In the United States, 20 million women and 10 million men suffer from an eating disorder at some time in their life, including anorexia nervosa, bulimia, and binge eating disorder. If you would like more information about these specific disorders, visit the National Eating Disorders website. Eating disorders are not a phase or lifestyle choice, but rather serious, life-threatening conditions that affect a person’s emotional and physical health.

Statistics and Facts

• Anorexia is the third most common chronic illness among adolescents.
• 95% of those who have eating disorders are between the ages of 12 and 26.
• 86% of those who have eating disorders report the onset of an eating disorder by age 20.
• One-half of 4th grade girls are on a diet.
• The mortality rate associated with anorexia nervosa is 12 times higher than the death rate associated with all causes of death for females between the ages of 15 and 24 years old.
• Over one-half of teenage girls, and nearly one-third of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives.

 

Steps for Parents

Faced with these troubling statistics, what should parents do?

1. Talk to your child about good health and the risks of eating disorders.
2. Model healthy behaviors.
3. Be able to recognize the warning signs of an eating disorder.
4. Seek professional help if you suspect your teen might be battling an eating disorder.

 

Parents are the first line of defense in young patients. You are likely in the best position to notice warning signs, and you play a vitally important role in helping to educate your teen about eating disorders and preventing a high-risk behavior from turning into a serious condition requiring medical and psychological attention. Let’s address each of the action steps above in detail:

Talk About Good Health

To help prevent teen eating disorders, talk to your son or daughter about eating habits and body image. It might not be easy, but it’s important. To get started:

• Encourage healthy-eating habits. Provide healthy foods at meals, limit the amount of junk food available at home, and make a habit of eating together as a family. Explain what makes up a well-balanced, nutritious, healthy diet. Talk to your teen about how the foods they choose to eat can affect his or her health, appearance and energy level, and be sure to encourage your teen to eat when he or she is hungry.
• Discuss media messages. The media is inescapable in our culture and it does not portray healthy body images. Teach your children to view images in magazines, on screen, and on the web with skepticism. Tell your teen about airbrushing, photo manipulation, stylists, personal trainers, cosmetic surgery, and other tricks that make up the beauty industry and celebrity culture. Limit their viewing of television and teen magazines. Watch television or read with them so you can talk about what your teen is seeing and feeling.
• Nurture self-esteem. Treat your teen with respect and acknowledge his or her achievements. Some key ways parents can foster self-esteem in their teen are to: make sure that you are listening (and making eye contact) with your teen when they talk; support their goals; admire their positive qualities, such as kindness or sense of humor; and celebrate your teen’s accomplishments. Demonstrate through your actions that your love and acceptance is unconditional — not based on your teen’s weight or appearance.
• Develop healthy eating habits. Do not try to lose or gain weight dramatically or use fad diets. You – and your teenager – should work towards a healthy weight by eating a well-balanced, nutritious, healthy diet. “Everything in moderation” is a far more positive message to share with your children than the messages sent by food exclusion and restrictive dieting.
• Use food for nourishment only. So many of us fall into the bad habit of using food as a reward or punishment. You should fight the temptation to offer food as a bribe or take away food as a punishment. Food should not be a negotiating tool.
• Share the dangers of poor eating choices. Every parent needs to talk to their teen about the risks associated with dieting, emotional eating, and eating disorders. Explain that dieting can compromise your teen’s nutrition, growth and health. If your teen wants to lose weight, talk to them about making a lifestyle choice to choose healthy foods and exercise. Talk to your teen about healthy ways to manage their emotions such as talking to friends or loved ones and remind your teen that eating or controlling his or her diet isn’t a healthy way to cope with emotions. Finally, explain what eating disorders are and why they occur.

 

Model Healthy Behaviors

Your teen is closely observing your lifestyle, eating habits, and attitudes about appearance and weight, even if it doesn’t seem like it. You must be careful about the example you are setting because the way you think about your own body image will have a tremendous impact on how your teen views their own body image. Here are some tips to follow:

• Set the example. If you’re constantly dieting, using food to cope with your emotions or talking about losing weight, you might have a hard time encouraging your teen to eat a healthy diet or feel satisfied with his or her appearance. Instead, make conscious choices about your lifestyle and take pride in your body.
• Promote a healthy body image. Never make comments – good or bad – about another person based on their appearance. Instead talk about how healthy body shapes vary, and compliment others’ healthy behaviors. Never make jokes or create hurtful nicknames based on a person’s physical characteristics. Refrain from critical and judgmental words about your teen’s appearance, even their clothing. Your negative comments will only make your teen more discouraged and exacerbate the problem. Instead, find ways to compliment your teen.
• Do not talk negatively about your own body. If your teen hears you complaining about the way you look, he or she will assume it is appropriate to dislike his or her body. When you are constantly stressing about your thinning hair or asking if your outfit makes your hips look too big, you are teaching your child to focus on their own flaws instead of their positive attributes. If you do need to lose or gain weight, be sure to talk about it in terms of your health, not on the way you look. Offhanded comments about having a “fat day” or rejoicing over fitting into a smaller clothing size can have a bigger effect on a developing teen’s body image than you might think.
• Model exercise. Yes, exercising is hard, but it truly is one of the best ways to ensure a healthy life. Take simple steps. Instead of flopping down on the couch to watch TV after dinner, invite your child to play Frisbee, walk around the block, work in the garden, or go for a bike ride. Not only will you both be getting exercise, you will also have a chance to talk!  Do not groan about needing to exercise more or express guilt about exercising too little. Just make it part of your life as best you can and talk about how good you feel when do get moving.

 

Recognize Warning Signs

Learn to recognize the warning signs of eating disorders:

• Weight loss or drastic weight fluctuations.
• Avoidance of or over-indulgence in different types of foods.
• Denial of hunger.
• Excessive drinking of fluids.
• Skipping meals, making excuses for not eating or eating in secret
• Eating much more food in a meal or snack than is considered normal
• Expressing depression, disgust, shame or guilt about eating habits
• Withdrawal from friends and activities.
• Excessive focus on food, food labels, dieting, and healthy eating
• Persistent worry or complaining about being fat and talk of losing weight
• Change in dress: over-sized to cover the body or revealing clothes to flaunt weight loss.
• Excessive, rigid exercise regimen.
• Self-induced vomiting.
• Use of dietary supplements, laxatives or herbal products for weight loss
• Regularly going to the bathroom after eating

This is a wide range of symptoms, but you should be aware that eating disorders are complex illnesses that are not characterized by one symptom, such as weight loss. It is usually a combination of warning signs. Perhaps one common denominator among people with eating disorders is that they are trying to manage their emotions by manipulating their food and weight. If you see any of the warning signs above – no matter how mild or severe – do not ignore them. If left unchecked, they could rapidly develop into a serious condition.

Seek Professional Help

People struggling with an eating disorder need to seek professional help. Eating disorders are complex illnesses that cannot just be addressed by the parent or by more “willpower” from the teen. The earlier a person with an eating disorder seeks treatment, the greater the likelihood of physical and emotional recovery.

To treat an eating disorder, teens need treatment from a doctor for their physical health and from a mental health provider for their psychological health. The doctor should evaluate your teen’s current body weight versus ideal body weight. They should also check your teen’s vital signs, such as blood work and blood pressure. Your teen’s therapist, who should have a specialty in treating eating disorders, should provide a psychological evaluation of your teen, which should include interviews of both parents, in addition to your teen. You might also want to contact a dietician or nutritionist who can provide your teen with guidance on healthy eating. You should feel that your teen’s providers see you as an important part of the treatment team and that they desire to continue hearing your concerns and observations.

It is not uncommon for a patient with an eating disorder to refuse to go to a medical appointment or cooperate with the providers’ assessments. In this situation, stress how critical it is to be healthy. If this alone doesn’t work, consider taking away a privilege that they enjoy (participation in a sport or activity, access to the family car, access to their cell phone, etc.) until they cooperate.

Final Thoughts…

Often when a family discovers that their child has an eating disorder, the initial reaction of the parents is to try to determine the cause. Inevitably this is a waste of time and energy. There is never one specific or simple cause to such an illness, and trying to find one can lead to blame, regret, and guilt, none of which helps your child get better. The best way forward is to focus on engaging in his or her treatment and implementing solutions aimed at a full recovery.