Unfortunately, this hesitation to share may lead them to choose to stay silent about their troubles when approached by parents, family, or even friends. Everyone needs privacy as part of their lives, however hiding negative feelings about their weight, body, and appearance can lead to the development of disordered eating behaviors. As the symptoms of an eating disorder such as anorexia nervosa or bulimia nervosa develop, they might feel intense guilt and shame and refuse to talk about it. Without help from their parents, many may wait far too long to seek out eating disorder treatment.
Parents can help their adolescent children open up and discuss their ED symptoms by imbuing each talk with confidence and using the following tips, which can help remove self-imposed barriers to discussion and start to engage in real, honest dialogue. Talking about ED is difficult for both parents and teens – but it’s the first step in saving a life.
That said, the first step is to know what to look for in terms of what eating disorders look like.
The Signs & Symptoms of Common Eating Disorders
It’s important for parents to enter each conversation about eating disorders with their teen feeling confident and knowledgeable. A good start for parents is learning about eating disorders and the signs associated with them.
With a strong knowledge base, parents can point out behavioral symptoms they’ve observed with more confidence and hopefully convince their child to open up. This knowledge can also help the teen to understand that disordered eating behaviors can cause serious health risks. Common symptoms of eating disorders include:
Anorexia Nervosa:
- Urge to restrict eating
- Fear of gaining weight
- Distorted and negative body image
- Low self-esteem
- Weight loss
- Malnutrition
Bulimia Nervosa:
- Recurrent and frequent binge eating episodes
- Purging behaviors after the episodes
- This is most commonly self-induced vomiting but can also take form as laxative abuse, diuretic abuse, excessive exercise or other methods
- Damage to fingers (from forced vomiting)
- Damage to the throat and teeth
- Malnutrition
Binge Eating Disorder:
- Frequent and recurrent binge-eating episodes
- Frequent dieting, without weight loss
- Sudden changes in weight
- Low self-esteem and body image
- Obesity
If you see these symptoms in your child, it’s worth doing further research and getting ready for a hard conversation. Once armed with the data, here’s a breakdown of how to approach your teenager and discuss eating disorders.
Keep the Pressure Low
Many people with ED experience a strong sense of perfectionism. Teens may fear disappointing their parents if they engage in a discussion about their symptoms honestly. With too much pressure, they may shut down completely, which doesn’t help anyone to make progress in recovery from eating disorders.
To overcome this dilemma, parents need to leave the pressure and expectations at the door and simply offer compassion to their teens. This can be accomplished by avoiding any expressions that imply disappointment, anger, or sadness. The primary role of the family in ED recovery is to provide support –not to judge, not to coerce.
Always Avoid Judgement
This is related to the “no pressure” concept – a judgmental tone may make teens immediately shut down the conversation. Parents need to make it clear that they want to help resolve the behaviors, not place blame on the teenager for them. To effectively leave judgment at the door, parents must identify their most judgmental responses (often a knee-jerk reaction) and leave them out of the picture.
When parents can avoid judgment in talks with their teens, they allow their compassion to shine through. This is what many teens need more than ever, especially when they are dealing with the symptoms of an eating disorder like anorexia nervosa. Without judgment, teens can share their thoughts, feelings, and experiences more easily.
ABC – Always Be Compassionate
Anger and irritation have no place in a constructive conversation about eating disorders; compassionate communication opens the doors for deep talks about the risks of eating disorders and the importance of treatment. Remember, no matter how hard this conversation is for you as a parent, it’s tougher for them. Many people with eating disorders feel guilt and shame, even before getting a feeling that they’re being berated. In response to a lack of compassion, they may shut down completely.
Communicating with compassion requires parents to sincerely try to understand where their child is coming from emotionally and in terms of their body image. They must attempt to put themselves in their teens’ shoes to experience their daily stressors and the impact of those experiences.
Use “I Feel” and Other “I” Statements
Saying something like “I feel there have been changes in the way you eat and I want to help” rather than “You are showing ED symptoms” helps teens from feeling attacked and defensive during each conversation about receiving a diagnosis and subsequent treatment. It’s much better to express your viewpoint gently than to cast (even perceived) aspersions.
Through the use of “I” statements, parents can express their love for their teens while addressing concerning issues. They can help their teens see their disordered eating behaviors from a new perspective, potentially helping them understand their need for professional help.
It Doesn’t Have to Be a Confrontation
While it’s tempting to hold an intervention or stake out time to have a serious conversation, it’s not always best to make a big to-do about the conversation. Parents can take advantage of the many small conversations families have throughout the day to make low-pressure inroads into a discussion about their possible ED.
Parents can find time to talk to their teens while:
- Driving to and from activities
- Getting ready for the day
- Preparing to go to bed
- Yardwork
- Cleaning the house
Parents can ask non-threatening questions like, “Did you like dinner tonight?” or “How are you feeling about that new pair of jeans?” which might lead the child to open up a little. These small conversations set a baseline of comfort discussing more difficult issues.
Let Them Know Why You’re Concerned
Parents need to share that the results of eating disorders can be severe and often worsen unless some changes are made. They should also discuss how disordered thought patterns and behaviors begin to overtake every aspect of life.
Many teens with ED are ambitions and are involved in after school activities, including but not limited to athletics. The health risks of EDs can often impede participation in these valued activities (and act as triggers for further negative emotions). These health complications may include:
- Stomach pain
- Irregular heartbeat
- Low blood pressure
- Muscle cramps
- Poor focus
- Dizziness
- Confusion
- Infections
It’s more than simply restricting their ability to engage in activities and academics, though. Serious medical problems can result from untreated eating disorders, such as pancreatitis, kidney disease, and heart failure.
Be Patient
Even when using a compassionate, judgment-free approach, expect that your teen will be resistant to discuss their weight or body image, and just as resistant to accept that there needs to be a change in their eating habits.Eating disorders can cloud judgment – but parents can get past resistance by using patience while talking with their teens.
Parents should be ready to have several small conversations rather than one “fix-it” intervention. They also need to temper expectations and avoid reacting in frustration when the talks do not seem productive. It might not seem apparent that the adolescent is getting anything out of or taking any inspiration to get help. In fact, it may often appear they are rejecting the information outright and refusing to see the situation before them.
In most cases, they are listening but struggling to reconcile the emotions ED is making them feel with the advice they are receiving from their parents. The process can’t be rushed; as a parent, firm patience is key.If you’ve reached a “brick wall” and can’t make further progress, it’s time to consult a therapist or admissions specialist at an eating disorder treatment center.
Ask Them to Ask You Anything
Nobody likes a lecture. Your conversation about ED with your adolescent should be a dialogue, not a monologue. The ability to ask questions allows your teenager to explore the subject on their own terms. They can direct the conversation and feel more in control, which is essential to conquering eating disorders.
Be prepared – depending on how receptive they feel to a discussion about an eating disorder, teens may not have a lot of questions at first. You should make sure they are comfortable before prompting them to ask questions. This will help allay the uncertainty and allow them to start to explore the questions surrounding eating disorders. Through this approach, parents and teens can work on demystifying their eating disorder and revealing it to be a mental health condition that can be resolved through treatment.
Here is where self- education and increasing knowledge about anorexia nervosa and bulimia nervosa will come in handy. Even without professional help, a knowledgeable parent can answer many of their teens’ questions with confidence. As long as you stay calm and compassionate, you can make your child more at ease and receptive to new ideas about treatment. If you’re unable to answer the questions, try researching the facts online, or getting help from admission specialists at an ED treatment center.
Inspire Action by Sharing Solutions
As you engage in more and more talks about ED with your adolescent, you should begin to move toward a solution. Parents can inspire action by talking about the kinds of treatment methodologies that typically work best for individuals with eating disorders and that are used at treatment centers. They can help their teenagers learn about how to seek treatment and what to expect through every phase of the process.
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Melissa Spann, PhD, LMHC, CEDS-S
Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.