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Posted on September 21, 2023September 21, 2023 by Ginny Jones — Leave a comment

Please don’t say that eating sugar and sweets causes diabetes

When parents say sugar causes diabetes it can lead to an eating disorder

3 real-life stories of women whose parents warned them about diabetes and ended up with body image issues and eating disorders

“If you eat too many cupcakes, you’ll get diabetes.”

“Chocolate milk is like drinking a tall glass of diabetes.”

“Eating that much sugar will make you diabetic like Grandma.”

Some version of this has been said to too many children to count. It’s hard to speak with an adult from Gen X down to Gen Z who hasn’t heard some version of this warning. The parents who say this aren’t trying to cause harm. In fact, they’re most likely hoping to protect their child from a serious disease. And yet these comments are both inaccurate and cause harm every day. Sugar does not cause diabetes, and many people in eating disorder recovery cite parental warnings about the link between sugar and diabetes as contributing to their disorders.

Note: Eating disorders have biological, psychological, and social causes, so these sorts of comments alone don’t cause an eating disorder, but they can increase risk.

Non-Diet/Health At Every Size® Fact Sheets, Guidelines, and Scripts

Fact Sheets About Weight Stigma, Diet Culture, Kids and Diets, and More
Non-Diet Parent Guidelines
Non-Diet Parent Scripts About Responding to Fat Talk, Diet Talk, and More
What to Say/Not Say When Talking About Bodies and Food

Learn More

What causes diabetes?

Diabetes is primarily caused by genetics. In fact, Type 2 diabetes has a stronger link to family history than Type 1. People who develop diabetes are usually not the first in their family to get it, and saying it’s caused by sugar is a massive oversimplification of how our bodies work. If sugar causes diabetes then everyone with a sweet tooth would have diabetes, which is not true.

“Genes play a large role in the development of diabetes. We’re all born with challenges in our genetic code — as well as in our life circumstances — and this is one of the challenges you were dealt. Your body was vulnerable to difficulty with glucose regulation, and some combination of factors triggered that genetic propensity.”
Lindo Bacon, PhD and Judith Matz, LCSW, Diabetes Self Management

And yet social stigma persists, and parents everywhere continue to warn children not to eat too much sugar, something that is delicious and rewarding. This creates a deep and confusing fear of a disease that kids can’t even understand yet. It’s terrifying and creates cognitive dissonance. The idea that sweets, which they (of course!) love so much, could kill them is overwhelming for kids.

Does being fat cause diabetes?

Similarly, if being fat causes diabetes, then everyone who is fat would have it, which they don’t. About 10% of Americans have diabetes, yet about 65% of Americans are on the higher end of the weight scale. So clearly not all fat people get diabetes. And thin people get diabetes, too.

A word about the word “fat”

The word fat can be used as a negative or a neutral descriptor. In its neutral form, saying fat is the same as saying thin, tall, or brown-eyed. Other words for fat bodies, such as overweight and obese, are currently considered to be stigmatizing. Many fat justice leaders have reclaimed the word fat as the preferred neutral descriptor for their bodies. As such, I typically use the word fat when referring to body weight.

However, due to our culture’s terrible history of weight-shaming, we should not call an individual fat unless we 1) are doing so kindly 2) have zero thoughts that they should lose weight; and 3) clearly have their permission to do so. And nobody should ever use fat as an insult. It’s always best to let people who live in marginalized bodies to define themselves rather than assuming a label on their behalf. And never tell a person in a larger body that they are not fat or should be proud to be fat. It’s their body and their choice to define themselves on their own terms.

In other words, being fat doesn’t mean you’ll get diabetes, and being thin doesn’t protect you from it. Genes above all, followed by lifestyle factors like stress reduction, healthy social interaction, and exercise matter far more than your weight.

“One cupcake won’t give you diabetes and joking that it will is dangerous on two levels: It creates misinformation about this disease and furthers the stigma that acquiring diabetes is something one has control over.”
Alysse Dalessandro for Healthline

Being fat does not cause diabetes, but the fear of being fat and eating foods associated with being fat like sugar can contribute to an eating disorder. Incorrect and harmful beliefs about sugar, diabetes, and fat are all driven by weight stigma, not science.

The biggest risk is stress, not sugar

The largest environmental factor leading to diabetes is not sugar, but stress. And one of the leading causes of stress for people who are at the higher end of the weight spectrum is their weight and the fear of getting diabetes. In this way, the fear of fat and diabetes can increase the conditions most likely to trigger it.

Parents who use the threat of diabetes and fat to restrict their kids’ eating sugar mean well, but they can accidentally create a cascade of negative outcomes, including an eating disorder.

For ideas about what to say to your child if another adult says something about sugar causing diabetes to your child, here’s a great post from Zoë Bisbing, LCSW (click to view full video and post on Instagram)

Here are three real-life stories of adults who were told to avoid sugar in childhood to avoid diabetes:

Sonja developed at eating disorder at 8 years old and is currently in treatment

My dad and his mother, who lived with us, both made regular comments that my being overweight would lead to me developing diabetes and “my feet would fall off.” They said things like “Sugar makes you fat,” and “Being fat gives you diabetes.”

I remember feeling so uncomfortable in my body, like it was a prison I just wanted to escape. I’ve always carried extra weight and no matter how much I dieted and exercised (this was a core piece of my childhood) my body wouldn’t change. I felt betrayed by it, like there was something inherently wrong with me, and that I was trapped by a disease that was going to happen to me no matter what I did.

Comments about sugar and diabetes led to an eating disorder that started as early as age eight. I developed a very complicated love/hate relationship with food and eating that I am still trying to heal 24 years later.

I had a very negative body image and developed body dysmorphia in high school. Because I was eating so little and exercising so much, my health was very poor. I was sick all the time and had no energy and awful moods. Now that I’m in recovery I recognize the profound health effects starvation had on my growing body and mind. I have been in treatment for 3 years now and I’m just starting to develop a healthy relationship with food and my body.

If I could go back in time and talk to my younger self, I would tell myself that those comments were based on my family members’ own insecurities about their own bodies and health, and it had nothing to do with me. I would also tell myself that scientifically we know that the best way to avoid conditions like diabetes is to take good care of our bodies, not neglect them. I would encourage myself to challenge my caregivers’ narrative and to find a professional to support me in finding my way to my own personal best health.

Andrea has struggled with body image and disordered eating since she was about 7 years old

I remember being about 7 and I wanted ice cream. My mom would use an ice cream scoop and scrape off the excess from the top of the scoop then serve it to me. I wasn’t allowed to just add some spoonfuls to my bowl without measuring it. She said, “You don’t want to be fat like Mama, right?” She lived in a bigger body her whole life. Mom would say “My Grandma died from diabetes, we can’t let that happen to us so we shouldn’t eat so much sugar.”

Hearing that “diabetes can kill you” scared me. At that young age I thought because I was fat and liked sugar that eventually that’s what I would die from. I would grab my belly rolls and squeeze them as hard as I could while looking in the mirror. I’m not sure what I had hoped would happen, maybe so I could make my fat body smaller.

At home I knew that I couldn’t drink sodas or eat sweets so I would go to a friend’s house and binge on whatever I wanted.

If I could talk to my younger self I would say that there is no “bad” or “good” food. You are worthy and are so much more than your body. Don’t let anyone treat you like you are less than. Your body is amazing, it keeps you alive!

Family and friends fueled my eating disorder by linking my weight and sugar to diabetes. If I lost weight it was always met with, “Wow what are you doing? You look great.” Now that I have children I want them to know that they are so much more than a number on a scale or a squishy belly. I WILL break the cycle. It isn’t always easy but I’m working on loving all of me.

Marie has struggled with body image and disordered eating since childhood

My mom constantly commented on what people were eating, particularly how much sugar. When we would see people drinking a soda or eating candy, for example, she would comment that they were consuming so much sugar. She said that sugar was “addicting” and that a bad diet, including too much sugar, gave people Type 2 diabetes. If someone had Type 2 diabetes, she would comment that a better diet would make their diabetes go away.

I was diagnosed with insulin resistance at 20, which can be a precursor to Type 2 diabetes. My mom immediately signed me up for a personal trainer and would comment on my need to lose weight and eat less sugar. She would say I was “obsessed” with sugar on occasions where I would eat more than a small serving of dessert. When I lost weight (mainly due to my eating disorder), she would constantly tell me that my diet cured my insulin resistance.

I felt a great sense of shame about my body. I had learned that only “fat people with bad diets” had ailments like diabetes. Her comments made me feel nervous. As a child, I was always concerned I was too fat and often felt tense and nervous.

Non-Diet/Health At Every Size® Fact Sheets, Guidelines, and Scripts

Fact Sheets About Weight Stigma, Diet Culture, Kids and Diets, and More
Non-Diet Parent Guidelines
Non-Diet Parent Scripts About Responding to Fat Talk, Diet Talk, and More
What to Say/Not Say When Talking About Bodies and Food

Learn More

I was very concerned about my weight and what I ate in front of my mom (I still am). I have struggled with eating disorders and body dysmorphia since childhood. When I was in my mid-20s, I started purging and calorie restricting, to the point where I was underweight and incredibly anxious. When I was underweight, my mom would talk about how proud she was of how I had lost weight. Now that I have gained the weight back, I still struggle with shame, but through therapy and self-guided work, I am trying to heal.

My mom cared about my well-being, but it was incredibly misguided and actually harmful. I wish I could tell my younger self that my mom’s issues do not have to be mine. I’m loved just as I am. I am enough just as I am. Food is just food – not a moral judgment.

Ginny Jones is on a mission to change the conversation about eating disorders and empower people to recover. She’s the founder of More-Love.org, an online resource supporting parents who have kids with eating disorders, and a Parent Coach who helps parents supercharge their kid’s eating disorder recovery.

Ginny has been researching and writing about eating disorders since 2016. She incorporates the principles of neurobiology and attachment parenting with a non-diet, Health At Every Size® approach to health and recovery.

Ginny’s most recent project is Recovery, a newsletter for deeply feeling people in recovery from diet culture, negative body image, and eating disorders.

See Our Parent’s Guide To Diet Culture And Eating Disorders

Posted on September 7, 2023September 7, 2023 by Ginny Jones — Leave a comment

How to handle mood swings in eating disorder recovery

Melanie feels worn out. Her teenage daughter Kimmy has an eating disorder, but that’s not even the biggest challenge right now. “What we’re really struggling with,” says Melanie, “are the endless mood swings. She’s up and down constantly, either yelling at me and getting in my face or slamming doors and shutting down alone in her room for hours. I’ve tried everything, and I feel like I’m out of options. What am I supposed to do with her when she gets like this? Will it ever stop?”

We’ve all heard about teenagers whose moods change constantly. Many of us assume it’s a natural phase that we must simply endure. We might think “all teens do this, so I guess I just have to wait it out.” But this thought is almost always followed by deep sadness and maybe even anger. You might think to yourself: “I hate this! I don’t deserve to be treated like this!”

And you’re right! You don’t deserve to be treated badly. And at the same time it’s normal for teens to have big mood swings and occasionally lose their temper or emotionally withdraw. The challenge is that massive, constant mood swings are a sign of extreme distress and often accompany dangerous mental health conditions like eating disorders. This means that while mood swings are normal during adolescence, extreme mood swings that damage your family are a symptom of mental disorder and need treatment.

Emotional Regulation Worksheets

Give your child the best tools to grow more confident, calm and resilient so they can feel better, fast!

Self-Esteem
Self-Regulation
Mindfulness
Calming strategies

Learn More

Mood swings and an eating disorder

Chronic mood swings mean your child is struggling with near-constant emotional dysregulation. They almost never feel calm, confident, and curious. Instead, they’re either highly activated, either by positive emotions like joy and excitement, or by negative emotions like anger and fear. Or they’re disengaged and withdrawn, typically based on emotions like sadness and despair.

It’s physically and emotionally draining to be emotionally dysregulated, like treading water with no shore in sight. It’s very hard to recover from an eating disorder if you’re experiencing massive daily mood swings.

Melanie’s daughter Kimmy needs her help learning how to regulate her emotions rather than being taken over by them. Working on this skill will help Kimmy feel better and improve her chances of recovering from her eating disorder. The goal is for Kimmy to go through normal adolescent mood swings, but at a lower intensity and frequency, which will indicate a greater sense of wellbeing.

Our goal is to raise adults who yes, have big feelings sometimes, but are able to manage their emotions and behavior even when they have big feelings.

How to respond to mood swings

Melanie feels terrible because when Kimmy yells, Melanie tries not to, but often yells back. And when Kimmy bursts into tears, sometimes Melanie does, too. “I feel completely taken over by her moods and emotions,” she says. “It’s so embarrassing, as if I have no self control.”

It’s quite normal to respond to a child in this much distress with your own feelings of distress. Of course it’s upsetting raising a child who is explosive and frequently drives you to either yelling or sobbing. It’s very hard to stay sturdy in the face of a raging kid. All of us can feel blown off course when our kids are in the thick of a powerful emotional storm.

But luckily, there are things we can do to prepare for and manage the aftermath of our kids’ mood swings. That doesn’t mean we can stop big emotions from happening, but we can reduce the damage and lower the intensity of future experiences. We can’t stop our kids from having big feelings, but what we do when those big feelings show up makes a big difference.

We can help our kids build emotional regulation skills, which will allow them to process their emotions more adaptively and without causing harm. With practice, even the most volatile people can improve their emotional regulation skills and decrease the fallout from their big emotions.

Emotional Regulation Worksheets

Give your child the best tools to grow more confident, calm and resilient so they can feel better, fast!

Self-Esteem
Self-Regulation
Mindfulness
Calming strategies

Learn More

Steps to build emotional regulation skills

Here’s what you can do to navigate your child’s big mood swings during eating disorder recovery:

1. Check the weather

Emotional storms can seem like they come from nowhere, but usually we can map out a few reliable triggers. The more triggers you know about, the greater your chance of reducing them before the storm hits. This doesn’t mean eliminating big emotions, but helping your child experience them safely.

2. Know what you can do—and what you can’t

When your child is raging, you can control your response, but you can’t control how they feel. This is really important and really hard to remember in the heat of the moment. But the more you focus on managing your own feelings and behavior, the better you can withstand the strong winds of your child’s feelings. This will reduce the storm’s intensity, because fighting back or trying to control your child’s emotions typically increases their intensity.

3. Regulate yourself

You can’t ask your child to regulate their emotions if you’re not able to regulate your own. Most of us need some help learning how to calm ourselves down when our kids are having an emotional storm. So reach out for support from someone who understands how hard this is and won’t judge you. You deserve support, and the more support you get, the better you’ll be able to support your child.

4. Co-regulate

If you sense that your child is getting emotionally dysregulated, take steps to co-regulate with them. This doesn’t mean saying “calm down” (which never works) but rather validating their experience of distress and using your calm, regulated nervous system to model safety and security. With practice, you can head off many storms before they gain intensity.

5. Hold your boundaries

You can’t control your child’s feelings or even their behavior when they’re in an emotional storm, but you can remove yourself from harm’s way if necessary. This is especially true if your child is being verbally or physically abusive. It’s OK to protect yourself from harm, and it will actually protect your child from harm, since hurting a parent increases shame, which reduces emotional regulation and increases intensity.

6. Regroup afterwards

First, take some time to reflect on the storm with another adult who you can trust not to blame you or your child for what happened. You want to review the emotional triggers and make sense of what happened. Next, find time to calmly and compassionately review the events with your child and discuss how you can work together to manage future emotional storms. As for punishments, if your child broke curfew, you can move the curfew back for a limited amount of time. If they damaged something, ask them to repair or cover the cost of replacement. These are natural consequences and are directly related to the events, but you want to avoid punishments that are disconnected from the events that took place, as they rarely make a positive impact.

Making progress

Supporting a child with an eating disorder when they have big mood swings is challenging. It’s not something most of us can do gracefully or naturally at first. But with practice, Melanie slowly made progress with Kimmy. “It was so hard at first—it felt like juggling,” she says. “I felt like I had to keep my eyes on so many moving parts, but with practice it became more natural and now it’s almost automatic sometimes.”

Kimmy is still dealing with a lot of ups and downs, and she’s working through eating disorder recovery, but having her mom’s support is making a difference. “The other day she apologized for how she behaved a few months ago,” says Melanie. “And though she doesn’t know exactly what I’ve done to change things, she was aware that something about what I was doing seemed to be helping her calm down a little faster. She actually thanked me! I finally feel hopeful again.”

Ginny’s most recent project is Recovery, a newsletter for deeply feeling people in recovery from diet culture, negative body image, and eating disorders.

See Our Guide For Parenting a Teenager With An Eating Disorder

Posted on August 23, 2023August 23, 2023 by Ginny Jones — Leave a comment

How to protect your child from dangerous weight loss interventions

The risks of 2023 AAP guidelines for weight loss in kids and what parents can do about it

Megan reached out to me after a disastrous doctor’s office visit with her eleven-year-old son, Carl. “I’m so upset, I could scream!” she said. “The doctor lectured Carl about his weight even though I called ahead and specifically asked her not to do that, and when I asked her to stop, she just kept going. She recommended that he start an intensive weight intervention …a diet.”

This news is upsetting but not uncommon. In 2023 the American Academy of Pediatrics (AAP) issued new guidelines regarding obesity* in children and teens. The guidelines recommend intensive weight loss interventions, drugs, and even surgery.

*Generally I don’t use the word “obesity” because it pathologizes higher-weight people based on the flawed, racist BMI scale. I’ve used it in this article sparingly in order to reflect the scientific data and guidelines accurately.

These guidelines are alarming for anyone who works with eating disorders. Because intentional weight loss of any type, for any reason, is identified as a major cause of eating disorders. The dubious claims in the guidelines rest on severe weight stigma, false assumptions about intentional weight loss, and poor evidence of the efficacy and safety of drugs and surgery on kids’ bodies.

Creating medical guidelines without considering that they will cause eating disorders is horrifying. Eating disorders are NOT RARE. They affect at least 9% of the population. That’s about 29 million Americans, and rates are rising exponentially. For comparison, about 6 million Americans have Alzheimer’s and about 23 million Americans have heart disease. Eating disorders are common, present a high level of risk to mortality and long-term health, and are heavily influenced by family, social, and medical beliefs about diet and weight.

Non-Diet/Health At Every Size® Fact Sheets, Guidelines, and Scripts

Fact Sheets About Weight Stigma, Diet Culture, Kids and Diets, and More
Non-Diet Parent Guidelines
Non-Diet Parent Scripts About Responding to Fat Talk, Diet Talk, and More
What to Say/Not Say When Talking About Bodies and Food

Learn More

Should a child get an intensive weight intervention?

The suggestion that Carl should undergo intensive weight loss counseling is not based on evidence that such programs are effective. In fact, there is no evidence that any diet plan results in long-term weight loss and health benefits. For example, a large Medicare study was created to find the most effective weight loss program for obesity. It was cancelled due to poor outcomes, including counterproductive side effects on both weight and health.

In another attempt to prove the effectiveness of weight loss interventions, this time for schoolchildren, a large randomized controlled trial (the scientific gold standard) was published in 2016. However, it found that high-quality intensive health interventions that included weighing children, nutrition counseling, and an exercise program were not effective in reducing BMI or improving health behaviors.

But the fact that intensive weight interventions are ineffective is not the worst problem; it’s that intentional weight loss has the following reliable outcomes:

Weight regain: The majority of individuals who lose weight are unlikely to maintain the reduced weight for an extended period of time.
Additional weight gain: Intentional weight loss predicts accelerated weight gain and risk of overweight.
Eating disorders: Intentional weight loss is the most important predictor of new eating disorders.

In other words, not only are intensive weight interventions ineffective, they have a high risk of harm. Even worse are the recommendations that children take weight-loss medications and undergo bariatric surgery, which have an extremely high risk of creating lifelong complications. And they’re being done despite evidence that fat itself is not deadly.

What to do to improve kids’ health without weight intervention

While we have a lot of evidence that intentional weight loss and weight interventions cause harm, that doesn’t mean you can’t support your child’s health. There are a number of excellent non-weight-based ways that parents can positively impact kids’ health, including:

1. Develop and nurture a secure attachment with your child.

“There is substantial evidence that children with secure attachments in childhood develop more positive social–emotional competence, cognitive functioning, physical health and mental health, whereas children with insecure attachments are more at risk for negative outcomes in these domains.” —Early Childhood Development and Care, 2008

2. Share family meals at least three times per week.

“The frequency of shared family meals is significantly related to nutritional health in children and adolescents. Children and adolescents who share family meals 3 or more times per week are more likely to be in a [non-obese] weight range and have healthier dietary and eating patterns than those who share fewer than 3 family meals together. In addition, they are less likely to engage in disordered eating.” —Journal of the American Academy of Pediatrics, 2011

🔎 Read more about creating family meals

3. Ensure your child has a healthy sleep pattern.

“Short sleep duration is associated with a wide range of negative physical, social, emotional, and cognitive outcomes including poor concentration, impaired academic achievement, an increased risk of obesity, depression, suicide ideation, and injuries.” —Sleep Research Society, 2013

🔎 Read more about optimizing sleep

4. Support your child in developing social skills.

“The influence of social relationships on the risk of death are comparable with well-established risk factors for mortality such as smoking and alcohol consumption and exceed the influence of other risk factors such as physical inactivity and obesity.” —PLOS Medicine, 2010

These four interventions are all well-documented and will improve your child’s health. And the effects are long-lasting and have no negative consequences. This cannot be said for weight interventions (almost all intentional weight loss leads to weight cycling).

🔎 Read more about preventing loneliness

Handling pediatrician visits with 2023 AAP guidelines

The 2023 AAP guidelines put kids at risk, since intentional weight loss is a major cause of eating disorders. But what can you do if your child’s pediatrician is committed to the 2023 AAP guidelines for weight-based interventions? Well, it may be time to consider finding a new pediatrician! These guidelines are suggestions for physicians, not requirements. But if that’s not possible, keep asking questions and seeking answers about the most likely outcomes and risks of weight-based interventions.

To help her navigate this distressing situation with her son, I recommended that Megan download the free guide provided by CRC for ED and Sunny Side Up Nutrition called “Navigating Pediatric Care in Light of the New AAP Guidelines.”

“We created this resource because we have concerns of the harmful impact the AAP guidelines are having on young people, particularly those with marginalized identities,” said Anna M. Lutz, MPH, RD/LDN, CEDS-S. “After the guidelines were released we heard from parents who were scared and worried about taking their child to the pediatrician. We hope parents can use this resource and feel more supported in navigating their child’s medical care.”

I also have some cards that you can use at the doctor’s office and an eBook, Non-Diet/Health At Every Size® Fact Sheets, Guidelines, and Scripts.

About the 2023 American Academy of Pediatrics guidelines

In January 2023 the American Academy of Pediatrics (AAP) issued updated guidelines on obesity evaluation and treatment in children and teens. It’s been deeply discredited by the eating disorder professional community.

For example, the Collaborative of Eating Disorders Organizations (CEDO) and the Eating Recovery Center say the recommendations put children at risk for developing eating disorders, disordered eating, and other mental and physical health issues.

The new AAP guidelines stray far from those released in 2016, which very carefully linked a focus on weight reduction to increased risks of eating disorders and recommended that physicians not recommend weight control to children and teens. It said:

“There are concerns that obesity prevention efforts may lead to the development of [an eating disorder].”
“Dieting, defined as caloric restriction with the goal of weight loss, is a risk factor for both obesity and [eating disorders].”
“The focus should be on a healthy lifestyle rather than on weight.”

Sadly, the 2023 AAP guidelines ignore the 2016 findings and suggest that physicians recommend weight loss using intensive behavioral interventions starting at age 2, weight-loss drugs as young as 12, and bariatric surgery as early as 13.

The new guidelines recommend intentional weight loss, despite evidence that it is 1) ineffective, 2) counterproductive, and 2) a major cause of eating disorders.

🔎 Regan Chastain has provided several deep dives into the problematic nature of the new recommendations, including a review of the conflicts of interest the guidelines failed to disclose and faulty presentations of the effectiveness and risks of bariatric surgery in kids.

Pushback against the new AAP guidelines

The Collaborative of Eating Disorders Organizations (CEDO) issued a letter saying “The statements made throughout these guidelines are problematic at best, and at worst, put American children and adolescents at serious risk for developing eating disorders, disordered eating, and other mental and physical health issues.”

The Eating Recovery Center in Denver, Colorado, launched a petition to change the guidelines saying “[W]e expect these guidelines will cause harm and put young people at risk of developing or worsening eating disorders, disordered eating, and other mental and physical health issues as well as perpetuate harmful weight stigma and move us further away from achieving universal weight-inclusive care.”

The Academy for Eating Disorders (AED) had three main concerns with the report, which it detailed in a press release saying “In line with the Hippocratic oath of first, do no harm, the AED urges the AAP to revise their Guideline with input from key stakeholders including eating disorder professionals and individuals/families with lived experience in higher-weight bodies.”

Non-Diet/Health At Every Size® Fact Sheets, Guidelines, and Scripts

Fact Sheets About Weight Stigma, Diet Culture, Kids and Diets, and More
Non-Diet Parent Guidelines
Non-Diet Parent Scripts About Responding to Fat Talk, Diet Talk, and More
What to Say/Not Say When Talking About Bodies and Food

Learn More

Ginny’s most recent project is Recovery, a newsletter for deeply feeling people in recovery from diet culture, negative body image, and eating disorders.

See Our Parent’s Guide To The Causes Of Eating Disorders

Posted on August 3, 2023August 5, 2023 by Ginny Jones — Leave a comment

Ultimate guide to a parent’s role in eating disorder recovery

Jeremy reached out to me with a simple but complicated question, “what’s a parent’s role when your child’s in eating disorder recovery?” There are so many ways to answer that question. But ultimately I think most of the advice can be boiled down to two main things: connection and boundaries.

Someone with an eating disorder is struggling on many levels of both physical and mental health. And in order to heal they need connection with others. No matter how introverted or independent we are, we all need people. We feel best when we are deeply and meaningfully connected with the people closest to us, especially our parents. Right now things may feel tense and disconnected between you and your child. That’s normal when there’s an eating disorder. But reconnecting and building a sense of family belonging is an important way you can support recovery.

Next, someone with an eating disorder does best with secure boundaries and expectations. If your child had cancer you would feel strongly about setting boundaries and expectations for their treatment. Even if your child complained, you would insist they go to the doctor. And even though it’s awful, you would get them the treatment they need. The same holds true for an eating disorder. Holding boundaries while maintaining connection is the key to success.

Parent Scripts For Eating Disorder Recovery

Use these scripts:

At the dinner table when behavior is getting out of control
When you need to set boundaries – fast!
After something happened so you can calmly review the triggers and events

Learn More

People who recover from an eating disorder agree that it’s one of the hardest things they’ve ever done. And they appreciate their parents’ love, strength, and support even if they don’t show it on their worst days. A parent’s role in eating disorder recovery is difficult, essential, and incredibly rewarding.

Connection

Parents often feel disconnected and shut out from their kids’ eating disorders. Sometimes their relationship was strained and challenging before the eating disorder. And it usually becomes even more difficult when there’s an eating disorder. Lots of parents feel helpless, as if there’s nothing they can do to help.

But the good news is that parents are in an excellent position to help their kids recover from an eating disorder. It all begins with connection. Having a secure connection with a parent helps kids recover. Building a secure connection takes time and patience, especially because an eating disorder tends to create a lot of disconnection and distancing.

3 ways to build your connection with a child who has an eating disorder:

Work on a positive mindset. If you approach your child with negative feelings, they will sense it, because kids are deeply tuned into parents’ emotions. A positive parenting mindset means you feel as if you can handle your child even when they’re at their worst, and this approach will build a secure connection.
Spend time together. Kids with eating disorders may actively distance themselves from parents, but we know that recovery is harder when you’re lonely and don’t have a strong sense of belonging. It may be hard to engage your child in family activities right now, but it is part of their treatment and critical to their recovery. If things are very tense, family therapy may be the first step to making progress.
Approach problems with the goal of motivating vs. controlling. Hollywood portrays effective communicators as people who make demands and give impassioned speeches. These fictional characters succeed when they convince others to understand their point of view and give in. But this approach is incredibly de-motivating in real-life, particularly with teenagers and young adults. Rather than telling them what to do, try to understand your child’s point of view and support them in considering their options. Active listening is both much harder and far more effective than giving speeches.

A child who feels connected to at least one parent is more likely to feel good about themselves and take the steps needed to get into recovery. It can be hard to build a strong connection with a child in eating disorder recovery, but it is an important part of a parent’s role.

Boundaries

Parental boundaries are important when supporting your child through treatment because, just like chemotherapy, eating disorder treatment is not something most people want to do or would choose to do. It makes sense if your child resists treatment. They need your help and support to keep going.

Residential treatment handles treatment in the short-term, but ultimately kids with eating disorders come home and must continue to engage in treatment. This may include structured and adequate meals, getting enough sleep, therapy, medical appointments, and prescription medicine.

3 boundaries parents need when a child has an eating disorder:

Structured mealtimes and snacks. A core component of recovering from an eating disorder is eating regular meals on a schedule. Parents can help by setting up meal and snack times, serving the food, and sharing the food with your child. Is this time consuming? Yes. But it’s one of the most reliable things parents can do to support recovery.
Scheduled bedtime and screen-free time. Sleep and real-life engagement with other people are both important for people in recovery. But in our culture it’s very hard for kids to get them, primarily because of our always-on devices. Your teen or young adult will not enjoy having a bedtime or screen locks on their phones, but consistently holding boundaries around these two things can go a long way to helping your child recover.
Emotional boundaries. It’s important to uphold your role as your child’s parent. This means maintaining clear emotional boundaries and not getting sucked into drama and distraction. Often parents engage in long, involved debates and discussions about weight, food, and exercise as well as things like appointments with professionals. It’s best to state your expectations and boundaries clearly, then hold steady. You don’t have to change your child’s mind to hold your boundaries.

Parenting a child with an eating disorder requires strength and endurance. You’ll need to dig deep and stay strong. It’s not easy to insist upon boundaries during recovery. You may feel tempted to give in and let things go because your child HATES IT when you set boundaries. I get it! This is hard. But stay strong, and get the support you need to keep it up as best you can.

Ginny’s most recent project is Recovery, a newsletter for deeply feeling people in recovery from diet culture, negative body image, and eating disorders.

See Our Guide To Parenting A Child With An Eating Disorder

Posted on July 19, 2023July 19, 2023 by Ginny Jones — 1 Comment

How to help your child with an eating disorder stay safe

Nicki reached out to me when her daughter Kiara was scheduled to return from residential treatment for her eating disorder. “My biggest concern is her safety,” said Nicki. “And I mean both physically and emotionally. I’m just so scared that she’ll come home and slip back into the disorder. I worry that all the hard work she’s done so far will be for nothing.”

I get it. It’s scary to have a child return from treatment, and of course you want it to stick. All most parents want is for their kids to be healthy and happy. Nicki’s concerns for Kiara’s emotional and physical safety are valid and important.

Here are 4 things parents can focus on to help a child in eating disorder recovery stay safe:

1. Feeding structure

Most kids with eating disorders don’t want parents to impose a feeding structure; quite the opposite! They’ll ask for more flexibility and try to negotiate around any eating boundaries you create. And yet a feeding structure is vital to physical and emotional safety during eating disorder recovery.

Parent Scripts For Eating Disorder Recovery

Use these scripts:

At the dinner table when behavior is getting out of control
When you need to set boundaries – fast!
After something happened so you can calmly review the triggers and events

Learn More

Early recovery rests heavily on weight restoration, and any dips in weight are a reason for concern. Many experts say that the psychological work of eating disorder recovery can’t truly begin until full weight restoration is attained.

The best way to minimize the risk of weight loss in recovery is to insist upon a feeding structure. This means parents take over feeding responsibility (plating and serving meals and snacks) completely in the beginning. As kids reach recovery milestones, parents can gradually and with checks and balances shift responsibility in an age-appropriate manner.

No, your child will not like you insisting on a feeding structure. But it’s like the seatbelt in a car: it’s not optional. Just because a kid tells us they don’t need to wear a seat belt every time they’re in our car, we still insist that they wear one. We insist because not doing so is a risk we’re not willing to accept. A parent-led feeding structure is necessary to help your child stay safe during eating disorder recovery.

2. Professional support

Monitoring your child’s physical and mental health in recovery should continue for a substantial amount of time after full weight restoration is achieved. Ideally, your child should see a medical doctor, a registered dietitian, and a therapist. The schedule and format of these check-ins vary widely. You can ask each provider for their recommendation in terms of how often your child should see them.

As long as your child is under 18, under your care financially and/or physically living with you, you can insist on a minimum level of ongoing check-ups. You’ll want professional providers to monitor your child’s physical and mental health for as long as possible.

I’m a big fan of therapy, but most parents tell me their teens don’t like going to regular therapy appointments. If this is the case with your child, you can possibly be more flexible with therapy. However, this applies only if your child is steadily improving in other areas of their recovery.

For example, if they’re meeting weight restoration goals and being monitored by a medical doctor and dietitian, at least one of whom has specific training in eating disorder treatment. In these cases, psychotherapy may be less essential right now. Another option if your child doesn’t want to go to individual therapy is family therapy. Family therapy can be just as helpful, sometimes even more so, as individual therapy.

3. Relational safety

Someone with an eating disorder is struggling to feel emotionally safe and secure. Anxiety and worry about weight, food, and exercise typically linger even when you’re seeing a reduction in other symptoms. It takes time to fully recover and enjoy life without those worries. And they’ll usually also have anxiety and worry in other areas of life. Luckily, parents are well-equipped to provide emotional safety and security to their kids. Children are born seeking security in a relationship with their parent. Our ability to soothe our kids is hardwired in their nervous system.

That said, when an eating disorder is in the picture it can be really hard to soothe your child. It’s not unusual for kids to seek support in confounding ways. They often behave in ways that are frustrating, irritating, or even infuriating. For example, kids with eating disorders can be argumentative, highly emotionally reactive, aggressive, withdrawn, or a combination of these things. The important thing is to recognize their behavior is communication and an attempt to connect with and be soothed by you.

When you see your child’s behavior as a form of communication that you can interpret and understand, you’re more likely to respond in a way that helps them calm down and feel safe in your presence. Feeling safe with you can be the foundation on which your child’s recovery is built, so the more you can build your skills in this area, the better. A great book to help with this is The Power of Showing Up by Daniel J. Siegel and Tina Payne Bryson.

4. Social engagement

We tend to focus on eating, exercise, and weight when we talk about health, but it turns out that the most important factor in health is actually the quality of our social connections. Long-term meta-analyses (considered by many to be the most reliable form of scientific analysis) have shown that social relationships are more important than health behaviors like not smoking, avoiding alcohol, and getting a flu shot.

And many people are surprised to learn that social relationships FAR outweigh the impact of diet, exercise, and BMI on our health.

Kids with eating disorders have high rates of social isolation, loneliness, and a history of feeling different, even being bullied by peers. They’re also more likely to have social anxiety. Their social skills are further compromised by eating disorder symptoms.

A key way parents can help kids be safe during eating disorder treatment and recovery is by helping them build social skills and expand their social engagement. Investing your time and energy in supporting your child’s social development is a worthy effort and will help recovery.

Ginny’s most recent project is Recovery, a newsletter for deeply feeling people in recovery from diet culture, negative body image, and eating disorders.

See Our Guide To Parenting A Child With An Eating Disorder

Posted on July 5, 2023July 17, 2023 by Ginny Jones — Leave a comment

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:

Parent Scripts For Eating Disorder Recovery

Use these scripts:

At the dinner table when behavior is getting out of control
When you need to set boundaries – fast!
After something happened so you can calmly review the triggers and events

Learn More

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!”

Ginny’s most recent project is Recovery, a newsletter for deeply feeling people in recovery from diet culture, negative body image, and eating disorders.

See Our Guide To Parenting A Child With An Eating Disorder

Posted on June 27, 2023July 17, 2023 by Ginny Jones — Leave a comment

5 things you should never do if your child has an eating disorder

Having a child with an eating disorder is not your fault. There are so many reasons kids get eating disorders, and no parent causes an eating disorder to happen. At the same time, there are things parents can do when a child has an eating disorder. Making changes in your own behavior is a hard but vital part of your child’s recovery.

Here are my top five things parents should avoid doing when they have a child with an eating disorder:

1. Don’t get into arguments about the eating disorder

It’s really common for parents to get into extended arguments with their children about the eating disorder. An argument means going back and forth in an attempt to convince the other person to see your point of view. For example, you might argue about how much they should eat, why they should eat, what they should eat, how they should dress, how they should feel about their body, and more. These arguments are very tempting. When you hear your child say something that is factually wrong and perpetuates the eating disorder, of course you’re going to want to try and correct their belief.

Parent Scripts For Eating Disorder Recovery

Use these scripts:

At the dinner table when behavior is getting out of control
When you need to set boundaries – fast!
After something happened so you can calmly review the triggers and events

Learn More

The trouble is that the eating disorder loves arguments because it gives it time to present its point of view. Rather than convincing your child’s eating disorder that you’re right and it’s wrong, arguments are likely to embed disordered beliefs even deeper. Unfortunately, the eating disorder may grow stronger when it defends itself against you.

Instead of arguing with your child’s eating disorder, validate that your child has an opinion and beliefs, and hold your boundaries. For example, “I understand you don’t want to eat this right now, but this is what’s for dinner.” No matter how hard your child tries to engage in debate about whether the meal is good or not, stick to a simple, clear message. This is not an argument because you aren’t trying to convince your child to agree with you, but you are holding steady with your boundaries.

2. Don’t intentionally lose weight (diet)

Most Americans are trying to lose weight or control their weight. But diet behavior is also eating disorder behavior. And it’s going to be very hard for your child to stop using eating disorder behaviors if you’re practicing diet/eating disorder behaviors.

It’s hard to let go of diet behaviors. I totally get it. And I’m not here to criticize you, but to gently remind you that our kids pay far more attention to what we do than what we say. So if you’re telling your child that they need to eat regular meals but you’re regularly skipping meals, it’s going to be hard to positively influence recovery.

Instead of trying to control your weight, learn about a non-diet approach to health, which involves practicing health behaviors without a focus on weight outcomes. This is a major shift, but it is better for everyone’s health long term.

3. Don’t try to prevent your child from gaining “too much” weight

Many people will gain weight in eating disorder recovery, which can be really uncomfortable for parents. Keep in mind that most people with eating disorders don’t look “too thin.” Even if you don’t believe your child needs to gain weight in recovery, there’s a good chance they will gain weight, and that doing so is an essential part of healing their body and brain.

This is a really complicated topic since we live in a culture filled with weight stigma. It’s not your fault if your child’s recovery weight gain is hard for you to handle. Still, it is your responsibility to work on your biases with a professional who can help you work out your feelings without negatively impacting your child’s recovery.

Instead of worrying about your child’s weight gain during recovery, focus on their health behaviors. First and foremost, pay attention to whether they’re eating regularly and eating enough food as prescribed by their eating disorder dietitian. Next, are they getting enough sleep? This is an essential health behavior that is often missed. Additionally, how is their social media use? Parents can and should limit kids’ social media use, particularly if they have/had an eating disorder.

Non-Diet/Health At Every Size® Fact Sheets, Guidelines, and Scripts

Fact Sheets About Weight Stigma, Diet Culture, Kids and Diets, and More
Non-Diet Parent Guidelines
Non-Diet Parent Scripts About Responding to Fat Talk, Diet Talk, and More
What to Say/Not Say When Talking About Bodies and Food

Learn More

4. Don’t talk about other people’s bodies

Talking about other people’s bodies is natural in our society, but it’s a habit we want to break when a child has/had an eating disorder. Eating disorders typically involve body objectification. This means viewing the body as an object rather than a living being. People who objectify bodies see them as parts rather than a whole, as objects to be manipulated rather than human beings to be respected.

Notice whether you have a tendency to observe and talk about people’s bodies as if they are objects. For example: “I wish I had her arms, they’re so toned!” or “Look at the size of those thighs!” or “You look great! Have you lost weight?” Objectifying comments separate the body from the person.

Instead of talking about bodies, talk about people. For example: “I love spending time with her!” or “He is so dedicated to Pickleball.” or “You seem so happy right now!”

5. Don’t vilify food

Our culture likes to put food into “good” and “bad” categories. Little kids are taught that carrots are good and cake is bad. But this sets up an unhealthy relationship with food. If talking about food in good and bad terms was good for our health, perhaps it would be all right, but evidence shows that it’s actually better for health if we teach kids that all foods fit in a healthy diet.

If you tend to see food as either good or bad, work with a non-diet dietitian. A few sessions can help you start to unpack your beliefs about food and build a healthier relationship with food and eating.

Instead of talking about food in good and bad terms, focus on how it looks, smells, tastes, and feels. Talk about how you feel when you’re hungry, full, and everything in between. Slow down and savor your food rather than dissect it into nutritional components. Food is not just mechanical for us, it’s also deeply social and emotional.

If you’re having trouble parenting your child through their eating disorder, you’re not alone, and help is available. You deserve support as you support your kid!

Ginny’s most recent project is Recovery, a newsletter for deeply feeling people in recovery from diet culture, negative body image, and eating disorders.

See Our Guide To Parenting A Child With An Eating Disorder

Posted on June 19, 2023July 17, 2023 by Ginny Jones — Leave a comment

How to talk to your child about their eating disorder

Kylie and her daughter Brooke are locking horns. “I just don’t understand why we can’t have a calm, rational discussion about Brooke’s eating disorder,” says Kylie. “Normally we can talk about anything, but when it comes to the eating disorder, Brooke is so reactive and completely closed off to me. I have no idea how to help her anymore.”

I completely understand. Talking about eating disorders is incredibly hard, but also so important. And the good news is that every parent can learn some new skills that will improve these difficult conversations. You’ve got this!

Why is it important to talk about eating disorders?

It’s important to talk about eating disorders because they typically don’t get better on their own. And parental intervention can make a significant difference in treatment outcomes. That said, talking about eating disorders is hard and requires parents to learn new conversational skills. This is high-stakes communication, and while you may be great at talking about tons of other things, it helps to get some additional insight and training for conversations about eating disorders.

Parent Scripts For Eating Disorder Recovery

Use these scripts:

At the dinner table when behavior is getting out of control
When you need to set boundaries – fast!
After something happened so you can calmly review the triggers and events

Learn More

What are the risks of talking about eating disorders?

There are risks when talking about eating disorders. Well-meaning and deeply loving parents, teachers, doctors, and coaches can easily make mistakes. When a child has an eating disorder, they are hypersensitive to comments about weight and food. This is why talking directly about food and weight can be especially tricky during an active eating disorder. That doesn’t mean avoiding the conversations, just trying a different approach.

Remember that eating disorders are mental illnesses. They aren’t a choice, and they aren’t something your child can just “decide” to stop doing based on your good reasoning. Intense and emotionally distressing arguments about eating disorders can actually increase their power, so it’s important for parents to learn new communication skills to avoid reinforcing eating disorders.

What typically happens when we talk about eating disorders?

The most common outcome of an attempt to talk about eating disorders is defensive communication. Basically, both the child and the parent get stuck in defending their own position, demanding that the other person give in to their will. This will keep everyone stuck in the cycle of an eating disorder.

A child’s deepest wish is to be truly seen, understood, and nurtured by their parents. When they fight and argue, it means they don’t feel understood. The solution is not to double-down on your argument, but to open up to your child’s true needs.

Listening to your child talk about their eating disorder will be hard, but it’s best not to shut them down when you feel uncomfortable. Rather than getting into defensive communication with your child, practice non-defensive communication while still holding boundaries about treatment and recovery.

Why can’t I talk to my child about their eating disorder?

Talking about eating disorders is really hard. You’re not alone if it feels impossible sometimes. The good news is that you can learn to have more effective conversations with your child. Don’t blame yourself if it hasn’t been going well. It’s not your fault, but at the same time if you want to change the pattern of defensive and unproductive communication, you can learn new communication skills that will help.

What is defensive communication?

Defensive communication is what happens when you’re facing off like opposing sides of a football team. Each of you takes your position and pushes, blocks, and tackles the other side’s position to try and win the game.

This is the communication style we typically see modeled on TV shows and movies, and usually the “winner” is the person who presents the strongest argument. But this approach is actually counter-productive in most interpersonal relationships. When conversations are based on winning and losing, nobody wins.

Signs that you’re stuck in defensive communication patterns

Here are the signs that you and your child are stuck in a defensive communication pattern:

It seems impossible to have a rational conversation with your child
Talking to your child usually results in someone getting mad, screaming, crying, and/or stonewalling
Your child accuses you of dominating and not understanding their needs
Your child stops talking to you altogether
Conversations quickly turn to contempt and blaming

Let’s take a deeper dive into how we can practice non-defensive communication with our kids.

1. Recognize that your child has an opinion (and it’s not the same as yours)

Defensive communication begins with assuming that you’re on opposing sides, and that your side/argument deserves to win. But this is a non-starter for talking about eating disorders because it puts your child’s dignity and agency at risk. And dignity and agency are at the heart of eating disorder recovery.

The key to non-defensive communication is taking the fight out of the conversation. Instead of lining up against each other and pushing your opposing beliefs, sit down next to your child and consider their opinion. Your child has the right to their own beliefs. Counterintuitively, we can only motivate our kids to change their opinions when they believe we respect their opinions.

2. Take a deep breath and acknowledge your desire to push back

You’ll feel compelled to get into the defensive position and start pushing your beliefs. Take a deep breath. If you react without respecting your child’s opinion, you will remain stuck in defensive communication.

Take a breath. On the in-breath say to yourself: this is hard. On the out-breath say to yourself: I can handle this.

This is a mindfulness technique in which we acknowledge the difficulty of our situation and send ourselves compassion in the moment. Repeat this breathing technique throughout the conversation to stay present and aware.

3. Invite them to talk

It’s natural to want to shut down a person who seems to be holding onto their eating disorder. But this can backfire because it destroys dignity and agency.

The most powerful way to defuse tense conversations is to get curious about your child’s position. Give them the floor so that you can hear what they are actually saying. This has the added benefit of letting them hear themselves. Strange as it may seem, sometimes the best way to motivate your child to change is to allow them to hear their own opinions out loud in a calm conversation with you.

For example, if your child is refusing to do something, you can say “what does not doing this mean to you?”

If a child is yelling, you can say “I can hear how angry you are. I want to understand what’s going on for you right now.”

4. Listen with compassion and patience

Most of us spend the time while the other person is speaking coming up with our response to their position. This is what we do when we believe we’re more reasonable and rational than the other person. We think if we just say the right thing in the right way, we’ll win.

But this is not the way to resolve difficult conversations, particularly when it comes to eating disorders. Instead, listen to your child with compassion and patience. Hear what they are trying to tell you. Practice not thinking about your response when they’re talking. Instead, focus entirely on understanding what they’re trying to communicate.

5. Validate their feelings

When we accept a child’s feelings as valid and valuable, we give them the gift of dignity and agency. These are essential ingredients to motivating change. Here are some things to say to validate your child’s feelings:

I hear you
I get it. Let’s talk about this some more
It sounds like [recap their feelings]
Let me see if I understand. What you’re saying is [recap their feelings]
I can understand why this feels unfair
It makes sense that you’re feeling this way
That sounds hard. I’m sorry
I’m sorry I said that to you. It sounds like it made you feel [recap their feelings]
It sounds like when I did that it made you feel [recap their feelings]

Parent Scripts For Eating Disorder Recovery

Use these scripts:

At the dinner table when behavior is getting out of control
When you need to set boundaries – fast!
After something happened so you can calmly review the triggers and events

Learn More

6. Set a boundary

Once you have listened well and validated your child’s feelings, you may need to set a boundary or make a request. Here’s an example of a boundary when a parent needs to feed a child who doesn’t want to eat in eating disorder recovery:

Your child threw a tantrum because you asked them to finish their meal.
You listened and understand that your child feels like you are trying to dominate and control them.
You validated your child’s feelings of indignation and unfairness because you’re asking them to do something they don’t want to do.
You say “OK, well I will pay attention to this, and I’d like you to keep talking to me about it. For now, I’d like you to please finish your meal.”

⭐ Notice: you’re still asking them to eat the food. But you’re also respecting your child’s autonomy by validating that they have feelings and opinions that are different from yours.

We are more productive and motivating when we listen non-defensively and validate our kids’ feelings. When we practice non-defensive communication while parenting a child with an eating disorder, we’re more likely to support recovery and increase the chances of our children maintaining close, healthy bonds to us for life.

Ginny’s most recent project is Recovery, a newsletter for deeply feeling people in recovery from diet culture, negative body image, and eating disorders.

See Our Guide To Parenting A Child With An Eating Disorder

Posted on June 5, 2023June 5, 2023 by Ginny Jones — Leave a comment

How parents can actually make binge eating disorder better

Cyrus is worried about his son Miles, who was recently diagnosed with binge eating disorder. “I honestly don’t understand what is going on, or what we are supposed to be doing at home to help,” says Cyrus. “We’ve got Miles in therapy, but other than that, we’ve received no guidance about what we should be doing. Are we supposed to keep binge foods out of the house? Should we remind him that binge eating is not healthy? Is there a cure for binge eating disorder?”

These questions make sense, and it’s frustrating that Cyrus isn’t getting more guidance as he faces this challenge. Binge eating disorder is a very common type of eating disorder, but it’s extra tricky to handle it in our society, where binge eating and weight gain are criticized and deeply feared. The good news is that there is a lot that Cyrus can do to help Miles recover.

What causes binge eating disorder?

All eating disorders are biopsychosocial disorders, which means they are caused by a combination of biological, psychological, and social factors.

For example, a child may have a genetic predisposition and traits that make it more likely they will develop an eating disorder. Specifically, there are neurobiological traits that make some people more sensitive and responsive to hunger cues, the physical sensations, and emotional experience of eating. Additionally, people who have ADHD or autism are more likely to develop eating disorders than the general population.

Psychologically, a child may have traits including perfectionism, impulsivity, anxiety, and depression, which increase the likelihood of developing an eating disorder. People who have OCD, GAD, PTSD, and other common mental health issues are more likely to develop eating disorders.

Finally, our social environment encourages eating disorders. We live in a culture in which parents, teachers, doctors, and coaches all worry about children getting fat. Meanwhile, peers tease and bully fat kids. This is not only about individuals being fatphobic; it’s the result of weight stigma, which is baked into our culture.

The outcome of weight stigma is not a thinner population, but a population that is so afraid of fat that we encourage food restriction and body shame. Counter-intuitively, both these things predict weight gain and, of course, eating disorders.

Society doesn’t cause eating disorders by itself, but if biology and psychology load the gun, our society is standing by at the trigger, just waiting to pull it.

What is the cure for binge eating disorder?

Many people assume that the problem with binge eating disorder is binge eating. However, binge eating is the very top of binge eating disorder symptomology.

Shame triggers binge eating, and binge eating triggers shame. It’s a self-perpetuating loop, which is why it’s usually best to address the other symptoms and causes rather than the binge eating itself. Trying to stop binge eating without addressing its causes is ineffective and even harmful.

Eating disorders have both physical and emotional components. Therefore, your child needs both psychotherapy and nutritional therapy.

A therapist can support your child in understanding their unique psychology and develop coping skills. They should also address any underlying mental health conditions, especially ADHD, autism, anxiety, OCD, and PTSD. Unless these conditions are treated, it will be very hard to recover from binge eating disorder.

In addition to a therapist, a certified eating disorder dietitian (CEDRD) can support your child in learning how to eat in a way that will minimize binge eating episodes. The biggest physical risk factor for a binge eating episode is skipping meals and restricting food.

Many people who have binge eating disorder eat too little and/or go too long between meals. This exacerbates the problem and increases the likelihood of binge eating. The most important physical treatment for binge eating disorder is feeding the body regular meals and snacks and eating enough food throughout the day.

How can parents help with binge eating disorder?

Parents alone can’t cure binge eating disorder; you’ll need professionals on board to help. But parents play an essential role in recovery. Parents can help kids recover from binge eating disorder by following these five steps:

1. Feeding structure

The biggest risk factor for a binge eating episode is not eating enough food. Skipping meals and restricting food are common, particularly for kids in larger bodies who are afraid of weight gain. However, restriction sets them up for larger and more frequent binge eating episodes. Parents should take an active role in recovery by feeding kids three meals and 2-3 snacks per day. Your child should not go more than 2-4 waking hours without eating.

Additionally, eating should be an important aspect of family life, and family meals should happen as often as possible. Binge eating is often done in secret, so it’s important to model the social nature of eating together and sharing meals. Eating is an important social and emotional activity, so pleasant family meals should be a priority.

2. All foods fit

Many parents are worried about kids’ health and weight and restrict kids’ sugar and “junk food” intake. This is popular advice, however, the evidence shows that restricting food to only “healthy” options at home increases kids’ likelihood of binge eating. Work with a non-diet registered dietitian to build your comfort with a wide variety of food. Yes, you should serve veggies and fruit, but you should also serve snack foods and desserts. A healthy diet incorporates all sorts of food. Restriction is a major trigger for binge eating episodes, so avoiding it is key.

3. Weight is not the same as health

It’s natural in our culture to be afraid of weight gain. Many parents believe they must keep an eye on their kids’ weight and worry about weight gain. But weight is not the same as health, and worrying about weight is associated with weight gain and eating disorders. Instead of worrying about your child’s weight, learn about a non-diet approach to health, which is shown to improve health behaviors and health outcomes. This approach focuses on healthy behaviors like eating, moving, sleeping, stress management, belonging, and human connection. Unlike weight control, these behaviors improve health with zero side effects.

Non-Diet/Health At Every Size® Fact Sheets, Guidelines, and Scripts

Fact Sheets About Weight Stigma, Diet Culture, Kids and Diets, and More
Non-Diet Parent Guidelines
Non-Diet Parent Scripts About Responding to Fat Talk, Diet Talk, and More
What to Say/Not Say When Talking About Bodies and Food

Learn More

4. Emotional regulation

Once you have your child in therapy to address underlying mental health conditions, you need to build their emotional regulation skills at home. Whether we mean to or not, parents teach kids how to regulate their emotions from the time they are born. It’s embedded in our DNA to learn emotional regulation from parents. Most people with eating disorders lack emotion regulation skills. Luckily, due to your role as their parent, you are by far the best person to build your child’s emotional regulation. Literally nobody else can do it as quickly and effectively as you. Get intentional about teaching and modeling emotional regulation skills and you’ll make a big difference, fast.

Emotional Regulation Worksheets

Give your child the best tools to grow more confident, calm and resilient so they can feel better, fast!

Self-Esteem
Self-Regulation
Mindfulness
Calming strategies

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5. Avoid shame

Above all, you want to avoid bringing shame to the process of eating and weight. Things like telling your child to eat less, pointing out that binge eating is leading to weight gain, and locking up food can be harmful. While doing these things might make intuitive sense to you, they are not an effective cure for binge eating disorder and can make things worse.

Food and body shame lie at the heart of eating disorders and drive disordered behavior, so you don’t want to add to it. Work on your own issues with food and weight, and talk about your fears and worries with another adult, not your child. You should never criticize your child’s eating and weight.

If you are tempted to criticize your child’s eating or weight, shift your energy to the other four steps I’ve described. They are much more likely to help your child recover.

Ginny’s most recent project is Recovery, a newsletter for deeply feeling people in recovery from diet culture, negative body image, and eating disorders.

For privacy, names and identifying details have been changed in this article.

See Our Parent’s Guide To The Different Types Of Eating Disorders

Posted on May 30, 2023June 1, 2023 by Ginny Jones — Leave a comment

Helpful ways parents can improve girls’ body image

“My body image has been terrible my whole life, and now I see the same thing happening with my girls,” says Liz. “I want to improve my daughters’ body image, but it feels impossible sometimes.”

Liz isn’t alone. Negative body image is a major issue, particularly for girls. One survey of 11–16-year-olds found that 79% said how they look is important to them, and over half (52%) often worry about how they look.

Poor body image is associated with many negative health outcomes, from anxiety and depression to eating disorders and suicidality. Given this, Liz is right to worry about her girls and it makes sense to find ways to improve their body image as much as possible.

Luckily, there is a lot that parents can do to improve girls’ body image.

How to help a girl with body image issues

To get some help with this topic, I spoke with Amelia Sherry, MPH, RD, CDCES, founder of NourishHer.com and author of Diet-Proof Your Daughter: A Mother’s Guide to Raising Girls Who Have Happy, Healthy Relationships with Food and Body. She knows personally how hard it is to navigate body image issues when raising daughters.

Body Image Printable Worksheets

The best tools to feel calmer and more confident in your body!

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Increase media literacy

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“When my own daughters’ bodies started changing in preparation for puberty, it triggered a lot of emotion in me ,” she says. “And seeing my discomfort with those changes made me realize that I still had a lot of work to do with regard to my own body image issues. I had to remind myself that weight gain, particularly in adolescent girls, was perfectly normal and perfectly healthy. ”

“As a dietitian, I knew the “right” things to say and do in terms of allowing them to eat food they enjoy and eat as much as they need to feel full and satisfied,” says Amelia. “But because of my own history with disordered eating and dieting, trusting them with food and giving them that freedom didn’t come naturally. It was challenging, and a lot more triggering and a lot more emotional than I realized it would be.”

At least as far back as middle school, Amelia remembers feeling judged and criticized about her body. “I was chubby, so I started dieting and trying to lose weight,” she says. In high school she experimented with purging, and in college she used exercise to control her weight.

Luckily for Amelia, when she started living on her own and feeling less judged, she started resolving her relationship with food and her body. Healing her relationship with herself led her to become a dietitian who helps families develop positive, happy relationships with food.

How to improve girls’ body image and self-esteem

After helping her own daughters get through puberty with their body image and a set of positive eating skills intact, Amelia started using the same framework to help other mothers who have a history of disordered eating do the same. Here are her five top tips for improving body image and self-esteem in girls:

1. Trust girls to eat as much or as little as they like

Encourage girls to listen to their bodies as opposed to taking information about how much to eat from the outside world. We can show our trust by avoiding commenting on how much they are eating. And if our daughters’ eating or appetites make us uncomfortable, we can look inward to ask ourselves why.

2. Accept our daughters’ natural body size and shape

Being accepting of their appetites as well as their food likes and dislikes. That doesn’t mean we avoid exposing them to new foods or offering balanced meals, by the way.

3. Rethink what it means to be a healthy eater

We have been conditioned to think of healthy eating as eating in a way that controls our weight. However, when we understand that body weight is not an indicator of health we allow ourselves and our daughters to eat in more relaxed, confident ways as opposed to being restrictive and fearful.

4. Be aware of the influences and pressures our daughters are under

From social media and peers, to diet culture and health culture. Teaching them to be critical thinkers, and conscious consumers of media can help them avoid ramping up their own body dissatisfaction. We can also protect our daughters from dieting by being aware of the influences in our own lives as a parent, such as the pressure to raise a perfect eater.

5. Keep nutrition simple

Emphasizing the importance of getting enough to eat and eating variety–more diversity means more nutrients–as opposed to focusing on complex information and avoiding foods and food groups and specific nutrients can help protect our daughters from diets. Teaching them to be skeptical of eating fads and trends as well as being aware of the dangers of dieting is essential too.

Body Image Printable Worksheets

The best tools to feel calmer and more confident in your body!

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What do you say to your daughter with body image issues?

It’s very common to praise little girls for their looks. Whether you call your daughter beautiful or cute, appearance-based praise can work against positive body image because it reinforces the idea that girls and women are valued primarily for their appearance.

“Non-looks-based compliments boost our kids’ resilience against dieting, disordered eating, body comparison, and body dissatisfaction,” says Amelia. “Specifically, I suggest we move away from saying things like “you’re so cute” or “you’re so pretty” and instead say things that focus on who your daughter is and what she’s capable of.”

Here are some ideas for non-looks-based-compliments Amelia suggests:

I love that you’re not afraid to show your emotions
You’re really loyal to people you care about and I admire that!
I love that you feel comfortable enough to tell others how you feel.
I appreciate how brave you are when it comes to meeting new people.
You’re really good at being open to people who are different from you.
It’s awesome that you’re always willing to make a new friend.
I like how you choose to wear something comfortable – that was well thought out!
I’m so impressed that you’ve been getting to bed on time – that’s not always easy to do!
I admire how you listen to your body and eat as much or as little as feels right for you.

Social media and body image

Body image has always been tricky for girls in our society, but it has definitely gotten worse with the rise of social media. And while it’s very challenging to change social media usage in kids, it can make a huge difference in their mental health and wellbeing.

Teens and young adults who reduced their social media use by 50% for just a few weeks saw significant improvement in how they felt about both their weight and their overall appearance compared with peers who maintained consistent levels of social media use, according to research published by the American Psychological Association.

If you’d like some more ideas about limiting your daughter’s social media use, here are a few articles:

TikTok is dangerous for body image and eating disorders

A new study found that TikTok videos focusing on “health” are dangerous for body image, promote weight loss, and may encourage eating disorders. TikTok’s most-viral “health” videos overwhelmingly say that weight…

Social media filters are ruining kids’ body image

Social media filters are impacting our kids’ body image, and luckily there’s something parents can do to help. We’ve got to have “the talk” with our kids about social media, and…

10 facts about Instagram and body image in girls

It’s fun to scroll through Instagram, but it can have a negative impact on body image in girls. Instagram is not inherently bad, but research suggests that people who use Instagram…

Raising a diet-proof daughter

Dieting is the best predictor of eating disorders, which affect about 9% of the population and are the second-most deadly mental disorder. But dieting has many other negative health outcomes. For example, almost everyone who diets ends up weight cycling, which reduces cardiometabolic health.

Amelia encourages families to raise diet-proof kids who will not fall prey to dangerous weight loss programs. “When you’re raising a diet-proof daughter, you’re teaching her to listen to her body, enjoy her appetite, take pleasure in food, and have a good perspective on eating and physical health,” she says. “You want her to listen to herself, honor herself, respect her body and her needs, her pleasures and appetite. If you do that, she’ll find a good balance between good nutrition and self-care.”

“Elements of diet culture–such as cutting out specific nutrients or entire food groups–will put her health at risk, which is the exact opposite of what diet promoters and “health gurus” promise our girls,” says Amelia. “Feeding yourself is the ultimate act of self care. It’s the most basic thing, and it gets overlooked. So that’s what I want parents to focus on with their girls, making sure they are well fed–that they get enough food and that they feel good about eating. This is the best way to make sure they’re well-nourished both physically and emotionally. I want families to raise girls who are able to eat without feeling judged. There are so many benefits to that.”

With these ideas and more, parents can do a lot to improve girls’ body image.

Ginny’s most recent project is Recovery, a newsletter for deeply feeling people in recovery from diet culture, negative body image, and eating disorders.

See Our Parent’s Guide To Body Image And Eating Disorders

Posted on May 22, 2023May 22, 2023 by Ginny Jones — Leave a comment

Real world stories of hormones and eating disorders

Elizabeth, Mireia, Lisette, Chelsey, and many others believe there is a link between their hormones and eating disorders. With the chemical changes throughout the menstrual cycle and the weight gain that often accompanies puberty and other hormone-related conditions, there’s a lot to unpack when it comes to body image, disordered eating, eating disorders, and hormones. Keep reading to hear their stories of how their experiences with puberty, PMS, hypothyroidism, PCOS, endometriosis, and diabetes interact with eating disorders.

Do hormones affect eating disorders?

Eating disorders are both more common in females and often begin around puberty. Because of this, researchers suggest that hormones may be one of the biological causes of eating disorders. According to one study, “Given the abundance of research suggesting that reproductive hormones play a critical part in normal eating behaviors and food intake, it is reasonable to postulate that these hormones also have a functional role in the dysregulated eating behaviors associated with eating disorders, with estrogens being the most promising candidate.”

Body Image Printable Worksheets

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Menstruation has a clear effect on women’s mental health. Psychiatric hospitalizations, suicidal behaviors, and depressed mood are more frequent during the premenstrual phase. Studies have shown that binge eating frequency and purging behaviors are significantly increased during the premenstrual phase compared with other phases of the menstrual cycle. One report showed a 60% increase in binge-eating frequency in the premenstrual phase. Meanwhile, body dissatisfaction and drive for thinness are highest during the premenstrual phase compared to other phases.

Since eating disorder symptoms are linked to menstrual phases, treatment should address female biology and the impacts of menstruation on mood and eating behaviors. For example, therapists can teach people cognitive techniques for responding to their increased chance of experiencing negative body image, “eating disorder thoughts” and eating disorder urges during the premenstrual phase. Unfortunately, hormonal fluctuations are rarely if ever a factor in eating disorder treatment.

How do hormones affect body image and disordered eating?

Beyond the biological fluctuations of menstruation, another trigger for eating disorders is the degree to which bodies change during puberty. Findings suggest that early puberty is associated with disordered eating and anxiety. Part of that may be due to the hormones themselves, but puberty also changes the way many girls look and therefore are treated by others.

Dramatic changes in appearance and the way people look at and respond to you can have a huge impact on a girl’s identity and sense of self, both of which are involved in eating disorder symptomatology. But it’s not just girls. Both males and females who undergo early puberty have higher rates of disordered eating. This suggests that there are both biological and psychosocial causes of eating disorders associated with puberty.

The research into the intersection of hormones and eating disorders is still in its early stages. However, there are many people with lived experience of their hormones influencing their eating disorder behaviors. Here are a few of their stories:

Elizabeth’s story of periods, anxiety, and eating

Elizabeth is 34 and actively in recovery from her eating disorder, which involves food restriction and food aversions. She has noticed a direct connection between her anxiety and her period. And since anxiety is a major factor in her eating disorder behaviors, identifying its source is essential to recovery. “When my anxiety gets worse, I have a harder time eating in general and a harder time with new or different foods or different textures.”

“I just recently noticed my anxiety gets worse right before I get my period, which directly affects my eating disorder,” says Elizabeth. “When I’m anxious, my OCD kicks in, I have a harder time working through things, and I have more issues with food. Now I’m able to realize where I am in my cycle and I can notice the voice of the eating disorder or the extra anxiety voice and know okay, well, it’s that time of the month. This is not just out of the blue, and it won’t last forever.”

Body Image Printable Worksheets

The best tools to feel calmer and more confident in your body!

Boost confidence
Improve self-esteem
Increase media literacy

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It’s been a relief for Elizabeth to track her period to her anxiety and eating disorder symptoms. “Right before my period, it shoots right up. I get super anxious and super hungry, but I also have more food aversions and more trouble eating. At first I asked myself ‘why is this happening? This is so annoying.’ And then I was like, ‘wait a minute, it’s the same time every month.”

“I was diagnosed last July with other specified feeding and eating disorders (OSFED), but I’ve been struggling since I was about 16, and I’m 34 now, so it’s been a long time,” says Elizabeth. “There are ARFID components to what I’m dealing with and a bit of anorexia as well.

Making the period-anxiety-eating disorder breakthrough is a milestone in Elizabeth’s recovery. “In the last month or so I’ve actually started feeling hopeful about the future,” she says. “Everything had always felt so out of my control and so uncomfortable that I never realized it all was so connected. I feel like now I’m in a different place with my thoughts, about my eating disorder.”

“Now I’m kind of like, all right, well, at least I know maybe the week before or even two to three days before my period the thoughts are going to most likely show up,” says Elizabeth. “I don’t have eating disorder thoughts every day now. So if it kicks in, I can say ‘oh, okay, no, get out of here, not now.’ And it’s easier to say knowing this is directly related to my period, and these are thoughts I do not want to engage in. I don’t have to listen to them.”

Mireia’s story of puberty, hypothyroidism, diabetes, and disordered eating

Mireia has struggled with disordered eating and body image issues since she was 12 years old. “I believe my body image issues started with puberty because it was a period of rapid changes. My period started and I started growing body hair well before my peers at age 11. I hated changing in front of girls my age, I was so ashamed of my body because it was different from theirs.” To this day, she says “My period always makes me hate my body, I perceive it bigger than it is when I’m on my period.”

“At 15 I started my first official intentional weight loss diet because I had a bigger body than my peers and it was pointed out to me by my pediatrician and family members and basically everyone in school, even teachers,” says Mireia. “I wanted to fit in and those changes in my body weren’t accepted by society. I felt rejected.”

Hormone-related conditions

Mireia has hypothyroidism, which is a hormonal condition associated with weight gain. When she was 21 years old she was diagnosed with Type 2 Diabetes, another hormone-related condition. “It triggered a lot of body image issues because again I thought it was my fault for eating badly,” she says. “The year prior to being diagnosed with diabetes I was eating a lot and I even told my therapist I was concerned I had binge eating disorder/bulimia but she gaslighted me and told me to eat healthy and exercise more. Later I learned that insatiable hunger is a symptom of uncontrolled diabetes.” Mireia’s hunger was a symptom of diabetes, not a personal weakness. Her therapist’s weight stigma led to delayed medical diagnosis and a missed opportunity to address her eating behaviors.

Mireia is now 26 years old and recently gave birth. Pregnancy with diabetes is more challenging, but she is grateful that her body was able to grow a baby. “I’m fat, but I try to remain at least neutral about it. I got so much better in the past months, pregnancy helped me realize I need to eat for nutrition and not to lose weight.”

Lisette’s story of PCOS, hormones, and body image

Lisette is 49 and is in her seventh year of eating disorder recovery. She traces her eating disorder back to when she was 17 years old and diagnosed with PCOS. She was prescribed two hormones and her body rapidly changed in response.

“My body changed a lot in about 3-6 months because it went through puberty very suddenly,” Lisette says. “It was alarming to me. It was scary. And that’s really when all of my disordered eating started. Looking back, I realize my body changing was normal and natural. But at the time, that’s really when I started messing around with eating disorder behaviors, and it just got worse as I got older. Maybe if I had understood that it was supposed to change my body and that these things were necessary in order to menstruate, it would have been different. But I got very strong messages that thin was good and dieting was what women did and all of the things most of us were exposed to.”

Lisette got positive feedback as her body changed, but she could not line up her new body with the identity she’d held for seventeen years of her life. “My mom said, ‘you look so beautiful,’ but in my head, it was way bigger than it had ever been. I was used to being smaller and all of a sudden, I wasn’t. I remember being at a pool party and comparing my body to my friends and really realizing that it had changed. My brain was thinking, ‘this change is not okay.”

Vivid memories

“I have this vivid memory of trying on clothes and there was some size that I always was and all of a sudden, none of it fit,” says Lisette. “And I had to go get bigger sizes and I remember looking at myself and thinking this is not okay.”

Lisette went into eating disorder treatment twice before getting married and having three kids. “I gained up to the target that they gave me and would not do certain behaviors. And in my mind, that was recovery, but I was not where my body wanted to be; I was still restricted.”

Lisette entered what she calls true recovery after her youngest son was one year old. “Throughout my pregnancies, I was working on it but I wasn’t free all the way,” she says. “But then I learned about Health At Every Size® (HAES®) and learned about how this is a social justice issue. I learned that some of the treatment I had received was harmful. And I did what I consider true recovery. My body changed and found its set point in a size much larger than any target weight they ever gave me in treatment.”

Non-Diet/Health At Every Size® Fact Sheets, Guidelines, and Scripts

Fact Sheets About Weight Stigma, Diet Culture, Kids and Diets, and More
Non-Diet Parent Guidelines
Non-Diet Parent Scripts About Responding to Fat Talk, Diet Talk, and More
What to Say/Not Say When Talking About Bodies and Food

Learn More

Chelsey’s story of puberty, endometriosis, and an eating disorder

Chelsey developed an eating disorder at age 14. She’s now 31 years old and has been working on recovery for three years. “When I first got my period, at 13 years old, I immediately struggled with severe pain,” says Chelsey. “I was told that I needed to lose weight, change my eating habits, or work out more. They even said that I probably have a low pain tolerance and just simply cannot handle the pain of menstrual cramps. I quickly became unhappy with my body for having pain. It felt like it was my fault. I would often become depressed, anxious, and irritable before my period and noticed increased fear and unhappiness with my body.”

After almost ten years of trying to get doctors to listen to her, Chelsey was finally diagnosed with endometriosis at age 22. It wasn’t easy. “The doctor that ended up diagnosing me did NOT believe me but I advocated for myself, demanded a laparoscopic surgery, and he then apologized for not listening to me,” she says.

Hormonal fluctuations

“Hormonal fluctuations have continued to contribute to my disordered eating,” says Chelsey. “I notice that I experience significant depression when I am PMSing, and it is all centered around how I feel about my body. Sometimes I’ll be feeling so low that I don’t want to get dressed, socialize or be intimate with my husband. I cry every day, thinking about how terrible my body is and questioning how my husband can be attracted to me. I experience deep, deep sadness and feel as though I will not escape it. Then, after having my period, I feel the opposite: content, proud of what my body has done, not afraid to eat certain things, and confident. It’s a struggle because it’s very up and down for me.”

“I think people need to realize that hormones and eating disorders go hand-in-hand,” says Chelsey. “For me, hormonal fluctuations heighten anxiety, depression, and OCD which then plays a huge role in your thoughts and emotions around negative body image, disordered eating, and/or over-exercise. I know that for me when my anxiety and depression are heightened, I obsess around “needing” to work out over what I ate, I pull and tug at my clothes, I am physically uncomfortable with how my body looks and feels, and the negative self-talk spirals.”

Ginny’s most recent project is Recovery, a newsletter for deeply feeling people in recovery from diet culture, negative body image, and eating disorders.

See Our Parent’s Guide To The Causes Of Eating Disorders

Posted on May 9, 2023May 11, 2023 by Ginny Jones — Leave a comment

How to supercharge eating disorder recovery with embodiment

Embodiment is the sensation of being in your own body and trusting the body’s signals, desires, and demands, and it’s very helpful in eating disorder recovery. An embodied person has a respectful, trusting, and kind relationship with their body. For centuries, Western culture has promoted the separation of mind and body, suggesting that the body is an inconvenient and unruly child, while the mind is the wise and knowing grownup who should dominate and control it.

This approach is everywhere, from education to medicine and psychology. It encourages the separation of body and mind. However, physically and emotionally we are one body-mind. There is no separation between the mind and body. They are one.

Emotions begin in the body and travel up to the mind. The body provides the mind with critical information about safety and threat. In our mind-first culture, people learn to ignore these essential signals and prioritize the mind’s thoughts, which are not always accurate or appropriate responses to the body’s signals.

Humans evolved with an intricate emotional system to keep us safe and healthy, but Western culture has worked to disembody us. Our culture has prioritized the mind as smarter than the body. This disconnect supports racism, sexism, heteronormativism, anti-trans bias, anti-fat bias, and other systems of oppression. It also leads to mental and physical illness. Almost all mental illnesses trace to a disconnect between body and mind. And the solution to many mental disorders, including eating disorders, is embodiment.

Emotional Regulation Worksheets

Give your child the best tools to grow more confident, calm and resilient so they can feel better, fast!

Self-Esteem
Self-Regulation
Mindfulness
Calming strategies

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Why is embodiment helpful for eating disorder recovery?

Eating disorders almost always begin with the suppression of bodily signals. Rather than feed the body adequately, the mind intervenes and creates rules and shame around the most natural and necessary act of staying alive: eating. Hunger exists to keep us alive. Eating feels good because it is essential to living. And yet societal messages turn our minds against these natural instincts.

These messages are planted by diet culture, which exists in every corner of our society. Diet messages are taught in schools, promoted in doctors’ offices, and perpetuated at almost all family dinner tables. These messages say the body is not to be trusted. Instead, diet culture says the mind must ignore bodily hunger cues, appetite, and cravings and control and limit food.

When an eating disorder takes hold, it whispers these beliefs repeatedly, leading the person to avoid food and eating. Because the body has needs, often it will react to deprivation by binge eating. Sometimes the person will compensate for eating by purging and/or over-exercising.

The body is a resource, not an obstacle, in the recovery process and often needs to be resourced directly through a wide variety of body-based interventions before it can effectively metabolize food.
Embodied Recovery Institute

Embodiment is essential for eating disorder recovery because it returns the person to a respectful and honest relationship between the mind and body. Rather than allowing the mind to dominate and control the body, with embodiment we trust the body’s signals and aren’t afraid to respond to its needs with intelligence, love and care. Embodiment means approaching recovery with more ease and confidence and the belief that the body is wise and trustworthy. The mind is part of embodiment, but it does not ignore the body’s messages.

What are some embodiment practices?

Many people with eating disorders describe themselves as disembodied. They find themselves unable to connect with how they feel in their body, what their body wants, or to take cues from their body. Rebuilding the brain-body connection takes time and practice, but anyone can do it.

The core skill of becoming embodied is mindful attention. With an eating disorder, people become intentionally disconnected from their bodily sensations. Mindful attention to what the senses are taking in and how your body is experiencing the world can begin the reconnection process. Here are a few ways to begin:

5 senses scan

Look around and notice five things that you can see. Tune into your sense of touch and notice four things you can feel. Listen carefully and notice three things you can hear. Bring your attention to your nose and notice two things you can smell. Focus on your tongue and mouth and notice one thing you can taste.

Body scan

Get comfortable and tune into the sensation of your breath going in and out of your body. Repeat this for several breaths. Now notice how your body feels in space. Depending on your position, feel your feet on the ground, the places where the floor or cushion touches the backs of your legs, back, etc. Beginning at the top of your head, slowly bring your attention to different body parts, making your way down to your toes. What do you feel in each body part? Repeat this with your internal organs.

Yoga

Many yoga poses can support embodiment. For example, savasana, or corpse pose, can be a way to tune into the body and become aligned with how it feels. Additional poses commonly used in embodiment practices include downward dog, tree pose, and crocodile pose. The important part is to notice how the body feels within the pose and remain mindful of your body’s signals throughout your practice.

Barefoot grounding

Grounding, also known as earthing, is mindfully standing or walking barefoot. It’s often done outdoors on grass, mud, or sand. Ideally, it’s in a park, forest, beach, or lakeside. While outdoors is typically preferred, indoor surfaces like carpet, wood, or concrete work. The goal is to notice how it feels, down to the minute detail, when your bare feet connect with the Earth’s surface.

Why is yoga such a good practice for eating disorder embodiment?

Embodiment is essential for eating disorder treatment and recovery because it reconnects the body and mind. And yoga is a common way to build embodiment during recovery. Research indicates that yoga is an effective tool for eating disorder treatment. This is likely due to its ability to shift from a negative to a positive relationship with the body. It also nurtures self-respect, well-being, and embodiment.

To learn more about the connection between yoga and eating disorder recovery I talked to Julia Oliver, RD, LDN, RYT. Her practice, Rooted Recovery, offers yoga and nutrition services for people in recovery. She also runs Embodied Yoga on Demand, an online library of yoga and meditation classes to support eating disorder recovery.

“Since it can be gentle in nature, yoga is a supportive option for individuals who need a recovery-centered reentry into movement” says Julia. “Yoga offers a stepping stone as individuals begin to safely enter back into their relationship with their body and reconnect with body signals.”

Julia describes an eating disorder as a disembodying disorder. “It takes the person out of their body and turns the mind against the body,” she says. “In the midst of an eating disorder, the body is something that is often manipulated, taken control of, and pushed around by a dictating mind.”

During recovery, reconnecting with the body’s signals is necessary to start feeling bodily cues like hunger and fullness. Yoga can help people begin this reconnection process. “By cultivating embodiment in yoga, sensations may become more apparent during the practice,” says Julia. “It can also get us more tuned into our nervous system. It provides a practice field for the grounding skills and regulation techniques individuals may be working on with their therapist.”

“Yoga in its Eastern roots is all about stilling the fluctuations of the mind (aka thoughts) so that we realize we are not our thoughts,” she says. “Yoga, when taught well, can guide us to practice presence, using the breath and sensations as anchors to the present moment where we can then find the space to let go, and not attach to thoughts. Challenging harmful thoughts and beliefs is a foundational part of the recovery process, so you can imagine how the yoga practice, when taught in a way that does not just focus on the physical shapes, can be an inherently supportive part of eating disorder recovery.”

Sample yoga session for early eating disorder recovery

In this vinyasa yoga class, you will be guided through twists, balancing postures, and supported backbends to begin noticing and responding to the unique cues of the body in each pose. As in every ‘Exploration Phase’ class, you will be prompted to use the breath and sensations in the body as anchors to the present moment. Here, you will become more attuned to the balance of effort and ease in your body.

Ginny’s most recent project is Recovery, a newsletter for deeply feeling people in recovery from diet culture, negative body image, and eating disorders.

See Our Eating Disorder Treatment Guide For Parents

Posted on May 4, 2023May 8, 2023 by Ginny Jones — Leave a comment

A remarkable book about a boy, body image, and disordered eating

A beautiful book about a boy, body image, and disordered eating

Following is an interview with Jarrett Lerner, author of A Work in Progress. This book poignantly illustrates the painful childhood experiences of a boy with negative body image and disordered eating. It shares what it feels like to be singled out and body shamed in elementary school, and how easy it is to slip into disordered eating in an attempt to regain dignity and control.

Jarrett’s book, which is based on his own experience as a boy with negative body image and disordered eating, touched my heart deeply. Though I’m not a boy, I was that kid. And for me, Jarret’s book beautifully describes what it felt like to believe my body was wrong and to desperately want to change it by any means possible.

This is Jarrett’s thirteenth book. A Work In Progress is written for kids aged 8-12 and tells the powerful story of a boy with negative body image and disordered eating. Here’s my interview with Jarrett:

Q: When did you first feel bad about your body?

Jarrett: I recall very clearly as a little kid we belonged to a pool and I loved it, I was in it all the time. And then my body changed and I was not a big fan of the pool anymore. And I remember being on a trip and really wanting to go into this amazing pool with all these cool features. I would make excuses to not go in it. And when I finally did go in it, I asked my mom to take me at night and in a T-shirt. So I swam at night in a T-shirt to have that experience I wanted.

I was worried about what would happen if I showed my body in public. And then I had a moment in elementary school where I was publicly body-shamed. And that sort of intensified it all and led to a hyper-awareness about my body and eating. I landed on this idea that I’m just going to do something to change my body by changing my eating.

A Life In Progress by Jarrett Lerner boy body image eating — Excerpt from the book *A Life In Progress* by Jarrett Lerner. Image courtesy of the author.

Q: What do you think influenced how you felt about your body?

Jarrett: At the time there was nothing like body positivity or body neutrality. It didn’t exist. We didn’t have any role models in the public eye doing that. If you go back two decades, which is when much of this was going on in my life, the messages that were out there were really stark and shameful.

You could barely see a movie or pick up a book without cheap jokes about someone’s size being used for comic relief. So that’s what I was ingesting. And then on the other side of things, there was the constant barrage of fad diets every week. It was always a new diet. It was a very intense time.

I was able to convince myself that the disordered eating and over-exercise I was doing was actually healthy because I wasn’t fully starving myself, I wasn’t bulimic. By staying on the other side of that line I convinced myself I was actually being healthy by watching what I ate and exercising. I didn’t know what disordered eating was until I was an adult.

Q: What do you think is unique about being a boy with negative body image and disordered eating?

Jarrett: Generally speaking, I think that boys who suffer from body image and eating issues have this sort of added issue to wrestle with, which is the concept of masculinity. So often growing up, the thing I heard most from my peers and even from adults in my life was man up. I can’t even count how many times in situations where either I or someone around me was showing vulnerability and were told to man up.

So that was something that I thought I had to do when I was struggling with my body. It was man up. Man up when I wanted to shout out and cry for help.

I think that’s changing. I think we have more models of male vulnerability in our culture, and more men who are more comfortable showing emotion. But I think it’s still an issue. I still hear “man up” or something similar when I’m in schools.

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Q: How did it feel to have body image issues and disordered eating?

Jarrett: I remember finding two books that broached the subject of eating disorders, and they were extreme cases with girls. And I’m glad those books existed, and I’m glad that today there’s more of them. But for me, who didn’t require hospitalization and was a boy, I think in some ways reading those stories actually did more damage than good.

Not seeing boys with body image and eating issues made me think that there was something even more wrong with me, that I was the only boy on Earth who was experiencing these things, that they were the territory of girls, and that I was doubly troubled because I was a boy experiencing it.

I felt so alone and overwhelmed. Even when surrounded by people, even in a caring family, even with friends and even with things going on socially, I felt very alone. I was overwhelmed by the intensity and consistency of the negative thoughts in my head. And I felt incapable of getting help. I convinced myself that the destructive things I was doing were constructive and positive.

My parents would have been the perfect people to open up to about it. I wish I had spoken to my parents and my friends. I wish I had felt comfortable and said what I was thinking and feeling, but I didn’t.

Q: How would you describe your journey out of disordered eating?

Jarrett: In the book, it’s Will versus the Will Monster and thinking he has to tame it. But he realized that fighting wasn’t working. Like Will, I had to stop fighting and sit down with these thought processes and obsessions and confront them. And instead of trying to slay this monster, I had to accept it and sit down with it and say, this is me and it wants something. It needs something, and maybe there’s another way to get it.

My best therapy was writing. I discovered my own sort of cognitive behavioral therapy, where writing things down helped me release my thoughts and helped me grasp them in a way that I could get beyond them and write myself a new story.

I also discovered a new group of friends that was much more accepting and open minded and much like Markus in the book. They were radically accepting and offered love to everyone, no matter the differences of their body or outlook or background. And I think all of that instilled confidence that allowed me to manage it better.

Q: How do you view recovery from disordered eating?

I’ve come to think of myself as in recovery. It helps me greatly to remind myself that it’s okay to have bad days when food and body stuff crops up. On days when it’s harder to quiet that voice and be nice, I remind myself to give it a hug instead of trying to chase it away, because that only leads to worse outcomes.

And thinking of myself like that has allowed me to extend myself the same sort of grace that I would any friend or family member. And that’s really the whole theme of the book, this idea of being a work in progress, that you might look at yourself today and say, “oh, man, I don’t love this thing I did or this part of me or the way I acted. But tomorrow is a new day, and I’m never going to be perfect. I’m always evolving. I’m always changing.”

Q: Why did you write this book?

Jarrett: I think the greatest opportunity I have right now is to openly say to kids “I’m going to talk to you about disordered eating and body dysmorphia and how I struggled with it for years.” I think the act of sharing encourages and inspires other people to share their stories. I hope that I serve as a model for kids who can maybe feel much more comfortable and even eager to share.

And that’s what compelled me to finish putting this book together. It was my motivation to finish this book and go on tour with it and stand in front of auditoriums of kids making myself vulnerable. I know in every auditorium I step into, there will be kids who are silently suffering and who feel like I’m speaking right to them. And if I’d had someone in 5th, 6th, 7th grade talk about it publicly in front of me, it would have been amazing and I think it would have gotten me into a healthier place much sooner.

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Q: How do you think your experience has informed how you parent your own kids?

Jarrett: I hope that I model vulnerability and openness and sharing of difficulties, external and internal. In terms of eating and food and body image, I think I’m extremely sensitive and careful about what I both don’t do and what I do. And I try to make sure that none of the hang ups that I continue to have and continue to struggle with seep out into my own language and my own responses to anything that they’re doing.

If you look at the data, chances are that my children will feel insecure about something or other. Maybe it’s the quality of their skin once they hit puberty. Maybe it’s their hairline, or it can be anything. But I think it’s exceedingly rare that someone gets through life without some sort of insecurity.

So I hope I’m just sensitive to that, that I’m both a good role model and a supportive parent, and that I can provide information should anything ever crop up or at least I get a sense that something’s cropping up.

Ginny’s most recent project is Recovery, a newsletter for deeply feeling people in recovery from diet culture, negative body image, and eating disorders.

See Our Parent’s Guide To Body Image And Eating Disorders

Posted on April 26, 2023April 27, 2023 by Ginny Jones — Leave a comment

ARFID: expert advice to help parents support recovery

Avoidant restrictive food intake disorder (ARFID) is an eating disorder that features highly selective eating patterns. The major risk for kids with ARFID is not getting enough nutrients and becoming weight suppressed, which can interfere with growth and overall health. Getting expert advice when a child has ARFID can help parents understand what their child is going through and support recovery from this eating disorder.

ARFID is strongly associated with kids who are highly sensitive. This sensitivity often includes being sensitive to food flavor (taste and smell) or texture. But eating is a 5-senses experience, so a child may also be sensitive to the way food looks and even the way it sounds and the sounds of others eating. Beyond the 5 senses, kids who are highly sensitive may also be very tuned into the emotional experience of eating and how their parents and others around them feel when eating.

ARFID is typically seen beginning at a young age. It is strongly associated with people who have ADHD and autism. Over time, ARFID can cascade into another eating disorder such as anorexia, bulimia, or binge eating disorder. It is typically characterized by high levels of anxiety about food and eating. Behaviorally, someone with ARFID will refuse to eat foods that make them feel anxious. Without intervention, the list of “safe foods” can dwindle to just a handful of options.

Many parents feel overwhelmed when their child has ARFID, but there are very good treatments available, and there is a lot that parents can do to help.

I interviewed two dietitians who specialize in treating ARFID, Rebecca H. Thomas RD, LDN, and Stefanie Ginsburg, RD, CEDS-S. They are members of the ARFID Collaborative, a group of clinicians dedicated to increasing ARFID awareness, education opportunities, training options, and treatment access.

Here is their expert advice for parents who want to support their child’s recovery from ARFID:

How do you explain ARFID to parents?

When we paint the picture for parents of what it is like to have ARFID, we ask them to think of some of their fears or things they dread doing. This may be flying, waiting at the DMV, a fear of heights, or maybe it’s creepy crawly things, like snakes or spiders.

Then we ask them to imagine having to engage with that fear or disliked thing, at least 3 times a day! All the while, enduring pressure and shame from an authority figure (maybe a boss or professor) for not being able to manage this easily.

Think about how doing this on a regular basis might affect your motivation to participate in daily activities that involve these fears. This can be what it is like for children who have ARFID.

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What is the hardest part of treating ARFID from your perspective?

There are so many obstacles within the treatment for ARFID. We would have to say the hardest part is helping parents and clients stay motivated to continue care. Progress with food acceptance and increasing dietary variety can take a long time and requires consistency and endurance.

Oftentimes parents are overwhelmed with their child’s struggle and with the amount of work it takes them to carry over the treatments from sessions into daily life. It can feel disheartening when you’ve spent months working on one food, and they are still only taking one bite. We try our best to let them know that things DO get better and easier and part of our role is to cheerlead even the smallest of wins and successes.

What treatment do you recommend for ARFID?

We recommend a hybrid-individualized approach that incorporates CBT-AR, Satter’s Division of Responsibility of Feeding, FBT-AR, food chaining, and food exposure therapy.

We have seen the most success with children when families are re-feeding from home and are being consistent providing the food we are working on at home between sessions. Parental commitment is an essential part of treatment.

How can parents be helpful in treating ARFID?

Presence and consistency. As we mentioned before, treatment is a 50/50 effort. Providers can give you guidance, coaching and resources, but ultimately, it is the caregivers showing up everyday to say: “I know this is hard for you, but we can do hard things. Let’s figure out how to get through this meal/food together” that is going to be the most helpful.

It can also be helpful to remind them that we do not have to “like” a food in order to eat it. We think there is a fair amount of unnecessary pressure to like all the food you eat. A lot of our normalized eating consists of eating and drinking items that can be tolerated.

How do you measure recovery/What does recovery look like?

Recovery from ARFID involves the following key elements:

Ability to maintain nutrition status
Preventing unwarranted weight fluctuations
Being free of nutritional deficiencies
Having enough energy to do daily activities
Staying on a regular growth trajectory
Managing daily eating with minimal distress
Dietary variety

The term recovery when it comes to ARFID is typically a life journey. It involves both acclimating to and building resilience for food-related anxieties or indifferences. One degree of change helps pave the way for ongoing progress in recovery.

Food Refusal & Picky Eating Printable Worksheets

Give your child the best tools to grow into a confident, calm, resilient eater!

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What resources/books do you recommend to parents who have kids with ARFID?

How to Nourish Your Child Through an Eating Disorder by Casey Crosbie RD, CSSD Wendy Sterling MS, RD, CSSD.
Helping Your Child with Extremely Picky Eating by Katja Rowell, MD Jenny McGlothlin MS, SLP
Avoidant Restrictive Food Intake Disorder: A Guide for Parents and Carers by Rachel Bryant-Waugh
Raising Adventurous Eaters: Practical Ways to Overcome Picky Eating and Food Sensory Sensitivities by Lara Dato MS OTR/L, SC-FES
Food Refusal and Avoidant Eating in Children, Including Those with Autism Spectrum Conditions. A Practical Guide for Parents and Professionals Book by Elizabeth Shea and Gillian Harris.
The Picky Eater’s Recovery Book by Dr. Jennifer Thomas (For those that have teens or young adults with ARFID)

Regardless of the type of eating disorder your child has, including ARFID, expert advice can help you support your child’s recovery.

See Our Parent’s Guide To The Different Types Of Eating Disorders

Posted on April 19, 2023May 2, 2023 by Ginny Jones — 2 Comments

A helpful strengths-based approach to eating disorder recovery

strengths based eating disorder recovery

Gloria has been in recovery from an eating disorder for years, but she feels hopeless. “It’s just that I have all these personality traits that doom me to a life with this problem,” she says. “I don’t see how I can possibly escape from my eating disorder because I’m such a perfectionist.”

I completely understand. Our personalities are a very important part of our identity. And it’s true that certain personality traits are associated with eating disorders. Eating disorders are “biopsychosocial,” which means they have biological, psychological, and social causes. Personality traits are some of the psychological causes of eating disorders. The stronger a trait is, the more likely it will be considered a “maintaining factor” in an eating disorder. In other words, a trait like perfectionism can drive an eating disorder to develop. And if it’s unmanaged it can also makes the eating disorder more likely to stick around.

However, I think viewing personality traits as purely negative is both inaccurate and unhelpful. Many people like Gloria feel like being labeled “perfectionistic” is a life sentence. This does not help Gloria achieve recovery. And in fact, it keeps her focused on what she doesn’t have rather than what she does have. A strengths-based approach to eating disorder recovery is much more hopeful and helpful.

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Personality traits associated with eating disorders

There are several key personality traits associated with eating disorders: perfectionism, obsessive-compulsiveness, neuroticism, negative emotionality, anxiety avoidance, low self-directedness, low cooperativeness, high impulsivity, sensation seeking, and novelty seeking.

These personality traits are commonly perceived as negative and seen as weaknesses. But every personality trait contains both strengths and weaknesses. And continuing to focus on weaknesses keeps people stuck in endless loops of self-recrimination.

NOTE: self-recrimination does not help people recover from an eating disorder.

A strengths-based approach to eating disorder recovery

Of course the so-called negative personality traits have downsides. But that’s because great strengths cast long shadows. Research shows that focusing on weaknesses is de-motivating. Conversely, focusing and building on strengths is motivating. It’s better to focus on what’s right with someone than what’s wrong with them.

“Many health systems have traditionally adopted a view of mental disorders based on pathologies and the risk individuals have towards mental disorders,” says Huiting Xie. “However, with this approach, mental disorders continue to cost billions a year for the healthcare system.”

The deficit-based approach to recovery damages recovery because it is inherently unmotivating. If Gloria believes she has a “fatal flaw,” she’s unlikely to embrace the resources available and fully engage in the recovery process. However, if she is confident that can apply her natural and intrinsic strengths to recovery, she’s more likely to embrace recovery.

A strengths-based approach to eating disorder recovery doesn’t pretend there aren’t difficulties to be faced, but it mobilizes a person’s strengths rather than focusing on what is wrong with them. Mental health issues like eating disorders can be seen as a normal part of human life that can be managed and overcome. This treatment approach focuses on a person’s abilities rather than their shortcomings, symptoms, and difficulties.

Here are four personality traits and examples of how we can take a strengths-based approach to eating disorder recovery:

1. Perfectionism

Perfectionism meaningfully and consistently predicts employees who are more motivated on the job, work longer hours, and can be more engaged at work. These strengths can clearly lead to eating disorder behaviors if they are focused on eating and body weight. However, they can become a driver of eating disorder recovery, too. For example, if a person with an eating disorder focuses on their strength of being highly motivated, they can become deeply engaged in recovery.

Typically treatment focuses on the negative fact that a person has become overly-engaged in their eating disorder behaviors. A strengths-based approach means we focus on their ability to deeply and passionately engage in things that matter to them. If they become deeply and passionately engaged in recovery, they can do anything!

2. Obsessive-compulsiveness

People with obsessive-compulsive personality traits are often confident, warm, organized, and high-achieving. They have meticulous standards of behavior and high expectations that can benefit them in every area of life. When these standards are applied to eating and body weight, they can drive eating disorder behaviors. However, this person has a strong ability to organize and make strategic decisions. When this strength is harnessed, they can become strongly motivated to recover.

This trait likely drives the people who “spontaneously recover” from their eating disorders. This really happens! Some people wake up one day and decide they don’t want to have an eating disorder anymore. Once an eating disorder no longer fits their rules of “good behavior,” recovery can be easier for people with this trait.

3. Neuroticism

The word “neurotic” is one of the worst-sounding personality traits, but, like all personality traits, it has strengths. People who have a more “neurotic” personality tend to be intelligent and funny, have more realistic expectations, and have greater self-awareness. They are also highly creative thinkers and tend to possess more emotional depth. Their emotional depth is likely what makes people with neurotic personalities more susceptible to eating disorders. Because they are more sensitive, they are more likely to need coping strategies for their big emotions.

However, when their creativity and intelligence are applied to building healthy coping strategies to replace their eating disorder behaviors, they can find deep and meaningful recovery. Additionally, embracing their neurotic tendencies can provide tremendous freedom and allow them to embrace themselves as they truly are, rather than try to fit into a socially-acceptable version of themselves. Recovery requires a person to embrace their body as it is. And it also requires embracing their SELF as it is.

4. Negative emotionality

Most personality traits arise as a combination of nature and nurture. But negative emotionality is a personality trait that is usually hardwired in the brain. We are all born with brain structures that determine whether we have a generally negative or positive temperament. And we have no control over our natural tendency towards negativity. Assuming that a negative temperament is bad is harmful and inaccurate. Negative emotions are adaptive, normal, and necessary. They are also highly motivating. Negative emotions prompt us to take action and provide valuable information about the inner and outer environment.

Someone with a more negative emotional state is better positioned to recognize when something is dangerous. Once danger is identified, they are motivated to build new skills and stop risking endangerment. But this is not a matter of “scaring people straight.” Adding more negativity to someone with negative emotionality will not support recovery. Rather, we need to support people in tuning into the messages their negative emotions are trying to send them. We can empower people to listen to their negative emotions with critical insight and use their intelligence and creative problem-solving abilities to embrace recovery.

Empowering recovery

Seeing personality traits as negative when treating an eating disorder is unmotivating and unsuccessful. Instead, seeing personality traits as strengths can support recovery. They can help a person find greater motivation and success.

That’s what happened to Gloria. “I found a new therapist who focused on my strengths and empowered me to claim recovery on my terms,” she says. “With her I found that my perfectionistic tendencies were actually exactly what I needed to recover.” She is now engaged in the process of recovering. And Gloria feels more hopeful and optimistic now that she’s using a strengths-based approach. By embracing her personality rather than rejecting it, she’s embracing recovery.

Ginny’s most recent project is Recovery, a newsletter for deeply feeling people in recovery from diet culture, negative body image, and eating disorders.