Starving to Death: Does My Child Have an Eating Disorder?

by Elisabeth Wilkins, Empowering Parents Editor
Starving to Death: Does My Child Have an Eating Disorder?

Michelle’s parents did not address her anorexia until she weighed less than 85 pounds. At 5’10”, she was a skeleton compared to the healthy teen she had once been. “My mom and dad said nothing to me about my weight loss, until one morning at breakfast when my father slammed a stack of pancakes down in front of me and demanded I eat them,” she said. “I refused.” Michelle’s eating disorder began when her older sister died in a car accident. “At first I didn’t want to eat, I was grieving so much. But the subject of my sister’s death was taboo at my house—we weren't even allowed to mention it. I continued to refuse food because of the pain I was in, and their unwillingness to see it.” Fortunately, after that breakfast table incident, her mother sought treatment for Michelle with a counselor who specialized in eating disorders. “I’m sure it saved my life,” said Michelle.

Of all psychiatric illnesses, eating disorders have the highest fatality rate. Nearly 45,000 people die from them in America each year, and that number is growing.

She’s not exaggerating. Of all psychiatric illnesses, eating disorders have the highest fatality rate. Nearly 45,000 people die from them in America each year, and that number is growing. Even after patients have sought treatment, eating healthfully becomes a lifelong struggle. Angela Blier, a clinical counselor who treats patients with eating disorders in Portland, Maine, explains this by comparing it to someone with a drug addiction. “When you give up drugs and get clean, you never do them again. With an eating disorder, you have to eat to survive, so there’s always the chance to backslide.”

The two most common eating disorders are Anorexia Nervosa—where the person has a distorted body image and severely restricts their intake of food, sometimes to the point of starvation—and Bulimia Nervosa, where the key symptoms are binge eating followed by purging, either by vomiting or using laxatives. Many factors play into the weight loss obsession, including genetic predisposition to the disease, family attitudes about food, the friends a teen chooses to hang out with, the presence of depression or anxiety, biological make-up, and a perfectionistic or obsessive personality.  In addition, images from the media of painfully thin models and actresses bombard kids daily, teaching them a distorted definition of what is normal, and encouraging them to aspire to a goal that is unattainable for most.  Often, like in Michelle’s case, a traumatic event may trigger the onset of a disorder—a death, their parents’ divorce, sexual abuse. The statistics about where we’re headed as a nation are disturbing: 40% of fourth graders report that they diet either “very often” or “sometimes.” According to a Mayo Clinic study, three out of every one hundred girls will develop an eating disorder as they mature. Though it’s less talked about, boys are not immune to the illness—one out of every 10 people with an eating disorder is male, and that number is growing as well, according to Dr. Roberto Olivardia of Harvard Medical School, a clinical psychologist who primarily treats men and boys with the disease.

If you suspect your child might have an Eating Disorder, take them to your family physician or pediatrician right away.
It’s important to trust your instincts when it comes to your child, says Dr. Patrice Lockhart, Medical Director of the New England Eating Disorders Program. The youngest children now being seen there are seven years of age. “You can’t hurt your child by bringing up concerns, but you can hurt your child by avoiding them,” says Dr. Lockhart. “So many parents come in here and say, ‘Oh, I wish we’d called 6 months ago.’ You’ve known your child since birth. The minute you have any concerns, trust your gut.”

Experts advise that you approach your child in a loving way, directly expressing your concerns for their health and the fact that you are worried about them. Don’t be surprised if your child denies the problem. “The danger with eating disorders is denial—denial with a capital D,” says Blier. “It’s easy to defend not eating a lot and exercising. If your child denies the problem, the next step is the doctor.”

When you take your child to your family physician for a check-up, tell them why you are doing so. “As a parent, you always have the responsibility to be as honest as you possibly can, if you want your kids to be honest,” says Dr. Lockhart. “Expressing concern makes children feel safer than not telling them why they’re going to the appointment.” Giving the child some control over what’s happening is also a good idea. Allow them to see the doctor first on their own, but tell them you will speak to the physician as well.  “This gives kids control in a safe way,” she says.

During the check-up, ask their physician to do tests to rule out any other problems. “Changes in electrolyte levels will show that something’s not quite right and the child is not healthy. If there are other reasons for the change in weight, good for you as a parent for checking,” says Blier. “You’ve found out something else that might be wrong. Getting the help of your child’s doctor is essential. That’s the one thing that helps with denial: numbers. The facts are there.”

Early Warning Signs
The earlier you address your child’s eating disorder and get them to the doctor, the better chances are for recovery. Early warning signs may include a child’s obsession with dieting and weighing themselves, and sudden dietary changes. In the case of bulimics, you may see your child running to the bathroom immediately after every meal. If you notice a pattern, follow them and listen by the door to see if they are purging. Another danger sign is if “they start on an exercise program that they can’t imagine stopping,” according to Dr. Lockhart. “Anything they can’t imagine stopping has the potential for being dangerous. In addition, another sign is that “they may suddenly decide to become a vegetarian but not have the education to support a healthy vegetarian diet.”

Boys are even more secretive about their eating disorders, and therefore their presence is often harder to detect than with girls. “With boys on the anorexic range, they’re more likely to disguise through exercise,” says Dr. Olivardia, who is also the co-author of The Adonis Complex. “They’ll spend a lot of time at the gym, and parents might dismiss it until their son starts losing lots and lots of weight and becomes hyper-conscious of everything he eats.” Boy who have a predisposition to eating disorders might gravitate toward wrestling, for example. “There are some who become bulimic as a function of joining the sport, but many others who had body issues before they joined,” says Dr. Olivardia. “People don’t suspect boys in the first place. They rarely use the language of ‘I don’t want to get fat,’ they’ll say ‘I want to get into good shape, I want to get cut.’ Words like ‘Cut,’ and ‘lean,’”—accompanied with drastic weight loss and obsessive eating habits— should be as triggering as a girl saying, ‘I don’t want to get fat.’”

In the case of girls, weight loss can become a way to interact socially. If you notice your daughter is hanging around with other girls who are excessively thin and obsessed with dieting, your antennae should go up. “It’s time to sit down and talk,” says Blier. “They’ve probably already been sharing unhealthy diet tips with their friends.” In addition, there are any number of websites and blogs that tell people how to lose weight, “whole websites dedicated to giving advice to people on how to go to a social function and appear as if you are eating when you’re really not, how to cut calories and lose weight.”  People with anorexia and bulimia will log on daily to report how much—or little—they’ve eaten, and how much weight they’ve lost. The social piece of it is that they encourage each other to keep going, often with dangerous results.

What should parents avoid doing?
If you suspect your child has an eating disorder, don’t try to force feed them. “Don’t try to put them into situations where they’ll eat—don’t try to take the treatment on yourself,” says Blier. “By trying to make the food they want, it will just result in them not eating it. Don’t schedule a family activity during their exercise time. Don’t you try to control what they’re doing. You’re not a treatment provider, you’re their parent.” Statistically speaking, the most important thing is to address the problem as soon as you sense there might be one, and that you get your child some good medical help as soon as possible.

Seeking Counseling
After consulting with your physician, if it’s determined that your child has an eating disorder, the next step is to find a counselor or accredited eating disorder program. Many use cognitive behavioral therapy to address poor eating habits and give patients a healthier approach to food. If the situation is more critical, children may have to enter an inpatient program.  If it’s severe enough, they may be put on IV fluids and admitted for a longer period of time. Family counseling may also be recommended. For more information, visit http://www.empoweringparents.com/parenting-resources.php.

Footnote on Michelle: Thanks to counseling— which at times included members of her family— and to the hard work Michelle did to change her eating habits, today she is a healthy mother of two who has been at a normal weight for more than ten years.

Grace Guerrette, PSL Specialist, contributed to this article.


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Elisabeth Wilkins is the editor of Empowering Parents and the mother of one son. Her work has appeared in national and international publications, including Mothering, Motherhood, and The Japan Times. Elisabeth holds a Masters in Fine Arts in Creative Writing from the University of Southern Maine.

READER'S COMMENTS

I have a sister who is 27, and she has been throwing up since she was 12, in and out of hospitals for it about all her life, and it scares me that one day we are going to wake up with her dead. And I don't ever want that to happen. She goes from 100 pounds to 85 pounds and it scares me. Everytime she eats she goes to the bathroom and throws up. And it doesn't do any good to get mad at her because she still keeps on doing it. I know she won't stop doing it until she is ready to quit, but I still want my sister around for a long time to come, but she has to want to stop. It started when she was made fun of by other kids because she was kind of fat. She quit school because of them making fun of her and now she throws up everday. I just want to see her better, so yes I do think it was a good article to tell people what could be going on with their children so they can take some kind of contol or try to help their child in some way. I just wish them all the luck in the world. Thank you for your time and letting me tell you a little bit about my little sister's life.

Comment By : Tonya Sue

Thanks for writing this article. My daughter was just diagnosed with an eating disorder. I wish I had known what to look for one year ago.

Comment By : Jerry

This is a great article on a topic that we cannot afford to keep taboo. It's amazing that we have dealt with this for so long, and yet know so little. Thanks for the hopeful reminder that maybe, if we are vigilant and HONEST with our kids, we can beat this back. With all the messages out there telling our kids that they should have bodies that they cannot possibly attain, this is more important than ever. Thank you for a beautiful researched and written article.

Comment By : Toronto Mama

My daughter just got out of a years stay in prison for drugs abuse and is back home with me and her 21 year old son who has mild CP. She also has bulimia and is going to multiple c ouseling three times a w eek. She has admitted to the rehab people her eating disorder, and I'm sure they are helping but lately she's taken a notion to cooking all the time and keeps bringing goodies home supposedly for me. I wonder if she has made them aware of these other things and how I can help too? I am also afraid her son has some form of it too as he spends a lot of time at the gym and refuses to eat at home except when his mom makes something special for him like breakfasts. He also had acquired a germ t hing and makes me feel like I'm some kind of dirty house Grandma especially kitchen stuff. AT his age I can't make him go to a doctor. any Help ideas? I have custody of him and his 11 yr old brother who now lives with my son and comes home weekends. She wants badly to regain custody but we can't see she's ready yet. Stress is tough at our house some days. A Parkinson's victim,(13 years) mom and grandma toughing it out.

Comment By : jojo

Dear JoJo: It seems you are taking on a lot - caring for your grandsons and your daughter, plus dealing with issues of your own. Without knowing all of the details, my first suggestion is that you consider attending a support group - you need to address your needs first. You may want to consider Al-Anon, a support system for families of addicts, as addiction (drugs or food) is a family disease (meaning it affects more than just the addict.) As for your daughter, recovery programs (AA, NA) are a tremendous help, in addition to counseling, in changing old behaviors and attitudes brought about by substance abuse. One important point from the article is for family members to avoid diagnosing and/or treating other family members. Gently express your concerns--you can even offer resources for them to seek out.

Comment By : Angela Blier, LSPC, LADC

Thank you--after reading this article, I am starting to think that my son has an eating disorder. I never would have known otherwise. I'm making an appointment with his doctor today. Thank you!!!

Comment By : motherofgymfanatic

Motherofgymfanatic, I hope things are going well for you and your son. I found this article helpful too - http://www.examiner.com/parenting-teens-in-jacksonville/talking-to-your-teens-about-eating-disorders. You are not alone!

Comment By : babyfufu

what to do when they are 19 years old and you cant make them go to the doctor, he is denial. I dont know what to do, i have another son and he is very scare that his bother will die. I need to continue with our life but I;m stuck in this pain, bulimia ruined my family

Comment By : eva

* To Eva: I can tell that you and your family are deeply concerned about your son. It’s so hard when you know your child needs help and they refuse to get it. In these kinds of cases it’s best to focus on what you can control which is how you react. It might be helpful for you to contact the 211 National Helpline, an information and referral service, to see if there are any support groups in your area for family members who have a loved one with an eating disorder. You can reach them at 1-800-273-6222 or visit them online at www.211.org. It might also be helpful for you and/or your other son to get some one-on-one support to work through what is going on and support you in coping with what is going on. We know this is incredibly hard and we wish you and your family luck as you work through this. Take care.

Comment By : Sara Bean. M.Ed., Parental Support Advisor

enlightening article. I have a 7 year-old grandson who is over weight. Children at school, church and other little friends, as well as some adults comment to him and his parents often about his weight. He has mentioned his unhappiness regarding his weight to his parents and I. Being uneducated regarding the issue, we simply said we need to cut down on snacks and vanilla shakes (his favorite). we also told him as he grows up, the weight naturally comes off, like his brothers did. He compares himself to his brother and other children. He worries about his weight and wants to loose. Even after conversations with him, we are finding open half-eaten large potato chip bags hidden in his closet or behind his curtain. I feel we need to pursue somehow or another before his emotional boundaries are stressed further. Any advice will be so appreciated. Additional info: His brother 13, is high-functioning autistic. Mother and Dad both work and their household is always in a rush. Baby sitters usually with them until 7:30 to 8:00 pm. I have limited time with them because I do not live close; a little over an hour away. However a once a week visit for counselling, etc. could be arranged.

Comment By : Sonja\'s Mom

* To “Sonja’s mom”: Thank you for sharing your story. What a tough situation to deal with. It can be difficult to watch our children and grandchildren struggle with challenging issues. I can hear how much you want to help your grandson with this situation. It may be helpful to talk with his pediatrician or primary care provider about this issue. Your grandson is still growing so you want to be sure he’s getting all the nutrients he needs for proper growth and development. His doctor would be in the best position to advise on a course of action to help your grandson. It may be helpful to have him see a counselor as well. His doctor should be able to suggest a counselor or therapist who would be able to work with him. You also might consider contacting the 211 National Helpline for a referral to someone in your area that specializes in child and adolescent counseling. You can reach the Helpline by calling 1-800-273-6222 or by logging onto 211.org. We wish you and your family the best. Take care.

Comment By : D. Rowden, Parental Support Advisor

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