Does my teenage daughter have an eating disorder?

Q: I’m afraid my daughter has an eating disorder. What should I do?

A: Food can bring pleasure and self-comfort, and, as you say, it can bring fear. Right now you are experiencing fears about something that may be affecting your daughter.

If she does indeed have an eating disorder, then she may also be experiencing fears about food, self-image, her ability to control herself, and other emotions.

First, let’s deal with your fear. Usually it’s a good idea to develop a plan to determine whether or not a problem exists. Then, if there is a problem, you can decide on some steps to take.

Have you personally struggled with food? Has your daughter watched you struggle or heard about what you dealt with in your youth? What messages has she gotten about eating, self-acceptance, and health from you?

Be observant, without being intruding or questioning. What are your daughter’s food practices? What do you see her doing for breakfast, lunch and dinner? Is she hungry when she comes home? Does she eat? Is it minimal or does she eat a lot of food?

Is she fastidious about food, only allowing herself a certain amount? Does she talk a lot about food, what she can eat, or voice worries about eating too much? Is she OK with attending social events involving food, or does she avoid them?

Over the years, what patterns have you observed about your daughter’s eating habits? Have there been any dramatic changes? Has her weight varied greatly? Has she always been slim or heavy? Have there been any changes in these patterns lately? Has she stopped having her periods? Has she suddenly become very picky about what she eats?

Has it gone to the extreme that she is not socializing as she once did with friends? Is she involved in a sport that pushes thinness to the degree that it might be influencing her food choices? Does she spend more time in the bathroom, especially after meals? Is she weighing herself obsessively?

Has she complained of constipation and bought laxatives, diuretics or enemas? Has anyone in the family thought that she has been vomiting after meals? What have other family members noticed? Do they have fears or concerns? Have any of your daughter’s friends shared any worries they might have?

Does your daughter seemed depressed, anxious, or lethargic?

Once you have some behavioral data to think about, listen carefully to what she says, especially about her own self-image, other’s bodies, her need to exercise, her assessment of hunger.

At the same time, observe yourself. How do you normally respond? We live in a diet crazed, “thin” culture that is heavily modeled in the media. Has she bought into that female stereotype? Was there ever a time when she thought health and balance were more important than being thin or overly self-regulating regarding food?

When or if she criticizes her own body, what does she hear from her family members? Are they listening, supporting, and challenging some notions she may have regarding her self-perception?

Now that you have some information, go to the web, or the library and take a look at eating disorders. You’ll find two major ones listed, Anorexia and Bulimia, along with binge eating, food phobias and body image issues.

The National Eating Disorders Association has a helpline as well as a great parent’s toolkit that gives a lot of information to help you on your journey to determine how you can best help your daughter. The Common myths about eating disorders and the page on Treatment options help parents focus on how to use what they learn.

The best case scenario is that you don’t think she really has a problem once you’ve done your homework. But don’t assume that you shouldn’t even talk with her about it.

Now is a safe time to talk with her about what you observed and what you feared. What does she think about that? Does it surprise her that you were worried? Does she have any friends that she’s worried about?

If she does have friends who are struggling with this issue, now is an opportunity for you to support her in helping them define an eating disorder as a problem. This is big. People die from this! Some people develop diabetes, lose their teeth, damage their hearts, kidneys, and wreck their health.

This is treatable. There are many options and therapists and doctors who work together to get healthy habits back in place once distorted thinking is dealt with and the family as a whole works to support the person struggling with her self-image and relationship to food. Ask her what you can do to help her help her friends.

Don’t be surprised to find out your daughter really does need help for herself. Make sure you leave the door open to her seeing you as a resource should she ever struggle with these issues.

She now knows how well you researched and found resources both on the Internet and locally. (Tulsa has a nationally recognized, premier inpatient eating disorders program at Laureate Hospital.)

If you do discover you have a daughter with a problem, you know what to do! Get a professional assessment. Follow the recommended treatment plan. Involve family, friends, classmates, and school professionals. Be the support to everyone affected.

Good luck!

Some tips for a healthy family mindset about food and body image:

• Be yourself. Don’t try to look like models in magazines.
• Try not to think or talk about weight, calories, and food.
• Make eating a positive experience: eating fuels both your body and mind!
• Don’t diet! Try to eat mostly healthy foods.
• Practicing healthy ways to deal with stress may help you avoid using food to deal with emotions.
• Avoid power struggles regarding food.
• Talk to your kids about what’s going on if they don’t want to eat with the family.
• Involve your kids in the preparation of healthy, nutritious meals.
• Let kids know that it’s OK to eat when hungry and refuse food when they’re not.
• Make exercise a fun, rewarding, and regular family activity.
• Teach your children to respect everything about themselves- the inside and the outside.