Eating disorders prevention: parents are key players

Eating disorders are much easier to prevent than to cure, and parents are in the best position to do that work. Most of your efforts will be carried out in the context of the family, not in organized programs. Keep in mind at all times that what you do is a much more powerful message than what you say.

Reject guilt. Most parents of eating disordered children are good people who have done the best they knew how to do as they raised their kids. In spite of their efforts, their children fell into anorexia, bulimia, or another disorder. Science is telling us that genetic factors that determine personality have more influence than previously suspected in the development of eating disorders. Those factors seem to be activated when a vulnerable person begins to diet, buying into the belief that losing weight will somehow make life happier.

At that point parents tend to fall into guilt and denial. Neither is helpful. Instead of bemoaning what you did or didn’t do (which may or may not have contributed to the current problem), take action and arrange an evaluation with your child’s physician and a mental health specialist. The sooner treatment is begun, the easier it will be to turn matters around. The longer the symptoms are ignored, and the longer parents hope the behaviors are “just a phase,” the harder the road to recovery will be.

We hope you read the following guidelines before the situation becomes critical. Use the suggestions to create a healthy environment for the growth of your child’s self-esteem and to counter some of the destructive media messages about body image flooding today’s young people.

  • Give your family and friends the gift of a healthy role model. If you are a woman, get comfortable with your own body and enjoy it, no matter what its size and shape. Never criticize your appearance. If you do, you teach others to be overly concerned about externals and critical of their own bodies.
  • If you are a man, never criticize anyone’s appearance, especially a woman or child’s. Phrases like “thunder thighs” and “bubble butt,” even if they are meant in jest, can wound deeply and puncture self-esteem. Remember that people are more than just bodies. They all have talents, abilities, hopes, dreams, values, and goals — just like you do. Treat them as you would like to be treated.
  • Likewise, don’t allow anyone in the family to tease others about appearance. Even so-called playful teasing can produce powerful negative consequences.
  • Emphasize the importance of fit and healthy bodies, not thin bodies. The goals should be health and fitness, not thinness. They don’t always go together.
  • Praise your children for who they are, their personal qualities, and what they do — not how they look. A child who feels unattractive but is told that s/he is good looking will feel only anxiety, not improved self-esteem, and you will lose credibility in her/his eyes.
  • Especially important: Don’t you diet. Ever. In the first place, diets don’t work. They also send a dangerous and unrealistic message to kids about quick-fix solutions. Rather than diet, stick to a healthy routine of nutritious eating and fitness-promoting exercise.

    Important fact: three of the most powerful risk factors for the development of an eating disorder are (1) a mother who diets, (2) a sister who diets, and (3) friends who diet. In addition, girls and women who diet severely are eighteen times more likely to develop an eating disorder than non dieters. (ANAD newsletter, summer 2001)
  • Encourage healthy eating, not dieting. There is a difference. Also, make eating tasty food OK. Demonizing french fries and ice cream only makes them forbidden fruit (to mangle the metaphor).
  • Don’t forbid certain foods. Don’t define some foods as “bad.” Healthy eating has room for just about all foods in moderation. In addition, learn what normal development and weight gain look like. It’s not what you see in magazines or on TV! Encourage normal, healthy development in your children.
  • Make mealtime pleasant. Enjoy eating with family and good friends. Treat your family to a special meal once a week, at home or in a restaurant. Watching what you eat in the service of health is fine, but obsessive attention to calories, fat grams, and weight can set up a vulnerable person to fear food and the consequences of eating. For too many folks, these preoccupations and expectations lead to anorexia and bulimia.
  • If a child is bound and determined to diet, get a physician or registered dietitian involved to supervise the effort. Doctors and dietitians can provide information about healthy eating and weight levels that can counteract myths about “good” and “bad” foods and realistic weight goals. In addition, if the diet gets out of control, the resource person will already be available to intervene.
  • Help your children build and commit to an active lifestyle. You don’t have to spend major money on athletic club memberships or promote organized sports, but encourage activities such as biking, walking, and swimming that are pleasurable and can be done every day. Physical fitness promotes healthy self-image.
  • Talk to your children about the normal body changes expected at puberty. Sometimes kids interpret developing female curves as “getting fat.” Girls certainly need to know that normal development is necessary for health in general and healthy childbearing in particular. Boys need to hear the message too so they can rise above the “no fat chicks” mentality so prevalent in adolescent male culture.
  • Also talk to your children about the unrealistic images they see in magazines, on TV, and in the movies. Tell them that some models and actresses achieve their “look” by resorting to plastic surgery and eating disorders. It’s the truth. Point out how advertisers prey on body image insecurities by sending vulnerable people messages about the benefits of being thin — and spending their money on the advertisers’ products. Being thin doesn’t make one popular and self-confident any more than smoking does, but the advertising techniques for cigarettes and diet products are almost identical.
  • Most important of all, show people — don’t waste your time telling them — how you take care of yourself in healthy, responsible ways. Demonstrate how a competent person takes charge, solves problems, negotiates relationships, and builds a satisfying life without resorting to self-destructive behaviors. A healthy role-model parent is a child’s best protection against a whole host of problems, including life-ruining eating disorders.

Recent research (UCLA and University of Pittsburgh) finds a strong genetic predisposition toward mood, personality, and behaviors that, if not recognized and handled effectively, can lead to an eating disorder. Specifically, people with EDs tend to have family members who struggle with depression, alcohol dependency, drug abuse, anxiety, perfectionism, obsessive thoughts, and compulsive behaviors. Children in these families can become competitive and goal oriented, able to stay focused on achieving a single outcome to the exclusion of all else. If this pattern fits you or your family, be very careful. Don’t even think of allowing a diet unless it is done under doctor’s supervision. Be especially wary of thoughts that seductively promise you and your children that weight loss will lead to improved self-esteem and self-confidence. It won’t, and whatever weight is lost will never be enough.

If you have a child for whom this pattern fits, consider the following guidelines: Don’t let him or her diet. Provide opportunities for healthy eating instead. Don’t nag your child about losing weight to make his weight class or fit into her prom dress. God and Mother Nature intended our bodies to be a certain healthy weight. Trying to override that weight can lead to tragic consequences. Dieting is the strongest eating disorders trigger there is.

Prevention, especially if your family carries some degree of genetic predisposition to the thoughts, moods, and behaviors that can combine to produce an eating disorder, demands a great deal of consciousness and vigilance on your part. Don’t make the mistake of thinking, “We are of good stock. My child could never become eating disordered.” Given sufficient peer pressure to diet, societal demands for thinness, and parental expectations of excellence, a vulnerable child can collapse into an obsessive pursuit of thinness and compulsive, unhealthy behaviors to reach that goal.

If you have trouble implementing these suggestions, or even believing that they are worthwhile, you might want to talk them over with a mental health therapist who is experienced in treating people with eating disorders. Please do so especially if your child begins to sound like a broken record about the need to lose weight and how fat s/he is (when that is clearly not the case).