Imagine Reducing Eating Disorder Behaviors in Kids

"I'm not eating dinner because I don't want to get fat" my 7-year old daughter said, sucking in her stomach. I was really sad when I heard these words, but, the more I thought about it, I don't know if I was really that surprised. While we can't prevent all eating disorders and mental health issues in our kids, we can be mindful of what we say and do. ERC experts weigh in.

“I’m not eating dinner because I don’t want to get fat,” my 7-year old daughter said, sucking in her stomach. I was really sad when I heard these words, but, the more I thought about it, I don’t know if I was really that surprised. 
I try to be conscious of the words and behaviors we use related to food and body image at home: 

  • We eat all foods in moderation.
  • We don’t talk about diets or calories. 
  • I remind my girls regularly that “all bodies are beautiful.” 

 But, unfortunately, I can’t put my kids in a vacuum to quiet the messages of a culture that consistently promotes specific body types. 
As a mom, I have often wondered, “What can I do? Can I do anything to prevent an eating disorder— or other mental health struggles — in my child?”
I turned to the experts here at Eating Recovery Center to ask them if parents can do anything to teach “healthy” eating habits, promote a “healthy” body image or prevent eating disorders/mental health issues in our kids. 
Here’s what they had to say:
Question: In the eating disorder treatment world, I’ve been told not to use the word “healthy.” Why is this? And what can we say instead?
Bonnie Brennan, MA, LPC, CEDS: For those who have struggled with eating disordered thoughts and behaviors, the word "healthy" can mean a variety of things. 
1. When used to describe appearance, an eating disordered mind translates "healthy" to "fat”; if they look “healthy”, then they must not look thin anymore. 
2. "Healthy" may also be a trigger word for someone who has been discriminated against due to their body size. 
3. “Healthy” can also remind those whose eating disorders started when they were trying to be “healthier” (in trying to eat better or "cleaner" or exercise more, they turned on a genetic propensity for an eating disorder) of how eating “healthier” can be a dangerous path. 
4. In our current culture, there are lots of examples of "healthy" tips that are actually behaviors and rules practiced by people with eating disorders (fasting, cleanses, fad diets, exercise programs, calorie counting, etc.).
What we can say: Instead of using the word "healthy" to describe food or body types, practice noticing the person for who they are inside, such as kind or adventurous. Notice food in non-judgmental language such as a crunchy salad or a chocolate dessert. 
Our kids respond well to what we notice as unique about them. A sense of well-being is not measured by how a person looks or the type of food they eat! Help your child recognize their strengths, their values, what makes life meaningful to them and how much your connection to their heart and soul means to you — rather than conveying your approval in the foods they eat or the body they reside in. 
Question: Is it possible to reduce the risk of mental health issues in children and adolescents, including anxiety, depression and eating disorders? 

Lara Schuster Effland, LCSW: Reducing the risk of an eating disorder (or a mood/anxiety disorder) is still an unanswered question. However, it is possible to reduce the severity and prolonged negative effects. It takes a proactive stance, education, and a willingness to be patient and flexible if the disorder develops regardless of the best intentions. 
Biologically, 50 percent of mood, anxiety, and eating disorders are genetically inherited. This genetic predisposition is uncontrollable. However, the inherited traits or characteristics, which make up the other 50 percent, are controllable. We can manage our intentional actions, responses, and try to improve our life circumstances. 
We can do the following to support our children:

  • Offer our children a safe space to live, learn, and grow
  • Offer our children the treatment or education to understand and feel equipped to manage their mood, anxiety, or eating disorder.
  • Offer our children a nonjudgmental ear, patience, and support.

As parents, we are constantly learning. If we accept our own fallibility and find willingness to keep trying, we can do our best. 
Please note that if you think your child needs help for a mood/anxiety or eating disorderit is best to seek treatment to better understand the most effective next step.
Question: What can we do if we notice disordered eating habits (dieting or binge eating) in our kids — or hear them say they are unhappy with the way they look? 
Eleanor Pike, MA, LPC: When we hear children discuss maladaptive food behaviors or hear them talk about body dissatisfaction, many parents can react based on their own fearful response. Disordered eating thrives in secrecy, so talking about eating behaviors can be a challenge. In order to have fruitful conversation with our children, it’s important to facilitate relationship with our child first! Relationship is slightly different than facilitating conversation— it’s creating a trusting, safe space for them to talk that’s not based on our reactions, but rather based on listening and understanding their experience.
Instead of negating a child’s negative body talk with a response like, “Oh honey, but you are beautiful the way you are,” we want to be mindful of continuing the conversation by providing empathy. One way to provide an empathetic response is by believing and validating your child’s experience. For example, you can say, “Oh honey, I understand that you’re feeling fat because this is the message you’re hearing from friends….” Or “I understand that you’re fearful of certain foods because you’ve heard your friends and their parents talk about ‘good’ and ‘bad’ foods.”
Once we provide empathy and a safe place of understanding, children are more likely to openly answer our questions about the food and body attitudes and behaviors they carry: Are they dieting? Over-exercising? Eating more than normal? Motivated to change their body? 
I also recommend this book on raising emotionally intelligent children.
Question: Many people worry about children and adolescents developing restrictive eating disorders, but what about binge eating disorder in young people? 
Ashley Solomon, PsyD, CEDS: Many parents share concerns about their children eating too much or engaging in binge eating. We do see what we call “loss of control (LOC) eating” in some children and adolescents, and this can have adverse impacts on their health and well-being. 
One of the most important prevention strategies for binge eating or LOC eating is to eliminate diet culture and to ensure that kids aren’t limiting their dietary intake. Restrictive eating and dieting are actually some of the most significant risk factors for binge eating. 
It’s not enough to communicate that they need to be nourishing themselves; we as caregivers have to do the same. Modeling is so vital during this stage of life. Also keep in mind that trying to categorize foods as “good” or “bad” or restrict certain foods from the home won’t work. It will lead to increased curiosity and seeking of those foods and prevent our kids from learning the joy of eating a varied diet. 
Question: Any final tips of what we can do around the home or in public with our kids to reduce the risk of eating disorders and inspire positive body image?
Alia Green, MA, NCC: Your children pay attention to what you say and do — even if it might not seem like it. Teach your child that their self-worth is not related to how they look:

  • Avoid complaining about your body; avoid talking about diets, calories and weight.
  • Praise your child on her or his efforts, talents, accomplishments, and personal values — not so much on personal appearance.
  • Have balanced and nutritious meals and snacks on hand and involve your children in planning and preparing meals.
  • Avoid using food as a reward or punishment.
  • Discuss negative and positive images you see on TV and social media.
  • Always keep the lines of communication open!

My daughter, worried about her weight at age 7, is not alone. “According to a Common Sense Media report, more than half of girls and about one-third of boys aged 6 to 8 think their ideal weight is thinner than their current size.” 
By age 7, one in four kids has tried dieting.
As parents, we have a responsibility to do what we can to nurture our children to live their best, most meaningful lives possible. Though I am sure I will make many mistakes as I raise my girls — and I know I can’t protect them from everything — I am grateful for the wisdom of my ERC friends above and I will always, always do my best.

- B. 

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