Low self-worth and eating disorders: what parents need to know

by Beth Mayer, LICSW

There is a high correlation between eating disorders and low self-worth. Because of this, when I’m working with clients who have eating disorders, I’m watching carefully for self-worth, self-compassion, and perfectionism. The more my clients build the first three and limit perfectionism, the greater their chance of entering recovery from their eating disorders. 

What is self-worth?

When you have self-worth, you believe that you are inherently valuable regardless of what you do or how you look. People who have low self-worth tend to look outside of themselves to feel worthy. This is really common among people who have eating disorders, and many of them are using their bodies as a way to pursue worthiness.

Unfortunately, low self-worth is pretty rampant. And what may be surprising is that often the people who look like they have high self-worth are actually suffering the most. These are the great students, powerful athletes, and leaders who get tons of accolades, yet many of them feel bad about themselves.

I worked with someone who was the top of her class, named the class president, and looked as if she should have been on top of the world. But she was depressed and had an eating disorder. The world just couldn’t see what she was feeling about herself.

These are tough cases, because we have to find a way to meet the person where they are while gradually supporting them in seeing their inherent self-worth, which must exist regardless of grades, awards, weight, or any other external measurement.

How parents can help kids develop higher self-worth

Lots of parents want to help their kids by jumping in with positive messages. But unfortunately this can exacerbate the problem, especially if they are focused on external measures of success.

For example, saying things like “you’re beautiful,” “you’re perfect,” “you’re a huge success,” can really backfire. This is because the person may come to believe that their parents’ love is dependent upon being those things.

What we need is for our kids to know that they are worthy for who they are, not what they look like or what they do to meet conventional standards of success.

This can be really hard for parents, but there’s a side door that can help. Start by recognizing them for their kindness rather than their appearance or accomplishments. For example, notice that they showed up for a friend when it was difficult, or they smiled at a child, or they gave a lovely hug.

The job of parents who want to increase their kids’ self-worth is to not try to convince a child that they are meeting conventional standards of success. Because that will just keep them on a hamster wheel forever, desperate to keep succeeding. Instead, parents should take tiny snippets of everyday kindnesses and work to feel good about them.

Self-worth and social media

People have always had low self-worth – it’s not a new thing. But something I’m seeing in my practice is that it’s easier than ever to fake happiness and self-worth. Social media makes it easy to seek social approval and look like you are successful. This can make it easy for people who are suffering to look like they’re living a great life.

On social media you can fake a vacation, fake happiness, and fake success. This makes it really easy to fake self-worth even when you feel completely empty.

At the same time, kids can see everyone else who looks like they’re living an even better life. The constant access to curated views of other people’s lives right at our fingertips means it’s hard to turn the volume down on the feeling that we’re not doing enough or good enough. 

Self-compassion and recovery

Possibly the best antidote to the low self-worth is self-compassion. The work that Kristin Neff has done to bring awareness to self-compassion is amazing.

Self-compassion means that even when the entire world seems to be screaming that we are not enough, we can reach inside and treat ourselves as we would a good friend.

I love this quote from Elisabeth Kübler-Ross:

People are like stained-glass windows. They sparkle and shine when the sun is out, but when the darkness sets in, their true beauty is revealed only if there is a light from within.

Elisabeth Kübler-Ross

Lots of the people I work with are looking for the light to come from outside of themselves, when the light they need is already inside of them. Building self-worth and self-compassion are the keys to help them light up and see their value without the external measures.

Our society keeps telling people that they are not enough. This is leading to massive increases in all sorts of problems, including depression, anxiety, suicidality, and eating disorders. All of my colleagues who are eating disorder specialists are seeing an influx of patients – and at younger ages – than ever before. We are definitely struggling as a society, and I think that if we can address self-worth, we will make some progress.

Perfectionism is the enemy of self-worth

Perfectionistic tendencies are highly correlated with both eating disorders and low self-worth. Perfectionism is a personality trait in which a person strives to be flawless. They set very high performance standards for themselves. Unfortunately, they also are highly self-critical and are overly concerned with others’ evaluations of their performance.

It’s easy to see how this relates to eating disorders. It may be hard or out of reach for a person to achieve perfection in many areas, but most people believe that if they just work hard enough and control their behavior enough, they can have a “perfect” body.

So many people who have eating disorders feel they aren’t smart enough or good enough, but they can have a good enough body. They mistakenly believe that if they look good, they are good. That becomes their focus, and everything else becomes non-essential. They aren’t able to celebrate who they really are.

Of course, there is no such thing as a “perfect” body, and in my practice I see the damage done by the pursuit of bodily perfection every day.

One of the things I see a lot is that when people are feeling out of control, one of the things that they perceive that they can control is their body. They feel like if they can fix their bodies they can fix their lives. Our society has promoted the idea that bodies can and should be changed. But the truth is that nobody is going to like you any more or less with a different type of body.

Parents against perfectionism

One way that parents can help their kids avoid the trap of perfectionism is to let their kids have issues. Don’t protect them from everything, because that suggests to them (subconsciously) that they need to get things right to be safe and valued.

Parents should give their kids responsibilities, and not always protect and advocate for them. This builds up resilience. The fact is that nothing and nobody is perfect. Unless we model to our kids that it’s natural and safe to make mistakes – even to fail – they may lean towards perfectionism.

What I wish parents knew

If there were one thing I could pass along to parents, it would be to pay attention to how willing you are to get messy. We have become a very driven society that avoids mess. We want everything to be clean and straightforward, but that takes away our creativity and our very humanity. 

We’re teaching our kids to avoid getting messy, which keeps them in a tight box of right and wrong, good and bad, perfect and not-perfect. The world just isn’t organized that way, and it really limits our resilience when we believe it is. 

It helps when parents understand the psychology of eating disorders is important. I would love to see parents get comfortable with, model, and encourage their kids to embrace the messiness of our lives. To embrace the fact that we don’t need to be perfect to be loved. In fact, most people love us most when we are most authentic and least perfectionistic. 

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Beth Mayer, LICSW, has been working in the eating disorders field for 35 years. She is nationally recognized for her clinical work with eating disorders and has spoken at conferences around the country. In addition to eating disorders, Beth specializes in treating adolescents and families. Beth has served as an adjunct professor at Simmons College, Boston University, Boston College, Lesley University and Salem State College, supervising MSW and LMHC graduate student interns. She is currently the co-chair of the NEDA network and serves on many local and national committees. Beth holds a B.S. in Clinical Psychology from Quinnipiac University and a Master of Social Work Degree from Boston College. She can be reached at  bethmayerlicsw@gmail.com / 617-325-1013

See Our Parent’s Guide To Mental Health And Eating Disorders