Food insecurity is the experience of not knowing when your next meal is coming. This is the reality for many children before being placed in foster care. It may result in an eating disorder known as Food Maintenance Syndrome (FMS). We provide information to help you recognise the condition, the short and long-term effects, and treatment options to restore the eating of healthy meals.

Food Maintenance Syndrome (FMS)

FMS is not a listed disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This makes it more difficult for even mental health professionals to diagnose correctly and treat. Common misdiagnoses are obsessive-compulsive disorder (OCD) and the umbrella term Other Specified Feeding and Eating Disorder (OSFED) for eating disorders that do match the DSM-5 criteria neatly.

Symptoms of FMS

Symptoms are rooted in the fear of going hungry and not trusting that food will be available in the future. This may lead to overeating beyond the point of feeling full or not experiencing satiety after an adequate meal. The child may shovel food in, eat rapidly, and fail to chew it properly for digestion. The syndrome may lead to stealing food from shops or their foster parents’ friend’s homes. Food will often be hoarded and hidden to be consumed in secret. These children will have difficulty sharing food and be protective of their plates. In some instances, the only way the child can cope with food uncertainty is to deliberately eat a limited amount.

Short-Term and Long-Term Side Effects

The short-term side effects of FMS are mainly gastrointestinal. These include indigestion, nausea or vomiting after eating, abdominal pain, and difficulties with swallowing food.

The long-term impact of FMS leads to electrolyte imbalances and dietary deficiencies. Vomiting becomes an ingrained reaction to eating so that the child automatically throws up after every meal or snack. When this happens, it is known as Rumination Disorder (RD). The effects of RD are gastrointestinal diseases, respiratory problems such as aspiration, bad breath, and tooth erosion.

Long-term side effects also encompass hypertension, stunted growth, hormonal disturbances, diabetes, overweight or underweight, insomnia and other sleep disorders, and anxiety conditions.

Treating FMS

Cognitive Behavioral Therapy (CBT) is a standard and effective treatment for many eating disorders. It works with disorder psychopathology. CBT aims to bring about changes in behaviour and cognition.

Family therapy (FT) addresses FMS from several angles. It provides psychoeducation to understand the syndrome and reframe thought patterns. Family therapy teaches the requirements for good nutrition. FT examines what happens at family meals and promotes the modelling of good eating habits. Additionally, it builds opportunities for exercise.

Nutrition counselling provides education on the effects of FMS and offers suitable plans for healthy meals.

Want to Help a Foster Child?

Foster children have unique needs, and it takes a special person to take up the challenge of turning their lives around. If you feel moved to assist, go to fosterplus.co.uk to see what allowance you could receive to foster a child. This generous amount will enable you to take care of all their needs, such as healthy meals, clothing, hobbies, entertainment, therapy, and pocket money. This amount also includes a professional fee to compensate you for dedicating your time to fostering.

With FMS, early intervention is critical. This requires a loving, supportive foster home.