Parent Cheat Sheet for Eating Disorders: What To Do (and Not To Do)

Parents, caregivers, and various professionals often ask me what they can do to better understand and support their kids who struggle with eating disorders and body image. So I  decided to reach out to over 100 patients who I previously worked with and ask them what they wished their parents and other loved ones would have known when they were struggling with their eating disorders.

When I was dealing with my eating disorder and angry or annoyed with everyone who tried to help me, my mom would always say, “Only when you have kids will you know how difficult it is for a parent to see their child suffering…” Of course, back then I didn’t think too much about it and it even made me more angry or annoyed, but now that I have three teenage girls, I know what she meant. When I thought about a parent “cheat sheet”—or what I wished my parents knew back then—I came up with a very long list of concrete things that you can do to support your child in their struggles. Obviously, a simple cheat can’t cover everything (and oftentimes, family therapy is extremely helpful when trying to help your child who is struggling), but I will do my best to summarize all of the “wishes” I collected from my clients and myself. While this is directed at parents, these tips can be helpful for those who have a friend who is struggling—whether that person is a teen or adult.

Tip #1 Don’t ignore the warning signs.

Most parents wait until things get very bad before seeking help. The earlier you detect there is a problem, the easier it will be to actually help your child. When I was young, I ate as fast as I could. In hindsight, it’s obvious that I used food as a coping mechanism for all of the chaos that I was surrounded by. My father was kind of oblivious to what was happening and my mom thought my eating habits were kind of funny. My whole extended family thought it was entertaining too, and comments such as, “I love her red cheeks,” and, “She is getting so cute and chubby” were thrown around. Later, the silent binges were replaced with isolation. “I am just not in the mood…” I would make tons of excuses to avoid any of that family attention. 

The signs were all there for me, but no one saw them or noticed them, and with each month I was able to come up with a new excuse that allowed me to welcome anorexia into my life with so much love and excitement. When I started rapidly losing weight, my family thought it was just a phase. By the time I reached 78 pounds, it was way too late for them to help me.

Tip # 2 Don’t make them the black sheep of the family (or the problem child).

One of the things that I hated most about having an eating disorder was that it was made clear to me by everyone, including the medical professionals, that I was the problem. As if I didn't have enough pressure already, I also had to carry the burden of being the “problem child.” The added weight of knowing I was causing my family to suffer and worry about me was too much to bear. When even the doctors told me that I had a serious mental illness and it would affect me for the rest of my life, I lost hope and gave up on trying. 

I wish that my parents and family didn’t treat me like something was wrong with me and instead took some responsibility so the burden of the disorder didn’t fall all on me. It is a family affair, after all, and more than that, it is a huge societal problem. Recognizing that is important for the person who is struggling.

Tip # 3 Find a professional who has extensive training in eating disorders.

The best thing my family could have done for me is to find the right therapist and team that had experience working with eating disorders patients. Eating disorders require extensive training and specific skills—not general therapy. Furthermore, there are different therapeutic modalities and some are more effective for eating disorders than others. Most importantly, in order to work with eating disorders, it is important that the therapist has the right personality, language, and attitude to work with this population. 

My first therapist was psychodynamically oriented, which is great for some patients, but not for eating disorder patients who are not equipped to deal with all the related feelings. My first therapist gave me the time to talk about my upbringing and dysfunctional family, which was relieving in some ways, but without the skills that I needed to help me navigate all the thoughts, feelings, and insecurities, I felt lost. Crying and more crying felt good for a few weeks but clearly I needed more than just that, and guidance and skills were not something that my therapist was equipped to provide me with. Eating disorders are unique and complicated but with the right professional team your chances of helping your child overcome the challenge are a lot higher. 

Tip # 4 Don’t be influenced by the negativity around eating disorders.

One of the things that frustrates me the most is to hear mental health professionals say things like, “An eating disorder is almost impossible to beat…” Or, “Once you have an eating disorder you will always have it…” I wish that my parents and everyone else would have stopped having such negative thoughts related to eating disorders and being so vocal about them. Parents (and caregivers), don't allow negative people, even if they are professionals, to influence you because hope is what you will need most to help support your kids. It might be hard to think about, but your child’s eating disorder has become the best way for them to protect themselves from feeling overwhelmed and stressed. 

While I dealt with an eating disorder for over 10 years, I am now realizing how lucky I was to have had this disorder that most likely protected me during the years that I didn't have other skills. How different would you behave if you knew that your child’s eating disorder is actually serving a purpose in their life? Would you understand them better? Be less critical? Less demanding? 

Tip # 5 Be VERY aware of your own thoughts and feelings around food and body image.

So many parents have their own challenges around food and body image, but very few actually speak about it. My father had a serious binging problem and everyone thought it was funny. He would always eat very fast and directly from the pot and there was always so much stress and chaos around him. When my mother opened up about her own eating disorder, I was already deep into my bulimia and she mentioned it in a way that was so shameful that I didn't feel comfortable asking more questions. My mother is a very kind, selfless person but she  doesn't express her thoughts and emotions very well. Comments such as, “You are eating too much you will get fat…” and, “You will not look good if you get fat…” were said as a joke but I took them very seriously. 

So many parents have their own insecurities and challenges and they think that keeping it quiet will prevent their children from having eating disorders. Your kids know so much more than you think. They can read your energy and they know what is happening. Give them the respect that they deserve and don't underestimate their intelligence and intuition. 

Tip # 6 Don't guilt your child.

One of the biggest complaints that I hear from the teens/young adults I work with is how guilty they feel for so many things. When I ask why they feel guilty many of them mention comments that their parents make such as, “We give you everything you want you can't do this to us…” and, “Your condition is creating so much stress in the house…” Today, a 21-year-old I work with told me that her mom told her, “We work so hard to pay for your college and trainer and this is the thank you that you are giving us?” As parents, you need to learn how to not blame your child for what is happening as it only feeds the problem.

Tip # 7 Accept your child just the way they are.

I always wished that my parents would accept me just the way I was without comparing me to others. Parents often compare their kids to others without intentions to offend anyone, but it can be pressuring and very stressful. I remember how my mom and other family members used to comment about how much I ate versus how much my older sister did. I was always the bigger, taller sister, while my older sister was the smaller one. When you accept your child for who they truly are without trying to change them, you provide them with a sense of security and safety. 

If the messages that your child gets is that who they are is not enough then they will try to work harder to be the person that you want them to be and not have the opportunity to be who they were meant to be. People struggling with eating disorders often seek the acceptance and validation of others and when they feel that they are accepted at home, they are less conflicted and confused, which will assist in their recovery.

Tip # 8 Don’t focus on the cause, but on the support that you can provide.

Parents often ask me why their kids develop an eating disorder, and while there are many reasons and factors that might have caused the eating disorder, it is very important to focus on ways that parents can be supportive, first and foremost.

Tip # 9 Don’t try to fix things by dismissing your child's thoughts and feelings.

Last week, a parent asked me about the best way to respond to her 19-year-old who has purging disorder. The parents are extremely kind and have all the best of intentions. When I asked how they respond to their child when she is feeling distress, they said that they tell her that she will feel better soon and this will all be behind her. As a parent, you have to accept the gravity of the situation and not dismiss the heavy emotional toll this is taking on your child. When you child says that he "feels" fat...Be curious and ask questions that might lead you to how your child really feels.

Tip #10 Be a good role model.

This week, I started working with a 17-year-old who at first couldn’t tell me why she was binging and purging, but by the end of the session, she was able to describe in detail her parents behaviors as they relate to food and body image. “My father has that fancy scale that is connected to his phone and at least twice a day he goes on the scale and makes sure to report to the rest of the family and brag about his weight loss..” During our second session, she was able to recognize that her mom was also skipping meals and making comments about her body “I ate so much today… I should not eat dinner.” This patient realized that these comments, which she hadn’t thought twice about before, were affecting her. So many of us make many comments related to food and body that has negative effects on others, but with awareness, we can take the first step towards changing our behavior and becoming a better role model for our children.

Tip # 11 Stop fat talk.

In addition to watching your actions, you have to actively not participate in the “fat talk” that our society is so accustomed to. As a mom of three teenagers, I am very sensitive to other parents making comments about weight around my kids. Sure, many of us might enjoy talking about Joe who gained weight and Lisa who lost weight and who looks good right now and who is super fit. Last month, during my little one’s graduation, a few moms approached me with comments such as, “She lost so much weight—she is so skinny now! Is she eating? “ Of course, my first instinct was to just tell them to shut up and not say this in front of my 10-year-old, but I also know that my history and the fact that I am an eating disorder specialist makes me unique in my sensitivity to the fat talk that our society thrives on. It was obvious to me that these moms thought they were being kind and they were naive to the long-term damage that their comments can trigger. As parents, you must STOP participating in this type of conversation. It starts with you. We must demand a change in conversations about our kids (and other adults). They should be ones based on self-respect and appreciation of humans that don’t revolve around the physical appearance of someone.

Tip # 12  Think like a teen when they speak with you, not like a parent. 

One of the most important things to do when your child has an eating disorder, or when you suspect they might be developing one,  is establish a relationship that is built on trust and appreciation. In order to establish a strong connection that is non-judgmental you need to get yourself back to a mindset of when you were their age. What did you think and feel when you were a teen? How selfish were you then? How important was being accepted and loved by others? This strong connection can help you create a bond that will allow you to have a better relationship with your teen, which will allow you to help your child better.

Tip #13 Mirror or reflect on what is happening with your child instead of trying to help them.

In my last blog, I mentioned the Imago Dialogue, which can help you better connect with others. As a parent of three teenagers, I know how challenging it can be to just listen to your child and reflect on what they are going through without trying to help them and save them from making the mistakes that we know they will make. We want to help our kids so badly and prevent them from hurting and suffering, but the truth is, no matter what we try to do they will have to experience whatever it is they were meant to experience. Reflecting is a lot easier than you might think, but it takes practice. The last thing your child needs is to hear that they will be ok and that this stage will pass. They are not stupid. Of course, they know that this will pass someday sooner or later. But right now it doesn't feel like it will, and all you have to do is JUST listen and validate what it is that they are going through and all the rest will follow. 

Tip # 14 Be direct and proactive.

So many parents I speak with tell me that they walk on eggshells and that they are afraid to speak up. Once again, you must give your child the credit and respect that they deserve because they know that you are projecting fears and anxieties on them. In turn, they internalize all of that. If you see something, say something in a respectful way. For example, if you notice that your child is not eating meals don't be judgmental and criticize them, but instead be very curious. Ask as many questions as you want and show them that you are noticing whatever it is that you are. Ask questions such as, “Is there anything that I can do to help you?” Get some books or read articles that can give you some insight into your child’s world. All you have to do—as challenging as it might be—is be very curious and have an open mind. The rest will follow. 

Tip # 15 Be prepared for your child to fight back.

Even if you follow these tips and approach your child the right away, there is bound to be some resistance. Nothing about eating disorder recovery is easy or quick or simple. Most likely, your child will fight back to some degree so don’t let your emotions get in the way of helping them. It’s easy to ignore some of these suggestions and get into an argument with your child, but the right communication skills are vital in their recovery.

Lastly, there are many books that are a must read. Here is a short list: When Food is Love, Goodbye Ed, Hello Me, Your Dieting Daughter, The F*ck It Diet: Eating Should Be Easy, Good Girls Don't Get Fat:, Brain over Binge, Overcoming Binge Eating.

Most importantly, I hope that you are able to see your children for who they are without putting a label on them that will affect your relationship. Try not to overthink things. Sometimes all you have to do is just be with your kids.

If your struggles seem overwhelming, learning the right skills and techniques can make all the difference and at Bespoke Wellness, our therapists are here to help.

Love,

Limor