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What Parents Need to Know About Eating Disorders
By Abigail H. Natenshon MA, LCSW

A Parent's Dilemma and Response

Even the most competent parents feel confused, inadequate, and guilt-laden in the face of their child's eating disorder. Parents typically do not know how to determine whether or not their child has an eating disorder, and if so, what, if anything, they should do in response. Misguided by the many myths and misconceptions surrounding eating disorders, diet and nutrition, the needs of adolescents, the psychotherapy process, and the assumptions that they may be to blame, parents fear losing their child's love or making matters worse by raising and pursuing uncomfortable issues.

In healing their child, parents need education about eating disorders, guidance and support, as well as permission to be parental in assisting their child to heal. Parents need to know what they are doing right; they need to learn to become fully responsive to, and supportive of, the changing needs of the recovering child and family. Empowered and proactive parents ultimately create a deeper and more meaningful emotional connection with the child, supporting recovery as well as the parent/child relationship from this time forward. Intervening with your child may be the greatest investment that parents can make. Not only that, it could save his or her life.

What eating disorders are about

Contrary to popular belief, eating disorders are not essentially about food, eating, or weight management. The assumption that anorexics under-eat and bulimics overeat and purge is simplistic, describing only isolated aspects of highly complex, multi-faceted and integrative diseases. Anorexia, bulimia, and compulsive overeating are diseases with chemical, genetic, emotional, behavioral and social implications for the afflicted individual as well as for the family. They are indicators of emotional inflexibility and the patient's inability to face and cope with adversity, of developmental tasks not yet achieved and/or cognitive distortions capable of derailing the child's effective development into adulthood. Characterized by a preoccupation with weight and a pathological fear of becoming fat, erratic or inadequate food intake reflects excesses, disregulation, and a lack of control in life spheres that extend beyond eating and weight control.

For the patient, the symptoms of eating disorders create an illusion of control and stability in response to the normal vicissitudes and unpredictability of daily living, making them particularly hard to give up. At the root of dysfunctional eating behaviors lies in the emotional issues that underlie and drive them; full recovery will require changes in behavioral patterns as well as emotional functioning, resulting in an improved relationship with food, the self and others.

Eating disorders; Definitions

Anorexia Nervosa represents a pathological fear of being fat, leading to food restriction and at times, purging and over-exercising. The condition is often accompanied by a distorted body image and the absence of the menses.

Bulimia Nervosa is the repeated cycle of erratic eating, bingeing followed by purging, and/or fasting or excessive exercise to compensate for the intake of calories. Bulimics often abuse laxatives, diuretics or diet pills and typically struggle with other forms of addiction.

Binge-Eating Disorder or Compulsive Overeating is characterized by eating when not hungry or without regard to physiological cues. Binge eaters report the inability to stop or control the behaviors. Deprivation-sensitive binge eating arises out of excessive dieting or food restriction; addictive or dissociative binge eating represents a form of self-medicating or self-soothing, with behaviors evoking tranquility or numbness.

EDNOS stands for Eating Disorders Not Otherwise Specified; this diagnosis describes eating disorders whose symptoms do not precisely fit the descriptions found within the APA Diagnostic Manual. Over 50% of eating disorders fall into this category.

Things you may not know about eating disorders

  • Eating disordered individuals typically are of normal weight, and often appear to be the picture of health and self-discipline. One cannot necessarily recognize an eating disorder through physical appearance alone.

  • Dieting or food restriction is the worst way to lose weight and can be harmful to the metabolism.

  • In most instances, parents are not responsible for causing eating disorders in their children, but when enlightened and empowered, proactive parents can become instrumental in facilitating their child's recovery.

  • Not every eating quirk represents an eating disorder. The distinction between pathology and benign idiosyncrasy in eating patterns lies in the motivation or purpose behind the behaviors. Using food for reasons apart from satiety, nourishment or sociability deserves vigilance and possible response.

  • Eating disturbances in the very young child is generally the result of anxiety and compulsivity, sometimes in combination with the child's imitation of significant adult role models. Adolescent and adult eating disorders are driven by unresolved issues of power and control, identity, self-esteem and body image disturbance.

  • Eating disorders are curable in 80 percent of cases when treated early and effectively.

About the Author:
Abigail Natenshon, MA LCSW, GCFP is a psychotherapist who has specialized in the treatment of eating disorders with individuals and families for the past 36 years. Natenshon is founder and director of Eating Disorder Specialists of Illinois and is the author of When Your Child Has An Eating Disorder: A Step-by-Step Workbook for Parents and Other Caregivers. As a Guild Certified Feldenkrais Practitioner, Natenshon pioneers in using body-centered techniques to augment and promote body image awareness, acceptance and healing. View her three interactive web sites: http://www.empoweredparents.com, www.empoweredkidZ.com, and www.treatingeatingdisorders.com.

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