Young people have many concerns regarding eating disorders and healthy eating including:

  • their own health and eating patterns
  • what to do if a friend has an eating disorder
  • what to do if a sister or brother has an eating disorder
  • how to respond when a parent has an eating disorder.

Questions for Abbie

  • From: Kirsten G
    Sent: Sunday, January 08, 2006 10:05 PM


    What happens to the calories I don't use at the end of the day when I fall asleep? Do they turn into fat cells? I'm unsure.

    - Kirsten

    No. Healthy calories work to make your bones strong, your blood cells rich, your brain cells smart and they help you to have a restful and undisturbed sleep.

    Good question.


  • Sent: Monday, March 14, 2005 4:50 PM
    Subject: I have a question

    Dear Abigail,
    I am a recovering anorexic. My lowest weight was about 90 lbs. I have since then gained about 20 lbs. and am about at 110. I had my last menstrual period in Dec. 2003. My mom thinks I should gain until I'm at 112. I would like to stop now!! Is there any way to get my period back before I reach 112? Are there any methods or certain foods you can eat to bring your period back? Thanks!


    Abbie's Response:
    Dear Rachel,

    No magical foods, unfortunately.

    Eating disorder recovery is about learning to trust in the body's wisdom. It is not important what your mom thinks you should weigh and what you would like to weigh. When you are fully and adequately nourished and all your internal systems are happy and "go," then and only then will you begin to ovulate and regain your menstrual cycle.

    Remember that getting your period now is your assurance that you will have fewer problems with infertility when you get married one day soon and want to start a family. It seems far away at this point, but that time will come before you know it.

    Good luck. Keep moving forward, and don't stop till you are there!



  • Hello, My name is Mary. Tomorrow is my 17th b-day. Let me tell you a little about my "situation." In September I decided that I was not happy with my appearance. I was the "biggest" that I had ever been. My sister's biggest time had been around 10th grade also and that's what happened to me. I probably just ate way too much out of boredom or something. I wasn't FAT though...I just had um..flab and I went up 1 or 2 pants sizes. It was the last straw when my skirt ripped.
    Okay, enough of that. I then decided that instead of being like my friends and complaining...(saying I'm fat all the time..which I NEVER said) I would do something about it. So I started out little by little exercising...a couple times a week. My step aerobics video. Then I lowered my calorie intake. Once I reached my goal I lowered it and got to my second goal. Then I no longer had a goal and kept going and kept lowering until I had about 450 to 500 calories a day. I lost about a pound a week.
    SURPRISE-tomorrow I start recovery for anorexia. The reason I kept going is because I am afraid of eating normally and almost don't even know how now..I am afraid of gaining weight.
    But now I do have to gain weight to be healthy. I was hoping you'd have some advice. I am so scared that once I start gaining weight it will never stop. I ruined my body. I am ashamed. I was hoping that I could somehow gain back muscle. -Sigh- I won't buy clothing because I am afraid that I will grow out of it. I just don't know what to do. I don't want them to "make me fat." I NEVER want to wear those pants again. The ones that I had to buy over the summer. I don't want to gain and gain and gain.
    Thanks for listening.

    Abbie's Response:
    Hi Mary,

    Good for you for starting treatment!! I believe that if you get read my book together with your parents, you will find that it will help to guide you all through the process, making the experience more understandable and meaningful. The book is called When Your Child Has an Eating Disorder. It will answer all your questions.

    As far as your fears of becoming fat, everyone in your situation worries about that very thing. It is hard to understand how eating more food more frequently, in the form of nutritious meals, can make your weight drop and stabilize, but because of how the metabolism works, this is precisely what occurs. Through recovery, you will learn to have a healthier relationship with food which will help you to feel happier and more comfortable with yourself and with others.

    Good luck! You'll be happy you did it!



  • Hi, I will be in 9th grade this year and am a girl. For the past week and a half I haven't been really eating anything. I'm not hungry. I'm very stressed out and nervous about going to a new high school. Does that play any role in anything? Is this an eating disorder? Is it a disorder?

    For example, on Saturday I had:

    Bagel at 9, glass of juice, and cinnamon twisties from taco bell at 11. I was at the house all day yesterday and this is still all I had.
    much appreciation!

    Abbie's Response:
    It is natural when you are nervous and upset to lose your appetite and not to want to eat. No, it's not an eating disorder....not yet anyway.

    The thing you want to do, however, is to remember that your body needs fueling, hungry or not. So, continue to eat three meals a day, whatever size they may be, including all of the food groups, particularly protein. If you are eating very little, make sure that what you do eat is nutritious food.

    Is it typical for your anxiety to get so severe? If your anxiety continues like this after you start school, or even around other issues, it would be good to talk to a psychotherapist. But surely, your first move is to talk with your parents, and be certain to see a doctor if things don't change.

    If these behaviors were to become habitual, if you lose significant amounts of weight, if you think in terms of restricting food and wanting to be thin, then, an eating disorder might become a matter of concern.

    Good luck to you!
    Abigail Natenshon

    A Follow-up Response:
    Thank you thank you!! That helped so much because I have been losing a tremendous amount of weight.... but after your tip I'm sure things will level out.

  • I'm a 17-year-old female. I'm 5'5, and 100 pounds. I know that isn't that bad, but I know that I'm starting to get really anorexic cause I'm always blacking out when I exercise and all my friends are telling me how skinny and pale I look. April of this year I weighed around 120 pounds, and then I decided I wanted to lose a little weight, and after one week of not eating breakfast or lunch, it became very simple... not eating equals being skinny. But it's not about being skinny for guys or anything like that, it's just that I'm an A student. I'm number 3 in my Junior Class and everything I have ever tried, I have been close to perfection. It's just when I look in the mirror, I feel so fat... even now after losing more than 20 pounds in less that 3 months. I just hate eating. My mom found out that I haven't been eating that much, and I told her I could control it after she threatened me that she'd take me into a doctor or something. It's just I'm scared, not that I'll get hurt or damage my health. I'm just scared that I'll get fat if my mom makes me eat. I have thrown up a lot of the food she has made me eat, although she doesn't know. What I'm trying to say is, please tell me that having anorexia is ok... Because I don't want to be "cured" of it. I love it!!! the only thing I don't like it not having any energy, and being cold all the time. But other than that, I love this. I love feeling like I can control my weight, by myself without my parents trying to make me the "perfect child". I can EAT when I want and what I want. So please, just tell me that it's ok for someone like me to have Anorexia.. or do I even have it?? I don't know. All I know is, is that I'm very confused and scared of food... Thanks for the web site.. I like most of it.. but Anorexia is not a problem to me. it's just my parents and friends are MAKING it a problem but I'm JUST FINE..

    Peace and Love."

    Abbie's Response:
    I am so glad that you wrote. I appreciate your being so honest with me. Great girl!

    Several things I want to say to you....
    1.Yes, this is anorexia in full bloom. Your disease is what is responsible for making you feel that you are not sick, and that the way you are is empowereing, not debilitating.
    2. You are damaging your body now and for the future. Once you are fainting, you know that you are soing significant damage.
    3. The damage is FIXABLE as long as you get help now.
    4. Do confide in your parents and see your doctor. It will be an investment in the rest of your life.
    5. I appreciate your wanting to be thin and fit. However, restricting food is the WORST way to accomplish this as you are damaging your metabolism more with each passing day. You don't realize that you have an increased chance of becoming a fat adult if you keep doing this to yourself as a young person.
    6. The best way to become and to stay thin is through just eating well, and not through dieting, though you probably don't believe it. It's true.

    Let me know what you decide to do and how things turn out for you.

    By the way, both you and your parents might benefit tremendously from reading my book, When Your Child Has an Eating Disorder. Good luck!

    Abigail Natenshon

  • “Ok I don't eat breakfast, lunch and I will only eat dinner when I am forced and then sometimes I purge it, when I am on holiday camps I am not allowed to the toilets for an hour after meals because they found out about it. My friends have told my school and the school rang my mom about it but she didn't say anything to me. I am scared that I will get sick from not eating but I dont want to eat cause I'm afraid that I will get fat and I just can't force myself to eat. I've been skipping meals for about 2 years now and purging for about 8 months. What should I do PLEASE HELP ME!!!”

    “Am so glad you wrote!! It sounds to me as though you are feeling out of control of your eating, and therefore of your life...that is certainly not a happy or comfortable way to live. Also, by abusing your body in this way, you know you are putting your health in danger.

    Talk to your parents. I have written a book that will explain all that your parents need to know about getting help for you to be well again. It is called When Your Child Has an Eating Disorder. If your parents are having a difficult time discussing this with you,you might want to bring up the subject. Remember that you can always go to your pediatrician, your teachers, counselors, relatives....any adult who will help you approach your parents.

    This problem is fixable. Don't be afraid to try.

    Good luck!

    Abbie Natenshon

  • “I am looking for help for my 15-year-old sister. She has bulimia, severe depression, and anxiety disorder. She was in an inpatient and a behavioral hospital for 2 weeks and the only thing she got out of that was learning how to hide what she is doing and to deceive everyone around her. Now she has been cutting herself and her binging and purging has gotten worse. I’m lost. What can I say to her to let her know that we all love her and want her to get better? She thinks there is nothing in her life worth living for…..PLEASE HELP ME.”

    “It sounds like you love your sister very much and are a very caring person. It might be helpful for you to read When Your Child Has an Eating Disorder, as it will educate you about what you need to know about eating disorders, your sisters’ predicament, and her pressing needs at this time. You will need to support her strengths, legitimize her feelings, and encourage healing behaviors. Do check out Chapter 3 in particular. It will guide you on how to best provide emotional support and find the most effective assistance.

    The hospital program that discharged her should provide her and your family with on-going outpatient support system now that she has finished her inpatient stay. Don’t hesitate to ask them to continue their professional involvement with her during her transition to the outpatient community, and in whatever other ways they might assist her following her release. You can expect this from any inpatient program; such continued support is your due.

    Good luck. Feel free to recontact me should you feel the need.”
    Abbie Natenshon

  • “Why do you say “don’t buy fat free or lite foods if you are recovering from an eating disorder or you are a normal, healthy eater? Isn’t it better to eat foods without fat?”

    “Certainly, it is better not to eat an excessive amount of fat, and particularly if those fats are saturated. My concern is that when parents primarily buy fat free or lite foods, children learn to fear fat as something that is intrinsically harmful to their bodies, even though this is not the case when fat is eaten in moderation. In actual fact, fat is an important part of a child’s healthful physical and neurological development

    Children who at a young age become “fat-aware” or hypersensitive to the nutritional content of foods are at high risk to become overly concerned with their own body image.

    Thanks for your question.”
    Abbie Natenshon

  • “I am 17 years old and I am constantly asked if I have problems concerning weight. I feel in some ways I have maybe a slight problem. I am 5’5” and I never let myself go under 85 pounds. I don’t puke often meaning not every day and most the time in spurts lasting a couple of weeks. I have never thought of myself as having a problem. Because I have always been this way since I can remember back to third grade. I do restrict portions of food and have strict rules on when I can eat. But I rarely completely starve myself. Anyhow, my question is do I have an eating disorder or am I just careful about my body? I would love an answer because this is too hard to ask anyone I know.”

    “Thanks for your letter. Perhaps you could go to the library to find a copy of my book, When Your Child Has an Eating Disorder. Though the title says it’s for parents, the book would be helpful to you in explaining what constitutes a “normal” relationship with food, and what an eating disorder is about. You may assume that you do not have an eating disorder, or you may have one that presents atypically or is not easily recognizable. The important thing is that your relationship with food sounds uncomfortable and is most likely propelled by the fear of becoming fat. You do sound anxious about food and eating, and seem to have used food at times for reasons other than satiating your hunger, restoring your energy, and for being sociable with friends and family. This usually indicates a problem that is worth looking into more in depth.

    Remember, an eating disorder is not defined by how thin you are, but rather by how you approach food and resolve the “problem” of eating. How you do that is probably indicative of how you handle other problems in life. That is why it is particularly important that you consider getting some help around these problems one day. Good luck!”
    Abbie Natenshon

  • “In your book, you say that it is important for families to eat together. Why would it be so important that families eat together? Personally, my parents are often out at meetings and other things. In fact, I would think that bonding over food would be a bad thing because it would encourage people to associate family and togetherness with food. Then, when something goes wrong with the family, something goes wrong with the kid’s eating habits too.”

    “I realize that families are busy, parents are often not at home for dinner, and kids need to eat alone at times. But when possible, eating can and should be a communal affair. When eating is healthy, it is a pleasure, and generally people enjoy doing pleasurable things together.
    Also, one of the most important functions of eating meals together is that it gives busy family members an opportunity to reconnect and communicate with each other after a hectic day where everyone has been off in different directions. Dinnertime should be a time of re-centering, a “catching up” time for parents and siblings, where everyone can reconnect and hear about the events of the day, what is on each other’s minds and in each other’s hearts. The family meal can be a restorative experience, nourishing you in many different ways and on many different levels.

    Now here’s a question for you to think about. Are you able to “separate” problems that may arise around family issues, and those problems that may exist for you around food and eating? These ought to be two very distinct spheres. Hopefully when something goes wrong in the family, food habits do not need to go awry, or vice versa. The family problem that gets talked through and resolved between family members (perhaps over the meal) ultimately has a better chance to be resolved no longer a problem.”

    Abbie Natenshon

  • “I can’t get my parents to understand that I have a problem with food. They don’t seem to get it, that I worry a lot and am always thinking about it. Sometimes I think they feel good about the fact that I have lost weight and don’t care all that much what I may need to do to keep the weight off.”

    “Your parents are not alone in not understanding what an eating disorder is, in recognizing its signs, and in understanding that it is a dangerous disease. It is important to get your parents’ attention somehow; perhaps you could ask your school counselor to sit down with you and them together to talk about what you have been going through and to help them to understand that you are in a great position to get well if you had their support at this time.

    When Your Child Has an Eating Disorder would be a great help to both them and to you as it would explain what an eating disorder is and what its implications can be for those people who choose not to be treated and to recover. The book explains that people do recover, that parents can be of help, that when the treatment path is defined and clear, there is nothing to fear. It would also direct them in how to find the best professional assistance for you.

    Good luck.”
    Abbie Natenshon

  • “I have a friend who is 15 years old and is a serious dancer. A few of my friends have noticed that she has been losing weight and that she seems to be eating less and less. We have been trying to give her "hints" that she needs to be eating more, but that has not worked at all. I went with one of my friends to the school counselor to describe what she has been doing. She told us that it is pretty obvious that she has a problem and she said that she would call her mom. However, things aren’t changing for the better. For example she used to always bring Cokes and Sprites to school to drink, then she started only bringing diet drinks, now it's water. She would also bring these fried chicken fingers (which she told us their number of calories) not she only eats a Power Bar and fruit. Or she brings some peppers and eats a 1/2 of 1/2 of a bagel.

    We are all really worried about her, but none of us know what to do. I'm not sure if we should try and talk to her mom, or talk to her, or go back to the school counselor. I think that her 18 hours of dance a week has a big influence on this, and this summer she is going to a month long dance camp and we know it is going to get even worse. Please, please write back and try to give me some advice. I know I can not "cure" her, but I am really scared that she will end up in the hospital, and I will know that I had the chance to do something and didn't.”

    “What a wonderful friend you are! All you can do for your friend is the best you can do. My suggestion is to keep talking to your friend about some very important things about nutrition and the body that she probably doesn't know and you may want to suggest to her that she read the article I have written about The Body’s Wisdom which you and she can find on my web site

    You may want to get a few of her friends together to talk with her about your mutual concerns (this is called an intervention). You should also go back to the school counselor and brainstorm with him or her, and still and always, contact and recontact your friend’s parents. My book, When Your Child Has an Eating Disorder would be a wonderful gift for them, as it explains things that her parents probably do not understand and that they need to know in order to help and understand their daughter.

    If none of this works, at least you will know that you did the best you could. Good luck!”
    Abbie Natenshon

  • “Dear Abigail: I have not been able to find any information on what to do if one of your parents has an eating disorder. I am the 17 year old daughter of an anorexic mom whose has been struggling with the disease for about 30 years now. I have four other sisters, one older and the other three are younger. We have been through everything imaginable except death and that is the one thing that we all fear the most. I already know everything possible about the disease.

    And I've learned to leave my mom's recovery up to her because she is the only one who can really do anything about it. I would like to make it easier on her though. The family as a whole has a lot of anger and resentment towards the disease but it is hard not to mistake it for her. She is going back in the hospital again tomorrow and I would like to do my part in her recovery as much as possible. We all go to counseling and I work a twelve step programs of my own so there isn't a lot more that we can do for ourselves other than talk about it with someone who understands and not someone who just has a degree. I would love some help or someone else to talk to who can relate with me. I've never met anyone else who is in the same situation as me.”

    You are not alone. An eating disorder in a parent will affect the entire family. Your situation is very difficult, but continue to look for support among your siblings and keep the lines of communication open with your mother and father. When Your Child Has an Eating Disorder will provide a lot of good “jumping off” points for discussion between you all that can prove to be very productive and therapeutic. It will also raise some issues that may prove to be important “grist” for the family-therapy mill.

    Be sure to recognize the legitimacy of your feelings and remember that you are not responsible to (or even capable of) saving anyone else’s life no matter how much you might love that person or wish that you could. If your mother will not get adequate help for herself, be sure to continue to get help for yourself, at least, in learning how to deal with your own feelings around a very untenable situation.

    Please email me your questions and I will answer them here.
    Best of luck to all of you.”

    Abbie Natenshon

Psychotherapist Abigail H. Natenshon has specialized in the treatment of eating disorders with individuals, families, and groups for the past 28 years. She is the author of When Your Child Has an Eating Disorder: A Step-by-Step Workbook for Parents and Other Caregivers, Jossey Bass Publishers, San Francisco, CA. October 1999. Based on hundreds of successful outcomes, this book shepherds concerned parents step-by-step through the processes of eating disorder recognition, confronting the child, finding the most effective treatment for patient and family, and evaluating and insuring a timely recovery. A guide to eating disorder prevention, this book is useful to parents, health professionals and school personnel alike in countering the pervasive epidemic of unhealthy eating and body image concerns, and destructive media and peer influences. Her work can be reviewed further at her web site at To order visit

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