Understanding Eating Disorders: Expert Insights for Parents and Teens
Eating disorders (ED) are complex mental health conditions that affect millions of people worldwide yet are often misunderstood or underestimated for the toll they can take on adolescents and young adults.
In this informative blog post, we dive into my discussion with Dr. Marcia Herrin, renowned expert in the field of eating disorders, to shed light on the intricacies of causes, contributors, and essential steps parents can take for early identification and treatment.
What Are Eating Disorders? Understanding the Basics
Eating disorders are highly nuanced conditions influenced by a variety of factors including genetics, environment, and individual experiences.
What’s important to understand is they’re not just about food or a relationship with food but instead they encompass significant emotional and psychological challenges.
Dr. Herrin explains that eating disorders can manifest in different forms, such as anorexia nervosa, bulimia, binge eating disorder, and a lesser-known designation called eating disorders not otherwise specified (EDNOS).
Each form has its own unique characteristics and diagnostic criteria, making it difficult to accurately identify without the help of an eating disorder qualified medical practitioner who uses the DSM-5R definition to provide a comprehensive framework for diagnosing the ED in question.
Key Differences Between Disordered Eating and Eating Disorders
It’s not uncommon to confuse disordered eating and full-blown eating disorders. Given the range of symptoms and types of ED’s it can be difficult to distinguish the differences that might alert when and how it develops into an eating disorder.
However, most experts agree disordered eating refers to unhealthy eating behaviors that may not meet the criteria for an eating disorder but can still be harmful.
Think of it as akin to an early phase of an eating disorder. While not all disordered eating develops into an ED it is a known pathway that can potentially lead there.
The following highlights some distinguishing differences that aide in identifying an eating disorder over disordered eating:
DSM-5R
As major aide in identifying eating disorders, an individual is evaluated against the DSM-5R criteria for more concise an consistent identification.
Physical, Emotional, Mental Harm
These three factors can be evaluated in severity to understand and diagnose the type and extent of the disorder. While disordered eating may be less significant initially, it can still increase in severity over time and transition into an ED
Genetic Predisposition
Eating disorders, particularly anorexia nervosa, have a strong genetic predisposition that can be triggered by weight loss. Disordered eating may not necessarily have this genetic component but through the act of losing weight or developing restrictive eating behaviors, can trigger a genetic predisposition activating an eating disorder.
Just as some individuals may have a genetic tendency toward alcoholism, Dr. Herron explains that certain genes can be "turned on" by weight loss, similar to how alcoholism can be triggered by alcohol consumption.
Entrenchment of Behaviors
Eating disorders involve more entrenched and serious behaviors which may involve validating the behaviors, pride over perceived results, denying concerns, and ignoring danger signs.
Progression
Another identifier is a path of progression such as increases in dieting, restrictive eating, binging, purging or other related behaviors both in frequency and intensity.
While both conditions warrant attention, eating disorders typically require more intensive treatment and professional intervention to resolve. Taking early and swift action is essential in either case.
Early intervention to resolve beliefs, behaviors and environmental conditions is a major factor in prevention.
Known Triggers for Eating Disorders
Besides eating behaviors, there are factors, or triggers, that are often overlooked or misunderstood yet warrant as much attention.
Life Stressors & Transitions
An often-overlooked risk factor, life transitions can trigger some adolescents. This might involve leaving home for boarding school, college or sleep away camp; family conflict or divorce; relationship breakups; bullying; athletic pressures & weight requirements.
Personality Factors
These can range from low self-esteem or perfectionism to a high propensity for moodiness, worry or fear.
Parental Pressures
While most parents are well-intentioned, there are certain child-rearing methods such as being overprotective or controlling that place extra pressure on a child and can influence eating disorders.
Trauma
Having a traumatic experience as a child or teenager can increase the chances of an eating disorder. It’s not unusual to have suffered bullying or sexual abuse.
Family and Peer Influence
Spending time with others normalizing, encouraging, or suffering from an ED can increase the likelihood of an eating disorder. This can range from family members to influencers on social media and friend friend-groups as they play a role in a young person’s perceptions about their bodies and acceptability in either their family unit or society.
Common Disordered Eating Progression Patterns
Disordered eating can develop into an eating disorder in the following ways:
Progression of Behaviors
Disordered eating often involves "playing around" with restrictive eating or dieting, which can gradually become more serious and entrenched.
Early Experimentation
Even early experimentation with unhealthy eating behaviors such as dieting, should be taken seriously, as it can quickly escalate.
Cultural and Environmental factors
Exposure to diet culture, negative messaging about food, and societal pressures regarding body image can exacerbate disordered eating tendencies causing them to increase or persist, escalating into an eating disorder.
Self-normalization of Behaviors
A teenager challenged with disordered eating may begin to normalize their disordered eating behaviors making it harder to recognize the need for help.
Nutritional Education
Well-intentioned but overly restrictive nutritional education can lead children to adopt extreme eating habits which have the potential to trigger an eating disorder.
Orthorexia Nervosa which involves a fixation with eating healthy foods, is one example.
Coping mechanism
Behaviors like emotional eating, picky eating or food restriction may initially serve as a means to cope with mental or emotional stressors. Over time, these methods can either become uncontrollable responses to mental triggers or, become part of a teenager’s identity creating a belief system and habits that progress into an eating disorder.
Social Media's Impact on Body Image and Eating Disorders
Research is now beginning to reveal the serious role social media plays in body image and eating disorders. Social media has presented parents with new challenges in the fight against eating disorders due to it’s rapid and significant influence in shaping young people's perceptions of body image and self-esteem.
Constant exposure to idealized images and the pressure to conform to certain standards can exacerbate feelings of inadequacy and lead to disordered eating behaviors.
Parental Role in Prevention and Recovery of Eating Disorders
Parents play a crucial role in both preventing eating disorders and supporting recovery. Take these steps at home to foster a positive and uplifting environment.
Role Model
Model positive attitudes towards food, body size, and shape.
When parents accept their body and embrace their shape or size, it sends a message that supports self-acceptance.
Avoid discussing personal diets or restrictive eating habits around children. Adolescents are very observant and astute to their parents’ role modeling. Do what you can to foster your own healthy approach to eating without dieting to live as you encourage your child to live.
Social Media - Limit time, use and content
Given the negative consequences when it relates to body image and weight concerns, it’s advisable for parents to considerably limit screen time, monitor content, and discuss negative messaging.
To foster positive mental health related to social media, parents can also encourage open discussion about feelings and thoughts associated with social media exposure, while simultaneously encouraging healthy yet realistic body image.
Seek Professional Help
Most of all, get help early and quickly when either disordered eating or an eating disorder is suspected. Early intervention can significantly improve outcomes for individuals with eating disorders.
Start by consulting your child’s pediatrician or primary care doctor for advice or referral. While they may not be equipped to consul and treat your child, they will likely be able to identify and steer you in a direction for additional support.
A qualified health coach or behavior-trained nutritionist can often help address disordered eating while resolving contributing factors such as low self-esteem and body image beliefs before they progress.
When an eating disorder is suspected - Seek out an eating disorder trained professional for evaluation and disagnosis. Ask for referrals and research carefully to find a qualified practitioner or team of professionals who can effectively address your child’s specific needs.
Parents should trust their instincts and seek professional help if they notice any concerning behaviors in their children. Doing so can help rule out any other explanations for the signs and symptoms occurring.
It's better to address potential issues early rather than risking the development of a potentially life-threatening eating disorder.
Key Takeaways
1. Eating disorders are complex conditions with psychological, genetic, behavioral, and environmental factors.
2. Setting limits on social media use can help mitigate its negative effects.
3. Parents should model positive attitudes towards food and body image. Be aware of of cultural and social pressures that may be influencing factors.
4. Early identification and intervention are crucial for successful treatment.
5. Trust instincts and seek professional help when concerning behaviors begin.
6. Taking swift action on disordered eating can help diminish outcomes before it escalates.
Healthy Teen Life Podcast
Listen to the full episode Dangers of Teen Dieting on Eating Disorders with Marcia Herrin - The role of Genetics, Nutrition and Parent Intervention
Marcia Herrin, EdD, MPH, RDN, LD, FAED, is a doctoral-level registered dietitian nutritionist with 35 years experience teaching and helping others with eating disorders. is a renowned expert in eating disorders with an extensive background in nutrition education and a passion for helping those affected. She is a graduate of University of California at Berkeley(Masters of Public Health), and Columbia University (doctorate in nutrition education); founder of the Dartmouth College Eating Disorders Prevention, Education and Treatment Program; Clinical Assistant Professor of Pediatrics at Dartmouth’s Geisel School of Medicine; and author of multiple books including the Parent’s Guide to Eating Disorders.