How to help a child with an eating disorder develop positive self-talk

Colleen’s daughter has been stepping in and out of eating disorder recovery, and one of the biggest barriers has been self-criticism and negative self-talk. “It’s as if we’re trapped in a cycle,” says Colleen. “We make a little bit of progress in recovery, and then the negative self-talk ramps up and we’re right back where we started.” 

Self-criticism and negative self-talk are strongly associated with eating disorders, and studies show that the more intense they are, the more severe the eating disorder symptoms become. And it makes sense because a significant symptom of an eating disorder is anxiety about eating and weight. Negative self-talk is an attempt to protect against anxiety and fear of the unknown.

Parents often feel helpless in the face of a child’s self-criticism and negative self-talk. But the key is to know why it happens and how you can help – because you can! That said, you can’t talk your child out of negative self-talk. Doing this backfires because it triggers more anxiety, which triggers more negative self-talk.

Instead, you want to model positive self-talk by validating your child’s feelings while also holding boundaries and expectations about how your child behaves and what they say. While it may seem counterintuitive, this approach is more motivating than telling your child to stop saying negative things about themselves. But it’s a total 180 from what most parents are doing, so it takes some practice. Here are five steps to respond effectively to your child’s negative self-talk:

1. Notice negative self-talk

You want to start by noticing the patterns and styles of self-talk your child uses. How do you know they’re having negative self-talk? Your child might say just 10% of what they’re thinking. But there are usually other behavioral signs that they’re engaging in negative self-talk. Do they spend a lot of time looking in the mirror? Does it take them hours to get dressed? Do they feel nauseated when you serve them food? You can guess that negative self-talk is behind many of these behaviors.

Your goal is to be able to recognize the different ways that negative self-talk shows up in both words and behaviors.

2. Identify the cause of anxiety

Negative self-talk is a way we try to reduce anxiety by reassuring ourselves that we can control the outcome. The focus of negative self-talk might be weight gain or how clothes fit, but the cause of negative self-talk is fear of uncertain and imagined outcomes. It’s not really about what’s happening right now but what it might mean about the future.

For example, if one pound of weight gain leads to negative self-talk, the anxiety might be based on uncertainty about how much more weight they’ll gain, how other people will respond to weight gain, and what it means to gain weight in our society. In other words, it’s not about one pound, but fear of what one pound will do to their future. Anxiety is future-focused.   

3. Don’t debate the details

It’s very tempting to debate the details of your child’s negative self-talk. For example, you may want to try and convince them that one pound isn’t very much. Or that they need to gain that pound, nobody will notice one pound, etc. You may be tempted to say “You look beautiful/amazing/perfect.” But this means you fall into anxiety’s trap. Anxiety is a pattern, but it acts as if it’s about an individual event.

You almost never want to debate the individual details that anxiety is worrying about but rather try to explore the pattern beneath it and support your child in facing their fear and getting through it without causing harm. The only way to reduce anxiety long-term is to face it over and over again and realize that your imagined outcomes are never as bad as anxiety makes them out to be.

4. Validate the feelings behind the anxiety

Rather than debating the details, focus on the feelings behind the anxiety pattern you’re observing. Validation is a parent’s most powerful tool because our kids crave being seen, heard, and understood by us.

Debating increases distance and pits you against each other. On the other hand, validating your child’s feelings brings you closer together and increases trust. For example, you can say “It seems like you’re having a hard time getting dressed today,” “This is hard for you,” or “I can hear how frustrated you are right now.”

Many parents worry that validating a child’s self-talk will make it worse. But the key is that you’re not agreeing with your child’s self-talk, but noticing that it’s there. It exists. Focus on the feelings, not the details, and you’ll help your child feel better. Here are some more ideas for validation for kids with eating disorders. 

5. Hold boundaries about behavior and language

Parents are responsible for setting and holding appropriate boundaries around behavior and language in the home. This includes food, eating, body behaviors, and body-shaming language. For example, if your child’s treatment plan involves eating regularly throughout the day and/or eating a certain quantity of food, you can hold boundaries around eating.

Similarly, you can hold boundaries around how your child talks about their body. Boundaries are best when they’re short, reliable, and repeated over and over. It’s not enough to set a boundary one time, and you usually don’t need to justify your boundaries, just say them simply and clearly again and again and again …

For example, you can say “I understand you don’t want to eat right now, but please sit back down. This is what’s for dinner.” Or “I hear how upset you are about this right now. We can talk about how you feel, but please stop using that language about fat.” You may want to print out our Policy of Body Respect to help with this. 

You can help!

Negative self-talk during an eating disorder is expected, but you’re not stuck; you can do something to help. Just because the bulk of negative self-talk takes place inside your child’s head doesn’t mean you can’t influence their thoughts and shape their behavior, nudging them in the right direction. Parenting a child with an eating disorder is hard, but you have more power than you know. With a little bit of practice, you can make a big difference in how your child views their body and food, and support them in moving from negative to positive self-talk.

That’s what happened to Colleen. “I assumed I had to either do nothing or try to convince her that her self-talk was wrong,” she says. “But when I started noticing the patterns, validating her feelings, and holding boundaries, it was a game-changer. It’s a constant effort for me to respond to her like this, but I’m starting to notice some changes in her behavior, and it’s pretty exciting!”

See Our Guide To Parenting A Child With An Eating Disorder