How to explain anorexia to a child

[DuggeesStick]

A teenager we know well, but don't see very often, has anorexia and is now so ill that she has been hospitalised. We are all very worried. My 9 year old doesn't know yet but I have no idea how to talk to her about it. She has been asking why we haven't seen the teenager and her family for so long. Everything I google assumes I'm explaining anorexia to a child who has disordered eating.

Does anyone have any advice?

You could just tell her she's sick and needs to stay in hospital to get better? I'd stay away from specifics. Is she asking for details?

Can't you just say she isn't well? A child doesn't need information about someone else's illness, just to know she is unwell and the doctors are looking after her.

I wouldn't go into the details, just say she's unwell and being looked after in hospital. It's not really necessary for a child who rarely sees the unwell person to know all of the facts.

It's a family member, so I think DD will want to know more, which is my concern.

A source I found (I've replaced some words with "teen" or "family member")

WHAT TO TELL A YOUNG CHILD?

This will depend on their age and where they are in their emotional, social, and cognitive development. There are no formal guidelines on what is best to tell a child and when, so use your best judgment and knowledge of the child.

It might be tempting to avoid saying something altogether with a very young child, since it can seem that they are unaware of the issue. However, children are often more observant than adults realize and frequently see what is going on, even if they cannot verbalize it. Acknowledging that something is going on with their loved one’s behaviour can validate their emotions and help them feel more safe and secure.

Some brief statements that might help very young children understand an eating disorder in a friend or family member:

“Teen has trouble eating properly. We are all working together to help her learn to eat better to get healthy. We all need food to help our bodies function properly.”

“Teen gets very frightened and upset at mealtimes. THIS IS NOT YOUR FAULT. We hope that this will get easier for them with treatment.”

“Having an eating problem can be very scary. It can also be scary when a family member has an eating problem. Do you have any questions about eating problems? Is there anything you would like to talk about?”

“Your family member's eating problem is being helped by grown-ups and doctors. Your job is to be yourself.”

“Your family member is not choosing to act this way. This isn’t their fault. It’s not your fault. We’re all doing the best we can to help them get better.”

www.nationaleatingdisorders.org/toolkit/parent-toolkit/talking-to-young-children

Link for more info

Want and need are two different things. She is 9, she doesn't need chapter and verse, that is for your benefit, not hers. It's not your information to tell. She is not likely to see her, but maybe if she does then telling her she may look very thin because she is not well to prepare her is enough. In the nicest possible way, don't let someone else's crisis become your drama.

I don't think it's helpful to explain eating disorders unless absolutely necessary. There's a contagion element- not that it will make her ill, but that it is a possible outlet for stress.

It's fine to explain someone is poorly, or even can't eat because they are ill. To go any further explaining that they are stressed about food, that they seek to control stress by controlling food or any other more detailed explanation invites trouble, imo.

Self harming behaviours are hugely tempting and attractive when you are vulnerable. The fewer we know about, the better.

(For clarity I stand by what I said upthread and think you should provide as little detail as possible - these examples are in case your DD asks questions and you don't know what to say)

Pickle you have articulated my worries perfectly, I don't want DD to start thinking differently about food.

Thank you everyone, that is very helpful.

I think, if pushed, I'd go with 'she has an illness that stops her from eating properly'.

Maybe after that 'the illness makes her think food is bad for her'.

I'd separate her illness, which is a mental illness, from the symptom- disordered eating.

Perhaps have separate conversations about phobias, how people can have an unreasonable fear of something quite ordinary. Also about anxiety, how normal it is to be anxious about things which are new or worrying, but how sometimes the anxiety gets bigger than the issue itself and becomes it's own new problem.

I would ask family not to discuss it in ear shot of child which is easy enough due to lockdown rules.
I would just say that she is sick and in hospital.thats it. She doesnt need to learn about anorexia. Even adults dont fully understand how you can get to that stage.

I would be open about it, in an age appropriate way. I think it's important not to give the idea that mental health topics are taboo.

I would definitely say she is ill in hospital. If your child wants more info, I would say that sometimes there is a problem in people's brains and it changes how they behave. (They might already be familiar with this concept, e.g. if you have any relatives with dementia). That because her brain is poorly, it's making her not eat properly, and so the doctors will help her eat lots of food and help her brain to get better.

I find the idea of not giving any information bizarre. Would PPs say the same about someone with another illness? How do you expect OP to answer her DC's inevitable questions?

I think you are right to not give full details of your relatives condition to your dd, op. There is a social contagion aspect with anorexia. It would be better if your dd was not aware of the condition at this young age.

Does she need to know beyond "Jane is poorly and is in hospital to get better, why don't we make her a card and post it to her?"

Surely covid means you wouldn't be mixing/provides a convenient excuse anyway?

I find the idea of not giving any information bizarre. Would PPs say the same about someone with another illness? How do you expect OP to answer her DC's inevitable questions?

I can only speak from personal experience, @ZadieZadie but I learned about eating disorders younger than OP's child and I remember having a thought along the lines of, "Huh, I wonder if that works". I subsequently had an eating disorder.

I think it's important not to stigmatise mental health issues (which is why I posted the source above in case OP's child asks any questions or wants more knowledge) but you have to be sensitive to the fact that children may already have underlying mental health conditions or other issues that could make them more susceptible to risk when it comes to self destructive disorders. I think there's a line that needs to be found between, "We don't talk about mental health issues because it's shameful" and a full rundown of OP's family member's dietary plan and mental health issue.

(Not suggesting you want either, just making a point)

Me too, when i heard about bingeing and then making yourself sick i thought what a brilliant idea thats how thin people eat everything and stay thin. I used information from educational sources warning about it.
I think no good or use will come from explaining an ED to children.

Some even if not overweight will see the love and attention she is getting as a way to get attention from family. It's just a bad bad idea. Not everything needs to be discussed with children.

You could just say she is unwell because she can't eat, and not eating makes people poorly so they are helping her to eat food to make her stronger and healthier
Or something along those lines. Vague but can't eat is true but you're not saying physically/mentally, and you're saying that you need to eat to be strong and healthy

I get it @berrygirlie - personal experience here too I'm afraid.

One of the things I found very hard is that my parents were clearly embarrassed by me - that's why I asked about whether EDs would be treated differently from other illnesses. No one would consider skirting around the issue if a family member had a broken leg.

I know it's different for everyone, so sorry if I seemed insensitive.

Definitely didn't seem insensitive, don't worry @ZadieZadie!

I absolutely agree it should be treated as a medical condition and not a personal failing, or anything along those lines, as that's what creates stigma. However, OP's daughter is 9 and so potentially about to go through puberty which would make me wary of notifying her of unhealthy coping mechanisms (especially ones that are related to changing your body and control, as those feelings are worsened during pubescence).

I think it's important to discuss eating disorders as a child-focused approach rather than a blanket one, as all children reach different levels of maturity at different points. I agree though, OP does need to approach it sensitively to avoid perceived judgement or shame as that won't help anybody involved.

Sorry to hear about your experiences, and you did nothing to be deserving of embarrassment.

My dd14 has anorexia and was in an inpatient unit for 4 months. I told my younger dd (10) that her older sister has an illness that meant her brain wasn’t working properly and it was telling her that a plate of food was really scary like it was a plate of spiders.

Interesting to read these replies as I wondered if I’ve taken the right approach. My daughter was quite young when she realised that something wasn’t quite right with her Auntie and her weight and eating habits. I explained that Auntie had an illness where she had a voice in her head which told her that eating was a bad thing and she had a big struggle between listening to the voice and not eating or listening to herself and eating. She was, and still is, very accepting of that. What she’s subsequently struggled with is why that Auntie’s sister (former anorexic) is very controlling of her child’s food intake - and I’ve explained that she too used to be anorexic like the first Auntie and that this is probably something to do with that. She’s quite disturbed by the second Auntie’s behaviour though, so I’ve obviously not handled that one as well as the first scenario! Although she was seven when she realised that Auntie no 2 was very controlling of her child’s food, whereas with first Auntie she was probably about 4.

2nd auntie's behaviour is disturbing though, your daughter is right

Yes, I know, both myself and my partner are concerned with second auntie’s behaviour and the effects that will have.