors, such as bullying about weight and negative comments from others about food and weight, could also play a part.
"Some people are just genetically more likely to get an eating disorder and some because of their personality characteristics . . . perfectionist, obsessive and intelligent," she said. "It is more common in the white middle-upper class, but we do see people from low socio-economic groups."
So far this year, nine patients under 16 had been admitted to hospital in Wellington, with most staying for about seven weeks.
Hall also sees about 12 young people with eating disorders as outpatients each week. "Certainly this year there's been a high volume, but we can always get a blip. The volume of outpatients I see, that's increasing."
Last year, 12 youngsters were admitted to hospital and of the 11 admitted in 2010, two were just 9 years old. But there had been children as young as 8 admitted for anxiety, which had caused eating problems, Hall said.
"The majority are 14-year-olds. The older they are, the more likely they are to be female."
The number of prepubescent boys and girls with eating problems were about equal, but more boys seemed to be needing treatment, possibly because of more awareness of the issue, she said.
"If young people are feeling insecure in any way, they're going to focus more on appearance. Some of them know that they're not overweight, but they're worried still about getting big."
Being underweight was dangerous, particularly in young people, as their brains were still developing, Dr Hall said.
"Your brain is mainly made up of fat, so if you have a lack of fat in your body your brain shrinks and you can't do things properly. That's why you have a lot of psychological changes."
Dieting was the biggest risk factor for developing an eating disorder. "There is something about restricting eating that can pull a trigger in some people that turns into an eating disorder."
Instilling self-esteem would help children become more resistant to eating disorders, she said.
TREATMENT FOCUS CHANGES
Before 2005, very few children and teenagers were admitted to hospital for eating disorders, and when they were it was for short periods for rehydration and a "little bit of feeding".
There was also a strong focus on psychological treatment, Wellington Hospital adolescent physician Anganette Hall said.
Now, when young people arrive, the focus is on refeeding and medical stabilisation before moving on to psychological aspects.
The final step in the Maudsley family-based treatment involves integrating them back into the community and their families.
On average, children and teens spend seven weeks in Wellington Hospital. During the last weeks their parents can take them to school and return them to the children's ward at night. The recovery rate was between 75 and 90 per cent, Dr Hall said. "Which is very different from adults. With them, we see maybe 30 per cent recover."
People aged over 16 are referred to the Central Region Eating Disorder Service, which has day programmes, residential beds, therapy, counselling and clinical services.
Health Minister Tony Ryall said an extra $26 million spent on eating disorder services since 2009 had doubled the number of families being helped.
"Clinicians tell me that without the extra funding for inpatient care and community treatment, including family-based therapy, these young anorexics would quite likely have ended up having to be sent to Sydney for treatment because services were inadequate here."
Nationally, 920 people were seen by specialist eating disorder teams last year, compared with 483 in 2008.
ONE FAMILY'S BATTLE
The Wilson family used to look forward to sitting around the dinner table at their Wellington home.
Then, as if a switch had been flicked, eldest daughter Emma developed a paralysing fear of eating. Anorexia had taken its grip and meal times became terrifying ordeals.
"Our really close, fun happy meal times turned into the most frightening time of the day," her mother, Nicki Wilson, said.
"I'm happy to say it is now once again one of the great pleasures that our family enjoys together."
It took a couple of years, but Emma, 18, has overcome the all-consuming illness and is now in her first year of study at Otago University, but the journey was long and difficult.
"It was Emma's courage and strength that got her through," Wilson said. "We were just there to support her, and what was lacking was the health system did not provide us the skills, did not arm us with what we needed to take her home and do the work.
"At the end of the day, the people that get the patients through are the family."
Online support groups and books by experts were crucial for the Wilsons, who said that, though the care Emma received at Wellington Hospital was comprehensive, the support afterwards was not.
Wilson started a support group for Wellington families about a year ago, which is part of the Eating Disorders Association of New Zealand.
The Wilsons were open about Emma's illness from the start and hope sharing their story will help whittle away the stigma that creates barriers to recovery.
"I guess, for us, it came out of the blue, because she had been a really healthy active person and she became ill very quickly and very seriously," Wilson said.
"That's the story I hear from everyone. It comes out of left-field." The family had to learn to gauge when it was Emma speaking and when it was the anorexia.
"It feels as though you've lost your child to a force so powerful, and it's learning to stand up to that force calmly and confidently."
Dad Dave said a major challenge was "recognising your daughter is still there and trying to find a way of communicating with her and seeing the illness for what it is".
"I think typically people think about - and it's sort of natural - weight, but the thing that we picked up is it's a state, not a weight."
Not wanting to eat in front of people. Eating slowly or doing abnormal things with food. Wanting to cook their own food or suddenly becoming vegetarian or requesting fat-free food. Weight loss and wearing extra layers of clothes. Depressed, irritable, argumentative. Becoming rigid in their approach to everyday activities and taking longer to finish them. Talking about weight and size more. Excessive exercising.
Contact Eating Disorders Association of New Zealand on 0800 4 edanz or go to www.ed.org.nz for more information and details about support groups.
- The Dominion Post
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