Marina Harris, Ph. D.
Former trainee of the Eating Disorder Institute, now licensed psychologist
National surveys suggest that nearly 30 million Americans will develop an eating disorder at some point in their lifetime. Most eating disorders will begin during adolescence. One of the myths about eating disorders is that they are caused by families. By the contrary, families can be a great source of allyship. In fact, the most science-supported treatment for adolescents with eating disorders is Family-based Treatment, in which parents take responsibility for restoring the health of their adolescent.
Families can also take an active role in preventing eating disorders. Here are six ways parents can set up a supportive home environment that may help to inoculate children from developing eating disorders.
Guideline 1: Encourage regular, intuitive, flexible eating
Infants are born with the ability to eat intuitively – to eat based on hunger cues, preferences, and satiety. Children often lose this ability, particularly when adults consistently exert control over their innate cues. Certain behaviors like forcing children to finish everything on their plate or restricting their eating prior to reaching satiety, make it difficult to remain an intuitive eater.
Intuitive eating has an incredible number of benefits for children and adults. According to the data, intuitive eating is associated with improved cardiovascular functioning, weight management, better emotion regulation, healthier body image, less anxiety when eating, and more pleasure when eating (Bruce & Ricciardelli, 2016; Camilleri et al., 2016; Hawks, Madant, Hawks, & Harris, 2005; Smith & Hawks, 2006; Spoor & Madanat, 2016). It is also negatively associated with eating disorders, whereas rigid control of food intake is positively associated with eating disorders.
Parents can facilitate children’s innate, intuitive wisdom by providing them with a variety of foods and encouraging them to check in with hunger and fullness levels. Remind your child that it’s ideal to consume a wide variety of foods – which includes both nourishing and play foods. Make sure your child eats on a somewhat regular schedule (i.e., avoid skipping meals), so they don’t feel as though food is not readily available to them. Encourage developmentally appropriate autonomy and responsibility.
Guideline 2: Encourage physical activity to move the body, not to burn calories, change size, weight, or shape
In our society, so many people focus on exercising for the purpose of losing weight or to achieve a desired body shape. This is inherently problematic for children to see and hear. Parents should encourage their children to engage in movement of the body, without emphasizing the movement as “exercise”. Parents should also avoid emphasizing calories burned or making eating contingent on exercise (i.e., eating is “earned” through exercise).
Parents can encourage and support movement for so many beneficial reasons, such as stress management, increased mood, fun/play, enhanced quality of life, restful sleep and increased cardiovascular health. Children pick up on what parents do, so it’s important to model a healthy relationship with movement for your child. Emphasize the health benefits of movement, while de-emphasizing the relationship between exercise and weight/shape control.
Guideline 3: Avoid judging, criticizing, or shaming bodies based on size, weight or shape
Many parents know that making comments about your child’s shape or size is harmful. But what many parents don’t realize is that this includes making comments about their own bodies, and the bodies of others. Children are perceptive, and when you make comments about body weight, shape, or size, they will learn that their parents’ value certain bodies over others.
Bodies naturally come in different shapes and sizes. Commenting on bodies continues to perpetuate the thin ideal, which moralizes body shapes as “good” or “bad.” Internalizing this thin ideal is a critical point in eating disorder development, so it’s crucial that you avoid making these comments so that your child does not associate bodies with moral value or intrinsic worth. Additionally, focusing on your child’s weight leads to weight cycling and increased weight gain over time in children, adolescents, and adults.
Give your child praise unrelated to appearance. For example, tell your child you are proud of them for never giving up, that you value their kindness, or that you enjoy their sense of humor. Promote talk that associates bodies with functionality (what your body can do), rather than appearance. Minimize appearance-related comments, because helping your child cultivate a positive body image protects against the development of eating disorders.
Guideline 4: Avoid dieting, talking about dieting, or promoting diets to others
Avoiding dieting and diet talk is probably the most crucial guideline for protecting your child from developing an eating disorder. Dieting is consistently one of the most prominent factors in eating disorder development. Teenagers who practice moderate and extreme dieting are 5x and 18x more likely to develop an eating disorder compared to those who do not diet.
Dieting sets up an internal threat of starvation. When our bodies are not fed regularly, our biology kicks in to reduce the threat by slowing down our metabolism and actively seeking nourishment. This also occurs when we cut out or limit access to certain foods.
Continue to encourage intuitive, flexible eating patterns. Ensure your child is eating regularly (3 meals and 2-3 snacks per day) and adequately. Try to keep a variety of foods available in the home at all times – that includes whole foods and play foods.
Guideline 5: Avoid classifying food as “good” or “bad”
In addition to avoiding diet talk, parents should also avoid discussing the makeup of food in a negative or rigid manner, or moralizing certain foods as “good” or “bad.” Talk of diets, calories, carbs or fat grams leads to increased social comparing and reduced body satisfaction. Calorie counting is predictive of eating restraint and eating disorder symptoms.
The American Dietetic Association says that “all foods can fit into a healthful eating style,” and so parents will want to discourage their children from making the association that calories, fats, or carbohydrates are inherently “bad.”
When anywhere from 34-60% of adolescent girls are dissatisfied with their bodies, we don’t need to continue to encourage diet talk.
Focus on the function of food, without moralizing certain foods as “good” or “bad.” Food is fuel for the body, but viewing food only as a mechanism for health misses some important functions of food that are important for children. For example, some food is to be enjoyed and savored. Food helps us connect with loved ones, and food can even provide pleasure and fun. As a parent, encourage your child to be unmindful of food makeup, keep a variety of foods in the house, reinforce the idea that all kinds of foods are fine to eat, and emphasize all the different functions of food.
Guideline 6: Use and encourage talk that is validating and compassionate
Eating disorders are often maintained by self-criticism, perfectionism, and negative self-talk. Alternatively, self-compassion is associated with better well-being and lower eating-related guilt. As a parent, it’s critical that you are able to catch this type of talk and help to modify it. Often what helps self-criticism is validation.
Validation is a way to show your child that you understand where they’re coming from. Validation can help soothe pain, without getting stuck in arguments about what’s “right.” Validation includes active listening, reflecting and checking that you understand the message, and communicating that your child’s emotions make sense given the context or their learning history. For example, if your child says, “I feel fat today,” rather than responding with “You aren’t fat,” instead try “It’s hard to feel uncomfortable in your body. I’m here for you.” This might lead to a discussion about the ways in which the diet industry profits on all of our insecurities, or the negative impact of viewing unrealistic images in social media. Or you can communicate understanding by helping your child to label their emotions by saying “It’s okay to feel sad.”
Here is a step-by-step guide to using validation with your child.
The takeaway
Being a parent is incredibly challenging. There are so many things to protect your children from, eating disorders included. But there’s hope, and families are a great resource for this purpose.
One of the best things you can do for your child is to raise them as intuitive eaters who listen and trust their hunger cues, eat a variety of foods, and balance health foods with play foods. Emphasize the mood and cardiovascular benefits of movement, rather than associating exercise with food or burning calories. Avoid judging the morality of food and bodies, and avoid diet talk and dieting.
As a parent, it is important to not only teach these behaviors, but to model them yourselves. Children pick up on more than we realize. Parents are in an incredibly unique position to cultivate holistic habits early in life that can help protect children from succumbing to toxic messages and pressure they will face to manipulate their eating and their bodies. By arming yourself with these strategies, you can help support your child in having a fulfilling life without eating and body image concerns.
Resources
If you or a loved one are struggling with an eating disorder, there are resources that can help.
National Eating Disorders Association (NEDA): NEDA is the largest non-profit organization dedicated to supporting individuals and families affected by eating disorders. NEDA offers a toll-free helpful to connect you or a loved one with support, resources, and treatment options. Call (800) 931–2237.
ANAD Helpline: The Association for Anorexia Nervosa and Related Disorders (ANAD) also has a helpline if you or a loved one would like personal encouragement and support. The helpline is available Monday-Friday from 9am-5pm CT. Call (630) 577–1330.
F.E.A.S.T: F.E.A.S.T is a global community for supporting parents and families affected by eating disorders. They also have an online forum for direct support.
Maudsley Parents: Maudsley parents is a volunteer organization of parents who have helped their children recover from anorexia and bulimia through the use of Family-based Treatment (also known as the Maudsley approach).
Intuitive Eating Website: Learn about intuitive eating, find community providers, find resources, and discover the benefits of intuitive eating.
National Suicide Prevention Lifeline: If you or a loved one are considering harming yourself or others, support is available. Call 1(800) 273-TALK (8255).
*Special acknowledgment to Megan Shope, MA, and Lindsey Ricciardi, Ph.D. for their contributions to this post.
