CORRECTION (PUBLISHED 13 JULY 1993) APPENDED TO THIS ARTICLE
'OFTEN the first hint of an eating problem with the mother comes from the child,' says Janet Treasure, senior lecturer at the Maudsley Hospital, London. 'Children as young as eight are investigated for stunted growth or glandular difficulties. Then we look into the family and find the mother is an anorexic who identifies so closely with the child that she can't feed it.
'Alternatively, anorexic mothers find a focus for their obsession with food in cooking, and force their children to overeat. Either way, research shows their children are 10 times more likely to develop the illness.'
In the past four years, Dr Treasure, a psychiatrist, has treated 30 anorexic or bulimic mothers, many of whose children show signs of eating disorders. About 2 per cent of young women are affected.
'People perceive eating disorders as a middle-class phenomenon, but research has shown that bulimia in particular - bingeing and vomiting - is increasing at an alarming rate across the spectrum,' she says. 'In the Nineties it seems to be replacing depression as a way in which women express their distress.'
Finding help is difficult: the Maudsley is one of the few places in Britain that deals specifically with the problem. Dr Treasure sees twice as many bulimic mothers as anorexics, mainly because it is easier for them to conceive. Anorexics often have to resort to fertility treatment because their periods stop when they dip below a certain weight.
'We're also seeing more and more anorexic mothers who face tremendous problems feeding their own children,' she says. 'These women constantly seek to control their children's intake. They don't let them have anything they perceive as unhealthy, and they serve minute portions. The most worrying thing is that they literally cannot see their children as underweight. Often it is the grandparents or teachers who notice that something's wrong.
'The husbands are usually extremely busy and unengaged in the family. All the running of the household is left to the mother. Families rarely eat together, as the mother is always trying to avoid meals and the children take their example from her. However, they pile the food on to their husbands' plates as a way of encouraging the rest of the family to eat.
'Children become confused, often resorting to subterfuge to supplement their meagre diets. When they go to visit friends' houses, they contrive games like picnics with real food, and at parties they eat so much they throw up. When the mother finds out, it confirms her belief that unless she controls their intake, they'll overeat, which reinforces the vicious circle.'
Dr Treasure sees cases where the mother's message has become so entrenched that the children refuse food. They may go on to suffer long-term growth impairment, and if puberty is delayed they may develop osteoporosis (brittle bones caused by loss of calcium and other minerals). 'These children are terribly loyal. Even when you talk to them about it, they never express any concerns; they simply say they don't eat because, 'Mummy wouldn't like it'.'
Dr Treasure is hoping to raise about pounds 50,000 to research the problem. 'At the moment it's like having a few pieces of a jigsaw,' she says. 'We hope to look at how the children of these women interact and develop. We'll also visit clinics for growth-disordered children to see if the patients' mothers have eating disorders.'
The solution for anorexic mothers who have difficulty in feeding their children is to let fathers take charge of cooking and serving, says Dr Treasure. Bulimic mothers also face internal conflicts over feeding their children, expressed in excessive control and an inability to cope with mess of any kind.
'Although the mothers tend to vomit in private, the young child often witnesses the bingeing sessions,' she says. 'When the child asks for the same food, the mother is unable to say no, yet is racked with guilt at giving them something unhealthy. If the child puts on weight, the mother often experiences feelings of rejection.'
For Dr Treasure and her team, the most frustrating aspect is the unwillingness of mothers to come forward. 'Anorexics are by nature very defensive and stoical. They often shun treatment for 20 years or more, by which time the death rate is as high as 18 per cent. The longer they wait, the worse their chances are of making a full recovery. That goes for their children too, many of whom have full-blown anorexia by the time we see them, thus setting in motion a cycle of eating disorders for the next generation.'
EATING DISORDERS Yesterday's Focus page on children affected by their mothers' eating disorders was written by Christina Kent. We are very sorry that her byline was left off the page.
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