Eating disorders affect children as young as eight as parents cry out for support

Children as young as eight are being diagnosed with eating disorders in Victoria, as families with sons and daughters gravely ill with anorexia say they are being failed by inadequate treatment and support.

The number of teenagers and children presenting with anorexia surged during the pandemic amid higher levels of emotional distress. By the end of last year, the number of young people receiving outpatient care for eating disorders from child and adolescent mental health services in Victoria was close to the highest it had ever been.

Rowan Brookes is speaking out about her family’s experience trying to get support for her son, 17, who has anorexia. Credit:Paul Jeffers

Clinicians say children are repeatedly being hospitalised in a dire condition and re-fed, only to lose weight again once discharged without specialist support to recover.

Child and youth psychiatrist Dr Anthony Gallagher, who works at Ramsay Clinic Albert Road private hospital, said one child had more than 120 re-admissions to Monash Health. Another had in excess of 30 re-admissions over a year.

“The real group that has taken everyone by surprise has been the drift in age downward. Children as young as eight or nine,” said Gallagher, who is seeking funding to launch a new eating disorder program.

Parents are frustrated at the lack of progress since late last year when independent federal MP Zoe Daniel called for the Commonwealth and Victorian governments to open a one-stop eating disorder hub for children and young people.

Daniel, the member for Goldstein, is calling on governments to act urgently to support the families with children “at risk of death”, such as support in their homes to help with feeding, alongside forming a taskforce to consider longer-term solutions.

“The families that I’m talking to really want action now, and I absolutely hear and understand that, because their children are at risk of death. And it’s no exaggeration. These kids … they’re caught in the revolving door vortex of re-feeding, in and out of hospital, and it is collapsing families,” Daniel said.

“Some families we’ve spoken to have remortgaged or sold their homes in order to pay for residential care for their child.”

Goldstein MP Zoe Daniel.Credit:Alex Ellinghausen

Although anorexia typically affects girls, some experts said they had noticed a modest increase in teenage boys presenting with eating disorders in recent years as well as more children presenting with “atypical anorexia”.

This means that they are not underweight, but have lost dangerous amounts of weight in a short period of time and have all the other features of anorexia.

“Initially if a young person who is very overweight has lost three or five kilograms, the family might be pleased that they have actually been able to lose a bit of weight,” said Professor Susan Sawyer, the director of the Centre for Adolescent Health at the Royal Children’s Hospital.

“But for a group of young people, this can get into a very negative slippery slide of further weight loss, and development of an eating disorder.”

Rowan Brookes said her teenage son first developed an eating disorder in 2021, but despite worrying signs he was developing eating problems, there was a long wait to see a psychiatrist.

“These kids … they’re caught in the revolving door vortex of re-feeding, in and out of hospital, and it is collapsing families.”

Brookes said the general practitioners they had been seeing were unable to provide help, and when a GP did finally refer them to Monash Health, her son was drastically underweight and so unwell he was no longer able to go to school.

Through Monash Health, they were able to begin a “family-based therapy” program which mostly relies on parents to “re-feed” their child through scheduled meal times. The arduous process of supervising and coaching her son through each mouthful of food took Brookes up to eight hours a day.

“The anorexia can really be really rude, it can be violent. It tries to get up and leave the table. It’s like something else has taken over your children through those meal times because they are so controlled by the eating disorder,” she said.

“At one point I reached a really low point, it was just so enormously taxing to be trying to care for someone that’s so unwell.”

Melbourne Royal Children’s Hospital faced a surge in eating disorders during the pandemic.Credit:Pat Scala

Brookes reduced her work hours to only one day a week to care for her son, now 17. When she eventually ran out of leave, they were then able to get him into a specialist eating disorder day program run by Monash Health, where her son’s weight increased promisingly. But when that ended after three months, Brookes was unable to find a psychologist for recommended weekly appointments.

“It took about 15 psychologists to find someone that had an open waiting list … and throughout that time his weight just started declining again. [So] the government spent all this money on him going through these expensive programs, and the care just essentially ended,” Brookes said.

“He’s not back to square one, but he’s heading that way. Twice now he has been sent to ED … but they’re not going to ever admit unless he’s almost dying.”

Federal Health Minister Mark Butler said more targeted eating disorder services were needed “rather than seeing people cycle through hospital emergency departments”. He wrote to the Victorian government last month for an update on a residential eating disorder centre that the federal government provided funding for in the 2019-20 budget.

The Royal Children’s Hospital saw a 63 per cent jump in eating disorder presentations during the pandemic. Sawyer said there are signs demand may be easing.

The paediatrician and researcher said the patients admitted to hospital with severe eating disorders were now much more complex than they were when she began her career, yet funding hadn’t kept pace with these rising complications and surging demand.

Sawyer also said there were variations in the services provided to families with children with eating disorders depending on where they lived in Victoria. She called for funding to enable data to be analysed on the recovery rates of each service.

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