How to Talk with Kids about Eating Disorders

Collage piece, circa 1998

Inside and outside of school, there are many pressures on children and teenagers to look or act a certain way. It’s hard to be aware of, and control, what they are exposed to – whether on social media or in their friend groups- but here’s a question & answer guide to facilitate conversations with your child.

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  1. Why is it important to talk to your child about eating disorders?

It is important to talk with your child about eating disorders as a precautionary measure. It will help them build awareness of their own eating habits and to notice if it starts to swing into disordered eating. They may be able to help identify peers or friends who may also need help.

  1. Should you have these conversations only if you’re concerned or just in general? Why or Why not?

There are two sides to this. By starting a conversation and saying that sometimes people starve themselves, over-exercise, or purge in order to look a certain way, a child may pick up on that as a valid way to change the way they look. Conversely, the conversation, including the detriments of eating disorders (e.g. on dental, bone, reproductive, or psychological health – even the risk of death) may help them stay on a healthier path with their eating.

  1. Some parents may be concerned that talking about eating disorders will put the idea in their head or make a situation worse? Is that a legitimate concern?

[See above]. For some children, it can plant a seed in their minds to try unhealthy eating behaviors in order to lose weight. A child, depending on age and disposition, may also rebel against the parents by doing the opposite of what they suggest and become entrenched, or further entrenched, in disordered eating. It would be very appropriate, and perhaps necessary, to bring in a more neutral third party, perhaps a therapist or registered dietitian, to educate the child about disordered eating and its effects.

  1. Should parents talk about how to approach eating from a healthy place or give any advice?

It’s always best for parents to model healthy eating. I’ve heard too many stories from my clients about how their disordered eating started because their mom was on a diet and always talked about how “fat” she was or how dad would eat “whatever he wanted” and then run it off. Children model after and emulate their parents, for better or worse. Talking about eating from a healthy, positive place can definitely help. If the child is open to advice, you can offer it, but I would suggest letting them ask questions to get engaged in the conversation, versus delivering a lecture.

  1. What should parents know about talking about eating disorders?

Just like other topics – including sex education, personal finance, healthy relationships – it’s likely to be an ever-evolving conversation, not a one-and-done deal. Making the child feel safe, by being approachable and providing support, is probably the most important factor in getting them to trust you and participate in these important conversations. Pull in an expert for questions you don’t know the answers to or for a more neutral, objective advisor to counsel your child on their feelings, the way they eat, and more.

  1. How do they start a conversation in an age appropriate way?

Most parents are aware of their child’s maturity level and understanding of various topics. Meet them where they are. Just as you wouldn’t give a five year old child a blow-by-blow account of what happens during a birth, explaining the tax benefits of a Roth IRA, or explaining narcissitic or borderline personalities when talking about building friendships in kindergarten, you’d want to match their level of understanding by simplifying the conversation and making it appropriate to what they need to know at this stage of their development.

  1. What are some phrases they might say to help the conversation along?

I’d suggest starting with questions. Perhaps a variety, and seeing what the child picks up on. For example, “do you know why we have vegetables with our dinner?”, “how do you know when you are hungry (or full)?”, or suggesting “you know why we typically have a treat(s) every week? It’s because we eat lots of foods every week that provide nutrients which keep us healthy (share examples of healthy meals or vegetables that you and your family eat) and part of balanced eating is enjoying special treat foods that don’t give us a lot of nutrients, but that have a taste we like – like cookies or ice cream. How do you feel about our healthy and treat foods?”

  1. What are some things they should avoid saying?

Commenting frequently on your child’s body – whether praising their leanness or thinness, or suggesting they need to cut back on the snacks because they are getting ‘plump’ – puts a pressure on the child to maintain the desired look (thin), by any means necesary, or to change their bodies (again, by any means necessary), in order to feel loved, valued, and respected by their parents.

  1. What are some ways they can be supportive?

Parents can ask questions about their child’s life, thoughts, foods they eat, foods their friends eat, and what they think about health and caring for their bodies. Then parents can guide and support the child through relevant conversations and reminding them that they will always be there to answer more questions and that the child has their unconditional love (no matter their size).

  1. What are some actionable steps parents can take if they are concerned?

It depends on on the level of concern and worrying thoughts or actions the child is expressing. When the child is either expressing thoughts or taking actions that show an unhealthy obsession with body image, number of calories in foods, or sneaking/hiding foods, this would be a good time to have conversations with your child and to bring in support of a registered dietitian and/or therapist. Preventative care at this stage can be essential in helping to avoid full-blown eating disorders.

  1. If the child does have an eating disorder and is in therapy, how can the parent support that relationship?

The parent could ask the therapist what is being worked on in their appointments, for example body image, and then supporting that with being positive with their own bodies (again, modeling is extremely important), having conversations about the bodies of actors/actresses in movies, and maybe limiting magazines or other forms of media that encourage body shaming or comparison.

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