Today begins a national awareness week for eating disorders. It’s estimated that 30 million Americans (20 million women and 10 million men) have struggled with an eating disorder at some point over their lifetime. Eating disorders can affect people of every age, sex, gender, race, ethnicity, and socioeconomic group. They are a serious illness; in fact, eating disorders are the mental illness with the highest mortality rate. The most common eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder.

Parents are the first line of defense in preventing eating disorders in youth. It’s important that parents discuss good health, role model healthy eating habits, recognize warning signs, and seek professional help if necessary. Let’s discuss each of these steps:

Talk About Good Health

To help prevent teen eating disorders, talk to your son or daughter about eating habits and body image. 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, energy level and mood. When children are young, parents should teach them to listen to the natural cues their body is giving them. If they feel hungry, they should eat something nutritious. If they feel full, they should stop eating.
• 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.
• Discuss media messages. The media is inescapable in our culture and it does not portray healthy body images. Teach youth to view images in magazines, on screen, and on the web with skepticism. Explain the tricks used by the beauty industry and celebrity culture, such as airbrushing, photo manipulation, stylists, personal trainers, and cosmetic surgery. 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. Some key ways parents can foster self-esteem in their teen are to: listen (and make eye contact) with your teen when they talk; support their goals; admire their positive qualities, such as kindness or sense of humor; celebrate your teen’s accomplishments; and treat them with respect. Demonstrate through your actions that your love and acceptance is unconditional — not based on your teen’s weight or appearance.
• 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.
• Teach positive coping skills. Talk to your teen about healthy ways to manage their emotions such as talking to friends or enjoying a relaxing activity. Remind your teen that eating or controlling his or her diet isn’t a healthy way to cope with emotions.

Model Healthy Behaviors

Your children are 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

It’s important that adults are aware of the signs of eating disorders. Symptoms vary depending on the type of eating disorder. For example, a teen with anorexia might skip meals, while a teen with bulimia will eat but might induce vomiting. The key is to be alert for a drastic change in eating patterns or beliefs about food or weight that might signal unhealthy behavior. Some red flags that might indicate an eating disorder include:

• A distorted body image
• Extreme weight loss or not making expected developmental weight gain
• Frequently skipping meals or refusing to eat
• Excessive focus on food or dieting
• Persistent worry or complaining about being fat
• Frequent weighing or checking in the mirror for perceived flaws
• Using laxatives, diuretics or enemas after eating when they’re not needed
• Self-induced vomiting
• Excessive exercising
• Repeated episodes of eating abnormally large amounts of food in one sitting
• Expressing depression, disgust or guilt about eating habits
• Loss of hair, nail quality, or tooth enamel
• 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. If you see any of the warning signs above, 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 complicated 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 until they cooperate.

Final Thoughts…

The National Eating Disorder Association offers a helpline for support, resources, and treatment options for yourself or a loved one. Helpline volunteers are trained to help you find the information and support you are looking for. You can contact their helpline by phone, online chat, or text message. Visit their website for more information.