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Help your teen with an eating disorder get enough sleep

Help your teen with an eating disorder get enough sleep

If you have a teen who has an eating disorder, then you probably know that getting enough sleep is a key component of their care. But it can be hard to get any teenager to get enough sleep. 

And when you add on the disruption created by an eating disorder, it can feel like just one more thing on your list.

Sleep and mental health

Getting enough sleep is a cornerstone of mental health. And while of course a person can recover without getting enough sleep, recovery will likely be easier with sleep hygiene.

There are three essential components of mental health: eating, sleeping, and relating. Parents are able to support mental health by ensuring these three components are fulfilled.

Eating: We support our kids’ mental health by serving consistent, enjoyable meals and supporting them in getting enough fuel for their bodies and minds. 

Sleeping: We support our kids’ mental health by establishing healthy sleep habits and boundaries to promote sleep hygiene.

Relationships: We support our kids’ mental health by being in a positive relationship with them, supporting their peer and other relationships, and offering them psychotherapy for additional support.

Teens and sleep

Science has shown that teenagers are not lazy or obstinate when they stay up late. They are actually driven by melatonin levels to stay up later in the night and awake later in the morning than either children or adults. And unfortunately this night-owl behavior is coupled with a biological need for the teenage brain to get 9-10 hours of sleep per night.

It goes without saying that most of our teens don’t get even close to 9-10 hours of sleep. Even teens who are able to fall asleep at midnight are likely only getting 6-7 hours of sleep to accommodate early school start times. 

A lack of sleep increases impulsivity, anxiety, and depression. And all of these are associated with eating disorders.

Eating disorders, like many mental disorders, first appear during adolescence. This is a time when the human brain undergoes a massive “pruning” effort to transform the child’s brain into an adult brain. This pruning is part of the maturation of the prefrontal cortex, which is the area responsible for planning, prioritizing and controlling impulses.

A lack of sleep isn’t the sole cause of mental disorders, but many studies have found that it is correlated with mental disorders.

“Sleep loss problems are linked with brain areas that control emotional processes and risk-taking,” says Wendy Troxel, a clinical psychologist and senior behavioral and social scientist at RAND. “Sleep problems and behavioral and mental health problems are linked.”

How to help teens get enough sleep

A lack of quality sleep has a profound impact on our kids’ health, cognition, and behavior. But what can we do about it?

If you’re like many parents navigating eating disorder recovery, then the thought of getting your child through recovery may seem like a heavy enough burden. The idea of adding on a sleep routine can feel unlikely or even impossible. 

But setting boundaries around sleep is something you can do. Just like eating enough, eating regularly, and going to therapy, sleep is important for recovery. We can’t force our kids to get the sleep they need, but we can create the conditions that make sleep more likely. 

1. Make a family plan

It is important to make sleep a priority for everyone in the family. It just won’t work to tell your teen who has an eating disorder that they need to sleep, but nobody else does. That will feel punitive and is unlikely to work.

Discuss the importance of sleep, and agree that as a family, every member needs to improve his or her sleep hygiene. This foundational agreement is the only way you will be able to successfully implement the following recommendations.

2. Turn off electronics

According to the National Sleep Foundation, “ninety percent of people in the U.S. admit to using a technological device during the hour before turning in, and children often use electronic media to help them relax at night,”

The problem with this trend is that using electronic devices is physiologically and psychologically stimulating and can adversely affect sleep. Yes, all of us believe that we do not fall into the category of people who find electronics disruptive, and all of us believe that our devices help us fall asleep, but the science shows that simply isn’t true.

Using TVs, tablets, smartphones, laptops, or other electronic devices before bed delays your body’s internal clock (a.k.a., your circadian rhythm), suppresses the release of the sleep-inducing hormone melatonin, and makes it more difficult to fall asleep. This is largely due to the short-wavelength, artificial blue light that’s emitted by these devices.

The more electronic devices that a person uses in the evening, the harder it is to fall asleep or stay asleep. Besides increasing your alertness at a time when you should be getting sleepy, which in turn delays your bedtime, using these devices before turning in delays the onset of REM sleep, reduces the total amount of REM sleep, and compromises alertness the next morning. Over time, these effects can add up to a significant, chronic deficiency in sleep. (National Sleep Foundation)

As a family, determine a time at which all electronics must be powered down. All the way. Not left sitting next to you so that you can see texts coming in. You may need to make it physically difficult or impossible for anyone to access the electronics at night.

Here are some options: 

1. Shut down the wireless from 10 p.m.-6 a.m. That may seem early to you, but if your teen has to be at school at 8, that means they need a bedtime of 11 p.m. at the latest.

2. Purchase a time-based safe. This can keep your phones locked up until the morning. 

3. Create a charging station in the house in which all electronics are stored for the night. 

Remember that all members of the family must participate in the activity of powering down – it can’t be something that only the kids have to follow. Your teen who has an eating disorder should not be targeted as the reason for the new sleep habits.

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3. Sleep hygiene

Bedtime rituals can be very helpful in signaling the brain to “power down” and prepare for sleep. Each person will have their own ritual, but the important thing is to talk about them as a family. For example, one person may enjoy a shower or a bath. Another may enjoy a cup of something warm and soothing.

Have books and physical reading materials available for everyone. Book-based entertainment is enjoyable but non-stimulating and therefore not disruptive to sleep. Get everyone proper sleeping clothing and invest in nice sheets and pillows so that everyone feels happy in their beds.

Begin turning off lights as the night wears on. Lights signal our brains to stay awake, so gradually turn off and dim household lights to help signal sleep. The best sleep hygiene involves going to sleep and waking up at the same time every day. Based on age and temperament, establish ideal bedtimes for each family member.

4. Avoid overwork

At this point, you may be wondering if this type of sleep program is unrealistic. Perhaps your child tells you they need to remain available for texts and do homework until midnight. If this is the case, then look at your child’s schedule. Enough sleep should be considered non-negotiable for every family member, especially when there is an eating disorder.

You may be surprised to hear that eating and sleeping should be the priority in your home. All other activities should come only once those two fundamental needs are well-met. And the third essential need? Socializing and enjoying life!

Consider reducing your child’s extracurricular load and your expectations so that they are able to complete homework well before 10 p.m. 

If your teen is not able to complete all school and sports activities by 10 p.m. then they are overworking. Our teenagers’ brains cannot handle the strain and may develop serious disorders as a result of chronic overwork.

Our culture has created a dangerous precedent in which some teens are going non-stop from 7 a.m. to 11 p.m. every day. And then they begin their relaxation and socializing, both of which are very important. As a result they often stay up well into the morning hours.

This interferes with sleeping, eating, and enjoying life. It is not healthy by any standards. In many cases, our teenagers are working harder and doing more than adults. We simply must edit our teens’ lives to raise healthy kids.

Getting support

I realize that adding sleep hygiene can be a daunting task when you’re already dealing with a teen who has an eating disorder. If you feel these steps are impossible in your family, then please consider getting some support from a therapist or coach. They can help you set and hold boundaries to support your own and your family’s mental health.


Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders and body hate.

She’s the founder of More-Love.org and a Parent Coach who helps parents who have kids with eating disorders and other struggles.

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Parents, don’t talk about weight and dieting with your kids

Parents, don't talk about weight and dieting with your kids

Many parents believe they can prevent their kids from gaining weight by talking about weight and dieting.

But weight is largely a function of genetic and environmental factors over which we have no control. And parents who teach their kids to fear weight gain create conditions ripe for eating disorders. [3] Living in a larger body is less deadly than we think it is. But weight stigma is serious, especially when it begins at home.

Lots of parents criticize weight in front of kids

Because of our culture, most parents engage in regular “fat talk” in front of children. This includes:

  • 76% of parents speak negatively of their own weight in front of children
  • 51.5% of parents speak negatively about “obesity” in front of children
  • 43.6% of parents speak negatively about their child’s weight in front of the child

Source: [4]

This behavior should not be surprising. Our culture widely criticizes people in larger bodies. Many people believe it is their duty to inform larger-bodied people that they are endangering their health.

Generational fat talk

Fat talk doesn’t arise from nowhere. It’s everywhere in our culture. Most media outlets trumpet the perceived dangers of weight. Doctors regularly engage in clunky attempts to discuss weight. And many families engage in generational fat talk and fat shaming.

Over 40% of young women and 27% of young men said they received encouragement from their mothers to diet to stay slim. And about 20% of young females and 18% of young males said they’d gotten similar messages from their dads. [3]

But parental pressure to get and stay thin is associated with poorer health in young adulthood. There seems to be a cumulative effect on adult behaviors centered on weight, weight-related behaviors and psychosocial well-being. [3]

Parents who talk about fat negatively increase their child’s risk of mental health conditions. This includes eating disorders.

If you’re trying to avoid weight gain, don’t talk about weight control

Body weight is a complex topic. Our culture has mistakenly promoted it as a simple equation containing three incorrect concepts:

  1. Fat is deadly (not true)
  2. The way to avoid being/getting fat is to diet and “watch your weight” (not true)
  3. People will avoid being/getting fat if they are afraid of being fat and/or shamed for weight gain (not true)

Many parents believe that they can save their kids from weight gain by teaching weight control. They think they can improve kids’ health by preventing weight gain. They teach their kids that weight gain is bad and that they should diet and control their weight.

But adolescents whose mothers or fathers had weight-focused conversations with them had higher BMI. [1] In other words, parents who try to avoid weight gain by talking about weight control increase the chance of weight gain in their kids.

Remember, weight itself isn’t as much of a problem as we’ve been lead to believe. But parents who attempt to control kids’ weight actually create conditions that seem to increase weight.

Girls who are pressured to diet by their parents were 49% more likely to be larger adults than girls who hadn’t gotten parental pressure. Boys who had a similar experience were 13% more likely to be larger. These results take into account genetic and environmental conditions. Therefore, it appears that an anti-weight environment may increase weight. [3]

This is because weight is more than just calories in/calories out. It’s a complex biological, environmental, social, and emotional equation. And parents who tell kids to control their weight influence their kids’ natural weight trajectory.

A healthier approach

It’s much healthier if parents accept that each child’s body will gain weight as it’s supposed to. This doesn’t mean ignoring health. For example, Intuitive Eating has significant health benefits regardless of weight. But there’s no need to worry about weight itself. And doing so can have the opposite effect.

Talking about weight control increases chance of eating disorders

Not only do parents who urge their kids to diet boost their odds for obesity later in life. Parents who talk about dieting and weight also have kids who have an increased risk of eating disorders. [3]

Disordered eating behaviors are associated with hearing hurtful weight-related comments from family members, for both females and males. [5] Eating disorders, like weight, are complex. They are based on multiple factors including biological, environmental, social, and emotional. Parents are never to blame for eating disorders. But their behavior can make an impact.

Messages about dieting from parents are linked to higher odds for poor self-esteem, body satisfaction and depression in young adulthood. [3]

Parents who pressure their kids to control their weight and fear weight gain are inadvertently promoting eating disorder behaviors. These behaviors, which include food restriction, binge eating, and purging, create significant health conditions.

Parental pressure to diet increased the risk of “extreme weight control behaviors” (i.e. eating disorders) by 29% for girls and 12% for boys. [3] It is far healthier for parents to allow their kids’ weight to develop without criticism than to intervene. Parental interventions in their kids’ weight often backfire and create worse health.

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But what about health?

The only thing parents are being asked to do here is to stop engaging in negative fat talk. And stop promoting unhealthy weight control and dieting. Parents who want healthy kids can still create conditions in which each child will thrive.

Parents can have a big impact on their kids’ health. Parent conversations focused on weight and size are associated with increased risk for higher weight and disordered eating behaviors. But conversations focused on healthful eating are protective against disordered eating behaviors. [6]

And every member of the family can benefit from Intuitive Eating. This is a healthy approach to food and movement with zero focus on the scale.

Parents can create an environment in which kids are healthy. But it has nothing to do with weight.

Tips for raising healthy kids:

1. Don’t discuss fat and obesity negatively. If you discuss weight, do so from a neutral standpoint. Respect each person’s unique biological, environmental, social, and emotional conditions. Don’t ever make assumptions about a person’s health or behaviors based on their weight.

2. Don’t criticize your child when they gain weight. Weight gain is a natural part of development. There will be periods during which your child’s body changes, sometimes significantly. Hold back from commenting on weight gain. It will not help and may cause harm.

3. Protect your child from negative weight talk. Outside of your home, your child may still be subject to negative weight talk. Help protect them by teaching them about weight stigma. Consider opting out of school and doctor weigh-ins.

4. Talk about health behaviors with no weight association. Bodies can be healthy in a wide range of weights. Rather than focusing on weight, focus on behaviors that are healthy. Help your child get enough sleep, exercise, human connection, and a wide variety of foods.

5. Approach food from a neutral standpoint. Parents who restrict and outlaw certain foods set their kids up for negative food behaviors and beliefs. Instead, pursue an all foods fit approach. Provide a wide variety of fruits, vegetables, grains and proteins. But don’t restrict other foods that are fun and delicious.

Overall, what parents do around weight and food matters more than what they say. Investigate your own relationship with food and weight. Explore Intuitive Eating and Health at Every Size® to gain more understanding of the concepts covered in this article.


Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders and body hate.

She’s the founder of More-Love.org and a Parent Coach who helps parents who have kids with eating disorders and other struggles.


References

[1] Berge et al, Parent conversations about healthful eating and weight: Associations with adolescent disordered eating behaviors, JAMA Pediatrics 2013

[2] Hainer et al, Obesity Paradox Does Exist, Diabetes Care, 2013

[3] Berge, et al, Cumulative Encouragement to Diet From Adolescence to Adulthood: Longitudinal Associations With Health, Psychosocial Well-Being, and Romantic Relationships, Journal of Adolescent Health, 2019

[4] Lydecker et al, Associations of parents’ self, child, and other “fat talk” with child eating behaviors and weight, International Journal of Eating Disorders, 2018

[5] Eisenberg et al, Associations between hurtful weight-related comments by family and significant other and the development of disordered eating behaviors in young adults, Journal of Behavioral Medicine, 2013

[6] Berge et al, Parent conversations about healthful eating and weight: associations with adolescent disordered eating behaviors, JAMA Pediatrics, 2013

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Helping our children find meaning and purpose in life in ways that have nothing to do with food and body

Our children who have eating disorders are devoted to their disorders in ways we parents can find frustrating and mind-boggling. How can they be in love with a disorder that can kill them? Why can’t they just open their eyes and see that everything would be great if they could just drop their eating disorder? Why can’t they just stop?

One way to understand our children’s obsession with their eating disorders is to see the hole in their lives that the eating disorder is filling. That hole is purpose, hope and strength. This may sound strange, but think about the eating disorder with these concepts in mind:

Purpose

The purpose may vary depending on the child and the specific eating disorder, but for many of us who have eating disorders, our purpose in life is to achieve a state of well-being and happiness, and we believe the path is through our bodies. We believe that restricting, binging and purging will lead us to achieve a state of happiness. This sense of purpose is a powerful motivator, and can be the reason eating disorder are so hard to let go of.

Hope

Our eating disorders provide us with hope. Hope that we can control our bodies. Hope that we can succeed at restriction or a certain weight. Hope that life will be better and more fulfilling if we can achieve a body ideal and/or control our actions, mainly eating and exercise. For many of us, control and success are tightly bound together, and thus we pursue control with the hope of achieving success in life.

Strength

We all want to feel strong and powerful in life. For many of us who have eating disorders, we feel somehow different and “less than” others. Our whole lives, we have held a deep belief that there is something wrong with us. Our eating disorders can come in and tell us that we are strong enough to resist eating food. We are strong enough to keep running even when we are exhausted. We are strong enough to force our food out of our bodies after we consumed it.

Purpose, hope and strength are fundamental pillars of happiness. Unfortunately, eating disorders distort these pillars and force our children to hurt their bodies and minds. When we have a child who has an eating disorder, we can help them heal by building four other pillars of a happy, meaningful life.

In her book “The Power of Meaning,” Emily Esfahani Smith describes the four pillars of meaning:

Belonging

“Belonging comes from being in relationships where you’re valued for who you are intrinsically and where you value others as well,” says Smith. Those of us who have eating disorders, like those who struggle with addictions, tend to feel a lack of belonging. We feel adrift in the sea of humanity, and question our role and value. Without a sense of belonging, we build maladaptive coping mechanisms to help us deal with a lonely world.

Sadly, an eating disorder isolates us, driving us even further into loneliness. This is a core reason why parents and families are such an important part of the healing process: we can build a sense of belonging, and help our children identify other opportunities to belong to something meaningful to them.

Purpose

Purpose is less about what you want than about what you give,” says Smith. “The key to purpose is using your strengths to serve others.” Our children who have eating disorders may be struggling to identify their purpose in life. They may be wondering “is this all there is to life?” Their pain and suffering blinds them to their inherent value as human beings, and they look to food and their bodies as a way to fulfill our need for purpose in life.

Parents can help their children who have eating disorders recover by helping them identify a purpose in life that has nothing to do with restricting, binging or purging. We can help them tap into their strengths and passions, and find ways that they can build self-worth by serving others.

Transcendence

“Transcendent states are those rare moments when you’re lifted above the hustle and bustle of daily life, your sense of self fades away, and you feel connected to a higher reality,” says Smith. Another way of thinking of transcendence is getting “in the zone.” For many of us who have eating disorders, our zone is best felt when we are restricting, binging or purging. These behaviors are actually providing us with a transcendent state.

In order to heal, we need to learn other ways of achieving transcendence. Many people in recovery find that writing, creating or observing art or music, working with wood, making slime or even solving math problems can fill the need for transcendence. These are activities that immerse us and make time and space stand still. We can work with our children to explore different options for transcendent experiences.

Storytelling

“Storytelling is the story you tell yourself about yourself,” says Smith. “Creating a narrative from the events of your life brings clarity. It helps you understand how you became you. But we don’t always realize that we’re the authors of our stories and can change the way we’re telling them. Your life isn’t just a list of events. You can edit, interpret and retell your story, even as you’re constrained by the facts.”

Our children who have eating disorders may be stuck in the story that they are sick and somehow broken. We can help them by opening up their story in a way that shows strength and grit. For example, if our child successfully overcomes eating disorder behaviors, that becomes a story of success.

We can gently and gradually help our children reframe the stories they tell about themselves by compassionately listening to their version and then asking questions that tap into strengths rather than weaknesses. We can’t rewrite our children’s stories, but we can help them shape their stories into success stories rather than tales of woe.

You can view Emily Esfahani Smith’s TED talk to learn more:


Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders and body hate.

She’s the founder of More-Love.org and a Parent Coach who helps parents who have kids with eating disorders and other struggles.

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Rat Park – could solving for loneliness heal our kids of addictions and eating disorders?

Eating disorders are complex mental illnesses. They are not the same as addiction, however, there are similarities. In both situations, people suffering from the disorders are seeking an emotionally stable state by chasing their disordered behavior.

The story of Rat Park is one in which we learn that rats who are put alone in a cage and offered drugs will take the drugs until they die. But since rats are social creatures, when the rats are put in a social environment and given the choice of drugs, they don’t become addicts.

The idea is that addictive behaviors can be impacted by the environment. If your child has an underlying brain condition that predisposes them to an eating disorder like bulimia, binge eating disorder or anorexia, they are at risk. That risk is amplified or may be decreased by the environment in which they live.

It’s an interesting concept to consider as you set up treatment for your child with an eating disorder. Help them find healthy ways to seek the connection and love they crave, help them avoid loneliness, and they may thrive.


This article and video were inspired by an article written by Johann Hari in the Huffington Post. You can see his article here: The Likely Cause of Addiction Has Been Discovered, and It Is Not What You Think


Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders and body hate.

She’s the founder of More-Love.org and a Parent Coach who helps parents who have kids with eating disorders and other struggles.