'Boys don't get anorexia' is a phrase that any parent who is concerned about a son who is losing too much weight or exercising excessively will hear at some time or other, hopefully from an uninformed friend or relative rather than a health professional.

Well boys DO get eating disorders and in this very personal and insightful book Jenny Langley looks at what it means to have a son who does in fact have anorexia.

Research, as well as anecdotal evidence, indicates that as many as 20 to 25% of school age adolescents who are affected by an eating disorder are male. However, the number of males diagnosed and seeking treatment is roughly half that. At Eating Disorders Association we know from callers to both our adult and youth helplines that males can find it hard to believe that they may have an eating disorder. Getting it diagnosed may be a struggle and finding appropriate treatment can be very problematic.

It is reassuring that with the approval of her son, Jenny has decided to write about the development of anorexia in boys and has taken the trouble to investigate and write about the wider issues in a way that will be helpful to parents and carers who are concerned about a young boy.

Any parent with an eating disorder in the family will know at first hand the problems that a young boy already caught up in the maelstrom of adolescence can both experience, and cause when anorexia arrives. Jenny writes about the way in which the disorder crept up on her family and then seemed to take over the household. Many parents will be relieved to know that they are not the only ones to experience this powerful and generally negative mix of emotions that surrounds and engulfs everyone nearby. Recent research indicates that boys affected by eating disorders are much more likely to blame themselves for their problems than girls do, complicating the already difficult process of recovery.

Jenny was lucky that the team involved with Joe's treatment involved her at every stage of the therapy. Although Jenny and the team often had very different views on Joe's progress, and at times the relationship was very strained, she and her family were never totally excluded. Many parents have found that talking to their doctor and even psychologists and psychiatrists is often not straightforward and many health professionals who struggle with these most complex of disorders hide behind a smokescreen of 'confidentiality' adding to parents' confusion and concern. Open communication and talking therapy is the key to recovery from eating disorders and except for those few cases where some form of abuse is at the heart of the problem, parents should be informed and involved with the whole treatment process.

Nevertheless, it is important to differentiate between the confidentiality of the consulting room and straightforward information about the progress of treatment. The relationship between patient and therapist can be slow to develop and difficult to unravel so it is entirely appropriate for the conversations during therapy to be confidential in every sense of the word. However, being prepared to discuss whether therapy is going as well as expected or is proving more difficult without needing to go into detail is the sort of information that should routinely be shared with parents or carers.

Many people find that pressured and confused health professionals can use the age of a patient (the NHS recognises 16 years old as an appropriate age for people to be treated as adults) to choose not to communicate with parents and carers who nevertheless are expected to care for the sufferer when they come home, either at weekends or at the end of the therapy. The Government Mental Health National Service Framework clearly states that patients must have a care plan that is drawn up with the involvement of the carer and the National Institute of Clinical Excellence (NICE) guidelines specifically recommend that all family members should be included in the treatment of children and adolescents with eating disorders.

Sadly, many carers find themselves having to fight to be included in the therapeutic process instead of being there by invitation from the professionals. This leads to even greater stress and disharmony in the family. Many parents and carers will find the practical tips Jenny provides on how best to approach medical professionals initially, and how to stay involved as treatment progresses, very useful.

As many parents have discovered, the problems do not disappear when the hospital takes over and the slow painful climb of Jenny's son back to recovery is recounted in uncomfortable detail. Ultimately however this is a story of hope. Joe does recover eventually and although life is by no means the same as before, it does return to a new normality.

Steve Bloomfield

Head of Communications

Eating Disorders Association

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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