Understanding Eating Disorders in Children and Adolescents: Expert Insights from Dr Hazel Fernandes
- Schoen Clinic UK
- Sep 9
- 6 min read
Eating disorders such as anorexia nervosa are among the most complex and serious mental health conditions affecting children and teenagers. They can develop gradually, are often difficult to spot in their early stages, and require specialist treatment involving not only the young person, but also their family and support network.
To shed light on this challenging topic, Dr Hazel Fernandes, Consultant Child & Adolescent Psychiatrist at Schoen Clinic Chelsea, shares her expert perspective on what anorexia is, how it develops, and why a family-based approach to treatment is so important.
“You don’t wake up one morning and decide to be anorexic. It’s a number of life events that occur that manifest themselves in a form of control,” explains Dr Fernandes.
What is Anorexia Nervosa?
Anorexia nervosa is more than just a desire to lose weight. It’s a serious mental health disorder characterised by a number of psychological, behavioural and physical symptoms, including:
Distorted body image
Extreme weight loss beyond what is healthy
A sense of control through restriction of food
Secrecy and difficulty in sharing what’s happening
Unlike some mental health conditions, anorexia also alters the body’s satiety control and chemical balance, making recovery particularly complex.
“Anorexia is one mental health disorder that is insidious and it creeps up on you. The onset is slow and before you even know it, you’re caught up in it,” says Dr Fernandes.
Different Types of Eating Disorders in Young People
While anorexia nervosa is one of the most well-known eating disorders, it’s not the only one affecting children and adolescents. At Schoen Clinic Chelsea, specialists treat a range of eating disorders, including:
Anorexia Nervosa: Restriction of food intake, intense fear of weight gain, and distorted body image.
Bulimia Nervosa: Cycles of binge eating followed by compensatory behaviours such as vomiting, laxative use or excessive exercise.
Binge Eating Disorder (BED): Repeated episodes of consuming large quantities of food, often in secret and without purging behaviours.
Other Specified Feeding or Eating Disorders (OSFED): When someone shows signs of an eating disorder but doesn’t fully meet the criteria for anorexia, bulimia BED they may be diagnosed with OSFED.
Avoidant/Restrictive Food Intake Disorder (ARFID): Severe restriction of food due to sensory sensitivities, fear of choking or vomiting, or lack of interest in eating.
Each condition presents differently, but all require specialist intervention to prevent long-term physical and psychological consequences.
Why Eating Disorders Develop
There is no single cause of anorexia or other eating disorders. Instead, they arise from a combination of social, biological and psychological factors.
Some of the common influences include:
Social media pressures and unrealistic beauty standards
Peer pressure during adolescence
Family dynamics and stressful life events
Perfectionism and need for control as coping mechanisms
Genetic predisposition and brain chemistry
Dr Fernandes highlights the particular risk of social media exposure:
“The aspect of how you look is given so much importance nowadays, especially because of social media. The pressure young people are undergoing with their exposure to social media doesn’t help the fight against this particularly difficult disorder.”
The Impact of Eating Disorders on Health
Eating disorders are not only psychological conditions, they affect the entire body. For children and adolescents, the consequences can be particularly severe as their bodies are still developing.
Physical health effects include:
Malnutrition and vitamin deficiencies
Slowed growth and delayed puberty
Hormonal imbalances and menstrual irregularities
Heart complications due to electrolyte imbalance
Risk of osteoporosis later in life
Mental health effects include:
Anxiety and depression
Social withdrawal and isolation
Cognitive difficulties due to malnutrition
Increased risk of self-harm or suicidal thoughts
Because of these wide-ranging consequences, anorexia is recognised as having one of the highest mortality rates of any mental health condition.
Why Eating Disorders Are Hard to Recognise in Children
Children and teens often don’t realise they have an eating disorder until someone else notices the signs. Parents, carers and teachers therefore play a crucial role in early recognition.
“It’s very difficult for a child under 18 to recognise they have an eating disorder. It becomes the role of carers to monitor what our children are doing,” notes Dr Fernandes.
Some early warning signs to look for include:
Restricting or skipping meals
Avoiding certain food groups
Sudden weight changes
Obsession with body image or calorie counting
Withdrawing from friends and family
Increased secrecy around eating habits
The Role of Families in Eating Disorder Recovery
Effective treatment for eating disorders in children and adolescents goes beyond the young person themselves. It requires parents, carers, schools and medical professionals working together.
At Schoen Clinic Chelsea, family involvement is central to treatment.
“We treat eating disorders predominantly in children through family-based therapy, which has the most evidence for treating it. Parents are the ones who are going to implement our recommendations. That’s why honesty, openness and collaboration are essential,” says Dr Fernandes.
Why Family-Based Therapy Works
Family-Based Therapy (FBT), sometimes known as the Maudsley approach, is widely recognised as the most effective treatment for anorexia in young people.
FBT typically involves:
Parents taking an active role in refeeding their child
Restoring healthy eating patterns before focusing on psychological issues
Gradually returning responsibility for eating back to the young person
Addressing family dynamics that may be contributing to the illness
Research shows that FBT can significantly improve recovery outcomes, particularly when started early. At Schoen Clinic Chelsea, FBT is delivered by a multidisciplinary team that includes psychiatrists, therapists and dietitians.
The Role of Schools and Teachers
Schools are often where early warning signs are first noticed. Teachers and school staff may see changes in a student’s eating habits, weight, mood or performance. Collaborating with schools is therefore a vital part of supporting recovery.
Dr Fernandes emphasises the importance of involving every environment a child is part of:
“Everywhere the child goes the challenges are there. So it’s a very complex disorder to treat and needs highly specialised, consistent care.”
Schools can support by:
Providing flexibility around mealtimes
Offering a safe, non-judgemental environment
Communicating with parents and clinicians
Encouraging peer support and awareness
Common Misconceptions About Eating Disorders
There are many myths surrounding eating disorders that can prevent families from seeking timely help. Some of the most common include:
“Eating disorders are just about food.” False: They are complex mental health conditions with psychological and biological roots.
“Only girls get anorexia.” False: Boys and young men are also affected, though they may be less likely to seek help.
“It’s just a phase; they’ll grow out of it.” False: Eating disorders are not phases. Without treatment, they can persist for years and cause lasting harm.
“Parents are to blame.” False: While family dynamics can play a role, eating disorders are never caused by a single factor. Parents are key partners in recovery.
Practical Advice for Parents and Carers
If you’re worried about your child’s eating habits, here are some steps you can take:
Trust your instincts – if something feels wrong, seek advice.
Open conversations gently – avoid blame or criticism, focus on concern.
Monitor changes – keep an eye on eating patterns, mood and social withdrawal.
Seek professional help early – eating disorders rarely improve without specialist support.
Get involved in treatment – your role as a parent or carer is crucial in recovery.
Why Early Treatment is Vital
Eating disorders are associated with some of the highest rates of morbidity and mortality among mental health conditions. The earlier intervention begins, the better the chances of recovery.
At Schoen Clinic Chelsea, our team of psychiatrists, therapists and dietitians provide specialist outpatient eating disorder treatment tailored to each child and their family.
Our services include:
Comprehensive assessments by experienced psychiatrists
Family-based therapy and adolescent-focused therapy
Collaborative support involving parents, carers and schools
Compassionate, non-judgemental care at every stage of recovery
When and How to Seek Help
If you suspect your child may have an eating disorder:
Speak to your GP as a first step.
If you want faster access to assessment and treatment, you can also refer directly to Schoen Clinic Chelsea.
Private health insurance (Bupa, Cigna, Aviva, Vitality and others) is accepted, and self-funding options are available.
Learn more about our Outpatient Eating Disorder Services at Schoen Clinic Chelsea
Read more about Dr Hazel Fernandes, Consultant Child & Adolescent Psychiatrist
Final Thoughts from Dr Hazel Fernandes
Dr Fernandes reminds families that recovery is possible, but it requires honesty and teamwork:
“Ignoring the role carers have to play in a child’s mental health would be quite dangerous. My job is to absorb the angst, the anger, the guilt, and help families along that journey. The only thing we ask of parents is to be honest.”
Key Takeaways
Anorexia and other eating disorders are complex mental health conditions that require early intervention.
Children often don’t recognise the problem themselves — parents and schools play a vital role.
Family-based therapy is the most effective evidence-based treatment for anorexia in young people.
Eating disorders affect both physical and mental health, with potentially life-threatening consequences.
Specialist support is available at Schoen Clinic Chelsea, where care is compassionate, evidence-based and family-focused.
