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childchkidEating disorders tend to occur in people who have high levels of stress that they feel are outside their control. Bulimia nervosa and anorexia nervosa, in particular, are disordered ways of coping with social pressures that create a sense of control within the patient, but at a cost of physical and emotional distress and damage. Eating disorders can also arise when social, familial or educational influences affect how a young person sees themselves, creating standards by which they compare themselves negatively. 

As many as 10% of young people will cope with some level of eating disorder in their lifetime, and without proper treatment, the physical and psychological damage can be severe. While the catalyst is typically internal, external verbal and social cues can be the tipping point to going from disordered eating to a clinical disorder. As a parent, what you say to your child matters but your unconscious and indirect communication can also have a tremendous impact.

We’re going to examine 5 ways that you might be unconsciously body shaming your kid and how it can impact thier self-esteem. We’ll also discuss how to self-critique your behavior, and ways to find help if your loved one is suffering from an eating disorder.

Signs Of Eating Disorders In Adolescents

There are many types of clinical eating disorders but the most common are anorexia nervosa, bulimia nervosa, and binge eating disorder. Each one has specific traits and signs, but they all have similar causal factors:

  • People who faced trauma are significantly more likely to develop an eating disorder. This is particularly true if the trauma resulted in PTSD or anxiety at a clinical level.
  • Children who faced food insecurity or neglect are also at an increased risk for developing an eating disorder.
  • Adolescents and teens, due to the constant internal shift of neurochemicals and external social changes, are a higher risk demographic. In particular, this group can be difficult to treat, as anxiety and depression run concurrent with eating disorders most of the time, and are also extremely common in teens. The reason these disorders are confounding when comorbid with an eating disorder is because of how similar their behavioral manifestations are. This means eating disorders are likely underdiagnosed in the young adult demographic.
  • Social media, television, and films put out a standard body type that is not realistic for most young adults but is nevertheless prevalent and influencing. Coupled with bullying and body shaming, the distressing impact on young people cannot be understated. 

While many young people deal with some or all of these stressors daily, when there exist other mental health difficulties, they can create an eating disorder. Because of the stigma of eating disorders (and mental health problems in general), your child will not likely go out of their way to seek help. Denial is a strong undercurrent of most eating disorders and can lead to a delay in starting treatment.

As the parent, there are things you can do to identify the signs of an eating disorder in your child and then intervene. ED symptoms can be broken down into physical and behavioral changes that, when presenting together, indicate the underlying disorder.

Physical Signs Of Eating Disorders

While the physical symptoms vary between the disorders, some are present in just about all of them:

  • Coldness, or bluish extremities from poor circulation
  • Fluctuations in body shape
  • Fatigue and weakness
  • Recurring infections and poor wound healing

Behavioral Signs Of Eating Disorders

Because not all eating disorders will have obvious physical signs, and because those signs might be minor in many cases, behavioral cues are the best way to determine if intervention is needed. Changes in a person’s behavior, particularly regarding meals, that are common in eating disorders are:

  • Ritualized eating behaviors — eating only certain foods, in certain quantities or only with certain other foods on the plate
  • Eating alone, or eating very little when with family and friends, using excuses about dietary changes or “not being hungry”
  • Social withdrawal in general
  • Changes in peer groups
  • Irritability and/or an increase in symptoms of an already present anxiety disorder or depression
  • Preoccupation with body image, other people’s bodies or compulsive mirror checking
  • Negative self-talk, particularly as it relates to their body

When coupled with physical symptoms, a sudden increase or appearance of these behavioral changes are a good indication that something is going on. It might begin as disordered eating, like skipping meals, being unusually restrictive or trying a new diet that cuts out food groups. Without treatment, however, it can progress into an eating disorder that can quickly take over a person’s life and damage their bodies, sometimes permanently. This is why it’s critical to be observant of the signs of these disorders, so you can intervene as soon as possible.


5 Ways You Might Be Unconsciously Body-Shaming Your CHild

It’s imperative to understand how your own words and actions — even when you don’t intend for this effect — can shame your child’s body and injure their self-image. Eating disorders do not develop overnight, nor are they caused by a single factor, but body shaming from a loved one can be especially causal. Let’s take a look at how you might unconsciously be affecting your child and how you can change those behaviors.

1 — Implying certain standards about people’s bodies

This one is common and often comes from a place of good intention. Phrases like “I wish I was skinny like you” come from a place that means to praise larger bodies or seem like a compliment. If your kid is insecure about their body, however, hearing these things can be damaging. The implication that only larger people are somehow authentic can be especially damaging, but the word “skinny” can be just as problematic. This is because not everyone sees “skinny” as a positive thing, so you have to be mindful that your thoughts on how bodies should look are by no means universal.

Instead, try complimenting their other traits, like hobbies, skills, and intellect. By taking the emphasis off complimenting bodies, you can divert attention from what they might see as flaws to the countless positive things about them.

2 — Reacting negatively when they show you an outfit they like

Phrases like “that’s pretty revealing, isn’t it?” or “I’m not sure that flatters your body type” indicates that there’s something wrong with how they present themselves. Statements like this undermine the very core of your ‘s self-image, particularly if they trust you enough to show you a new outfit or a daring new look they’re trying out. 

Instead, compliment their style and emphasize all the great ways they express their personality through their outward, non-body appearance. Things like accessories, makeup or hairstyle are all great targets for compliments that don’t impact body image.

3 — Using the word “fat” to describe bodies

Even if it’s your own body you’re describing, using “fat” is almost always negative. “They’re so fat now”, or “I’m getting fat” might seem innocuous to you, but to someone who feels they are extremely overweight, that can seem like an attack. Worse yet, if your adolescent sees you talking that way about other people, they will question their value in your eyes as well.

Instead of using “fat” negatively, avoid using the term at all. If you feel you need to lose weight, couch it in terms of health; “I want to lower my blood pressure” or “I want to run a mile without stopping, so I’m going to skip dessert”. These are positive ways to frame the goal of weight loss or the belief that you feel overweight.

4 — Criticizing their food choices

Of course, nobody wants to outright say “you shouldn’t eat that, you’ll get fat” but some people actually do that. Suggesting food choices is one thing — “try this” or “that doesn’t taste good” are fine ways to make suggestions, but steer clear of judgmental suggestions, like “do you really need that piece of cake?” Additionally, don’t do it to anyone else — it’s never your place to judge someone else’s food choices, but when you do, you demonstrate how you might be silently judging your child.

Instead, ask a qualitative question about their meal, like “how are you enjoying it?”. Additionally, you can also steer the conversation in non-food directions.

5 — Asking questions about weight loss

We often think to remark about someone’s weight loss when we see them or offer it up as a compliment. It’s rarely a good thing to ask, though, because it creates an awkward situation; unless the person has very visibly lost weight from a very public determined effort to lose weight, you never know what’s going on. They could have been ill, struggling with an eating disorder themselves or might not have lost weight at all, and it’s still awkward no matter what. The bigger problem is the emphasis you put on how positive weight loss is in front of your kid. While health is important if the only positive thing you can bring up is “did you get less fat?”, that sets a negative example for your child.

Instead, compliment their dress, their accessories or simply ask questions about how they’ve been. It seems like extremely common sense advice, but body shape questions are often some of the most awkward and potentially damaging questions you can ask, so best to steer clear of them.

None of the above situations are things people go out of their way to do insultingly. Creating a social and familial space for your teenager to create a positive self-image is easier to do when you identify toxic phrases and behaviors and work to eliminate them. In particular, young people who see a committed effort to change phrasing or behavior will have a greater sense of comfort around you, and that will be critical to helping them get into treatment.

Helping Your Child Get Treatment For Eating Disorders

If indications exist that your child is suffering from an eating disorder, and you’ve made the effort to self-critique and change your behavior, then the next step is an intervention. This is best done one-on-one with your child, in a comfortable setting away from other people.

Do not approach them in a way that makes them feel cornered or judged; instead, ask  open-ended questions about their life:

  • How have you been doing lately?
  • Is there anything that’s been bothering or hurting you recently you’d like to discuss?
  • How can I help you with whatever you might be dealing with?

These types of questions allow them to direct the conversation, and with that power in their hands, they are more likely to open up to you. If they identifies that they have been struggling with body image and food-related mental health problems, then it’s time to seek out treatment.

Treatment facilities like those at Clementine are designed to create a homelike environment, increasing comfort and a better basis for intervention. Studies have shown that outpatient clinics that resonate comfort have a dramatically higher chance of long term recovery in their patients. 

These facilities use a combination of medical doctors, therapists, dietitians, and group counseling to treat eating disorders to create the highest level of care outside of a hospital. All of these professionals are trained to handle the difficulties and intersectionality that come with treating EDs, creating a more effective program.

Outpatient facilities that involve the family have been shown to be dramatically more effective at long term recovery than in-patient hospitalization or seeking individual therapy. Additionally, any treatment program that you enroll in should offer a well-formed aftercare program, so that as your child reacclimates to life, they have a support system to fall back on. Clementine provides aftercare and trains the family in other ways they too can support their loved one’s recovery. 

The first step to getting treatment is to schedule an evaluation, moving past the stigma of eating disorders and into a life of recovery.


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.