Disordered Eating in Youth: my perspective
As parents, we want what’s best for our children. We feel responsible for their personalities, their intelligence, their social abilities or limitations, their appearance, size and shape, and their health. In a society riddled with childhood obesity and chronic disease starting at such young ages, we begin to parent out of fear. When our kids are small, it’s realistic to control their weight, the quality of their diet, and their risk for obesity related diseases: you buy, cook, and serve only healthy food, set the daily agenda with a certain amount of physical activity, you role model the behavior you want for your child, you might even scold them for behavior that doesn’t align with your ideals such as too much watching TV or wanting junk food. I’m not saying this is good or bad, it’s just a very common parenting style I see in my practice, and I believe it stems from wild love and fear for our children.
As kids get older, they will want some of this control back. After all, it’s their body, their health, their life. Because kids are kids, this desire for control is sometimes expressed in strange ways. Sometimes they rebel and sneak the food you don’t approve of. Sometimes they stop trusting that what you want for them is best. They decide they want a different body, or different picture of health for themselves, and they try taking matters into their own hands. Sometimes they develop extreme fear, guilt, and shame related to the foods you’ve been trying to keep them from eating too much of. This is what I would call the beginning of the spectrum of disordered eating.
I prefer to look at eating disorders on a spectrum. Every client I see is at a different place on this spectrum. Sometimes we get the opportunity to pick up the earliest signs that something is not quite right. This is where I can guide and encourage parents to work as a team with their child – listen to what they want for themselves, what they believe is the best food and activity plan to meet their own goals, and how you can work together on these goals. We give the child some control, and their disordered eating behaviors subside. When kids get past the disordered eating part of the spectrum, our plan looks much different.
An eating disorder could take the form of anorexia – extreme restriction, bulimia – bingeing followed by purging, binge eating disorder – binging without any form of purging, or a combination of these. Young girls and boys both struggle with this disorder, and once they’re this far long on the spectrum, they’ve lost the control they tried so hard to get. While treatment for this part of the spectrum plays out differently – now giving them more control will do more harm than good – it still starts with working as a parent/child team. We listen to their fears, their desires and their beliefs. We build trust, educate, and help them understand how much they need their parents to feed them again; to buy, cook and serve what they know is best for their child. And when our young boys and girls are ready, they slowly take back control.
Some might say that looking at the disordered eating spectrum as a control struggle is overly simplistic. It is. There is so much complexity within this disorder. There is so much we still don’t understand, but after years of working with parents who are wild with love and fear for their children, I know that we need to start with a simple approach. We need a simple concept that our parent/child teams can grasp before we can move forward. And we must move forward.