Parent and Teen Weight Relate to Feeding Practices

A new study helps identify which parents of teens are most likely to use feeding practices that have been linked with unhealthy outcomes, researchers say. Parents most often pressure their teen to eat when neither they nor the teen are overweight, while when parents and teens are both overweight, parents most often use food restriction, the researchers found. Previous research has shown that when parents use restriction and pressure-to-eat feeding practices, children and adolescents are at higher risk for being overweight and having eating disorders, said lead author Jerica M. Berge of the University of Minnesota Medical School in Minneapolis, in email to Reuters Health. She and her colleagues analyzed data from two studies involving more than 3,000 parents and more than 2,000 teens. Teens had their height and weight measured by trained professionals at school, and parents filled out a questionnaire at home, self reporting their own heights and weights.

Parents also reported how often they encouraged their child to eat more at mealtimes and how often they restricted sweets, high-fat foods or their teen’s favorite foods. In about 1,200 cases, parents were overweight or obese but their teen was not. In almost 900 cases, both parent and child were overweight. In almost 700 cases, the parent and child were both not overweight, and in only about 300 cases the parent was not overweight but the teen was. Pressuring kids to eat was more common when both parties were not overweight, compared to pairs who were overweight or had differing statuses. Similarly, food restriction was most common for pairs that were both overweight or obese, compared to those who were both not overweight or who differed between parent and child, the authors reported in Pediatrics.

Clare Collins, professor in nutrition and dietetics at The University of Newcastle in Callaghan, Australia who wasn’t involved in the new study, noted in email to Reuters Health that the surveys were taken only at one time point so it is unclear from the results if parent feeding practices go on to influence future eating and weight status in the adolescents. “The problem with restricting food from a child or pressuring a child to eat more is that prior research has shown that it may have unintended consequences such as, a child becoming overweight or obese, or engaging in disordered eating behaviors such as, binging or purging,” Berge said. “Rather than restricting or pressuring your child to eat, it is more helpful for parents to make sure that there are a variety of healthy food options in the home, or on the table, for children to eat and then allow the child to decide how much they eat,” she said. Having unhealthy food in the fridge and on the table and telling a teen they cannot eat it is not helpful and sets up food fights, Collins said. But keeping unhealthy food out of the house in the first place does work and helps keep harmony in your house, she said.

Reprinted from Reuters (Kathryn Dole)

Tip of the Day

Can’t find something in your kitchen? Add it to the list! Keeping a running list of items you need and bringing it to the store will minimize the number of products you buy and the size of your bill.

Daily Inspiration 

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Eating Disorders-General Knowledge

Eating disorders are psychological illnesses defined by abnormal eating habits that may involve either insufficient or excessive food intake to the detriment of an individual’s physical and mental health. Bulimia nervosa and anorexia nervosa are the most common specific forms of eating disorders. Other types of eating disorders include binge eating disorder and OSFED (Other Specified Feeding or Eating Disorders). Bulimia nervosa is a disorder characterized by binge eating and purging. Purging can include self-induced vomiting, over-exercising, and the usage of diuretics, enemas, and laxatives. Anorexia nervosa is characterized by extreme food restriction to the point of self-starvation and excessive weight loss.

The extreme weight loss often causes women and girls who have begun menstruating to stop having menstrual periods, a condition known as amenorrhea, although some women who meet the other DSM-5 (Diagnostic and Statistic Manual of Mental Disorders, 5th editions) criteria for anorexia nervosa still report some menstrual activity. The DSM-5 currently specifies two subtypes of anorexia nervosa: Restricting and binge/purge type. Those who suffer from the restricting type of anorexia nervosa lose weight by restricting food intake and sometimes by over-exercising, whereas those suffering from the binge/purge type overeat and/or compensate through some method of purging. The difference between anorexia nervosa binge/purge type and bulimia nervosa is the body weight of a person. Those diagnosed with anorexia nervosa binge/purge type are well under a healthy bodyweight, while those with bulimia nervosa may have a body weight that falls within the range from normal to overweight and obese. 

Though primarily thought of as affecting females (an estimated 5–10 million being affected in the UK), eating disorders affect males as well. An estimated 10 – 15% of people with eating disorders are males. Although eating disorders are increasing all over the world among both men and women, there is evidence to suggest that it is women in the Western world who are at the highest risk of developing them and the degree of westernization increases the risk. Nearly half of all Americans personally know someone with an eating disorder. The skill to comprehend the central processes of appetite has increased tremendously since leptin was discovered, and the skill to observe the functions of the brain as well. Interactions between motivational, homeostatic and self-regulatory control processes are involved in eating behavior, which is a key component in eating disorders.

The precise cause of eating disorders is not entirely understood, but there is evidence that it may be linked to other medical conditions and situations. Cultural idealization of thinness and youthfulness have contributed to eating disorders affecting diverse populations. One study showed that girls with ADHD have a greater chance of getting an eating disorder than those not affected by ADHD. Another study suggested that women with PTSD, especially due to sexually related trauma, are more likely to develop anorexia nervosa. One study showed that foster girls are more likely to develop bulimia nervosa. Some think that peer pressure and idealized body-types seen in the media are also a significant factor.

Some research shows that for certain people there are genetic reasons why they may be prone to developing an eating disorder. Recent studies have found evidence of a correlation between patients with bulimia nervosa and substance use disorders. In addition, anxiety disorders and personality disorders are common occurrences with clients of eating disorders. People with eating disorders may have a dysfunctional hunger cognitive module which causes various feelings of distress to make them feel hungry. While proper treatment can be highly effective for many suffering from specific types of eating disorders, the consequences of eating disorders can be severe, including death.

Tip of the Day

Dessert? Try the salad bar. Enjoy sliced fruit from the salad bar as your dessert when dining out. This will help you resist other dessert options that may be higher in calories.

Daily Inspiration 

“When he had received the drink, Jesus said, “It is finished.” With that, he bowed his head and gave up his spirit.”

~ John 19:30

Eating Disorders and Teens

Eating disorders are so common in America that 1 or 2 out of every 100 students will struggle with one. Each year, thousands of teens develop eating disorders, or problems with weight, eating, or body image. Eating disorders are more than just going on a diet to lose weight or trying to exercise every day. The disorder represents extremes in eating behavior and ways of thinking about eating; the diet that never ends and gradually gets more restrictive, for example or the person who can’t go out with friends because he or she thinks it’s more important to go running to work off a snack eaten earlier. The most common eating disorders are anorexia nervosa and bulimia nervosa (usually called simply “anorexia” and “bulimia”). However, other food-related disorders, like avoidance/restrictive food intake disorder, binge eating, body image disorders, and food phobias, are becoming more and more commonly identified.

Anorexia:

People with anorexia have a real fear of weight gain and a distorted view of their body size and shape. As a result, they eat very little and can become dangerously underweight. Many teens with anorexia restrict their food intake by dieting, fasting, or excessive exercise. They hardly eat at all and the small amount of food they do eat becomes an obsession in terms of calorie counting or trying to eat as little as possible. Others with anorexia may start binge eating and purging; eating a lot of food and than trying to get rid of the calories by making themselves throw up, using some type of medication or laxatives, or exercising excessively, or some combination of these.

Bulimia:

Bulimia is similar to anorexia. With bulimia, people might binge eat (eat to excess) and then try to compensate in extreme ways, such as making themselves throw up or exercising all the time, to prevent weight gain. Over time, these steps can be dangerous both physically and emotionally. They can also lead to compulsive behaviors (ones that are hard to stop). To have bulimia, a person must be bingeing and purging regularly, at least once a week for a couple of months. Binge eating is different from going to a party and “pigging out” on pizza, then deciding to go to the gym the next day and eat more healthfully

People with bulimia eat a large amount of food (often junk food) at once, usually in secret. Sometimes they eat food that is not cooked or might be still frozen, or retrieve food from the trash. They typically feel powerless to stop the eating and can only stop once they’re too full to eat any more, or they may have to go to extreme measures (like pouring salt all over a dessert to make it inedible) in order to get themselves to stop eating. Most people with bulimia then purge by vomiting, but also may use laxatives or excessive exercise.

Although anorexia and bulimia are very similar, people with anorexia are usually very thin and underweight, but those with bulimia may be an average weight or can be overweight.

Binge Eating Disorder:

This eating disorder is similar to anorexia and bulimia because a person binges regularly on food (at least once a week, but typically more often). However, unlike the other eating disorders, a person with binge eating disorder does not try to “compensate” by purging the food. Anorexia, bulimia, and binge eating disorder all involve unhealthy eating patterns that begin gradually and build to the point where a person feels unable to control them.

Avoidant/Restrictive Food Intake Disorder (ARFID):

ARFID is a new term that some people think just means “picky eating,” but a number of other eating issues can also cause it. People with ARFID don’t have anorexia or bulimia, but they still struggle with eating and as a result don’t eat enough to keep a healthy body weight. Types of eating problems that might be considered ARFID include:

  • Difficulty digesting certain foods
  • Avoiding certain colors or textures of food
  • Eating only very small portions
  • Having no appetite
  • Being afraid to eat after a frightening episode of choking or vomiting

Because they don’t get enough nutrition in their diet, people with ARFID lose weight, or, if they’re younger kids, they may not gain weight or grow as expected. Many people with ARFID need supplements each day to get the right amount of nutrition and calories. People with ARFID also might have issues in their day-to-day lives, at school, or with their friends because of their eating problems. For example, they might avoid going out to eat or eating lunch at school, or it might take so long to eat that they’re late for school or don’t have time to do their homework. Some people with ARFID may go on to develop another eating disorder, such as anorexia or bulimia.

Signs of Anorexia and Bulimia:

Sometimes a person with anorexia or bulimia starts out trying to lose few pounds or are hoping to get in shape. However, the urge to eat less or to purge or over-exercise gets “addictive” and becomes too hard to stop. Teens with anorexia or bulimia often feel intense fear of being fat or think that they’re fat when they are not. Those with anorexia may weigh food before eating it or compulsively count the calories of everything. People to whom this seems “normal” or “cool” or who wish that others would leave them alone so they can just diet and be thin might have a serious problem. How do you know for sure that someone is struggling with anorexia or bulimia? You can’t tell just by looking; a person who loses a lot of weight might have another health condition or could be losing weight through healthy eating and exercise. However, there are signs to watch for that might indicate a person has anorexia or bulimia.

Someone with anorexia might:

  • Become very thin, frail, or emaciated
  • Be obsessed with eating, food, and weight control
  • Weigh herself or himself repeatedly
  • Deliberately “water load” when going to see a health professional to get weighed
  • Count or portion food carefully
  • Eat only certain foods, avoiding foods like dairy, meat, wheat, etc. (of course, lots of people who are allergic to a particular food or are vegetarians avoid certain foods)
  • Exercise excessively
  • Feel fat
  • Withdraw from social activities, especially meals and celebrations involving food
  • Be depressed, lethargic (lacking in energy), and feel cold a lot

Someone with bulimia might:

  • Fear weight gain
  • Be intensely unhappy with body size, shape, and weight
  • Make excuses to go to the bathroom immediately after meals
  • Only eat diet or low-fat foods (except during binges)
  • Regularly buy laxatives, diuretics, or enema
  • Spend most of his or her time working out or trying to work off calories
  • Withdraw from social activities, especially meals and celebrations involving food

What Causes Eating Disorders?

No one is really sure what causes eating disorders, although there are many theories about it. Many people who develop an eating disorder are between 13 and 17 years old. This is a time of emotional and physical changes, academic pressures, and a greater degree of peer pressure. Although there is a sense of greater independence during the teen years, teens might feel that they are not in control of their personal freedom and, sometimes, of their bodies. This can be especially true during puberty.

For girls, even though it’s completely normal (and necessary) to gain some additional body fat during puberty, some respond to this change by becoming very fearful of their new weight. They might mistakenly feel compelled to get rid of it any way they can. When you combine the pressure to be like celebrity role models with the fact that bodies grow and change during puberty, it’s not hard to see why some teens develop a negative view of themselves. Celebrity teens and athletes conform to the “Hollywood ideal;” girls are petite and skinny, and guys are athletic and muscular, and these body types are popular not only in Hollywood but also in high school. Many people with eating disorders also can be depressed or anxious, or have other mental health problems such as obsessive-compulsive disorder (OCD). There is also evidence that eating disorders may run in families. Although part of this may be genetics, it’s also because we learn our values and behaviors from our families.

Sports and Eating Disorders:

Athletes and dancers are particularly vulnerable to developing eating disorders around the time of puberty, as they may want to stop or suppress growth (both height and weight). Coaches, family members, and others may encourage teens in certain sports, such as gymnastics, ice skating, and ballet, to be as thin as possible. Some athletes and runners are also encouraged to weigh less or shed body fat at a time when they are biologically destined to gain it.

Effects of Eating Disorders:

Eating disorders are serious medical illnesses. They often go along with other problems such as stress, anxiety, depression, and substance use. Eating disorders can lead to the development of serious physical health problems, such as heart conditions or kidney failure. Someone whose body weight is at least 15% less than the average weight for that person’s height may not have enough body fat to keep organs and other body parts healthy. In severe cases, eating disorders can lead to severe malnutrition and even death. With anorexia, the body goes into starvation mode, and the lack of nutrition can affect the body in many ways:

  • A drop in blood pressure, pulse, and breathing rate
  • Hair loss and fingernail breakage
  • Loss of periods
  • Lanugo hair — a soft hair that can grow all over the skin
  • light-headedness and inability to concentrate
  • Anemia
  • Swollen joints
  • Brittle bones

With bulimia, constant vomiting and lack of nutrients can cause these problems:

  • Constant stomach pain
  • Damage to the stomach and kidneys
  • Tooth decay (from exposure to stomach acids)
  • “Chipmunk cheeks,” when the salivary glands permanently expand from throwing up so often
  • Loss of periods
  • Loss of the mineral potassium (this can contribute to heart problems and even death)

A person with binge eating disorder who gains a lot of weight is at risk of developing diabetes, heart disease, and some of the other diseases associated with being overweight. The emotional pain of an eating disorder can take its toll, too. When someone becomes obsessed with weight, it’s hard to concentrate on much else. It can be exhausting and overwhelming to monitor food intake and exercise, and be in a constant state of stress about food and how your body looks. It’s easy to see why when you develop an eating disorder you could become withdrawn and less social. It gets too hard to join in on snacks and meals with friends or families, or too hard to stop the addictive exercising or working out to have fun. Having an eating disorder also can use up a lot of mental energy planning what to eat, how to avoid food, planning a binge, getting money to buy food or laxatives or other medications, making up reasons to use the bathroom after meals, or figuring out how to tell people around you that you want to be alone after a meal.

Treatment for Eating Disorders:

Fortunately, eating disorders can be treated. People with eating disorders can get well and gradually learn to eat well and more like their family and friends again. Eating disorders involve both the mind and body. Therefore, medical doctors, mental health professionals, and dietitians will often be involved in a person’s treatment and recovery. Therapy or counseling is a very important part of getting better, in many cases, family therapy is one of the keys to eating healthily again. Parents and other family members are important in supporting people who have to regain weight that they are afraid of, or to learn to accept the body shape that their culture, genes, and lifestyle allows for.

If you want to talk to someone about eating disorders but are unable or not ready to talk to a parent or close family member, try reaching out to a friend, teacher, school nurse or counselor, coach, neighbor, your doctor, or another trusted adult. Remember that eating disorders are very common among teens. Treatment options depend on each person and their families, but many treatments incorporate journaling, talking to therapists, and working with dietitians and other professionals. Learning to be comfortable at your healthy weight is a process. It takes time to unlearn some behaviors and relearn others. Be patient, you can learn to like your body, understand your eating behaviors, and figure out the relationship between feelings and eating, all the tools you need to feel in control and to like and accept yourself for who you are.

Teens Health

Tip of the Day

Avoid oversized portions. Use a smaller plate, bowl, and glass. Portion out foods before you eat. When eating out, choose a smaller size option, share a dish, or take home part of your meal.

Daily Inspiration

“He will swallow up death forever. Then the Lord God will wipe away all the tears from all faces.”

~ Isaiah 25:8.

Victor Hugo said of death: “When I go down to the grave I can say, like so many others: I have finished my work but I cannot say I have finished my life. My day’s work will begin the next morning. My tomb closes in the twilight to be opened in the dawn.”

The Devil Wears Prada but Also Rose-Colored Glasses

Leaders of the three leading eating disorders organizations expressed disappointment after an “invitation-only panel discussion on beauty and health in the fashion industry” held early in New York City, February 5, 2007 during New York’s semi-annual Fashion Week. Members of the National Eating Disorders Association (NEDA), the Academy for Eating Disorders (AED) and the Eating Disorders Coalition (EDC) urge the Council of Fashion Designers of America (CFDA) to improve its health initiative and take the problem of eating disorders more seriously. “We commend the CFDA for its initiative. However, it seems that the devil not only wears Prada, but also rose-colored glasses,” said Lynn Grefe, CEO, NEDA. “Our goal is to protect the health and lives of young women in the fashion industry. Clearly the catwalk is a dangerous balance beam for some, who will not be helped by such baby steps. We urge the Council to take a position of leadership and to take the next step.”

The panel presented the Council’s recommendations to promote health and wellness among models. Missing from those guidelines is a requirement for an annual physical exam certifying that models are healthy to work. Recommendations did include educating the industry about eating disorders; requiring models with eating disorders to seek professional help; not permitting models with an eating disorder to work without a doctor’s approval; and promoting a healthy backstage environment. States Dr. Eric van Furth, president of the AED, which issued its own guidelines for the fashion industry in January (www.aedweb.org/public/AED_Guidelines_for_Fashion_Industry.pdf), “Requiring yearly physicals is a practical and effective solution to monitoring health in the fashion industry. Such an exam should include a comprehensive evaluation for eating disorders.” Kitty Westin, president, EDC, who believes that external regulation may be required, said, “We are concerned that a federal response to industry practices may become necessary if the industry is not able or willing to adopt meaningful self-regulation and protect the health and well-being of models. As a mom who lost her daughter, I am here to help save lives.”

Eating disorders are serious illnesses with a biological basis modified and influenced by emotional and cultural factors. Nearly 10 million females and 1 million males are fighting a life-and-death battle with an eating disorder such as anorexia or bulimia. In May of 2000, the British Medical Association identified a link between the images of “abnormally thin” models, which are increasingly common in the media, and a rise in eating disorders. The National Eating Disorders Association (NEDA), headquartered in Seattle, Wash., is a not-for-profit organization advocating prevention, treatment and research funding for eating disorders; expanding public education and awareness; promoting access to quality treatment for those affected; and providing support for their loved ones. Since the inception of its Helpline in 1999, NEDA has referred more than 50,000 people to treatment and tallies more than 40 million hits annually on its Web site. NEDA’s 20th annual National Eating Disorders Awareness Week is Feb. 25 – March 3. For more information on eating disorders visit www.NationalEatingDisorders.org

The Academy for Eating Disorders is an international, trans-disciplinary professional organization with over 1,400 members worldwide. The AED promotes excellence in research, treatment and the prevention of eating disorders. It provides education, training and a forum for collaboration and professional dialogue. Visit www.AEDweb.org for more information.
The Eating Disorders Coalition for Research, Policy & Action is a cooperative of professional and advocacy-based organizations committed to federal advocacy on behalf of people with eating disorders, their families and professionals working with these populations. Visit www.EatingDisordersCoalition.org.

Eating Disorders: About More Than Food

What are eating disorders?

The eating disorders anorexia nervosa, bulimia nervosa, and binge-eating disorder, and their variants, all feature serious disturbances in eating behavior and weight regulation. They are associated with a wide range of adverse psychological, physical, and social consequences. A person with an eating disorder may start out just eating smaller or larger amounts of food, but at some point, their urge to eat less or more spirals out of control. Severe distress or concern about body weight or shape, or extreme efforts to manage weight or food intake, also may characterize an eating disorder.

Eating disorders are real, treatable medical illnesses. They frequently coexist with other illnesses such as depression, substance abuse, or anxiety disorders. Other symptoms can become life-threatening if a person does not receive treatment, which is reflected by anorexia being associated with the highest mortality rate of any psychiatric disorder. Eating disorders affect both genders, although rates among women and girls are 2½ times greater than among men and boys. Eating disorders frequently appear during the teen years or young adulthood but also may develop during childhood or later in life.

What are the different types of eating disorders?

Anorexia nervosa:

Many people with anorexia nervosa see themselves as overweight, even when they are clearly underweight. Eating, food, and weight control become obsessions. People with anorexia nervosa typically weigh themselves repeatedly, portion food carefully, and eat very small quantities of only certain foods. Some people with anorexia nervosa also may engage in binge eating followed by extreme dieting, excessive exercise, self-induced vomiting, or misuse of laxatives, diuretics, or enemas. Symptoms of anorexia nervosa include:

  • Extremely low body weight
  • Severe food restriction
  • Relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight
  • Intense fear of gaining weight
  • Distorted body image and self-esteem that is heavily influenced by perceptions of body weight and shape, or a denial of the seriousness of low body weight
  • Lack of menstruation among girls and women.
  • Some who have anorexia nervosa recover with treatment after only one episode. Others get well but have relapses. Still others have a more chronic, or long-lasting, form of anorexia nervosa, in which their health declines as they battle the illness.

Other symptoms and medical complications may develop over time, including:

  • Thinning of the bones (osteopenia or osteoporosis)
  • Brittle hair and nails
  • Dry and yellowish skin
  • Growth of fine hair all over the body (lanugo)
  • Mild anemia, muscle wasting, and weakness
  • Severe constipation
  • Low blood pressure, or slowed breathing and pulse
  • Damage to the structure and function of the heart
  • Brain damage
  • Multi-organ failure
  • Drop in internal body temperature, causing a person to feel cold all the time
  • Lethargy, sluggishness, or feeling tired all the time
  • Infertility

Bulimia nervosa:

People with bulimia nervosa have recurrent and frequent episodes of eating unusually large amounts of food and feel a lack of control over these episodes. This binge eating is followed by behavior that compensates for the overeating such as forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors. Unlike anorexia nervosa, people with bulimia nervosa usually maintain what is considered a healthy or normal weight, while some are slightly overweight. But like people with anorexia nervosa, they often fear gaining weight, want desperately to lose weight, and are intensely unhappy with their body size and shape. Usually, bulimic behavior is done secretly because it is often accompanied by feelings of disgust or shame. The binge eating and purging cycle can happen anywhere from several times a week to many times a day. Other symptoms include:

  • Chronically inflamed and sore throat
  • Swollen salivary glands in the neck and jaw area
  • Worn tooth enamel, and increasingly sensitive and decaying teeth as a result of exposure to stomach acid
  • Acid reflux disorder and other gastrointestinal problems
  • Intestinal distress and irritation from laxative abuse
  • Severe dehydration from purging of fluids
  • Electrolyte imbalance—too low or too high levels of sodium, calcium, potassium, and other minerals that can lead to a heart attack or stroke.

Binge-eating disorder:

People with binge-eating disorder lose control over their eating. Unlike bulimia nervosa, periods of binge eating are not followed by compensatory behaviors like purging, excessive exercise, or fasting. As a result, people with binge-eating disorder often are overweight or obese. People with binge-eating disorder who are obese are at higher risk for developing cardiovascular disease and high blood pressure. They also experience guilt, shame, and distress about their binge eating, which can lead to more binge eating.

How are eating disorders treated?

Typical treatment goals include restoring adequate nutrition, bringing weight to a healthy level, reducing excessive exercise, and stopping binging and purging behaviors. Specific forms of psychotherapy, or talk therapy, including a family-based therapy called the Maudsley approach and cognitive behavioral approaches, have been shown to be useful for treating specific eating disorders. Evidence also suggests that antidepressant medications approved by the U.S. Food and Drug Administration may help for bulimia nervosa and also may be effective for treating co-occurring anxiety or depression for other eating disorders. Treatment plans often are tailored to individual needs and may include one or more of the following:

  • Individual, group, or family psychotherapy
  • Medical care and monitoring
  • Nutritional counseling
  • Medications (for example, antidepressants)

Some patients also may need to be hospitalized to treat problems caused by malnutrition or to ensure they eat enough if they are very underweight. Complete recovery is possible.

What is being done to better understand and treat eating disorders?

Researchers are finding that eating disorders are caused by a complex interaction of genetic, biological, psychological, and social factors but many questions still need answers. Researchers are studying questions about behavior, genetics, and brain function to better understand risk factors, identify biological markers, and develop specific psychotherapies and medications that can target areas in the brain that control eating behavior. Brain imaging and genetic studies may provide clues for how each person may respond to specific treatments for these medical illnesses. Ongoing efforts also are aimed at developing and refining strategies for preventing and treating eating disorders among adolescents and adults.

Where can I find more information?

To learn more about eating disorders, visit:
MedlinePlus (National Library of Medicine)

For information on clinical trials, visit: ClinicalTrials.gov

For more information on conditions that affect mental health, resources, and research, go to MentalHealth.gov

Eating Disorders-Finding Help and Support

The National Eating Disorders Association (NEDA) partners with Screening for Mental Health, Inc. (SMH) to provide an online eating disorder screening tool. This website provides people with the option to take a free, anonymous self-assessment to gauge their risk of an eating disorder. The anonymous SMH online screening takes only a few minutes and consists of a series of questions, developed by treatment professionals in the eating disorders field, which are designed to indicate whether clinical help is needed. The availability of such a “low pressure” first-step towards recovery is a vital tool. After completing a screening, participants (if indicated) will receive referral information through NEDA’s Helpline for personal evaluation by a medical professional and treatment. There are two screenings available, one for college students – a particularly vulnerable demographic for the development of eating disorders – and a standard screening for other demographics. This is an outstanding resource for people who may need help or know someone who may need help and don’t know where to begin. Take Screening

Youth Helpful Info-For Family

I’m concerned about my loved one…

  1. How do I know when someone has taken their diet too far?
  2. What are some warning signs I should be looking out for?
  3. How should I approach my loved one?
  4. How can I talk to my children when I see a problem?
  5. Can you recommend some helpful books?
  6. How can I connect with other parents?
  7. Any tips for parents at mealtimes?

How do I know when someone has taken their diet too far?

Dieting is about doing something healthy for yourself. It’s about losing weight in a healthy way so how you feel on the outside will match how good you already feel on the inside.

Having an Eating Disorder is much more than just being on a diet. An eating disorder is an illness that permeates all aspects of a sufferer’s life, is caused by a variety of emotional factors and influences, and has profound effects on the sufferer and their loved ones. Eating disorders are about trying to make your whole life better through food and eating (or lack of) and/or exercise. They are about seeking approval and acceptance from everyone. Eating Disorders are about how life won’t be good until weight is lost, and there’s no concern for what kind of damage you do to yourself to get there. Eating Disorders are about being convinced that your whole self-esteem is hinged on what you weigh and how you look. They are an attempt to control your life and emotions through food/lack of food and are a huge neon sign saying “Look how out of control I really feel!” Eating disorders are about stress, coping, pain, anger, acceptance, validation, confusion, fear, cleverly (or not so cleverly) hidden behind phrases like “I’m just on a diet” (adapted from www.something-fishy.org).

What are some warning signs I should be looking our for?

Warning Signs of Anorexia Nervosa

  • Dramatic weight loss
  • Preoccupation with weight, food, calories, fat grams, and dieting
  • Refusal to eat certain foods, progressing to restrictions against whole categories of food (i.e. no carbohydrates, etc.)
  • Frequent comments about feeling “fat” or overweight despite weight loss
  • Anxiety about gaining weight or being “fat”
  • Denial of hunger
  • Development of food rituals (i.e. eating foods in certain orders, excessive chewing, rearranging food on a plate)
  • Consistent excuses to avoid mealtimes or situations involving food, such as “I ate a big meal earlier so I’m not hungry now,” or “I’m not hungry now so I’ll just eat later
  • Excessive, rigid exercise regimen despite weather, fatigue, illness, or injury- the need to “burn off” calories taken in
  • Withdrawal from usual friends and activities

Warning Signs of Bulimia

  • Evidence of binge-eating, including disappearance of large amounts of food in short periods of time or the existence of wrappers indicating the consumption of large amounts of food
  • Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics
  • Excessive, rigid exercise regimen despite weather, fatigue, illness, or injury- the need to “burn off” calories taken in
  • Unusual swelling of the cheeks or jaw area
  • Calluses on the back of the hands and knuckles from self-induced vomiting
  • Bloodshot and/or watery eyes after using a bathroom
  • Discoloration or staining of the teeth
  • Creation of complex lifestyle schedules or rituals to make time for binge-and-purge sessions
  • Withdrawal from usual friends and activities
  • In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns

Warning Signs of Binge Eating Disorder

  • Dramatic weight gain or obesity
  • Disappearance of large amounts of food in short periods of time or the existence of wrappers indicating the consumption of large amounts of food
  • Frequent episodes of eating large quantities of food in short periods of time
  • Feeling out of control over eating behavior
  • Feeling ashamed or disgusted by the behavior
  • Eating when not hungry
  • Eating in secret

How should I approach my loved one?

Here are some ideas you should take into consideration when approaching a loved one with the possibility they are suffering with an eating disorder:

  • Be gentle and caring, and be prepared to listen without offering mounds of advice. You are not the person’s therapist, nor should you pretend to be. Being a good listener means your ears are open and your mouth is shut, you are not intervening with “I know what you mean, that happened to me once when….”- just listen. If they then finish and ask what your thoughts or opinions are, be honest and caring.
  • Don’t make the person feel threatened. It is not your job to dictate what they should and shouldn’t do. If this person has finally decided to talk to you and trust you, cherish it and uphold your role in holding their confidence.
  • Be encouraging. The recovery road can be a long and uphill battle, with pitfalls and setbacks. Don’t be disappointed or disapproving when a sufferer displays signs of falling back, just encourage them to continue pushing forward. Recovery is not only hard work, but can be very confusing and painful, be sure to remind them that you understand this, and that “you cannot always continue to stride forward without a stumble from time to time. It’s okay.” Recovery is about progress, not perfection.
  • Read as much as you can on the topic of Eating Disorders. The more you know, the more equipped you will be to offer a helping hand. Photocopy or print out articles of interest and if time presents itself share the info with your loved one, but do not overstep your boundaries. If the person has asked you not to do certain things, or talk about things, then respect their wishes. The only exception is if the person is truly at risk and needs immediate medical attention.
  • Do not talk about food or weight! Don’t continuously ask what the person has or hasn’t eaten, how much weight they have lost, or how great or bad they look after gaining or losing. This is harsh and very threatening and you are fighting a losing battle either way. Saying they look “healthy since you’ve put on some weight” is heard as “you are fat,” and expressing disappointment or concern in weight loss comes across as “you’re a failure” or “you’re a burden.” By the same token, don’t be afraid to talk in front of the person about your own day to day living (such as, “Fred and I went out for dinner last night and the steak was so good.”) When you stumble trying to avoid topics it will be as noticed as your persistence in discussing them. Don’t watch the person intensively when they are eating, or give looks when they excuse themselves from a meal or from the table. Recovery is not easy and does not happen overnight. Be respectful and courteous and do not try to be the Food Police.
  • If your loved one is looking for recovery resources try not to let him/her get discouraged. Unfortunately, there are doctors and therapists out there that do not know what they are doing, or who do not recognize eating disorders as the serious issue they are. Be supportive. If you feel it’s within your boundaries, offer to help by finding names of local support groups and therapists, and offer to go with them their first time if they’d like the company and support. If they are getting discouraged, remember to be patient and supportive, and don’t push. Recovery is a very personal choice each sufferer will need to make for her or himself. Encourage them to find support in others who share the same experiences, through support groups, on-line bulletin boards or chat rooms, or through larger meetings like those of Overeaters Anonymous.
  • Don’t pretend to understand if you have never had an eating disorder yourself, as it can sound condescending and ingenuine. You can be supportive without living with Anorexia, Bulimia or Compulsive Overeating yourself, and your loved-one will appreciate that more than you putting on a facade of empathy. The sufferers of eating disorders can do better in their own recovery with a good support network behind them. Consider it this way: don’t we all do better in life when we know we have people we can count on? Learn to be a good listener and what “being there” for someone truly means (adapted from Something-Fishy.com).

How can I talk to my children when I see a problem?

  • Be calm and caring when you convey your worry
  • Use proper timing to open up the conversation
  • Use “I” statements
  • Think about what you most want to convey and be specific
  • Watch your body language
  • Empower with your own personal experiences
  • Make statements about behaviors and actions, not the total person
  • Stay on the most important topic and focus on one issue at a time
  • Offer choices; compromise when appropriate and keep an open mind
  • Learn to say no when you need to set limits
  • Make eye contact, face the listener, and speak slowly, calmly, and clearly
  • Check it out; seek further information in order to understand the adolescent’s point of view
  • Do not judge

Can you recommend some helpful books or newsletters?

Click here for some great books for parents and family members
Click here for a great monthly newsletter for parents of daughters
Click here for an informative monthly newsletter for families struggling with an eating disorder

How can I connect with other parents or loved ones?

In the Atlanta area, attend the Families of Eating Disorders group at Ridgeview Institute.
National Eating Disorders Parents and Family Network
Something Fishy Support Finder
Eating Disorders Coalition Family and Friends Action Network

Any tips for parents at mealtimes?

  • Try to control your emotions and vent any negative feels away from your child
  • Set boundaries/limits on the behavior that you will tolerate; praise them when things go well
  • Enlist professional help so that you have a strategy; planned meals at planned times are crucial
  • During mealtimes, appear positive and warmly supportive
  • Make sure that everyone else eats balance, age-appropriate meals
  • Be aware that your other children may be experiencing the same grief, or feelings of jealousy over the amount of attention their sibling is receiving
  • Remember that their eating disorder is not your fault, neither is it theirs; eating disorders are serious mental illnesses
  • The quicker eating disorders are caught, the more likely it is that sufferers will make a full recovery

By: Eating Disorders Information Network