Your daughter seems to be losing too much weight lately. She has become more
finicky about food and hardly eats in your presence. She claims she is not
hungry or feels "too full" when you know she has not eaten all day. Just as she
appears to be going overboard with her dieting, she is also exercising
Could your daughter be suffering from an eating disorder? What is an eating
disorder and what are the symptoms? If your child does have an eating disorder,
what caused it, what are the treatment options and how can we help her?
What are Eating
Eating disorders are self-destructive patterns of behavior related to
food. In all cases, there is a preoccupation with food, meaning that the person
is constantly thinking about dieting. With anorexia, for example, the intake of
food may be controlled, severely limited and/or ritualized. Anorexics may be
unwilling or unable to eat in anothers presence. They often complain of feeling
full or bloated when they are, in fact, starving.
Bulimia is characterized by alternating bouts of binge eating followed
by purging, or induced vomiting. In some cases, laxatives are abused to reduce
body weight. In all cases of eating disorders, the young persons body image is
severely distorted. They see themselves as much heavier and unattractive than
they are seen by others. And they strenuously resist efforts by others to
correct those distortions.
Both anorexics and bulimics may exercise excessively in a desperate
attempt to lose even more weight. They may work out for hours, engaging in
strenuous aerobic exercises that they feel are necessary to eliminate imagined
excess body weight.
While there have been cases of children as young as seven or eight
years-old as well as middle-aged adults diagnoses with eating disorders, the
overwhelming majority of cases appear in the teenage years. And 95% of all those
who suffer from eating disorders are female.¹
For the most part, those with eating disorders tend to be perfectionists
and highly-self-critical. They suffer from low self-esteem and often lack
confidence. They crave attention and approval from others and may even appear
manipulative in their interpersonal relations. They are quite secretive about
their eating habits and almost always deny they have a problem with
While eating disorders are very much a psychological problem, they
have extremely serious medical consequences. The self-starvation of anorexics
and the bingeing and purging of bulimics often so severely interferes with body
function that the usual cycle often ceases. In addition, the drastic weight loss
associated with eating disorders can lead to renal failure, heart attacks and
even death (heaven forbid).
What Causes Eating
Eating disorders are caused by a variety of factors.
In any case, there may be one or more of the following contributing
1. Media images. Even if your children do not watch TV
or go to the movies, they are exposed to clothing ads on billboards and in the
print media that glamorize thinness. The message conveyed by these images is
that you cannot be socially accepted or successful unless you are as skinny as
the models. For teenage girls who may already feel insecure about their social
standing and appearance, weight loss may rise to the level of urgent
2. Abuse in any of its forms. When young children have been
traumatized by physical abuse, they need professional help to prevent long-term
psychological damage. If their parents were unaware of this trauma to the child
or were unable, for any reason, to arrange for necessary treatment, the child
has a high risk of developing an eating disorder in adolescence.
3. Dysfunctional family dynamics. If children grow up in
homes where there is considerable verbal abuse or high levels of conflict and
hostility, regardless of whether the children are the targets or only the
bystanders, they are at an increased risk of developing an eating disorder.
Teenagers who live in such dysfunctional homes often feel helpless to correct
the problems that are clearly not under their control. By regulating their
eating with an eating disorder, they are unconsciously attempting to exercise
control in the one area of their lives, namely food, which is totally under
their control. They may also be unconsciously attempting to unite their
discordant parents by forcing them to focus their attention on the eating
there is no single treatment option that has been proven to effectively cure
eating disorders. Consequently, it is often necessary to implement more than one
of the following strategies.
1. Hospitalization. Because of the life-threatening nature
of eating disorders, hospitalization is necessary, at times. Aside from such
emergencies, hospitalizations can also be helpful as part of an in-patient
treatment program designed specifically for patients with eating disorders.
These programs are geared for teens and include nutritional education and
retraining, as well as group and individual therapies.
2. Medical consultation. Although there is no medical
treatment for eating disorders, it is often recommended for the young person to
be monitored by a physician specializing in adolescent medicine. The purpose of
this consultation is to help determine if and when hospitalization may be
needed, as well as to treat any medical complications resulting from the eating
3. Individual psychotherapy. It is always helpful for the
young person to have his/her own therapist who can help work through the
underlying emotional conflicts, distorted body image and unhealthy family
relationships. Those with eating disorders tend to be secretive and mistrustful.
Consequently, it is vital for them to have their own therapist in whom they can
confide without fear of unwanted disclosure.
4. Family therapy. By the time a teen has developed an
eating disorder, his/her relationships with one or both parents have usually
become strained. The best way to resolve these conflicts, build trust and
reconcile the differences is with family therapy, in which the teen is seen
together with both parents.
How to Be Helpful
making the necessary arrangements for treatment, there are a number of things
you can do to help your child cope with and eventually overcome his/her eating
Do not discuss food. Although this condition is very much
food related, it will not be cured by you encouraging your child to eat
properly. Paradoxically, one of the best things you can do to help is to avoid
initiating any conversation about food.
While arranging treatment is important, it is equally, if
not more important, to cooperate and participate fully with your childs
physician and therapist. If they give you guidelines and recommendations, follow
them, even if you do not always agree. If they request your attendance at family
therapy sessions or group meetings, make every effort to attend. Your
participation in your childs therapy demonstrates your concern for his/her
welfare much more than anything else.
Whether in a therapy session or at home, try to accept
your childs feelings without becoming defensive. You do not have to agree with
all of your childs complaints against you. To be sure, some of them may be
exaggerated, or distorted. Nevertheless, your child may have developed an eating
disorder as a result of feeling unheard or invalidated so it will be extremely
therapeutic for you to listen as effectively as you can.
Encourage and even pull for your child to express
suppressed feelings of resentment or disappointment toward you or any other
member of the family. This may be difficult for you to listen to but it will
greatly speed up your childs recovery.
It can be terrifying for you to see your beloved child imprisoned by the
self-imposed and self-destructive regimen of an eating disorder. The serious
consequences of this condition justify your high level of concern and worry. The
good news, however, is that with proper treatment, considerable patience and
ample time, eating disorders can be successfully overcome and your child can
move on to a healthy marriage and family his/her
1. Diagnostic and Statistical Manual of Mental Disorders (Third Edition
Revised), Washington, D.C.: American Psychiatric Association, 1987)
p.66 Adapted with permission by Dr. Meir Wiklers from his new book Partner
With Hashem 2: More effective guidelines for successful parenting, copyright
2006 by ArtScroll Mesorah Publications Ltd., 4401 Second Avenue, Brooklyn, NY