WHAT PARENTS NEED TO KNOW
BODY IMAGE DISTURBANCES AND EATING DISORDERS
Q: "Am I overreacting by worrying that my child who eats healthfully now might one day develop an eating disorder?"
Unless your eyes have been closed to the forces all around us, you are attuned to the influences of a society where youngsters (and oldsters alike) feel driven to strive for thinness as a route to beauty, success, popularity, and happiness. High schools and colleges have been joined by middle and even elementary schools, in experiencing the phenomenon that kids as young as age 5 and throughout their adolescence, young and middle adulthood years, are becoming vulnerable to the destructive influence of society, of peers and the media.
The good news is that parents, though they cannot protect their children from the forces that their children encounter outside the home daily, can provide their children strength, resiliency and an immunity to developing body image disturbances and eating disorders. A parent with know-how can virtually "eating disorder proof" his or her child.
Parents need to assume responsibility and take control when and where they have control; they need to teach their children what healthy eating is and to "live" that message themselves, providing healthy role modeling for their child with meals and exercise. Parents who cook and provide meals, and who sit down to enjoy them together with the family, can do a great deal to counteract even the most pernicious of outside influences.
Q. "I am told that I must never discuss food with my child, so what should I do if I notice her putting on a lot of weight, skipping meals, or eating restrictively?"
The theory behind this "hands off" policy is that parents should avoid becoming involved in fruitless power struggles with their child. In actual fact, power struggles are not an option when it is understood that the parents, in intervening, are joining, not opposing, the child in the battle against eating dysfunction. Kids and parents ultimately share the same goals, that being to have the child grow up to become an independent and highly functioning and productive adult who is a healthy eater, and a gratified individual.
If parents feel a power struggle brewing, this is their cue that they have not yet been successful enough at listening deeply enough to the underlying feelings behind the childís words, at hearing the true essence of what their child needs and wants to convey. In such instances, even more important than speaking, parents need to listen to encourage the child hear herself. "Tell me moreÖ." Or "Ö.and what else?Ö" are generally two phrases that will facilitate these goals.
In confronting a child, it is important for parents to be persistent and to speak from the "I" position, stating their own observations, concerns, thoughts, and suggestions about options, then noting realistic consequences of the childís actions. Your child was not born spontaneously competent to know what is healthy and how best to nourish herself. She is counting on you to become her teacher, mentor and guide.
Q. "My child is a quirky eater. Am I wrong to assume that because "everyone" has issues around food of one sort of another these days, itís silly to worry?"
There is often a thin line between what is normal and what is pathological when it comes to food and eating. The determining factor is the purpose and motivation that the eating behavior carries for the affected individual. As an example, if skipping breakfast occurs because a child is late for school, the situation is far less critical than if she felt she had no choice but to deny herself food and satiety if her morning were to be free from guilt, fear, regret and anxiety.
Even if your childís eating-related issues have not yet become diagnosed as clinical disorders, the concerns and attitudes driving the eating quirks or dysfunctions may still warrant some clinical attention. Destructive underlying attitudes are often more damaging than behaviors. Values, eating irregularities, diets, body image concerns and preoccupations can all put a child at high risk to develop an eating disorder. Also, in terms of the potential for prevention, it is far easier to deal with issues and attitudes before they become problems, to change your childís mind rather than ask her to break intractable habits.
Q. "It disturbs me that I find myself being so consistently critical of my nine year old daughter because she wants to wear nail polish, indecent halters tops, high heel shoes and take no lunch to school because "nobody eats lunch." I wish I could find a less confrontational way to communicate what I feel is important."
Why not replace prohibitions with positive parenting messages? It might be helpful to find more positive and substantive ways to engage with your daughter. Lunching and shopping may not be not as valuable for the childís emotional development as field trips together to the planetarium, volunteering on a Saturday morning at a neighborhood nature preserve, distributing meals to the homeless, or attending religious services together. Such activities teach children a vision of the world around them as being greater then themselves. While connecting with parents, kids engaged in such activities develop a sense of meaning in life and healthy passions that extend beyond the self. Your childís self-esteem derives largely from the contribution he or she can make to the community, to the manner in which he can "give back" to society, not from his or her appearance.
Q. My child asked me "Do I look fat?" I felt as though I didnít know what to say, but that anything that came out of my mouth at that time was going to have tremendous impact."
Youíre correct in thinking that with this question you are walking into a conversation trap. If you answer, "Yes," your child will never forgive you. If you answer "No," your child wonít believe or trust you. The most meaningful response to this question would be, "What makes you wonder about this?" "Why do you question your appearance at this particular time?" "Do you not trust yourself and your own perceptions to answer this question for and within yourself?" "Are there other areas in your life where you also are feeling that you canít trust your own perceptions?" Your goal in answering a question like this is to assist the child to know herself, her fears, and her anxieties more profoundly.
You might also do well to let her know that it sounds as though her question may signify some underlying fear, that though it sounds as if she is asking about her weight, you sense that her concerns are more far reaching and deeper than that.
Q. My daughter is not anorexic or bulimic because she is 175 pounds and 5í5" at age 14. I keep the house free of junk foods, but suspect she is eating in secret. She eats low fat meals, avoids sauces and fried foods at restaurants, and plays basketball after school three times a week. If this isnít an eating disorder, could it be another kind of disorder?
It is important to understand that weight is not a defining factor in whether or not an eating disorder exists, and that the emotional issues and attitudes that underlie dysfunctional behaviors such as junk food bingeing or secret eating may be of greater significance even than the physical affects of disease. You might consider getting therapeutic help for your daughter to discover and resolve relevant emotional issues underlying her problem that are separate from and/or including food. Your daughter may have a propensity towards eating dysfunction and if so, now is the time to prevent these from occurring.
Particularly when there may be problems involving overweight and overeating, it is critical to establish a healthy eating and exercise lifestyle; it sounds like you are in the right direction with your daughter. Be sure to keep in mind that healthy eating is not restrictive eating. For your daughter, healthy eating might not entail eating less, but rather eating differently (filling up on more nutritionally dense foods.)
Scientific evidence is increasingly pointing to genetics and brain chemistry as being the most highly significant determinants in how the body metabolizes fat. In many instances, the goal is not to wage a war with oneís body, but to learn to accept and appreciate it as it is.
Here are a few questions that pertain specifically to eating disorders.
Q: "If my eating disordered child knows that what she is doing is harmful, why canít she simply stop doing it?"
There is nothing simple and straightforward about dealing with or eradicating eating disorders. Your child may not even believe that she has a disorder, nor does she feel comfortable considering the option of living without what may have become her chief and most reliable coping tool. In many instances, eating disorders give a person the feeling that they have never looked better, and in many instances, they create a sense of mastery and achievement. They represent the only disease I can think of, short of substance abuse, where recovery feels worse and requires more courage than being sick. Most sufferers donít want to give up their disorder; they are frightened of facing the world without this "crutch."
Be aware that the eating disordered attitude, mind-set and behaviors develop over time and through life stages, in many instances, becoming as deeply ingrained as addictions. The underlying emotional issues and concerns that drive them are long in coming; they are not to be eradicated quickly or easily.
Q. "If I say anything to my child about her eating disorder "secret," wonít she resent me? I am afraid that by confronting her, I might make matters worse."
Your child has chosen to keep this condition a secret for fear that she may be irrevocably ill, or because she doesnít feel she has the internal strength to face life without the disease. At first, she chooses the eating disordered behaviors; eventually the eating disordered behaviors takes over her life and "chooses" her; in the end, the child believes that she cannot go on without her disorder and she feels no choice but to partner with the disease indefinitely.
The parent can expect to encounter resistance in confronting her child with these realities, though mustnít back down in the face of it. Defining a problem, uncomfortable as this may be, is the first step in resolving it. Your child will probably experience a sense of relief to know that she is not alone with her problem and that you care so deeply about her. She needs to combine your strength with her own to stand up to a force as all-consuming as that of an eating disorder.
Q. "Should a parent have any influence over the affairs of my eating disordered child once she has grown to become a competent young adult? I wouldnít want to do anything that could threaten her already established sense of self-esteem and autonomy."
Your eating disordered childís malnourished brain has become incapable of logical thinking, accurate perceptions and sound judgment. She cannot be expected to rely on herself to assume responsibility to attend to her own healing under these circumstances, so she must rely on you to take charge temporarily, until such time as she becomes capable of resuming responsibility for self-regulation, self-control, and self-care. If your child had cancer or diabetes, you would have no ambivalence about stepping in to secure the best treatment. This situation should be no different; eating disorders are the most lethal of all the mental health disorders, killing six to ten percent of its victims.
You can be assured that her self-esteem and autonomy are being severely compromised by the insult of this disease, which takes over and sucks the life out of its victims.
The authorís work can be reviewed further at www.empoweredparents.com and www.parentingbookmark.com.
Last updated on 04-05-2002