For Families and Loved Ones (Part 1): How Widespread of a Concern is This?

From personal and professional experience I know how difficult considering this topic of eating disorder awareness can be.

I also know how powerful it is that you’re reading this article. No matter what your child or adolescent may be going through, the more that you can understand about it, and the earlier they can get the support and professional help they may need, the better it will be for you and them.

This topic is close to my own heart as well as I struggled with anorexia nervosa starting from a young age, and years later worked as a dietitian with adolescents struggling with eating disorders. From both experiences I have seen how difficult and confusing this experience can be for caregivers, and I hope to provide you with a sense of clarity, reassurance and hope for you and your family.

I also know that it can be difficult sometimes to determine when your child’s relationship with food and their body is cause for concern to begin with.

These days, unfortunately, it can often seem like the minority of individuals whose relationship with food and their body is a joyful, or even neutral, experience.

With the ‘war on obesity’ mentioned in the media so often, schools considering weighing and measuring children, normalization of classifying foods as 'good' and 'bad’, and school health classes recommending that children count calories plus other worrisome healthy eating advice, it can often be difficult as a parent to make sense of any changes you see in your child’s eating behaviours or the way they view their bodies.

How do you know when your child’s relationship with food and their body is cause for concern when it seems so prevalent in our society to cut out ‘bad’ or ‘junk foods’ (which seem to be encompassing more and more foods) and to be scared of becoming or being too large? When does an interest in healthful eating and wanting to take care of one's body turn into something that warrants concern and indicates that there may be a disordered relationship with food or an already-present eating disorder?

Unfortunately, body dissatisfaction and weight control behaviours in girls and boys are not uncommon, and start at far too young an age.

According to the Canadian National Eating Disorder Information Centre (NEDIC) and the American National Eating Disorders Association (NEDA):

28% of girls in grade nine and 29% in grade ten engaged in weight-loss behaviours according to a 2002 Canadian survey.
37% of girls in grade nine and 40% in grade ten perceived themselves as too fat. Even among students of normal-weight (based on BMI), 19% believed that they were too fat, and 12% of students reported attempting to lose weight.
By age 6, girls especially start to express concerns about their own weight or shape. 40-60% of elementary school girls (ages 6-12) are concerned about their weight or about becoming too fat. This concern endures through life.

While these behaviours appear to be more common in girls than boys, boys are affected as well. According to the National Eating Disorders Association (NEDA):

62% of teenage girls and 29% of teenage boys report trying to lose weight. 59% of girls and 28% of boys are actively dieting. 68% of girls and 51% of boys exercise with the goal of losing weight or to avoid gaining weight.
Over one-half of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives.
Subclinical eating disordered behaviors (including binge eating, purging, laxative abuse and fasting for weight loss) are nearly as common among males as they are among females.

And while not every child or adolescent who suffers from body dissatisfaction or who engages in dieting or weight-control behaviours will go on to develop an eating disorder, dieting and food restriction are associated with greater risk for developing an eating disorder in the future. According to the National Eating Disorder Information Centre (NEDIC):

In a study of 14- to 15-year-old adolescents, girls who engaged in strict dieting practices were 18 times more likely to develop an eating disorder within six months than non-dieters, and had almost a 20% chance of developing an eating disorder within one year. Girls who dieted moderately were five times more likely to develop an eating disorder within 6 months than non-dieters.

Furthermore, while the average age of onset for anorexia nervosa used to be 13 to 17, it’s now 9 to 12, and children as young as 7 have been diagnosed (Costin, 2013).

Even if your child is not struggling with a diagnosable eating disorder, disordered eating, dieting, and body image dissatisfaction of any kind can impact their wellbeing and be cause for concern. For more information on this topic, Eating Disorder Hope has a helpful article describing the differences between disordered eating and eating disorders and how they are also related.

However, while the above statistics may sound disheartening, the fact that you are reading this article and gaining awareness about what your loved one may be going through is so significant. Detection as early as possible, specialized professional treatment, and support from loved ones makes such a difference in increasing the chances for full recovery no matter how far along your child may be in their food and body concerns.

In the next part of this blog series I will describe the warning signs and symptoms to look for to help you know if your child’s relationship to food and their body may be cause for concern. Then, in my final post, I will suggest trusted readings and resources to help you understand what your loved one may be going through as well as for supporting your next steps, such as having the initial conversation with your loved one to express your concerns as well as seeking professional help should it be needed.

My goal for this blog series is to provide you with a sense of clarity as well as reassurance and hope. Full recovery from an eating disorder or any food and body image concerns is possible (more on this in my final post), and the support of loved ones is so powerful.

I hope you will find this blog series to be both reassuring and helpful,