Parenting Advice From Your Physicians at Kaiser Permanente

An eating disorder can wreak havoc on the life of a teen and their family. As a child therapist, I know that talking about eating disorders can bring up feelings of fear, guilt, shame, and blame, for both teens and parents. Eating disorders thrive in secrecy and often get worse over time, so seeking out support early is crucial.

A teen with an eating disorder (ED) may be preoccupied with food, body shape, and size. They may experience distressing emotions and thought patterns. They may have a distorted image of their body, believing they’re much larger than they actually are.

Though eating disorders can develop at any time, they most often start in adolescence. They can affect people from all backgrounds, genders, and ages. Up to 5% of the total population has an ED, according to the American Psychiatric Association.

Teens with an ED will often say there’s no problem, and deny that they’ve changed their eating or exercise patterns. They may wear more baggy clothing items to conceal their changing bodies. Behaviors related to disordered eating may include:

• Counting calories
• Exercising excessively
• Being obsessed with their appearance
• Frequently checking their weight
• Restricting food or avoiding foods they previously ate
• Vomiting after meals
• Misusing laxatives

Eating disorders can result in many physical consequences. Teens with an ED often feel cold, fatigued, and dizzy, making daily activities difficult. They may experience malnutrition, poor growth, stress on their hearts, and digestive problems. Some grow more hair on their bodies. Menstruation may stop, and there may be future fertility problems. Vomiting can cause dental decay. And tragically, eating disorders can result in death if not treated.

Research suggests that the development of an eating disorder can be genetic. But there are other factors that contribute. Teens often tell me about the pressures they feel from family, friends, and media to change their appearance, and how their own mental health struggles contribute to having a poor self-image. Some tell me that the pandemic has left them feeling isolated, anxious, and depressed. Referrals for mental health care in general, and for care of eating disorders, have skyrocketed since the pandemic began.

Teens seek ways to cope with these strong emotions and feel more in control of their lives. Many share that at first, disordered eating behaviors give them a short-term sense of control. But ultimately, they lose control, act in ways that are detrimental to their health, and feel worse about themselves. Finding alternative ways to cope with their emotions and feel empowered is vital to recovery.

Parents often feel at a loss when they find out their teens have an eating disorder, or are struggling with their relationship to food and body image. While it’s a complex issue with a lot of factors, you can help have a positive effect in some key ways:

• Avoid talking about body weight and shape at home. Focus more on what your body can do for you, rather than what it looks like.
• Avoid labeling food as “good” or “bad.” Nutritionists remind us that the only “bad” food is food that is spoiled and needs to be thrown out.
• Share family meals and try to make mealtimes calm and peaceful.
• Encourage “eating by the clock,” meaning you set a routine for your child to eat at the same times each day.
• Seek help if you suspect your child is struggling at all, even they deny they need it. Many teens later express gratitude that their parents noticed the problem. Reach out to their pediatrician or to a therapist.

Teenagers are extremely resilient, and I’ve worked with many who’ve successfully recovered from an eating disorder. Seeing them meet the challenges of recovery and learn to love and care for themselves again is why I do this work.

Overcoming an eating disorder is best approached as a team, and the more knowledgeable and supportive people on the team, the better. Pediatricians and therapists are wonderful resources who are here to partner with you to support your teen on their path back to health. Please reach out – you’re not alone.

Resources for Parents:

Parent toolkit: ParentToolkit.pdf (nationaleatingdisorders.org)

Helping a loved one: How to Help a Loved One | National Eating Disorders Association

Virtual support: Free & Low Cost Support | National Eating Disorders Association

Warning signs and Symptoms: Eating Disorder Signs & Symptoms | Learn | NEDA (nationaleatingdisorders.org)

10 Steps to Better Body Image: 10 Steps to Positive Body Image | National Eating Disorders Association