Eating Disorders Can Start Young, Local Expert Says

How’s that resolution coming?  You know, the one where you pledged to drop a few pounds?  Or exercise more? Or eat healthier? All of these are worthy achievements — if the end goal is better health.

If, on the other hand, the end goal is looking better, you are right there among the three-quarters of American women who are dissatisfied with their appearance. Most days, I’m right there with you.

Between January and June (aka the start of swimsuit season), weight loss seems to pop up on everybody’s radar. There are guys who aim to lose a few pounds, but most men are satisfied with how they look (or even overrate it). Researchers have found that the majority of women, by contrast, think they’re larger than they are.

Females’ conception that they are too big or that they need to lose weight can start early. Various studies peg the age of the first diet at anywhere from 6 to 10 years old.

Cathy Lander-Goldberg of the St. Louis Behavioral Medicine Institute in Chesterfield agreed that eating disorders can be a problem in youngsters: “Elementary-school children may show signs of eating disorders,” she said via e-mail. “In our clinical practice, we are seeing more pre-teens than ever before.”

Lander-Goldberg, a Licensed Clinical Social Worker in the Eating Disorders Program, said there can be many factors that contribute to the problem. For example, she said, “In this age group, oftentimes the eating issue is linked to underlying anxiety.”

Other factors can include “a drive for perfectionism, low self-esteem, underlying anxiety or depression, and family/relationship problems. There's also more research indicating that individuals may be predisposed to eating disorders due to their genetics."

And, of course, there are the ever-present cultural messages that focus on thinness. In researching this piece, I read that just over half of young women say they would rather be hit by a truck than be fat, according to a Pew Research Center poll. (Hit by a truck? Really?)

Naturally, women who are parents can pass these insecurities on to their children, especially to daughters; about 90 percent of those affected by eating disorders are females. Lander-Goldberg, who specializes in providing psychotherapy for clients with eating disorders, took time out to answer a few questions about prevention for SmartParenting.

SP: Are there things parents can do to help prevent their child for developing an eating disorder?  Or, conversely, are there things well-meaning parents do that could actually make a problem worse?

CL-G: It's important to remember that families don't “cause” eating disorders, but there are some behaviors that may contribute to an environment where eating disorders are more likely to grow. For example, it's best for parents to role-model a healthy relationship with food and exercise and not be overly focused on dieting, weight, calories, label reading and exercise. I suggest not having scales in the home where children have access to them or watch adults use them. 

It's also critical that parents do not allow "fat talk" in the home. This means not allowing siblings to call each other 'fat'; parents not criticizing their own or others’ bodies or even complimenting anyone's weight loss. It's also best for children not to watch television shows that focus on weight loss or modeling shows, which glorify being underweight. We want to teach our children that their internal qualities are what is important about them — not how they look."

As a society, we're very concerned about childhood obesity, and this can lead to parents and schools to over-emphasize diet and exercise, which can jump-start an eating disorder. We want to let kids know that there are no "good" or "bad" foods, and that eating a variety of foods — including treats in moderation — is healthy for them.  It's also best to not use food as a reward.

We want to lead by example that exercise is healthy because it helps our heart, makes us stronger and reduces stress. We don't want to teach children that exercise is only about losing weight or that after overeating, one should compensate by going to the gym.

SP: What recommendations do you have for parents who are worried about their child’s eating behaviors?

CL-G: I recommend not getting into a power struggle about food. If you notice that your child is losing weight, being overly concerned about reading food labels, eliminating food groups or obsessively exercising, I would recommend an assessment with a pediatrician, nutritionist or therapist who specializes in eating disorders. 

If your child is diagnosed with an eating disorder, family education and therapy with an eating disorder specialist will be very important. We are also fortunate, locally, to have St. Louis Cardinal Glennon Children's Hospital and St. Louis Children's Hospital. Both hospitals have Adolescent Medicine Units who diagnose and treat the medical aspects of eating disorders.

SP: I’ve heard that this is a really tough problem to combat – is there a positive message that you’d like to leave with our readers?

CL-G: That's true. Eating disorders can lead to very serious medical problems. The important thing to remember is that the earlier young people get help for an eating issue, the better their chances for recovery.

Editor’s note: Lander-Goldberg said her team “works with children and adults of all ages who have eating disorders as well as ‘disordered eating.’  Individuals with disordered eating may include very ‘picky’ eaters or those exhibiting unhealthy eating habits without showing all of the classic characteristics of eating disorders,” she said. “We also work with children with Autism Spectrum Disorders who have issues related to eating.

To learn more about outpatient individual therapy, family therapy, group therapy or nutritional sessions at the locations in St. Louis, Chesterfield or Belleville, call 1-877-245-2688 or 314-534-0200.  For clients whose eating disorder requires a higher level of care, the institute also offers a six-days-per-week Intensive Outpatient Program.

By Amy De La Hunt, Health Blogger for SmartParenting