Parents Cheat Sheet - Twelve things kids want their parents to know about eating disorders.

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 thought about a parent's “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 at the age of 14, 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. 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 Be aware of triggering comments you may be making in front of your child

Oftentimes parents don’t realize that some things they say can be extremely harmful to their children with eating disorders. Triggering comments such as “You are eating too much you will get fat…” and, “You will not look good if you get fat…” may not be intended to be taken seriously, but frequently are.

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.

Certain comments can be triggering to people with eating disorders. Things like “you don’t look like you have an eating disorder,” and “you look great!” are words that, more often than not, only fuel eating disorder behaviors. Other phrases like, “you just need to try harder,” and “at least you’re not a drug addict” minimize the struggles of a person with an eating disorder.

Tip # 5 Don’t be afraid to be open and vulnerable with your children's’ struggles

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 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 message 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 # 7 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 #8 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.

Tip #9 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 week, 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 # 10 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 # 11 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 # 12 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.

Now that you have read the tips above, which ones resonated with you? I challenge you to delve deeper into these ideas. Be curious about your own actions and the affect that they have. How can you be more present for your child?

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!

With much love,

Limor