When does a restricted-calorie diet become a cause for concern? Our nutrition expert, David Swain, advises.

Raisingkids member's problem
My daughter is almost 14 yrs-old and wants to make it as a model. She is very pretty and I think she could do well. All the guys fall for her. She is already skinny enough but she is starting to starve herself. What are the signs of anorexia? She sees the stars doing it, so she wants to just be like them. It makes me sick to see that going on. It's very sad. I didn't think this would start happening to my own daughter!

David's advice
Dieting to slim is very common among teenage girls and as you are aware much of the reason for this is their conception that thinness results in attractiveness. Fortunately, in most cases these self-imposed calorie-restricted diets are usually short lived,either because the individual gets bored with the diet or because hunger wins through. In some individuals however, the slimming process can take over and eating disorders can result.

There are a number of different types of eating disorder including Anorexia Nervosa and Bulimia Nervosa. The main warning signs of Anorexia Nervosa include

• Deliberate self starvation with weight loss
• Intense, persistent fear of gaining weight
• Refusal to eat,except tiny portions
• Greater amounts of hair on the body or face
• Sensitivity to cold temperatures
• A self-perception of being fat when the person is really too thin
• Compulsive exercising
• Absent or irregular menstruation
• Some individuals try to increase weight loss by self-induced vomiting

The difficulty in treating eating disorders is that the affected individual will often deny that there is a problem and try to reassure everyone that they are in the peak of health. Consequently the treatment of established eating disorders is not easy and specialist psychiatric input is usually needed.

With regards to your daughter it is important to remember that in most cases these periods of strict dieting are usually short-lived and although I understand that it must be very worrying, try not to be too confrontational with your daughter. My advice would be to try and monitor the situation without making it too much of an issue and to continue to encourage her with a healthy well balanced diet.

If she starts to show some of the warning signs of developing Anorexia Nervosa, you could try and talk to her about your worries and if she seems unwilling to discuss her eating problems with you, then try suggesting that she at least reads about the condition. Ultimately if she continues to starve herself or continues to lose weight then you should consult with your GP. It may be that she will need to be assessed by a specialist.

Finally there are a number of useful addresses and websites that may be of help to you to learn more about eating disorders and for advice. When researching for this question I found that the Mental Health Foundation had published two very good booklets on Anorexia Nervosa and Bulimia Nervosa. These can be seen at www.mentalhealth.org.uk

Other useful organisations include the Eating Disorders Association (103 Prince of Wales Road, Norwich NR1 1DW) www.edauk.com which provides telephone helplines, information sheets, leaflets and newsletters and runs a national network of self-help groups. MIND (Granta House, 5-19 Broadway, London E15 4BQ) is a national charity which offers information on mental illnesses. MIND have leaflets and information sheets on eating disorders.

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