The appearance of an eating disorder, or disordered eating patterns that may trigger one, is an indicator that a child is struggling with emotional problems of self-esteem and behavioral difficulties with self regulation. These signs are a parent’s call to action. Remember that eating disorders are more likely to show up at home, in kitchens, bathrooms and bedrooms than in doctors’ offices, in physical examinations or in laboratory tests. Like it or not, prepared or unprepared, parents are primary diagnosticians.

Parents and families must understand that the malnourished child afflicted with an eating disorder or with signs that may be precursors to the onset of disease hasn’t the judgment or accuracy of perception to perceive or acknowledge that these problems exist, or to assume any degree of self-initiation or control in seeking solutions. Many youngsters do not understand what healthy eating actually is; they may assume that dysfunctional behaviors may be simple benign quirks. By taking charge of the situation where their afflicted child is incapable of doing so for herself, parents educate, nourish and prepare that child to eventually assume self-regulation and self-determination. Being in charge of a situation is in no way synonymous with taking control of the child. Do not confuse appropriate parenting interventions with intrusive parenting.

Interventions that Work

It is important to confront your child with your observations and concerns, with the potential dangers of ignoring what might be the start of an eating disorder. Defining a problem does not make it worse; it is simply the first step towards finding a solution. Ironically, the most potent way to exert influence over your child is through active listening, hearing her fears and concerns, and addressing them by reflecting back her own concerns and requirements. Active listening not only gives the parent a heads up, but also helps the child better know herself and her needs better, an importnat first step in getting those needs met.

Child: "I'm too fat and I ate before. …I don’t need to eat dinner. Anyway, I don’t enjoy eating in front of a crowd of people.”

Parent: "You're not fat.  Sit down with the family and eat your dinner!" This typical, but not terribly constructive response may become an invitation to battle.

An active listening response might sound more like this:

Parent:

    " What makes you think you are fat?"

    " That way of thinking could make a person feel pretty badly about herself. Is that how it is for you?”

    " Are you trying to lose weight?  If so, do you have a plan of action?  What might that entail?"

    " Did you know that dieting or skipping meals is the worst way to lose weight, that it can damage your metabolism, leading to obesity in your adult years and potentially to eating disorders? Did you know that you don’t have to be skinny or restricting food to the point of starvation in order to carry a diagnosis of anorexic?"

    " Hungry or not, it's dinner time, and we’d love your company.  Come and sit down and be with us, even if you choose not to eat. It’ll be a good opportunity for us to talk and be together.”

  “ Perhaps it might be a good time for us to begin to think about getting some professional counsel for you.”

What to do When an Eating Disorder has Been Diagnosed

Where an eating disorder diagnosis already exists, parents and children do well to use survival techniques for navigating rocky seas.  Here are a few:

Afflicted youngsters living at home:

Learn to recognize your feelings. 

Are you aware of feeling anxious?  Remember that anxiety has unique ways of showing itself; some people become withdrawn and become isolated, others become feisty, irritable, or intolerant of others.  Sometimes anxiety compels people to exert strict control over their lives and their eating.

If you are anxious or depressed, know what makes you feel this way.   

Are you afraid of eating calorie-dense foods? of gaining weight? of not being able to stop eating once you begin? of eating in front of loved ones? of being expected to participate in meals? of feeling forced to eat when you don’t want to? of having your secret eating behaviors discovered?  of the shame of feeling fat?

Know your facts!

Don't become a victim of commonly held myths and misconceptions about food and eating.  Recognize and understand that

• The best way to lose weight and keep it off is to eat lots of nutritious foods, including all the food groups, in the form of meals, and at least three meals a day.
• There are no "bad" foods, as long as what you eat is in moderation.
• Young women normally put on 20% of their weight in fat with the onset of puberty.
• Anorexia is highly curable when recognized early and treated effectively.

Devise a plan…and vow to follow it. By anticipating a problem ahead of time, you are in a position to take action to prevent yourself from falling more deeply into self-destructive behavior patterns. By seeking professional help, you can be assured that you will get the help you need to resolve problems that at times may seem insurmountable.

Parents: 

Talk with your child about upcoming holiday festivities.  Anticipate together with him/her what the holiday experience might be like with all of its feasting, and expectations of eating in the company of others. Discuss various options for eating healthfully, and for responses to possible inquiries. By helping your child put words to her anxiety before events happen, you are helping him or her to be prepared and feel more in control, teaching important life lessons about problem solving.

When parents and children anticipate, address and seek to resolve eating disorder problems together, healing tends to be most effective, timely and sustained and the benefits far-reaching… affecting the life quality of the entire family.