A Parent’s Guide

A Parent’s Guide

Many children — particularly teenagers — are concerned about how they look and can feel self-conscious about their bodies. This can be especially true when they are going through puberty, undergoing dramatic physical changes, and facing new social pressures. Unfortunately, for several kids and teens, this concern can lead to an obsession that can become an eating disorder. Eating disorders such as anorexia nervosa or bulimia nervosa cause dramatic weight fluctuation, interfere with normal daily life, and can permanently affect their health. Parents can help prevent kids from developing an eating disorder by building their self-esteem and encouraging healthy attitudes about nutrition and appearance. If you become worried that your child might be developing an eating disorder, it’s important to step in and seek proper professional care.


Generally, eating disorders involve self-critical, negative thoughts and feelings about body weight and food, and eating habits that disrupt normal body function and daily activities. While more common among girls, eating disorders can affect boys, too. Eating disorders are so common, that in the USA 2 in 100 kids will suffer from one at some point, most commonly anorexia or bulimia. Unfortunately, many kids and teens successfully hide eating disorders from their families for months or even years. People with anorexia have an extreme fear of weight gain and a distorted view of their body size and shape. As a result, they strive to maintain a very low body weight. Some restrict their food intake by dieting, fasting, or excessive exercise. People with anorexia try to eat as little as possible, and take in as few calories as they can, frequently obsessing over food intake. Bulimia is characterized by habitual binge eating and purging. Someone with bulimia may undergo weight fluctuations, but rarely experiences the low weight associated with anorexia. Both disorders can involve compulsive exercise or other forms of purging food eaten, such as by self-induced vomiting or laxative use. Binge eating disorders, food-phobias, and body image disorders are also becoming increasingly common in adolescence. It’s important to remember that eating disorders can easily get out of hand and are difficult habits to break. Eating disorders are serious clinical problems that require professional treatment by doctors, therapists, and nutritionists.


There is not one specific cause of eating disorders. However, a combination of psychological, genetic, social, and family factors is thought to be involved. For kids with eating disorders, there may be a difference between the way they see themselves and how they look. People with anorexia or bulimia often have an intense fear of gaining weight and think they look bigger than they actually are. Certain sports and activities (like cheerleading, gymnastics, ballet, ice skating, and wrestling) that emphasize certain weight classes may put some kids or teens at greater risk for eating disorders. There is also an increased incidence of other problems among kids and teens with eating disorders, like anxiety disorders and obsessive-compulsive disorder. Sometimes, problems at home can put kids at higher risk of problem eating behaviours. Some research suggests that media images contribute to the rise in the incidence of eating disorders. Most celebrities in advertising, movies, TV, and sports programs are very thin, and this may lead girls to think that the ideal of beauty is extreme thinness. Boys, too, may try to emulate a media ideal by drastically restricting their eating and compulsively exercising to build muscle mass. Concerns about eating disorders are also beginning at an alarmingly young age. Research shows that 42% of first- to third-grade girls want to be thinner, and 81% of 10-year-olds are afraid of being fat. In fact, most kids with eating disorders began their disordered eating between the ages of 11 and 13. Many kids who develop an eating disorder have low self-esteem and their focus on weight can be an attempt to gain a sense of control at a time when their lives feel more out-of-control.


While eating disorders can result from serious mental and behavioural health conditions, as well as trauma (for example, sexual abuse), they can lead to very serious physical health problems. Anorexia or bulimia may cause dehydration and other medical complications like heart problems or kidney failure. In extreme cases, eating disorders can lead to severe malnutrition and even death. With anorexia, the body goes into starvation mode and the lack of nutrition can affect the body in many ways:
  • a drop in blood pressure, pulse, and breathing rate
  • hair loss and fingernail breakage
  • loss of periods
  • lanugo hair, a soft hair that can grow all over the skin
  • light-headedness and inability to concentrate
  • anaemia
  • swollen joints
  • brittle bones
With bulimia, frequent vomiting and lack of nutrients can cause:
  • constant stomach pain
  • damage to the stomach and kidneys
  • tooth decay (from exposure to stomach acids)
  • “Chipmunk cheeks,” when the salivary glands permanently expand from throwing up so often
  • loss of periods
  • loss of the mineral potassium (this can contribute to heart problems and even death)


It can be a challenge for parents to tell the difference between kids’ normal self-image concerns and warning signs of an eating disorder. While many kids and teens — girls in particular — are self-conscious, compare themselves with others, and participate in negative diet talk, this doesn’t necessarily mean they have eating disorders. Kids with eating disorders show serious problems with their eating and often have physical signs. Someone with anorexia might:
  • become very thin, frail, or emaciated
  • be obsessed with eating, food, and weight control
  • weigh herself or himself repeatedly
  • count or portion food carefully
  • only eat certain foods, avoid foods like dairy, meat, wheat, etc. (of course, lots of people who are allergic to a particular food or are vegetarians avoid certain foods)
  • exercise excessively
  • have a skewed perception of their body weight
  • withdraw from social activities, especially meals and celebrations involving food
  • be depressed, lethargic (lacking in energy), and feel cold a lot
Someone with bulimia might:
  • fear weight gain
  • be intensely unhappy with body size, shape, and weight
  • make excuses to go to the bathroom immediately after meals
  • only eat diet or low-fat foods (except during binges)
  • regularly buy laxatives, diuretics, or enemas
  • spend a lot of time working out or trying to work off calories
  • withdraw from social activities, especially meals and celebrations involving food


If you suspect your child might have an eating disorder, it’s important to intervene and help your child get diagnosed and treated. Kids with eating disorders often react defensively and angrily when confronted for the first time. Many have trouble admitting, even to themselves, that they have a problem. Sometimes getting a family member or friend who has been treated for an eating disorder can help encourage someone to get help. A misconception of fat as a negative thing to fear is a core problem for anyone with an eating disorder. As such, there might be heavy pushback from your child when recovery is suggested. Trying to help when someone doesn’t think they need it can be hard. Still, getting the professional assistance needed, even if your child resists, is essential. Enlist help from friends and family that your child trusts and loves — people known to have your child’s best interests at heart. Your child may be more receptive to a conversation if you focus on your own concerns and use “I” statements rather than “you” statements. For example, steer clear of statements like “you have an eating disorder” or “you’re too thin,” which may only prompt anger and denial. Instead, try “I’m worried that you have lost so much weight so quickly.” Cite specific things your child has said or done that have made you worry and explain that you will be scheduling a doctor’s appointment to put your own mind at ease. If you still encounter resistance, talk with your doctor or a mental health care professional about other approaches. The other day I heard my 13-year-old daughter complain, “I’m fat.” She’s started to stay away from family meals and says she’s not hungry. I’m upset that she’s already worried about her weight and that she may be developing an eating disorder. How do I know if there’s a problem and what can I do to help her if there is? – Dana It’s particularly common for teenagers to be concerned about how they look and to feel self-conscious about their weight. During puberty, kids’ bodies change dramatically, and they face mounting social pressures, like dating, making friends, and fitting in. But when these concerns become obsessions or begin to involve abnormal behaviours or negative thoughts about body image, weight, and food, eating disorders can occur. Someone who starts to do things that are emotionally or physically dangerous to lose weight may have an eating problem. Other signs of an eating disorder include becoming very thin, having a fear of weight gain, playing with, or moving food around on the plate instead of eating it, exercising compulsively, loss of menstrual periods, or constantly talking about weight and food. Some people with eating disorders binge eat, then induce vomiting, use laxatives, or use diuretics. If you’re concerned that your child may have an eating disorder, it’s important to get them the help they may need right away. Let them know that you’re worried because of the things that you have noticed. Disordered eating can be very dangerous and can lead to a variety of health problems. Have your child talk to a counsellor, doctor, or a mental health professional.


You can play a powerful role in your child’s development of healthy attitudes about food and nutrition. Your own body image can influence your kids. Constant discussions of body weight in a negative manner, obsessions with food and exercise, and demonstrating dieting practices can lead a child to understand weight stigma and distorted body practices as normal and acceptable. When talking about good health outcomes with your children, it is always best to emphasize health, rather than weight. Make sure your kids know you love them for who they are, not how they look. Delivering the message that your child is great as they are that their bodies are healthy and strong is a wonderful gift that parents can give their kids. Try to avoid power struggles regarding food — if your child wants to try vegetarianism, be supportive even if you’re an avid meat-eater. Teens frequently go through trendy eating periods, so try to set good limits, encourage healthy eating, and avoid fighting over food issues. Kids can catch on pretty quickly if their parents panic over one skipped meal. Try to gain perspective and talk to your kids about what’s going on if they don’t want to eat with the family. Finally, take an active role in creating a healthy lifestyle for your family. Involve your kids in the preparation of healthy, nutritious meals. Let them know that it’s OK to eat when hungry and to stop eating when they feel full. Make exercise a fun, rewarding, and regular family activity. Developing your own healthy attitudes about food and exercise will set an excellent example for your kids.