Does Your Child Have an Eating Disorder? What Parents Need to Know
Sunday, May 23, 2010

By Abigail Natenshon, MA, LCSW, GCFP

What eating disorders are and what they are not

Eating disorders, contrary to popular belief, are not principally about food, eating, or weight management. The assumption is that anorexics starve themselves and bulimics overeat and purge, but the issues are much more complex. Anorexia nervosa and bulimia nervosa, different manifestations of the same disease syndrome, are characterized by a preoccupation with weight and body shape, a pathological fear of becoming fat, erratic or inadequate food intake, and the inability to regulate eating, along with the self.

A child’s eating habits provide a window into the child’s emotional health and capacity to deal with life. Dysfunctional eating behaviors indicate emotional imbalances, cognitive distortions, and developmental tasks not yet achieved that could derail the child’s effective functioning into adulthood. Driven by emotions, needs and values, the eating disordered child feels powerless, inadequate, or fearful turns to symptoms which create the illusion of being in control, thereby establishing a pseudo-sense of security and predictability in an unstable world. Ultimately, the disease takes control and makes a victim of its host. The disordered child does not know how to nourish or care for the self, in ways that far exceed eating and food management. With eating disorder recovery comes an expanded emotional facility and capacity to cope with life that will benefit the child in all life spheres.

With their origins in genetics and body chemistry in the company of environmental triggers

·  Anorexia Nervosa is a pathological fear of being fat, accompanied by food restriction and at times, purging and over-exercising. It is generally accompanied by a distorted body image, by the absence of the menses and co-occurring mood disorders.

·  Bulimia Nervosa is the repeated cycle of out of control bingeing accompanied by purging or by fasting or excessive exercise to compensate for the intake of calories. Bulimics typically abuse laxatives, diuretics or diet pills and typically struggle with other forms of addiction.

·  Binge-Eating Disorder or Compulsive Overeating is characterized by eating when not hungry or without regard to physiological cues. With binge eating episodes, patients report the inability to control the behavior. Deprivation-sensitive binge eating arises out of excessive dieting or food restriction; addictive or dissociative binge eating is the practice of self-medicating or self-soothing, with behaviors evoking tranquility or numbness.

Things you may not know about eating disorders

* Eating disordered children typically are of normal weight, and often appear to be the picture of health and paragons of self-discipline, excelling in academics, sports, and other activities.

*Eating disorders are diseases, which in the vast majority of cases are totally curable. They are the most lethal of all the mental disorders.

*Dieting is the worst way to lose weight.

*Parents are not responsible for causing eating disorders in their children.

*Proactive parental involvement in the child’s recovery is typically instrumental in facilitating healing, despite the warnings of misguided health professionals who imply that eating disorders are caused by parental interference or over-control in their children’s lives; that the disordered adolescent in recovery requires laissez-faire autonomy and independence from parents in order to get well and separate healthfully from the family. Professionals might exclude the child’s parents from the psychotherapy process in an effort to protect patient/therapist confidentiality rights if they are uncomfortable performing family therapy, unaware of the power of the family system or the benefits of conjoint family treatment for the child at home to support healing.

*Parents do not need to wait until symptoms of eating disorders have become full-blown and prominent before feeling free to take action with their child. An educated hunch should serve as a sufficient motivator to confront the child and seek professional help.

*Eating disorder treatment and recovery are unique in many ways. Addressing eating disorders requires simultaneously addressing the wide variety of issues that the eating disorder encompasses, which are physiological, behavioral and nutritional, emotional, social and academic. In eating disorder recovery, the patient can expect to feel worse before (s)he feels better.

*Not every eating quirk represents an eating disorder. The distinction between disease (an eating disorder) and benign idiosyncratic eating (disordered eating) lies in how food is used and its the purpose for the individual. When food is used to address needs beyond satiety, fueling, or sociability, the parent may want to become vigilant or further involved.

Remember that eating disorders in your very young child reveal different kinds of issues than you may encounter in teens and young adults. The very early disorders typically are the result of anxieties and compulsions, as well as the child’s imitation of significant adult role models. Adolescent and adult eating disorders are largely driven by issues of control, identity, self-esteem, coping and problem-solving. In all situations, it is critical to first see a medical doctor to rule out origins in organic problems.

Author : Abigail H. Natenshon LCSW
A foremost expert in the treatment of eating disorders, Abigail H. Natenshon, MA, LCSW, GCFP is a psychotherapist who has specialized in the treatment of children, young adults and their families for the past 40 years. The author of When Your Child Has An Eating Disorder: A Step-by-Step Workbook for Parents and Other Caregivers and Doing What Works: an Integrative System for the Treatment of Eating Disorders from Diagnosis to Recovery, Natenshon is the founder and director of Eating Disorder Specialists of Illinois: A Clinic Without Walls. You can learn more about Abigail H. Natenshon, MA, LCSW, GCFP here on the Directory.