Inheriting eating disorders

I don’t envy parents of teens today.  Raising teenagers can be difficult enough without adding all the issues unique to our times.  There’s one problem that’s not new: eating disorders.  They’ve been around for a very long time.  Long ago, anorexia was associated with religious fervor.  Now we associate it with fashion magazines.  While the classic image is of an anorexic middle class teenaged girl who wants to look like a fashion model, kids (and adults) from all backgrounds can develop this type of problem for a wide variety of reasons.  Risk factors include genetics, psychological predisposition, peer pressure and family environment.

The impact of family was the focus of a recently published research article with the imposing title:

Intergenerational Transmission of Parent Encouragement to Diet From Adolescence Into Adulthood

Here’s what it means: when parents “encourage” (nag, badger, criticize) their kids to diet, that pressure can push the child into destructive food behaviors like binge eating, bulimia and anorexia.  Worse, when those eating-disordered kids grow up, they are likely to pass that attitude and behavior on to their children.  the study followed over 550 adolescents for many years.  Result: kids who were pushed into dieting by a parent were more likely to be obese or engage in destructive dieting behaviors like bingeing or anorexia, and to then encourage their own children to diet.  It’s a vicious circle of inherited eating disorders.

Parents might thing: “Oh I don’t do that.  I don’t pressure my child to diet.”  Well maybe not in so many words, but there are plenty of subtle indirect ways to encourage dieting.  One of the least appreciated is the parent’s own obsession about his or her own weight, out loud and frequently.  Young children watch Mom weighing herself and sighing or exclaiming over the number on the scale.  They hear Mom or Dad say things like “I need to lose 15 lbs” or “I’m on a diet, I can’t eat that (delicious dessert)”.  Or “Do I look fat?”  You may not be directing that fat talk at your child, but your child hears it loud and clear.  Conclusion: this is what is important.

Criticizing other people about their weight is another way to transmit those negative messages.  But of course the most negative messages would come from direct criticism of your child.  Comments about clothing size or lack of fitness or how much is eaten at a meal or what food is chosen at a restaurant are all examples of indirect encouragement.  Direct statements like “You need to go on a diet” or “You can’t eat that, you’re on a diet” or “You’re too fat” are equally bad.

Some kids in diet-focused families never develop problems.  They may remain obese, which isn’t a great outcome either.  Kids with a predisposition to an eating disorder are easily pushed into that behavior by this kind of parental pressure.  Initially if they lose weight, they get additional encouragement from the parents: “good for you,” “you look so much better”, “how much do you weigh now?”  Parents frequently stop paying attention once the excess weight goes away.

One potential warning sign that the diet is going wrong, which I discuss in my book “Feed Your Vegetarian Teen,” is a progression to restrictive eating.  It all starts innocently enough.  The teen becomes vegetarian, which sounds so healthy and admirable.   Then she moves on to a vegan diet.  Then she stops eating much of that.  There’s nothing wrong with well-planned vegetarian or even vegan diets for an adolescent, but when these diets are used to disguise a developing eating disorder, parents need to pay attention and be prepared to intervene.

What’s the Take Away message from this study?

There are two actually:

  1. While you, the parent, may have your own personal issues with weight, you need to keep those to yourself around your children.  Your toddler doesn’t need to grow up watching her parents obsessing about a number on a scale, or engaging in negative self-talk about their own weight or how many calories they’re eating.
  2. If you think your child needs to lose weight, approach that problem as a family health project, not as a fat child problem.  If you serve healthy food in moderate portions, encourage physical activity, strictly limit treats and don’t use food as a reward, you can create an atmosphere where health, fitness and good food are positive aspects of life, not dreary punishments for being overweight.

Certainly, there’s nothing wrong with a teenager who decides to try a vegetarian or vegan diet.  If you’re not familiar with how that type of diet fits with a growing teen’s nutritional needs, my book will provide you with that information.  The point is to pay attention.  While a small percentage of kids hide their eating disorder behind these healthy-sounding diets, most teens who try vegetarian or vegan diets do fine if the diet is balanced and the food tastes good.

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