A Perth parent’s heartbreaking letter conveys the devastation of watching a child with an eating disorder

“As a parent, you devote yourself to protecting your child as they grow. You do everything you can, outside-in, to give your child the best possible shot. But there’s little you can do, as a parent, when something strikes from inside-out.” These powerful words are from a Perth father who for years has watched his child suffer through an eating disorder. He has watched on as they struggled to take a bite of food, knowing the damage the insufficient food intake is doing to their body, and grieving the experiences, friendships and opportunities they are missing out on as they battle the insidious, complex and all-consuming illness. And he is fearing when they might next walk through the doors of Perth Children’s Hospital, for his dangerously unwell child to have a feeding tube inserted. “Beds are limited. They always are,” he writes. “And the staff do their best – but there’s not enough to cope with the growing demand. And little to support family members. “It’s an epidemic. And we risk losing a chunk of a generation of beautiful young people unless more is provided to assist.” The father wrote the letter to The West Australian this week after an article in these pages highlighted what one Perth doctor described as a “national crisis.” Dr Andrew Leech, who founded the Garden Medical Clinic, said his patients as young as seven are showing disordered eating patterns and obsessing over their diet and appearance. He also criticised the public health response to eating disorders, claiming that some of his severely ill young patients have been turned away from emergency departments because they are “not sick enough”. The West Australian has spoken to doctors, psychologists, parents and those with lived experience who now dedicate their lives to others suffering from devastating eating disorders, to gain an insight into how the crisis is impacting thousands of families. All agreed the number of children and teenagers seeking treatment for eating disorders was increasing, while the age of those seeking help was falling. Shannon Calvert has lived with an eating disorder for more than 30 years and is now a lived experience educator, supporting individuals, families and services and advising on reform. She was diagnosed with anorexia nervosa and bulimia nervosa at 13, and fluctuated between the two as she battled a relentless cycle of restriction, bingeing, purging, and laxative use that continued for decades. Despite being very unwell she recalls feeling like a “fraud” and “not sick enough” to have an eating disorder. “I felt very disconnected and uncomfortable in my body, especially when it began to change,” she recalls. “I was taller than my peers, and people would say, ‘You’re a big girl.’ They meant tall, but as a child, the word ‘big’ left little room for interpretation — and certainly not in a positive light.” Ms Calvert now advocates for a better, more individualised system of care and reform. She told Agenda she has witnessed a “growing intensity” in body dissatisfaction and eating disorder-related behaviours across all genders. “Children as young as eight or nine are showing signs of restrictive eating, anxiety around food, and fear of weight gain,” she said. “Often, they haven’t been exposed to what we might think of as ‘traditional’ eating disorder risk factors. Instead, they’re internalising distress through family dynamics, peer culture, and digital media. “These early signs matter — and we must respond with compassion and developmentally appropriate support, not wait until a child becomes medically unwell.” Young children referring to food as “bad”, or saying “I can’t eat that, I’ll get fat”, “I feel disgusting after I eat” or “I hate the way I look in that photo” has become common. “More children are describing food with guilt and shame, echoing what they hear from adults or from restrictive online content. These patterns may not yet meet the threshold for a clinical eating disorder, but they lay the foundation for disordered thinking and self-surveillance,” Ms Calvert said. For this reason, she says early intervention and education in schools is vital. “We need to act early — with age-appropriate, non-stigmatising support — before these patterns escalate into entrenched illness.” Sarah Dyer will never forget how she felt when a Perth nurse asked her for “weight loss tips” during one of her many hospital admissions. Or when after being told by a doctor at a psychiatric facility that she had a low heart rate because she was an athlete, and was extremely fit, she decided it was better to disengage from treatment because she wasn’t “unwell enough” for specialists. Now 34, Ms Dyer channels more than two decades of living with an eating disorder into her work with young people, hoping to offer the understanding and support that was missing when she was growing up. Ms Dyer’s eating disorder started when she was living in Victoria and an elite-level swimmer over four years in primary school and early high school. Competition and training required that she be slim, that she strive for perfection and adhere to rigidity with training and diet. “I was indoctrinated with ‘don’t eat before you swim’, and despite being at a really early developmental age there was no focus on support,” she recalled. “No one knew anything was wrong, and there was no early intervention stuff. By the time I was diagnosed it was well and truly ingrained in me.” Throughout her life Ms Dyer has experienced “the whole gamut” of treatment, including inpatient admissions, emergency presentations and private treatment. She says it took her 10 years to find “something that stuck” and now has an amazing treatment team. Now living in Perth after relocating following university, Ms Dyer took up endurance running and in 2022 upskilled to coach kids athletics and cross-country running. It is her hope to provide what was missing for her as an up-and-coming athlete. “I want to try and redefine the experience so they don’t have the same experience as me,” she said. Ms Dyer said it was extremely difficult for kids to escape constant comparison and pressure due to social media. “There is no delineation between boys and girls, they are all feeling the pressure, and the language they are using, I am trying to catch and correct it,” she said. She is among a growing cohort of advocates and specialists who have realised that recognising and addressing body image issues must start from an early age. The Butterfly Foundation’s national helpline manager and clinical psychologist Sarah Cox said more primary schools were seeking support in addressing concerning behaviours such as negative self-talk, fears around eating certain foods, weight gain and body comparisons. The foundation has launched a primary school program, Butterfly Body Bright, in response to this trend, aiming to help schools nurture positive body image and healthy relationships with eating and physical activity. An evaluation of the program showed 54 per cent of students felt an immediate increase in how happy they felt about their body. Ms Cox said more needed to be done in schools, particularly given “lunch box policing” still existed, where teachers commented on students’ food and labelled foods as “good” and “bad.” “This really speaks to the fact that unfortunately, in our society, diet culture and disordered approaches to food and exercise have become really normalised, and with so many confusing messages about health, it’s not surprising that many adults aren’t sure how to talk to their kids or students about these issues without doing harm,” she said. “In reality, we should be calling foods simply by their name, encouraging young people to approach food with curiosity, and ensuring we talk about food as not only a form of nutrition and fuel, but also for enjoyment, culture and connection.” Ms Cox said if parents should seek medical advice if they noticed any warning signs in their children, including excessive or compulsive exercise, weight loss or gain, obsession or preoccupation with food or food preparation and cutting out major food groups. Experts working in the space agree progress has been made in WA in recent years to address the long public hospital waits and disjointed care. Ms Calvert said there was genuine effort underway in WA to expand and improve treatment options, thanks in large part to the WA Government’s five-year Eating Disorders Framework and its Eating Disorder Specialised Service which recently opened in Subiaco. The hub offers multidisciplinary support for people aged 16 and above, aiming to reduce symptoms and improve quality of life, and is also home to the WA Eating Disorders Outreach and Consultation Service, which informs clinicians on best-practice treatment. This follows the 2023 launch of the Kara Maar eating disorder service in Cockburn which offers triage, assessment, day programs and outpatient clinics, overseen by psychiatrists, psychologists, dieticians, social workers and Aboriginal mental health workers. Despite these changes, Ms Calvert said demand continued to outpace capacity. “Families often face long waitlists, strict eligibility criteria, or are told to wait until things worsen. These barriers can delay vital early intervention and make recovery harder,” she said. “The system is moving in the right direction — but it needs resourcing, integration, and continued collaboration with lived experience leadership to keep pace.” Many families are seeking private treatment at clinics such as The Swan Centre and Esus Centre. Swan Centre director and clinical psychologist Emma Dove said it was important for patients and families to hold out hope for recovery. “People recover from eating disorders and go on to make valuable contributions to their community. We know prognosis is best when treatment is received early, but we have seen people recover who have had eating disorders for many years as well,” she said. Dr Dove said the increased exposure children had to social media played a part in them developing unhelpful, unrealistic ideas about body image. Part of the treatment at The Swan Centre involves teaching young people to critique social media images to identify altered and fake photos, and changing a young patient’s social media algorithm to encourage a more positive body image. Esus Centre medical director Vash Singh said it was encouraging to see the State Government recognise eating disorders as a serious public health priority, but despite the steps forward significant structural challenges remained. “Currently, public services are heavily geared toward the most severe, medically compromised end of the spectrum — and while this acute care is absolutely essential, it leaves the vast majority of people with eating disorders without access to timely, appropriate treatment,” she said. “Individuals with moderate illness or those who don’t meet restrictive diagnostic thresholds often struggle to access help until their condition worsens, creating a tragic and preventable bottleneck. Esus Centre was created to offer an alternative to what Dr Singh described as the siloed public system, where medical, psychiatric and psychological services are fragmented across different departments and providers. “This lack of integration places an enormous burden on families to coordinate care themselves — something that is difficult even for the most resourced families and near-impossible for those already under strain.” That strain is something the Perth father who penned the powerful letter knows all too well. He refers to a desperate, exhausted “underground network of parents who seek each other out, talk about their experiences, and share tips and tricks that have helped their own kids.“ Parents who desperately want others to understand what they are going through, and just what is at stake. “This is so much more than a child looking at a mirror and wanting to look different,” he writes. “I don’t think the wider public get it. The battle that goes on in their own minds is horrendous.” If you need help or support for an eating disorder or body image issue, please call Butterfly’s National Helpline on 1800 334 673 or email support@butterfly.org.au