So far in our eating-disorder prevention series we’ve focused on stopping eating disorders before they begin (primary prevention). But even if you put all the protective factors in place — fostering a healthy body image, having regular family meals and declaring a diet-free household — there’s still a chance your child will develop an eating disorder.
According to Sari Shepphird PhD, eating disorder specialist and author of 100 Questions & Answers About Anorexia Nervosa, eating disorders have a strong genetic connection. For example, a child whose parent suffered with an eating disorder is 12 times more likely to be diagnosed with one. And according to the National Eating Disorders Association, some individuals have altered brain chemicals making them more vulnerable to eating disorders.
“Parents can prevent a certain amount of disordered eating,” says Laura Collins author of Eating with Your Anorexic: How My Child Recovered Through Family-Based Treatment and Yours Can Too. “But some young people seem to be so deeply predisposed toward this illness that they will develop it no matter what their environment is.”
This is where “secondary prevention” comes in. It focuses on the early identification of an eating disorder – to treat this disease before it gets out of control. Shepphird explains that when caught early, persons suffering from eating disorders have the best chance of full recovery.
So with that in mind, here are three tell-tale signs that can help you catch an eating disorder early.
1. Significant changes in weight:Weight loss is almost always the first sign of an impending eating disorder. The drop in weight may be hidden from others by baggy or oversized clothes.
Some children, on the other hand, may maintain their weight but fail to gain weight or height as expected. And then others may gain quite a bit of weight, especially those prone to binge-eating disorder.
In addition to weight changes, look for a preoccupation with weight in general. You might notice your daughter commenting on how this person gained weight or that person lost it. This focus on weight is typically accompanied by a poor self body image despite a normal or low body weight.
It’s important for parents to watch how they react to their child’s changing body shape. Take it easy on the physical compliments or criticism which can add fuel to a developing eating disorder.
“I am very thankful my parents got REALLY proactive RIGHT when I started losing weight. They took me to a doctor and psychologist immediately. I can’t imagine what would have happened if they hadn’t gotten me help ASAP!” Katie, 19 year old diagnosed with an eating disorder at age 15. She blogs at Faith, Food & Fitness
2. Change in Eating: Alterations in the way your child relates to food is another red flag. Regular family meals help as you get a front seat view to how your child is eating.
Shepphird explains that skipping meals, being anxious while eating and rituals such as dividing, weighing and playing with food are all things to watch for (we’re not talking about picky toddler behavior here). Some might become a vegetarian to avoid eating. And going straight to the bathroom after meals could also be a sign of bulimia.
But you’ll also want to watch out for the most common behavior linked to eating disorders: dieting. In a 2002 study published in the Journal of Adolescent Health, half of Minnesota high-school girls engaged in disordered eating patterns such as vomiting, diet pill use and laxative use.
Even if children don’t use the word “diet,” you’ll see them restricting calorie-rich foods. They often see food as either “good” or “bad” and may avoid eating socially where they have no control over the food being served.
Those who are developing a binge eating disorder may feel out of control when eating, including times where they eat much more food than would otherwise seem normal. Their weight can fluctuate but in the case of bulimia and binge eating disorder, a low body weight is uncommon.
“My mom once confronted me about weight loss pills I was taking and I freaked out and told her they were vitamins. I was young and I wish she would have been more insistent about me getting rid of them.” Jenna, 22 year old recovering dieter who blogs at Healthy. Happy. Well.
3. Excessive exercise: Using exercise as a way to purge calories is another warning sign.
George Hillinger, Clinical Exercise Specialist and Owner of the Fitness Connection, says super long cardio sessions that can go an hour and a half or longer and inappropriate exercise timing (such as running during recess or any chance they can get) can be problematic. The exercise behavior is excessive, he explains, and there’s an “I’ll burn calories at any cost” mentality.
“The biggest hurdle in what I do is to teach individuals with eating disorders that exercise is not about torture and they should not have a ‘no pain, no gain’ attitude” he says. “It’s much better if they can start at a sensible pace and find something they really enjoy doing.”
When Melissa Schlothan was in college she started running 7 miles almost daily, barely ate and got down to a meager 103 pounds (she’s 5’6″). When she returned home her family was afraid to approach her even though they were concerned about her weight.
“I definitely wish my parents had been more inquisitive when they first started to notice I had lost a lot of weight,” she says. “I think they (and I) might have been able to stop the progression of my disease sooner rather than later”
What’s a Parent to Do?
So you’ve gathered the clues and believe that your child might have an eating disorder. What exactly should you do with this information?
“A great first step for parents is to talk to their child’s pediatrician for an accurate diagnosis and guidance for getting help,” says Shepphird. “Parents also need to learn all they can about eating disorders.”
Laura Collins was in this very position when her daughter was diagnosed with an eating disorder at age 14. Her biggest issue was finding support from other parents going though the same thing. She found most parents hiding in shame mostly due to society’s tendency to blame parents.
“When parents spend all their time blaming themselves their energy is spent on the wrong things,” she says. “Parents need to realize it’s not their fault and that they need to be proactive with this very real and serious diagnosis.”
Because there was so little support for parents Collins decided to take action. Her mission is to educate the public about eating disorders. She does this through her book, blog and role as executive director of F.E.A.S.T (Families Empowered and Supporting Treatment of Eating Disorders).
The health and psychological consequences of eating disorders are significant and could even result in death either through poor health or suicide. And the worst part is eating disorders are at an all-time high.
So put into place those protective factors, arm yourself with accurate information and be on the lookout for signs and symptoms of eating disorders. And if you see some red flags, you’ll want to act fast. You won’t regret it.
“I wish my mom had been more persistent and trusted her instinct. She recognized that I had a problem and confronted me about it, but in my eating disorder-fueled rage I got so upset that she backed off completely until I was really sick. If I had gotten help at that very early stage in my eating disorder, I would have spared myself a lot of agony, physical harm, and years of very expensive and grueling treatment later on.” Stefanie, 22 year old diagnosed with anorexia at age 18. She blogs at the popular More to Life Than Lettuce
Croll J, Neumark-Sztainer D, Story M, Ireland M. Prevalence and risk and protective factors related to disordered eating behaviors among adolescents: relationship to gender and ethnicity. Journal of Adolescent Health. 2002:31(2);166-175.