Parents, what you say to your kids about their bodies matters, especially when it comes to eating disorders. A study in the Journal of Adolescent Health found a strong relationship between girls at age 14 that had been labeled as “fat” especially by their family members and girls who developed a eating disorder in the next five years.
“It has a greater impact when it’s actually coming from family versus nonfamily members,” says Allison Chase, a psychologist with Eating Recovery Center in Austin.
We already noted the impact a doctor can have on a child’s later eating habits. Austin doctor Stephen J. Pont, who last year was an assistant professor at the Dell Medical School at the University of Texas, did a study that caused a policy change by the American Academy of Pediatrics about the way doctors should talk to their patients who might be becoming obese.
“We see kids as young as 10,” Chase says. “Many will say it started when a doctors said, ‘Well, did you think about eating healthier?’ Keep in mind it’s not that alone.” Genetic factors come into play as well as environmental factors, she says.
Now this study, which was done at the University of California, Los Angeles, points to the impact family members’ words have on children.
“The idea of losing weight and being skinny is promoted,” Chase says.
She recommends parents focus on health, not appearance. For example, she says, talk about getting out and getting moving to help our heart, which is a muscle, instead of playing video games. Tell them, “We really need to find ways to keep our body healthy.”
She’d like parents to model healthier eating patterns and habits, but “It doesn’t mean all the diet foods and obsessing about it, but balanced eating,” she says.
Talk about food as something kids need for their bodies, she says, rather than something to feel better.
If you are a parent who is trying to lose weight, check how you are talking about your own body and how you are treating the dieting process. “It really requires parents to be mindful about what messages they are conveying,” Chase says.
Don’t have food become an all or nothing food. There’s a place for sugar and fat in everyone’s diet, Chase says. Food isn’t a “bad food.” If you ate more than you wanted or something that isn’t healthy, don’t say, “I was so bad today.”
“Kids are going to mimic things,” she says.
They have seen somebody who is an example of how to restrict food or how to binge on food or how to binge on food and then vomit afterwards. It might be a peer, it might be a family member, it might be something they saw on social media.
“Often times there is this trigger, something they see by example or commentary that somebody made,” Chase says of her patients. “Something opened up those gates, and you had all those factors, those predispositions … it takes things running.”
Christa McWhirter, 24, who is in recovery for anorexia (restricting food) and bulimia (binging and purging), has a very vivid memory of being in the fourth grade and having a girl bring a whole lunch box with only a Crunch bar in it. The girl’s mother talked about crash dieting and the girl shared that message with the other girls at the lunch table.
McWhirter already had defined herself by her outward appearance. She was always the thin one. People commented about her weight. “I was a string bean,” she says. “People point blank asked me if I was anorexic. Is that how people define me? There was stigma to the word, there was a stigma to any kind of weight. I got stigmatized as a thin girl.”
Her father was not thin and was always going on a diet. And when he was on a diet, the whole family was on a diet. And then he would go off the diet and the unhealthy food would return.
And then, puberty hit and McWhirter started to gain weight. She stopped playing as many sports. She gained weight in places she had never gained before.
“I was no longer that person I had been defined as for so long,” she says. “I was no longer the thin one. I didn’t know what to do with that.”
She now realizes that she had undiagnosed depression that was labeled ADHD. She abused her ADHD medicine to make herself nauseated. She restricted her calories to 600 a day, and yet, her body rebelled and she didn’t lose weight like she expected to. She turned to bulimia instead.
Eating disorders can be difficult to treat because they have both physical and psychological components, Chase says. Physically, “the damage is pretty incredible,” she says.
With anorexia, it can affect all the major organs. Girls lose their periods and aren’t producing estrogen. They get osteoporosis, which is not reversible. With bulemia, the purging can damage the stomach, the throat and the teeth, and it can throw off electrolytes, which can cause a heart attack or cause you to be dizzy.
McWhirter says it has taken her several years to get her body healthy once she stopped purging. Still today, her stomach is sensitive to certain foods and medications. She still gets nauseated, which brings up many of the emotions again.
“I was in a bad way going into treatment,” she says, “but I didn’t look like it.”
That’s often true with people who are bulimic, not so much with people who are anorexic.
Chase says it’s important for parents to pay attention to kids’ physical state as well as their habits.
- Has their place on the grown chart changed a lot since the last doctor’s visit?
- Are they finding reasons not to eat?
- Are they eating and then immediately taking a shower or going to the bathroom?
- Are they sneaking food?
- Have they changed in their disposition — are they not as social or withdrawing more?
- Are they more tired?
- Are they more cold?
- Does their hair not look as healthy?
Chase says the sooner kids start treatment, the easier it is going to be to get to recovery. “Do not get caught up in the fear of what it might mean, but in thinking about how they can help their child get better,” Chase says.
“Once the eating disorder takes over, it can be really ingrained and really tough,” she says. “There’s both a physical and psychological part of it. While it can be challenging, we do know that recovery does exist.”
Treatment might mean an in-patient stay at a recovery center for weeks to months, it might mean partial hospitalization with 10-hour days of treatment, but going home at night, it might mean years of out-patient therapy. It also will mean getting families involved in the recovery process, too.
Chase says, parents come in and think: “I’m going to send them (to treatment) and they’re going to be fixed, and we’re going to move on with our lives.”
That’s not how it works, though. “There are a lot of things to work through,” she says. “It’s important to understand that you’re on a bit of a journey.” She tells parents, “You have to strap on your seat belts and we’re going to take a bit of a ride. … it’s really important to all hang in there because that’s how we get success in the end.”
McWhirter went to treatment several times before it started working. Now it’s been four years since she’s last acted on her eating disorder. She can eat with friends, but she still thinks about it.
“I can eat three meals a day with snacks in between,” she says. “I never thought I would be able to do that.”
She’s returned to college, and she’s even moved into her own apartment. “A bunch of things are happening that I never thought I could do,” she says. “A big part of that is because of recovery.”