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S/O Eating Disorder - Preventing in Tweens?


SKL
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If you saw possible signs of an eating disorder developing in your tween daughter, what would you do / what do the experts say to do?

My eldest is healthy and athletic, but has never had a good relationship with food.  I adopted her at age 1 and she all but refused to eat anything.  Gradually I got her to eat a reasonable variety and quantity of "super foods" and she has slowly climbed the percentiles of height and weight.  She is slim, but a healthy slim with lots of muscle.  Her thighs are thicker than most, but it's all muscle.

Nowadays she has a few foods she will eat, mainly pizza and ice cream.  Cooking for her is largely a waste of time.  She has been a hoarder / secret eater of sweets since age 5, and I gave up trying to fight that years ago.  I am a fountain of wisdom about nutrition, most of which goes in one ear and out the other.  I keep her alive by pointing out that she needs to eat actual food in order to do well in sports.  I give her vitamins, which she often hides rather than taking them, despite having put a lot of effort into finding a brand she "likes."

Things have gotten worse in 7th grade, as apparently the locker room talk is all about how "fat" each girl considers herself to be.  Very few of these girls are actually overweight of course.  My kid has cut her food intake because she doesn't want to be "fat."  I told her that skipping meals will just mess with her metabolism and make her put on fat, so hopefully that helps, but you know moms are stupid at this age, so ....

So, any tips?  I don't want my kid to start trying any "tricks" to keep weight off etc.  She does have internet access and if she comes across anything stupid, she might try it.

I should add, if it isn't obvious, my kid has some control issues.  She has self-diagnosed as having OCD and anxiety.  And she can be a pill, but I'm not sure how much of that is the age.  She doesn't have difficulty managing life in general.  And the few times I've mentioned her psychological "stuff" to doctors, she has vehemently denied everything.

Edited by SKL
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I would keep the focus on health and not weight.  I would model self acceptance and tell her how beautiful she is.  I would remind her if she says things over and over to herself she will start to believe them.  I would remind her that lots of girls are insecure about their bodies during this time which is why she is hearing so much locker room talk.

I don't know what can be done to actually prevent an eating disorder, but I would be watchful and pay close attention if I had a teen daughter with any food issues or body image issues.  Maybe some one with more experience in those areas could chime in. Or for those of you who struggled with eating disorders, what did your parents do right or what could your parents have done differently to help?  

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I have a friend who is a counselor who runs an eating disorder clinic.  I asked her this question at one time and her response was that the root causes are complex and vary so much from case to case.  But, she said that the number one predictor of eating disorders in teens was the body image of the girl's mother.  Mothers who had poor body images (either overly concerned about how they looked, their own weight, what they ate, or those who did not eat healthy and exercise themselves) were more likely to have daughters who developed eating disorders.  While that was the most common predictor--the correlation was still low.  

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13 minutes ago, Starfish said:

So sorry you're dealing with this.  As @Carol in CA suggests, we've always kept teen magazines out of the house.  We've also tried to emphasize to dd that as you grow you'll get wider/heavier before you get taller since your body needs the extra energy for your next growth spurt.  One unexpected place we experienced  pressure to lose weight was the ped's office.  Dd went in for her yearly physical,  and the doctor printed off the line graph of her BMI.  He told my athletic daughter ( track team running 20+ miles a week ) that she needed to lose weight.  Both of our mouths just kind of flew open. 

Yeah, that BMI thing with athletic girls - you would think doctors would have a clue.

My kid has long had a BMI above the 50th %ile, because of her shape and muscles.  She always had a really small waist though.  Now she is developing into a young lady and that includes getting wider hips and (for the first time) a butt.  I have explained to her that this is about growing up and has nothing to do with "fat."

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Just now, jdahlquist said:

I have a friend who is a counselor who runs an eating disorder clinic.  I asked her this question at one time and her response was that the root causes are complex and vary so much from case to case.  But, she said that the number one predictor of eating disorders in teens was the body image of the girl's mother.  Mothers who had poor body images (either overly concerned about how they looked, their own weight, what they ate, or those who did not eat healthy and exercise themselves) were more likely to have daughters who developed eating disorders.  While that was the most common predictor--the correlation was still low.  

Realistically, though, isn't this most moms of tweens?  Either weight watchers or indulgers or both?  I tend to be somewhere in the middle, not obsessive either way.  But - I don't share DNA with my kids, and maybe this connection is nature rather than nurture.

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I don't know how to prevent eating disorders. I do know three things.

First, if the locker room talk is all this garbage, it's time to ask the school to address this in health class or gym. It might not make any difference, but somebody needs to tell these kids, as a group, about healthy body image and then KEEP telling them.

Second, if your child has a number of potential mental health issues and lies about them to the doctor - not wholly unexpected behavior, I might add - then you need to cut to the chase and get a referral to a child psychologist or psychiatrist if you think the OCD traits are serious enough that medication may be warranted. I promise, the shrinks of the world know that sometimes patients lie.

Third, if your child is as picky an eater as it sounds, it's not too late to ask for a referral to an SLP to help improve her habits here.

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2 hours ago, kiana said:

I definitely agree with talking about fueling the body for proper sports performance. I noticed that when I was not eating enough my lifting ability went completely down the tubes, and so did my cardiovascular endurance. 

 

I also agree that this is very important.  I am fortunate that my dd is athletic and her older brothers who are also athletic influence her a lot on sports nutrition.  She wants to gain muscle and strength plus increase her endurance so she won't restrict or overeat.  She does suffer from anxiety, though, so I worry about her developing eating disorders at some point because EDs focus on control so much.  Anxiety is all about what you can't control so EDs become a good way to control certain aspects of your life - exercise, body size, weight, diet, etc.  

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One thing I was told recently is that most of the girls they are seeing now are conceptualising their restrictions differently than they used to.  Before, it was all about calorie restriction.  Now, it's about clean eating, cutting out bad foods, detoxing and the like.  The girls will cut out meat, gluten, dairy, and just restrict their diet for health and other reasons more and more.  And adults don't always pick up on it the same way they would otherwise, or actually think it is healthy, or are doing it themselves and enabling the kid who has the problem.

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1 hour ago, Bluegoat said:

One thing I was told recently is that most of the girls they are seeing now are conceptualising their restrictions differently than they used to.  Before, it was all about calorie restriction.  Now, it's about clean eating, cutting out bad foods, detoxing and the like.  The girls will cut out meat, gluten, dairy, and just restrict their diet for health and other reasons more and more.  And adults don't always pick up on it the same way they would otherwise, or actually think it is healthy, or are doing it themselves and enabling the kid who has the problem.

 

Do you mean orthorexia?  

For me, my mother was overweight and I was a huge baby/toddler who turned into a kid who tended to be on the chubby side.  My mother was obsessed with my weight because she wanted things to be easier for me physically and socially, but it backfired because I can't remember a time when there wasn't such intense focus on dieting, body size, food, weight, etc.  My mother and I would diet and then binge together.  We would do crash diets and WW when I was very young.  She would tell me things like being heavier made you look low-class because poor people couldn't afford healthier foods.  She didn't mean to be hurtful, but it certainly planted the seeds for EDs.  I can't say if I wouldn't have ED without that kind of upbringing but it was the way I was raised and I don't know any other way of life - I've always been obsessed with exercise, food, the scale, clothing size, etc.  I grew up thinking that being overweight was unacceptable and shameful.  

 

 

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I honestly don't know how one prevents eating disorders, especially if there is a genetic factor. My personal opinion is that the behavior is typically a way of self-medicating for depression and/or anxiety.

One of mine was a secret sweet eater, though I did not recognize the behavior as an eating disorder at the time. I'd find candy wrappers shoved in odd places and dirty dessert dishes in the back of her closet or desk drawers. This teen also went vegan her senior year and was very dramatic about her eating restrictions. She honestly seemed more stable though on that way of eating, so, again, I did not recognize the choice as an eating disorder. In retrospect, I think strictly controlling some aspects of her diet was soothing for her. She was never under- or overweight, though she did lose interest in dance and skating because of the required attire as a young teen.

Now that she has had a few years of good mental health care (because it took us a while to connect all the dots and locate the right combination of help), she eats a diet with fewer rules. I do think that sugar still lifts her spirits.

Another child had significantly less severe issues, but also made a restrictive diet choice (pescetarian) in her late teens. I think this kid was also using a full schedule as a way to feel less anxious. Eventually she required antidepressants for a time, but seems to be learning better ways to control the depression and anxiety. She's off meds, and the diet is less restrictive, though still healthy. She still maintains a full schedule, but seems more comfortable with free time these days. She never used therapy.

My youngest seems to have developed some mild anxiety as a teen, and complains a lot of stomachaches that keep her from eating. In general she eats enough though, and is active, so I am just keeping an eye on her. With our genetics though, I wouldn't be shocked to see something develop.

Interesting side note, my aunt once told me that my grandmother was bulimic. She was never particularly thin,and definitely not a restrictive eater, and was quite a positive person. This was in rural Mississippi in the 1940s-50s, and fashion magazines were not something that interested her.

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52 minutes ago, Kassia said:

 

Do you mean orthorexia?  

For me, my mother was overweight and I was a huge baby/toddler who turned into a kid who tended to be on the chubby side.  My mother was obsessed with my weight because she wanted things to be easier for me physically and socially, but it backfired because I can't remember a time when there wasn't such intense focus on dieting, body size, food, weight, etc.  My mother and I would diet and then binge together.  We would do crash diets and WW when I was very young.  She would tell me things like being heavier made you look low-class because poor people couldn't afford healthier foods.  She didn't mean to be hurtful, but it certainly planted the seeds for EDs.  I can't say if I wouldn't have ED without that kind of upbringing but it was the way I was raised and I don't know any other way of life - I've always been obsessed with exercise, food, the scale, clothing size, etc.  

 

 

 

Well in a way - what I have been told is that to a large degree, this is how anorexia is now presenting itself at clinics and such, as a sort of orthorexia.  The excuse or narrative or whatever isn't the need to keep weight down, it is the need to avoid certain foods - that is what they tell others and I suppose themselves, rather than needing to avoid calories and fat.  But it's still the same underlying problem.

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5 hours ago, SKL said:

We don't have any fashion magazines or similar in the house, never have.  I'm not aware of my daughter having any skinny role models either.

We never had fashion magazines or tv and I went through fads like this.  Peer pressure is a huge part of it and to be honest only time really helped.  I think having plenty of other positive activities going on helps to prevent the obsession deepening but obviously I’m not an expert on eating disorders at all.  

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1 hour ago, GoodGrief1 said:

 My personal opinion is that the behavior is typically a way of self-medicating for depression and/or anxiety.

Agreed.

The need to control weight/food intake so stringently is a symptom of other things. Or it was for me, and for the two others I know well who've dealt with eating disorders. I suspect the only way to prevent an eating disorder is to get control of those other things before they manifest as an ED.

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2 hours ago, StellaM said:

If we knew how to prevent eating disorders, there'd be a lot fewer really sick children, teens and adults.

I considered my kids vulnerable - all the girls on dh's side of the family have some form of disordered eating - his sister is bulimic.

I did a couple of things in response. Firstly, food was never a battle ground. I provided a reasonable diet, which included treats, they ate it or didn't eat it and that was that. Secondly, I chose a dance school for the girls which actively challenged 'ballet body', and put their money where their mouth was. No 'put the bigger girl up the back' going on there. 

I have no idea if that made any difference or not, but none of them are eating disordered. Probably just luck.

 

No real advice as we haven't had issues as of yet.  I like this.  My girls are all dancers too and my ds.  So far they haven't come across any body shaming from the ballet world.  I know some places might do that, but the places they dance are not like this.   I would find places that are good for them vs body shaming them.  I would assume a lot of sports are breeding grounds for things like that.  Ballet, gymnastics, figure skating, wrestling.  I didn't grow up in such a sport, I was in soccer and your body shape wasn't important at all. 

I have heard so many sad stories from other moms of kids who are thicker about them being teased and called fat since they were 7 or so.  And then they go on diets at that age. That is so sad.  I think the parents have to do as much good modeling and education as they can.  

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I don't know if this helps... but somehow getting your child to love herself is a great first step. I am not sure how you go about that. Learning to take care of yourself is so important. I really like how yoga teaches positive affirmations but that may not be best for someone with body image issues. 

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8 minutes ago, maize said:

When one of my children started obsessing about weight and skipping meals as a preteen I threw away the scale.

There were some other things that I think helped but not having a scale in the house was a part of helping that child change course.

 

I think that is great too.  We have never had one.  The kids get weighed at the doctor once a year and that is it. 

I am glad I don't have one for my sake too. 

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