Eating Disorders

Dear Rachel,

I know that eating disorders have been around for a while, but now that I am raising my own daughters, the topic concerns me more. I see that our culture surrounds girls from younger and younger ages with media that portray thin not only as "in," but as the only acceptable way to be. The pressure of dieting and physical appearance is something that my eight year old daughter is already aware of!

She will pat her belly and ask me if I think she is fatOccasionally she will pat her round little belly and ask me if I think that she is fat. She is a little chubbier than some of her friends, but certainly nothing unhealthy or out of the ordinary. Should I put her on a diet? I don't really want to encourage the extreme focus on body image in our home. I have a friend with a teenage daughter who started out a little chubby, went on a diet and was recently hospitalized for anorexia, I certainly don't want that.

Are there other factors that make a young woman more likely to have an eating disorder? What can I do to protect my eight year old daughter as well as her five year old sister?

Sincerely,

Concerned

LA, CA

Dear Concerned,

You are right to be concerned. Eating disorders are a danger that the young women of our generation fall prey to. A recent study of teenagers in Minnesota showed that 13% of girls and 7% of boys reported disordered eating behaviors. It is most likely that your daughter will have among her friends someone suffering from an eating disorder.

I will not go into the details of what anorexia, and bulimia look like as there is much information available, and obviously you have some awareness already to be asking the question that you did. If anyone reading this is concerned that they or someone close to them is already suffering from an eating disorder, it is best to speak to a doctor immediately, as the chances of a full recovery are much higher when the illness is diagnosed early and treated immediately.

Use food to feed hunger, but not to feed emotional deficitsYour question of how to create a safe environment to prevent the development of an eating disorder in your daughters is a very important one. The research shows that while there is no one "cause" of eating disorders, parents can influence many factors that that can lower the risk.

• Don't Diet

Your hesitation to put your eight year old on a diet is certainly in place. Anyhow 95% of weight taken off by dieting is put back on with interest. It is likely that she will thin out as she grows taller. Many eating disorder cases start out as diets that get out of hand.

You, as her mother, can create an atmosphere in the house that is conducive to a healthy mind and body. Buy and serve foods that are colorful, fun and nutritious. It takes time and creativity, but is well worth the investment. Use food to feed hunger, but not to feed emotional deficits. Don't worry about your daughter being fat.

• Downplay the Importance of Being Thin

How do you feel about your own body? More than half of women surveyed in the USA said that they refrain from activities that they would like to participate in because they are embarrassed by their appearance. Don't be one of them! Develop a sense of self that is based on who you are and what you do, not how you look.

Your daughters will absorb and internalize your attitude. Comments like, "This makes me look so fat!" "Doesn't Aunt Hilda look great? She went on a diet," or "I was so good this week, I lost two pounds," are poison. Better to say, "I was so good this week, I didn't gossip at all!" and "Doesn't Aunt Hilda look great? Ever since she started volunteering at the hospital she has been smiling much more!" The more you have a positive and balanced approach to food and body size, the safer your home is.

If your daughter pats her belly and asks you if she is fat, ask her if she knows what's in that belly. There is a stomach, intestines, a liver, kidneys, etc. Explain to her what goes on inside there. Let her feel a little bit of awe at the function of her body. Jewish tradition has us make blessings every morning for our basic physical abilities, even being able to go to the bathroom! Our bodies are tremendous gifts no matter what shape or size they are!

• Develop Your Spiritual Side

Spend time every week alone and with your daughters doing something spiritual. Young children connect very naturally to prayer. Emphasize that what makes people special is their soul, and how they use the gifts that life has given them to do good. The richer the inner life is, the less important the external becomes. If you notice, the days that you feel bad about the way you look are often days that you feel bad about who you are. Build yourself and your family on the inside and that will shine through.

• Express Feelings Honestly

Our bodies are tremendous giftsWhen your children see you expressing your feelings in an honest and candid way, both positive and negative, they will learn "feeling vocabulary." Even with your five year old. If she gets upset, talk to her about what's going on. Help her to define it to herself and you. I have heard from girls with eating disorders that when they felt bad they would tell their parents that they felt fat. Feelings were not talked about in their homes, and they could never just state honestly that something had upset them.

Eating and restricting food is often a sad replacement for communication. If a child cannot express her feelings she is more likely to eat them or purge them. It is not realistic to ask a parent to listen to everything a child wants to say at all times, but make sure to spend some time each day listening to each child. When life is tough for them they will come to you with their problems if you have proven to them that you are a trustworthy confidant. The time that you invest now listening to their small problems will have big returns in the teenage years.

• Deal with the Aftermath of Trauma

As far as I know, your daughters have not been through any trauma. One study showed that 74% of girls with anorexia had experienced some sort of trauma, and more than half of them exhibited some symptoms of post traumatic stress disorder. It is well known that sexual abuse is a risk factor for eating disorders.

If your children have been through something that they may have experienced as traumatic, be sensitive to any changes in their mood, appetite or sleep patterns, and contact a mental health professional if you are concerned.

• Don't Create a Perfectionist

Perfectionism drives anorexics to be perfectly emaciated, and still not be satisfied with their bodies. Help your children set realistic goals for themselves, and work hard to achieve them. Self esteem is built in both children and adults when we accomplish things that are challenging to us, but within our range of ability. Don't criticize a child for not being to do something that is beyond her. Don't worry, they will naturally enjoy their successes, and strive for more.

• Do an Emotional Housecleaning

If you or your husband have heavy personal issues, deal with them now, and don't pass them on to your kids. Your emotional health sets the standard for what your kids feel is normal. If there are addictions, low self esteem and constant arguments between the parents, your children will internalize the discord, and it will show at some point. Studies show that problems at home put kids at a greater risk for eating disorders, addictions, and other problems.

The richer the inner life is, the less important the external becomesWhile there is nothing you can do to make your child's life problem free, you don't need to burden her with your problems. Likelihood is that if you have been carrying the problem this far in life you will need some help to resolve it. Find someone you trust and do the work. Being lazy here may cost heavily later.

• Limit Media in Your Home

You are right that the media are targeting your daughters. There is a huge market aimed at teens and youth. That doesn't mean that you have to let it into your home. You are the parent; you decide on the quality and quantity of media in the home. Today there are many resources available that focus more on being good than looking good. (Check out Chabad's great kids' website!)

When your girls are older it will become more difficult to control what they see outside of the house. When you are driving and come across a billboard that uses slender female bodies to sell anything from insurance to dish soap, talk to your girls about the absurdity of it. Most models are thinner than 98% of American women. They are trying to sell an extreme that is not healthy for most people.

Educate your daughters to be objective and critical of media. If you have taught them in their younger years to appreciate internal qualities it will be easier for them to use their judgment and not feel judged by all that they see.

• Teach a Spiritual Approach to Food and Body

The Torah teaches us to make blessings before we eat. We use food to create the special feeling of Shabbat and holidays. We abstain from food on certain days of the year when we are meant to focus on other things, yet we eat reasonably before and after fast days.

Our body is a gift that is fantastically functional. With it we can do so much to make the world a beautiful and meaningful place. The more that we see our physicality as a means to a greater end, the less likely it is to stand in our way.

• Pray!

All that said, we are just human. We do our best and a sprinkling of prayer is a good seasoning for even the best parenting!

You are right to be concerned, but don't get stressed out. Trust yourself, and your love for your children. Your positive and balanced approach to life will rub off on them!

Rachel