We're Worried About Eating Disorders


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Q: Our daughter is very concerned about gaining weight. She is not overweight at all but talks constantly about getting fat. Her Dad and I are very aware of the pressures on young women to be slim in our society, and we are trying to be positive and to focus on the importance of balance in our lives. We eat healthy at home and are a very active family. We are so afraid that this may develop into something serious. She’s only 13. Please tell us what we should do.

A: “I’m fat, I’m ugly, I don’t like my hair or my nose . . . if only I was taller, shorter, thinner, prettier, I would be happy, and more kids would like me.” This is reality for many teenagers today. Bombarded by media images of unrealistic body types, unhealthy means of losing weight and misleading promises of happiness, it is easy to see where their confusion comes from. Combine these images with a culture addicted to super sizing, buy one get one free, low-cal and fat-free, and your daughters comments about “getting fat” begin to make more sense.

At 13, your daughter is beginning the emotionally tumultuous period of adolescence and the dramatic changes in her body brought on by puberty. Adolescence is a time of individuation and separation from parents, in which increased importance is placed on friendship cliques and acceptance by peers. It is common for teenage girls to compare themselves, their bodies and their attitudes to those of their primary peer group. If your daughter’s friends spend a lot of time talking about their bodies and their dissatisfaction with them, your daughter will be influenced by this and most likely adopt similar attitudes to fit in.

Since one of the primary developmental tasks for your daughter is to figure out who she is separate from you, she does this by “trying on” different ideas of herself and experimenting with them. This uncertainty creates a vulnerable space for any teenager to live in and can sometimes lead to low self-esteem. Teens with higher self-esteem seem to navigate adolescence easier, feel more in control, makes friends easier and have an overall higher satisfaction with life in general. Thus, the better your daughter feels about “who she is,” the more accepting she will become of her own body.

While complaints about body image are one symptom of eating disorders, it is not the only one. Eating disorders fall into two major categories: Anorexia Nervosa and Bulimia.

Anorexia Nervosa is characterized by:

  • The refusal to maintain body weight at or above the normal weight for the specific age and height.
  • An intense fear of gaining weight or becoming fat, even though underweight.
  • Disturbance in the way in which one’s body weight or shape is experienced. For example, anorexics see a “fat person” in the mirror, despite being underweight.
  • Absence of menstruation for three consecutive cycles.

Bulimia is characterized by:

  • Recurrent episodes of binge eating that occur in a discrete period of time while consuming unusually large quantities of food.
  • A lack of control over eating during binges.
  • Recurrent binging to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics or excessive exercise.
  • Binge eating and purging occur on average at least twice a week for at least three months.

The sooner an eating disorder is identified and diagnosed, the better the prognosis. So pay attention, stay involved in your teenager’s daily life and seek professional help such as counseling when needed.

To help your daughter:

  • Acknowledge that you are on the right track by asking for help. Parents desire to see the best in their children, but sometimes this gets in the way of seeing a child struggle.
  • Know what you are up against! Limit the fashion magazines, television and movies that encourage unrealistic body images.
  • Examine your family’s eating habits. It sounds like your family has a healthy diet. Maintain this and continue to offer and encourage healthy choices.
  • Examine your food attitude. How you feel about your body directly affects your family. Limit negative talk about your body image and encourage other family members to do the same.
  • Focus on health first! Debunk the myths that models actually look like this in real life. Educate your daughter that 98 percent of models are underweight and that all magazine images are touched up to cover imperfections or reality.
  • Model healthy exercise behavior. Continue your family hikes and bike rides and have fun doing it.
  • Promote uniqueness and individuality concerning different body types.
  • Lastly, continue building your daughter’s self-esteem through positive role modeling.

The journey toward a positive self-image is a long one, but the rewards greatly outweigh the challenges along the road.

Kristin Norden, LCSW, is the Outpatient Clinical Manager at Moses Cone Behavioral Health Center. Please submit your questions to “Is My Kid OK?” via e-mail to Sherri.McMillen@mosescone.

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