- Eating Disorders - 

Mana Ake Workshop

Presenters - Louise Bennett, Clinical Dietician & Ursula McCulloch, Consultant Clinical Psychologist

Normal Eating - about 16% of NZers don't have breakfast and average 8 snacks a day.

When it becomes a concern - 

• weight
• nutrient deficiency
• restriction of food groups

Influences - 

• socio-economic
• food environment
• media/social media
• peers
• family/whanau environment
• teachers/educators

How to help build a positive relationship with food - 

• modelling, be aware of influence
• encourage a variety of food from the main food groups
• avoid labelling food as 'good' or 'bad'
• involve in food preparation and gathering

Picky Eaters - 

normal food stage for children 1&1/2 - 4 years old

concerns - 

• eating less than 20 different foods
• lack of nutrition
• missing out entire food groups
• particular about textures & stressed

The Whys of ARFID (Avoidant/Restrictive Food Intake Disorder)

• sensory issues
• super tasters
• association with negative events eg choking
• developmental concerns
• anxiety issues
• genetics
• environmental and management issues

The Whys of Anorexia (many unknown)

• low self-esteem
• anxiety. perfectionism
• genetics
• environmental issues

As a result of the struggles the parent - child relationship is often fractured

Parents/Whanau may feel - 

• like a failure
• judged
• manipulated
• over people giving them 'good advice'

Managing ARFID

What doesn't work

• force-feeding
• lengthy meal times
• dishing up guilt
• comparisons with peers
• punishments & threats
• ignoring
• tricking your child

It takes 20x of tasting to get used to a food.

Children need to know sometimes you have to eat foods that are ok but not your favourite.

Get the child to use their senses to learn about food and gradually build up to tasting and then eating ....

Images might help the child to visualise their progress ...

 Language

Challenge language around food. If a child says 'It's yucky," respond with "You are still learning about the taste. To me it tastes salty/or other." Say 'You can," rather than "can you." The child is a 'food explorer.

Implications for schools

• don't judge lunchboxes
• don't force feed or comparative shame
• don't offer advice
• do be empathetic
• do allow the child to bring their preferred food
• do celebrate success

Managing Anorexia

Myths around anorexia

• attention seeking
• passing phase
• mum's fault
• vanity etc

Externalise anorexia - it is in control not the child

Family Based Treatment - 3 Phases, generally lasts a year

1.    Phase 1 - weekly visits to home environment

• discussion
• family meal observation
• teach strategies

2.    Phase 2 - fortnightly sessions in home environment

• child gradually allowed to take more control
• finishes when ideal body weight is reached

3.    Phases 3 - monthly sessions

• address other related issues