I am sorry that the eating disorder field has not been there for you in the ways we should be. As a field we have let you, and your children, down. We have reinforced the stereotype that only thin, white, wealthy, straight, cis girls get eating disorders and have put a great deal of research into anorexia while mostly ignoring other eating disorders. We have sent the message that parents are intentionally harming their kids and forget that parents exist in the same culture that we all do. We have harmed you and we have harmed your kids. It is time for us to do better. 

As parents, we are seeking to do what’s best for our kids. We fall short often, but when we know better, we do better. This is also true in the eating disorder field. The vast majority of us in the eating disorder field came into this line of work wanting to help people whether through direct clinical work, research, or teaching. We fall short often, but when we know better, we need to do better. There is an opportunity here for us all to do better. 

I think the eating disorder field and the parent community are in a parallel process in how we are needing to evolve and change in order to do better for our communities and help more kids with eating disorders. As a parent community, you need us in the eating disorder field to be doing this work. Those of us in the eating disorder field need you, as parents, to be doing this work. We need to push each other forward. Moving forward is scary, but staying stuck in our old convictions and beliefs doesn’t help anyone. 

There are many ways we need to evolve and it is impossible for any one list to be exhaustive, but here are some suggestions of things we need to do both as a field and within the parent community to create change:

  • We need to stop centering thin, white, cis girls with anorexia. This does not mean that the experience of people who fit this description isn’t important, but what it does mean is that every time this is the only image that is seen of someone with an eating disorder, anyone who doesn’t fit this description moves a step further away from getting help. We know that the quicker someone gets diagnosed, the better their prognosis. When we stop centering only one story and one stereotype, we help everyone else get diagnosed and treated quicker. 
  • We need to start recognizing eating disorders as a social justice issue. I know there are a lot of varying opinions and beliefs about what contributes to the development of eating disorders, but you don’t need to believe that culture causes eating disorders to recognize them as a social justice issue. The fact is that we live in a white supremacist culture that tells us some lives are more valuable than others. We live in a culture that tells us some bodies are more valuable than others. We live in a culture that tells us some voices should be heard over others. We live in a culture in which some people are given access over others. If we want to help those suffering with eating disorders (and prevent some eating disorders from starting) we need to acknowledge that living in this culture has an impact and be working to change it. 
  • We need to address fat phobia and weight stigma. As a field, we need to stop having any relationship with the “obesity” field. Body size is not an eating disorder or a problem to be solved. Period. We need to stop being afraid of our clients getting, or staying, fat. We need to stop setting goal weights too low. We need to stop giving one treatment plan to someone in a smaller body and another to someone in a larger body. As providers, we need to be willing to stop dieting and address our own internalized fat phobia. As parents, we need to stop commenting on our kids’ bodies or suggesting that they need to be changed. We need to stop our own dieting. We need to stop healthcare providers from telling our kids they need to lose weight. We need to take a firm stance on this. There should not be a single treatment center, provider, researcher, or professor that doesn’t practice from Health at Every Size(R) and we need to be helping the parent community to do the same. 
  • We need to recognize the role of trauma in eating disorders. I know this is a controversial one. I am not suggesting that everyone with an eating disorder has a trauma history, but I am suggesting that we need to make sure we are assessing for a history of trauma and providing trauma informed care-whether there is a history of trauma or not. We need to recognize that having a marginalized identity in this culture is trauma and name it as such. We need to remember that treatment that is fat phobic is trauma. We need to remember that if someone tells us something was traumatic for them- it was. It’s not up for debate. 

As I said, this list is not exhaustive, but it is a place to start from. We have a common goal of helping those with eating disorders recover and preventing more people from developing eating disorders. We push forward together for the benefit of those who are most marginalized and most harmed.  

Originally posted at https://www.feast-ed.org/to-parents-of-kids-with-eating-disorders-especially-those-who-dont-fit-the-stereotype/

I have recently heard a lot of conversations about different attempts to find ways to get kids to lose weight. I have heard this in the context of research studies that are being done that starve, limit, or restrict kid’s eating. I have heard it in the context of discussions about higher weight kids in schools. I have heard it in the context of healthcare providers talking about higher weight kids and ways to promote weight loss. I have heard it from other parents who are concerned with one or more of their kids being in larger bodies. I have heard it from weight loss companies that are targeting children to become members. One of the things that stood out to me during all of these conversations was the short sightedness of the discussion. In each situation, the children involved were talked about as if they will only be impacted during the time they are trying to lose weight. Every time I hear plans to put children on diets I wonder if the adults involved realize that the impact on these children will likely be life-long. While the diet itself may end, the physical and emotional toll of dieting is ongoing.

I am a psychologist and certified eating disorder specialist, but I am writing this blog as someone who has not only recovered from eating disorders, but has a history of having my food restricted as a child and adolescent in efforts to get me to lose weight. I want to be clear here that this is not about blaming my parents. Even the most loving, caring, supportive parents internalize diet culture. My parents didn’t put me on diets because they were bad parents. They put me on diets because they thought they were doing the right thing. They put me on diets because they were put on diets. They put me on diets because medical providers told them to put me on diets. They put me on diets because they believed the messages from diet culture that it is possible to make fat kids into thin ones and they believed that if I could be a thin kid and thin adult my life would be better. They put me on diets and even though their intent was good, I was harmed.

Infants and toddlers are completely embodied and in love with themselves. They are endlessly fascinated with all of their new parts.  They are excited to discover what their body can do and the ways they can move. They can spend long periods of time just looking at their hands and taking in that that hand belongs just to them. It is heartbreaking to think of kids being restricted of the food they need and taught that their bodies are not to be trusted. Kids learn this young, they learn it quickly, and the lesson has a devastating and lasting impact.

I was put on my first diet as an infant. In my baby book, my mom writes about how the pediatrician advised her to cut back on the amount of formula she was giving me. My mom writes “poor, Rachel” in my baby book following that pediatrician appointment. The reason the pediatrician told my mom to do this is because they felt my weight was too high. They didn’t want me to gain weight as quickly. As a mother myself, it is hard for me to imagine what it must have been like for my mom not to give me formula when I was asking for it. I remember when my own kids were babies and how intuitively they knew what they needed (and still do). They couldn’t use words, but they communicated so clearly what they were needing on any given day. Having gone through my own eating disorder recovery and learned about Health at Every Size® and intuitive eating, I was able to trust their bodies entirely. I can’t imagine what it would have been like for them if they had cried out and I did not respond by giving them a bottle. They would have learned that not only were their most basic needs not going to be met, but that they couldn’t trust me and they couldn’t trust themselves, which is exactly what I learned when I was a baby.

Being restricted as an infant was the first in a very long list of weight loss attempts and messages that my body size was not ok, my hunger was not to be trusted, and weight was something I should be able to control. I learned to fear and dread appointments with healthcare providers because I knew they were going to tell me that my weight was too high and scold me for not losing weight. I learned that there were a different set of rules to follow based on the size of your body. My thin friends were permitted to eat whatever they wanted and there seemed to be some trust that their bodies knew what to do around food. They were often looked at with admiration by adults because they seemed to have cracked some secret code that even the adults hadn’t figured out. I knew there must be something very wrong with me when all the other students in our elementary school were allowed to take whatever the cafeteria was serving and my lunch had to be packed by my mom and the lunch monitor was keeping their “eyes on me” to make sure I wasn’t eating anything except for what was packed in my bag. I realized everyone knew that my body was wrong and a problem to be solved when my middle school teacher suggested I go to weight watchers and the other students made fun of me. I knew that kids weren’t supposed to look like me when there were no softball uniform pants in my size for our township team so I had to wear something different than everyone else. I heard that I wasn’t as good of a tennis player as I could’ve been when my tennis coach let me know how much faster and better I would play if I just lost a little weight.

I tried to lose weight. I tried eating less and exercising more. I tried not eating all the foods that I learned were “bad” and off limits to kids like me. I tried to make “good” choices. I tried to learn to tolerate being “just a little bit hungry” as I was told I would need to do to lose weight. I tried “not eating snacks in front of the TV” as my healthcare provider suggested I do. I tried every weight loss plan and every diet suggested. I knew what food in the house was for my younger, thinner siblings and that I was not supposed to be eating that food. I tried harder throughout my childhood to lose weight than I tried at anything else I did during those same years. Sometimes I would lose some weight and everyone would compliment me on how great I looked including the time a friend’s parent said it was “worth it” that I had the stomach bug because at least I had lost weight. The weight loss would last for a few weeks or a few months, but I always gained it back. I didn’t need a scale or tight clothes to know when I was gaining weight back. It was obvious on the faces of everyone around me.

What I want anyone involved in trying to find ways to get kids to lose weight to know is that what you are doing is not benign. The harm inflicted does not end when your study ends. While the experience of each person is unique, there are some common themes that happen for kids and adolescents who are told they need to lose weight and who are given directions to diet and restrict food to do so. Each one of these children are being taken further and further away from trusting and knowing what their body wants and needs. This kind of trust is not easy to rebuild. The trust we all come into the world with can be taken from us so quickly, and can take the rest of our lifetime to find again. I am still rebuilding it and I am in my 40s and have had years of therapy and support. Every time I was on a diet as a kid, I would eventually sneak food and eat as much as I possibly could while I had access. I would hide food in my room. I would eat as much of the forbidden foods while I was at friend’s houses because I knew I would get in trouble if anyone in my own house saw me eating it. My body was doing what it needed to do to keep me alive. It was saving me from starvation and making sure I had what I needed while I could. My body was doing the hard work of protecting me from the famine these diets were inducing. And each time my body overpowered my resolve to stay on my diet, I felt more hopeless, more wrong, and more like a failure. No one ever said to me “look at what your amazing body is doing for you,” what was said was that I didn’t have enough “willpower.” I didn’t try hard enough. I didn’t “care” enough about being thin. I wanted to be thin more than anything. I dreamt about being thin every night, and still I learned that I was too weak.

I also learned that my hunger and fullness signals could not be trusted. I learned I should ignore my hunger signals and when I would finally eat I would be so hungry it was hard to stop. I learned that fullness signals would come too late and I should stop before feelings of fullness came. I learned that I should try to “cheat” my hunger by doing things to “trick” my body into thinking I was full when I wasn’t. I learned that it didn’t matter how boring or painful a particular exercise was, I should be doing it because it might help me lose weight. The effects of all of this continue until this day. I still have to remind myself every day that my body can be trusted. I still have to remind myself that the foods that were once off limits are no longer so and that I can have them when I want them and don’t need to eat them all now. I still have to remind myself that there was never anything wrong with me or my body- that it was diet culture and the messages I received that taught me my body was a problem to be solved.

Even after years of therapy and strong eating disorder recovery, eating can still be complicated and difficult for me. It is in many ways the emotional toll of those early diets that has the greatest impact, because learning that my hunger and eating was not ok taught me that I was not ok. The same is happening for children placed on diets today. They learn that their worth has limits and their value is less when they are fatter and more when they are thinner. They learn that they should be quiet and find ways to take up as little space as possible. They learn that if the adults around them think there is something wrong with them- there must be something wrong with them- and everyone can see it. I cannot say for sure that every single child being signed up for a weight loss diet is going to end up with an eating disorder or disordered eating or that every single child is going to hate themselves for years to come, but I can say with absolutely certainty that every single child being told they need to lose weight or their body cannot be trusted is being put at risk.

If you are an adult putting kids on weight loss diets, restricting their eating, or telling them they can’t trust their body, you are an adult who is saying that the risk of a lifetime of struggle- a lifetime of self-hatred, a lifetime of disordered eating, a lifetime of not trusting oneself- is worth the possibility of a brief moment of thinness. We don’t know what size any child is ultimately meant to be. We do know that we are not going to make the kids who are meant to be larger into kids who are meant to be smaller. Their bodies are way too smart for that. Let’s put our energy and resources into helping kids learn to be resilient, to build community, to love themselves and each other, to find joy, to speak up for those who are being harmed. Let’s teach kids that their bodies are so wise and can be trusted. Let’s teach our kids that we are not all meant to be the same size and that having a world of different size bodies is a beautiful thing.

This post originally appeared on Be Nourished on May 2, 2019

Rachel Millner (she/her), PsyD, CEDS, CBTP
Healing Relationship with Food and Body
[email protected]   |    215-932-9885
Designed by Andrew Collings