Children are emotional sponges. They pick up on everything we do even when we don’t realize we are doing it. Like it or not, our children idolize us. They want to please us and imitation is the most sincere form of flattery right? Unfortunately, children are unable to differentiate our healthy and positive behaviors from the self-destructive. So what exactly do we do to help perpetuate eating disorders?
Be critical and abusive. There is a tremendous amount of research on the connection between trauma and eating disorders. Physical, sexual and emotional abuse creates a lack of safety and lack of control in our lives. Food becomes one of the only elements of life we can control. In many ways emotional abuse is more subtle. When we don’t give our children positive feedback and only pay attention to areas in which they fall short, they will grow up feeling like they are not good enough. Food becomes a comfort and never failing friend.
Encourage perfectionism. Expect straight As. Expect perfect behavior. Expect them to never make mistakes. When we consistently give children the message that falling short of perfection equals failure, they will never feel successful. When they see us verbally berate ourselves when we make mistakes, they learn by our example that it is unacceptable to fall short of perfection. When feeling out of control emotionally, it is easy to turn to an eating disorder and use food as a means for emotional control.
Withhold emotionally. When you are not emotionally present with your children, they pick up on this and don’t form a secure attachment. When children don’t form secure attachments to us, fears of abandonment can lead to self-destructive behaviors like eating disorders. When we have our own emotional issues, we are unable to be emotionally present in our relationships. Particularly if you have issues like depression or substance abuse, you cannot be present in your relationships. Getting the help you need now will ultimately lead to a healthier future for your children.
Nurture your own eating disorder. Your own dissatisfaction with your body has a HUGE impact on your children, particularly your young daughters. The more you discuss how much you dislike your body, the more your child will start to question theirs. It is likely that their shape bears some resemblance to yours, so it would be easy for them to question their own looks. Constantly dieting and talking about foods you should and shouldn’t eat will help to build the foundation for an unhealthy relationship with food. Addressing your relationship with food will help your children to form a healthier relationship with it as well.
Use food for rewards and punishments. Using food to soothe an upset child automatically sets up a conditioned response for emotional eating. The same could be said for using food as a reward. Withholding food as a punishment teaches children that they must always be in control of their food because their control may be taken away at any time.
Ultimately, we are not the cause of the issues our children might develop, but we can heavily influence their future. If you have a child who has developed an eating disorder, this is in no way an attempt to point the finger at you and call you a bad parent. There are many factors outside of our control that contribute to eating disordered behavior, like genetic predisposition. The biological component is huge, but in the words of Cynthia Bulik, “Genes load the gun and the environment pulls the trigger.” My intent is to illustrate ways we unconsciously impact our children. This is true of parents, but it is also true of aunts, uncles, grandparents, teachers and coaches. Any adult who interacts with children impacts them. My hope is that we will all be more aware and by addressing our own issues, help our children to become happy and healthy adults.
Michelle Lewis
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Michelle Lewis has been working in the mental health field since 2001. She has a Bachelor’s degree in Psychology from Weber State University and a Master’s degree in Social Work from the University of Utah. She is passionate about helping others achieve their goals.
Ms. Lewis,
My heart breaks a bit to read this article. Eating disorders are mental illnesses that need no cause, influence, or trauma to occur. They happen in all kinds of families. In fact, there is no evidence that parenting style or action can influence the risk of an eating disorder. This is a common misperception and tempting idea, but one that confuses the normal range of eating and body dissatisfaction present in human beings with what we now know is a terribly serious mental illness like schizophrenia or autism. Does parenting matter? Of course, but when it comes to an eating disorder where parenting matters most is in how we help get evidence-based treatment and we participate fully in the treatment and support.
The idea that we can give our kids eating disorders is no more true than we can give our children Type 1 diabetes by giving them sugar, or autism by being cold and distant, or schizophrenia by inconsistent parenting..
I share your distaste and join with you in calling out parents who are abusive, withholding, inconsistent, or poor role models. Those are terrible things that cause damage to any child. For someone with an eating disorder, parenting like this is a further injury, but it is so very important to know that a loved one with an eating disorder doesn’t say ANYthing about the family or parents – or even the patient – except that they have a treatable mental disorder.
My intention with Surefire Ways to Give Your Kid An Eating Disorder is not to say parents are THE cause of eating disorders, but their actions can certainly cause children to have low self-esteem, trauma and body dissatisfaction which can lead to eating disorders. Of course, there are other causes like mental illness and other factors outside of the control of parents. My point in this article is not to point blame, but to encourage people to look at their behavior and be more aware of how they unconsciously impact children.
Very good article on the topic! Short and very informative. I will surely recommended for clients and family/friends that are going through an eating disorder with their kids.
That is very interesting Anne. When I look at causes of eating disorders on Mayo Clinic, http://www.mayoclinic.com/health/eating-disorders/DS00294/DSECTION=causes, I certainly see biological factors, but it also specifically discusses perfectionism, low self-esteem and troubled relationships. Why it doesn’t discuss abuse is beyond me because abuse, specifically sexual, is clearly tied to eating disordered behavior.
I know there is strong evidence that there is a biological component to eating disorders. I won’t dispute that, but it is not purely biological. There are several environmental factors and caregivers are one of them. I’m not saying they are bad people in any way. My point is that our influence on young people is very powerful and often unconscious. I hope that we will all become more aware of how we impact children.
Excellent article Michelle. After working with clients with eating disorders for 20 years, I couldn’t agree more. Thank you!
I wrote something similar, “Ten Ways to Raise Children to USE Drugs,” or what not to do. I certainly understand your article. For mine, click on:
http://www.kellybear.com/ParentTips/ParentTip3.html
Thank you for this concise, if not complete, summary of risk factors that parents often unknowingly create regarding eating disorders in children. I could not agree more, based upon both life, research, & clinical experience, yet I hear no mention of social media & peer pressure effects. Our society as a whole is eating, appearance, & perfectionism disordered, which I feel are the underlying drivers of such generational behavior. Bio/temperament & environmental factors are intertwined & play off of each other. I believe that kids are definitely sponges & both imitate & react to caregivers as their first map of the world regarding organizing experience & coping behaviors. I think that both modeling & the way parents adjust/react to a child’s temperament, vs expecting a child to adjust to them, is much more important than temperament itself. Parenting is the hardest job in the world, & I can understand why many are sensitive to what sounds like criticism, yet the intention here is to improve ourselves & raise healthy children. Furthermore, I fear that simply refraining from the article’s behaviors is not enough, since approx 70% of communication is non-verbal, & kids are highly attuned to mixed messages. I believe we need to heal our own unhealthy ways of being, more assertively challenge our society & media standards (money vs health), & learn to adjust to each child’s unique temperament, in order to raise healthy children.
weigh loss cause serious neurological damage and have ‘powerful effects on the brain and other organs’ … ‘causing neurI join other’s here who dispute your claims of causation and yet, I also agree family dysfunction and abuse on any level to any child or adult is detrimental and leads to very distressing consequences. I had not intended to respond, as I would prefer to take the position of ignoring any article written to point to families as a cause either explicitly or implicitly so as not to draw further attention to this view.
I am just about to write another blog very much in support of a neurobiological approach to eating disorders, because, well, quite frankly, at a time of great distress, worry and anxiety when my daughter was diagnosed with AN, it was the only thing that made sense and had a plethora of evidence to support a neurobiological approach. I never dieted, always cooked fresh meals and we always sit together, as a family for dinner; my children did not suffer abuse, we are a caring, loving family, and my daughter fell ill. I scoured the Internet for answers – “what caused this?” “What did I do?” I was full of blame and guilt and I found plenty of mis-information confirming that I probably abused my daughter in some way. I mean REALLY? Thank goodness I came across, evidence based approaches to eating disorders, and you know what, yep, it works!
I will cite, Dr. Walter Kaye from Eating Disorders in Children and Adolescents: A Clinical Handbook; Ed. Daniel Le Grange & James Lock. In Kaye’s article Neurobiology of Anorexia Nervosa, he clearly outlines that a common denominator to the onset of ED in adolescents is puberty and patients present with very similar symptoms in behavior driven by strong neurological factors.
He poses an interesting conundrum in that we ‘do not know whether it [ED] reflects a primary disturbance of the brain systems that regulate appetite or whether changes in appetite are caused by anxiety or obsessional preoccupation with weigh gain. At the end of the day, starvation, malnutrition and weigh loss cause serious neurological damage and have ‘powerful effects on the brain and other organs’ … ‘causing neurochemical disturbances that may exaggerate preexisting traits’. The complex processes of the brain which regulates how much we eat, when and what we eat and also weight gain, are, for example, located in the hypothalamus and insulin and leptin, are neuro-chemicals which regulate these processes, go awry.
The factor of genetics do in fact play a very large and significant role in causation and in fact, as cited in the work of Dr. Cynthia Bulik, Director of the University of North Carolina Center of Excellence for Eating Disorders, is somewhere around the figure of 80%, and during puberty, in girls, the hormone estrogen plays a significant role in kicking off or switching on the genetic profile of someone pre-disposed to the development of an eating disorder. Looking at traits commonly associated with those who develop AN, are perfectionism, anxiety, depression, people pleasing and are present in early childhood, hence, providing valuable biomarkers.
Family Based Treatment/Maudsley (FBT/Maudsley), initially from studies roughly 30 years ago at the South London Maudsley Hospital, has evolved as the front line approach to treating eating disorders in adolescence by Dr. James Lock and Dr. Daniel LeGrange of Stanford and Chicago Universities, respectively. RCT’s have evidenced very robust findings of 75% recovery rates in treatment outcomes and more importantly, maintained recovery or remission at 5 year follow ups.
These findings are very significant and profound. FBT is successful in so much it involves the family, parents in particular, as those who know their children best and are experts in understanding how to care for their child. Articles of this nature drive loving, caring, confused, anxious parents/families in the wrong direction, which at the end of the day exposes their sick child/adolescent to no treatment or ineffective treatment at best.
It is very well documented and evidenced that psychotherapy is completely ineffective in a malnourished and starved brain of an anorexic. CBT is evidenced to work as a primary treatment approach for bulimia. Effective treatment for eating disorders requires a collaborative approach enlisting a team of experienced professionals who each, contribute greatly to achieving lasting recovery and remission from eating disorders. To continue to place blame on families and parents draws attention away from this approach, leads parents to believe something that has been utterly disproven and more importantly, leaves the sick children of these parents seconded to a life threatening illness when this does not need to be the case and worse, can spend utterly years of trying to unravel irrelevant, childhood experiences as the cause of eating disorders.
Eating Disorders are Biologically Based Brain Disorders and need to be treated as such.
Thank you Gaby and Charlotte for posting sources.
I too nursed my babies loved motherhood, encouraged individuality and independance. . We are a close knit outwardly living family. When my daughter became ill I too, searched for support and researched all I could find on the subject. my children and my family are my my most important priorities into life.
What I found in my search was that because my daughter was 10 years old at the time of her diagnosis and sunburnt treatment, I was asked to stand by and let my daughter fall. Despite her obvious distorted and delusional thoughts and self destructive behavior, I was told that she had to do this for herself. The first therapist called us entrenched because I was so concerned and seemingly over involved in trying to help my daughter. I watched as she deteriorated under that plan. Her recovery has been most effective under the team approach starting with medical and weight stabilization that includes and respected my husband and I as a vital part of the recovery team. Understanding the neurobiology of this illness helped us the most to be effective caregivers.
I completely agree. It is not either or, but a combination. I am merely pointing out some of the factors. Yes, the biological component is HUGE, but there are also environmental factors that cannot be discounted.
What part of you is blind to the research. You remind me of stints that would come to the emergency room swearing g they had food poisoning because they became violent ill shortly after eating. That my friends is NOT cause and effect like the therapist that Imiplied that the mother who was a dietician with 2 Ed daughters was the cause of their developing illness. I wonder statically if you looked at all those this woman may or may not have pathologically advised, developed EDs. I know that research has clearly shown the opposite. Read dr Thomas Insels response to this kind of Profesional practice. More likely this family had strong genetic pre dispositions and co morbid high risk traits which you do not refer to at all.
Personally I’d a kid people like you , like the plague. You are pathological and can do more harm than the oathkgical families you speak of. Your judgmental tone clearly demonstrates your lack of understanding mental illness.
Patients not stints. Sorry for the typo
Avoid not kid. Autocorrect gets me every time. Sorry
I really loved your article. As a psychotherapist who has worked with women and men suffering with eating disorders for nearly 15 years, the above points are almost always present. I am also in recovery of an ED myself (from age 8-27). In my personal and professional experience (and Master thesis research) – I don’t believe eating disorders are mental illnesses – this is a pathologizing and medical model point of view. For myself, and the many people I have worked with, soul sickness fits better for me. It is a shame more health professionals don’t seek to understand what the person’s deeper self/soul is crying out for. In saying that, of course it is important that we do not ignore biology/neuroscience etc. In my experience, these are contributing factors, not the core issue.
ps. it is important that we have a holistic approach – biological, emotional, psychological, cultural, social, spiritual. not everything can be explained by a medical/scientific model alone!
Hi Gaby, I don’t have exact stats but in my practice, the majority of those who attended medium / long term therapy (1-4 years) are living well and healthy. The feedback that I often receive is that they have also found value, meaning and purpose out of their suffering. i.e their ED isn’t just something to get rid of. It has served them in some way and they appreciate that it is valued.
I really believe it was my hope that this dialogue could evoke a greater understanding for both psychotherapy and the science that now better define mental illness of anorexia, bulimia and BED. When you as psychotherapists discount or Lack of medical biochemical understanding of mental illnesses you essential do what fundamental religious right does with evolution and what ignorance did for those who believed the world was flat. You stay I’m your own self acknowledging bubble and cannot grow as a clinician, healer or provider.
There is no doubt in my mind that psychotherapeutic and behavioral interventions can and are invaluable resources for the recovery and whole mental health picture but without a strong understanding and respect for the science of the brain, well intentioned psychotherapy can a actually do more harm than good.
I would like to add that there is a lack of looking at the whole patient and not just a set of symptoms that got your paradigm.
Rcame a neighborhood alcoholic is a regular in our Er over the years He is often brought in by police unconscious and enebriated. His speech is slurred and he smells like alcohol. So routinely he is placed in a bed sometimes blood drawn and left to sleep it off. Many hours later and more seemingly life threatening patients later the nurse checks in on him to see if he’s awake enough to feed and discharge. But this te he’s still slurred and lethargic. Well turns out this dtug had a intracranial hemmorhage.
My point is things are not always what they appear to be and we have a tendency to bypass the best way to evaluate a whole patient by our preconceived experiences and notions but medicine as in mental health, that is a very dangerous practice and could cost someone their life.