Category: Feeding With Eating Disorders

Dan reached out to me for some help with his son Braden, who has ADHD and needs to gain weight. “I’m not sure when it started, but suddenly Braden lost weight and his doctor tells us that we have to do something about it right away,” says Dan. “We’re really trying, but we feel totally stuck. Braden says he’s not hungry and rejects almost everything we offer him. We don’t know what else to do!”

I get it. Eating issues are common when you have a child with ADHD. And while it’s not easy, Dan and his partner Eric can make a big difference. They can improve Braden’s lifelong health by addressing this right away.

The link between ADHD and eating issues

People with ADHD are more likely to develop eating disorders than the general population. One study found that 31% of adults diagnosed with eating disorders also had ADHD. This is much higher than the general population, of which 3-10% of people have ADHD. About 36% of people who have bulimia and anorexia with a binging/purging subtype and 18% of people with anorexia have ADHD. Eating disorders have been described both as a symptom of and/or a coping mechanism for the emotional dysregulation that is common with ADHD.

Why it can be hard for a child with ADHD to eat

There are many reasons why eating issues are associated with ADHD. First, people with ADHD are usually highly sensitive to their five senses (smell, touch, taste, sound, and sight), all of which are involved in eating. This can lead to picky eating and a limited palate. They are also more sensitive to their interoceptive state, especially their digestive system, which can lead to disorganized hunger and fullness cues and/or feelings of nausea and other gastrointestinal distress. 

They are also highly attuned to neuroception, the sensation of other people’s emotional states, which can impact eating habits especially if family meals are stressful or chaotic. Together, these sensitivities combine to increase emotional dysregulation, making eating more difficult. A child who is both highly sensitive and has low emotional regulation skills is more likely to adopt coping behaviors like an eating disorder.

Also, a person with ADHD may not notice they are hungry or, even if they do, they may not be motivated to feed themselves. This tendency to be distracted and/or procrastinate eating can cascade into eating disorder behaviors. Most eating disorders begin with under-eating, either intentionally for weight loss or unintentionally due to distraction or avoidance. 

In cases of anorexia and ARFID, the person continues to eat too little. In cases of binge eating, the person restricts then binge eats. And in cases of bulimia, the binge eating episode is followed by purging. Either way, postponing and avoiding eating is a precursor to most eating disorder behaviors.

Finally, the medication used to treat ADHD can interfere with hunger cues, further affecting eating, weight, and digestion. This does not mean you need to discontinue medication, but it’s a good idea to check with your child’s psychiatrist to see if there are any adjustments that might help with eating.

Your child’s weight curve

A big thing to keep an eye on is your child’s weight and height curve. You should see a nice growth curve from birth through today, with your child staying approximately within their natural weight and height curve. This indicates your child is growing according to their body’s unique genetic blueprint. 

For example, if your child was born at the 95th percentile for weight and was there at age 2, 4, 6, and 8, but they have now dropped to the 65th percentile, your child may be weight suppressed. Though it surprises many parents, we don’t want a child from the 95th percentile to drop down to the 65th percentile. And if they do, you’ll likely see an increase in disruptive behaviors and a lower appetite, which leads to more weight suppression, more disordered eating, etc. 

If your child has dropped off their weight curve, they will need help eating enough food to get back to their healthy weight. The further they are from their natural weight, the harder it may be for them to eat. Nonetheless, it’s essential that you step in and intervene, as it is a serious medical and psychological issue. If your child has ADHD and needs to gain weight, please keep in close contact with your child’s doctor to monitor their health.

How to get a child with ADHD to eat

Getting a child with ADHD who has fallen off their growth curve to eat is extremely challenging. It’s also essential medical therapy. Start by seeking advice from a physician and/or registered dietitian (RD). However, beware of a professional who thinks it’s a good thing if your child has dropped off their childhood growth curve. That just means they’re stuck in outdated understanding of weight and health. Find a provider who recognizes that your child’s historical growth path should inform their weight trajectory. 

Assuming they agree that your child needs to gain weight, you can work with them on a plan for feeding. If your child is medically compromised, they may need residential treatment. But in most cases you will be told to feed your child more regular meals. You may get a meal plan with ideas for what to feed your child. But in my experience most parents already know what to feed their child. What you really need to know is how, given ADHD, you can feed your child enough food for them to gain weight. In these cases, parents need a behavioral intervention that won’t trigger their child’s oppositional tendencies or emotional dysregulation.

Here are my top four tips for feeding kids with ADHD:

1. Structure

It’s common in our culture for meals to be chaotic and grab-and-go style. Everyone eats separately and parents may be short-order cooks, feeding each child a different meal at a different time. However, a child with ADHD who needs to gain weight needs structured meals that acknowledge the ritual of eating as important and meaningful. We are social animals – we were never meant to eat alone. 

Create an eating and feeding schedule that involves you serving your child food on a plate, at the table, together with other family members as often as possible. Meals should feature high-calorie foods you know your child will accept as well as other foods they may currently avoid like fruits and vegetables. This will model for your child what a healthy meal looks like even if they are not ready to expand their palate yet. 

Keep the atmosphere at the table “light, bright, and polite.” Any criticism or negative discussions will result in emotional dysregulation and either a loss of appetite or a tendency to binge eat.

2. Fed is best 

If your child is weight-suppressed they need a lot of calories to make up the deficit and get back on their growth curve. While it’s common for parents to worry a lot about the nutritional content of their kids’ diets, at this point your main focus is on feeding a lot of calories as efficiently as possible. Worry less about the nutritional content and instead use the saying “fed is best” to remember that your primary goal is to feed your child enough food regularly so they gain weight. 

Offer fruits and vegetables and other non-preferred foods at every meal. Put them on the table so your child sees them. But your focus is high-calorie, high-fat foods that will help them gain weight. You will have a lot more flexibility and can expand their palate more as they gain weight.

As your child with ADHD achieves weight gain, you will notice that rigid or chaotic eating patterns reduce and you’ll have a lot more leeway for increasing food flexibility.

3. Validation + Expectation

Kids with ADHD are extremely sensitive to demands and criticism, and yet many adults use these techniques to try and motivate them to do things. You will have a lot more success if you change your approach and consistently use a combination of validation and expectation. Here’s how this works: 

1. Validate that they have an opinion, complaint, or resistance
2. State your request or expectation

Always do these two things together, not apart. And resist the temptation to add defensive arguments or compelling incentives. Keep your communication kind, short, and direct.

Here’s a good example of validation + expectation: “I understand that you’re playing a video game right now, but I’d like you to come to the table.” Or “I get it, you don’t want to eat right now, but I think you can handle it.” You may have to repeat yourself several times, varying the words a bit, but this technique is 100% more effective than arguing, negotiating, and debating with a child who doesn’t want to come to the table. 

4. Build emotional regulation skills

While eating and weight gain are the outcome we’re seeking, emotional regulation is the underlying skill that will keep eating and weight, and therefore health, on track for life. Building emotional regulation skills is essential for any child with ADHD, and it will make a difference in every aspect of their health, including their ability to maintain a healthy weight. Parents can do this by building kids’ emotional regulation skills, and we are actually the best people to do this since we’re biologically wired with our kids. Building emotional regulation skills includes:

• Emotional literacy – building an emotional vocabulary so kids can label, name, and talk about their feelings. 
• Emotional co-regulation – regulating your child’s emotional state with your calm, regulated emotional state. You may want to get some training and coaching to do this.
• Skill-building – teaching your child the emotional regulation skills they need to process their emotions rather than coping with automatic, subconscious behaviors. My emotional regulation worksheets can help with this.

Measuring success

If your child with ADHD is weight suppressed it’s important that you restore their weight as quickly as possible. This will not be easy, but it is possible. And many times parents are the best people to help a child in this situation because you know your child best. Your aim is to achieve steady weight gain every week until weight restoration (getting back in their original growth curve) is achieved. Please remember to maintain close contact with your child’s medical and therapeutic providers and get support for yourself, too!

Checking back with Braden

Dan and his partner Eric met with me over the course of several months to optimize their meal structure, behavioral interventions, and emotional regulation skills. They put tremendous effort into Braden’s health, and it paid off. Braden slowly but steadily restored his weight and is back on his growth curve. And the family structure is now set up to support Braden’s nutritional needs.

They have noticed a big difference in Braden’s emotional regulation skills, and their own! Braden is still fairly picky, so Dan and Eric are working on food flexibility, but overall he’s doing great, and the family is closer and more connected than before. “The best part of all of this is that we’ve become much better parents to Braden and partners to each other,” says Dan. “We feel a whole lot more confident about what we’re doing now.”

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

See Our Parent’s Guide To Eating & Feeding A Child With An Eating Disorder

This site is designed to provide information and resources. It is not intended as, nor should it be used as medical advice pertaining to any individual person’s healthcare. People should always consult with a qualified medical professional regarding their specific health needs.

Brandon has been worried about his son Michael for a few years. “He’s always been really into sugar, sweets, and junk food,” says Brandon. “I’ve tried to tell him he needs to avoid sugar. Telling him it’s bad for him doesn’t change anything. I’ve tried hiding the sweets, not buying sweets at all, and even punishing him for eating too many sweets. It seems like sugar addiction, or is it an eating disorder?”

I can understand where Brandon is coming from. There’s a lot of fear about sugar right now. In fact, there’s a lot of common knowledge saying that sugar is a direct cause of disease and weight gain. But the first thing to know is that scientifically sugar is a causal factor in tooth decay, but it is only correlated with other health issues. The truth about sugar is complex and nuanced. 

But the media hates nuance and loves a bad guy, and sugar is it right now. Most of us parents were raised to fear fat, but sugar has taken over as the new nutritional evil. Imagine if we’d heard about a butter board in 1998! The horror! Meanwhile, our “healthy” Snackwells fat-free cookies were loaded with sugar. Nutrition is subject to trends, so it’s a good idea to keep this in mind every time we meet a new nutritional bad guy.

It’s a matter of degree

Look, nobody’s saying we want our kids to eat only sugar all the time. That doesn’t make any sense. But there’s a huge distance between banning sugar and eating only sugar all the time. And that’s what I want to explore with Brandon. Just how often is Michael eating sugar? What’s happening when he eats sugar? Let’s tease this apart a little bit.

“I guess he eats sugar a few times a week,” says Brandon. “Since I rarely have sweets, cookies, and candy in the house now, it’s definitely a special occasion thing. For example, after baseball practice they always get a snack, and it’s often cookies or something like that. And of course there are birthday parties and family events. Stuff like that.” 

Brandon has banned sugary foods from the house. It sounds like he’s concerned about how Michael responds when he gets access to it out of the house.

“He goes crazy for the cookies,” says Brandon. “I see him taking more than his share and it’s embarrassing. And at family parties when there’s a cake, he’ll have two or three slices if I don’t stop him.” 

Got it. So the big question for Brandon is whether this is a sugar addiction or an eating disorder or something else. 

Is sugar addiction real?

I checked in with registered dietitian Marci Evans to find out more about sugar addiction. “I’ve been carefully watching the science of food addiction for years,” she says. “And aside from the fact that the “news” about sugar as an addictive substance sounds a lot like fear-mongering to me, it also doesn’t square with my clinical experience as a dietitian. My quick answer is that I don’t believe that sugar is addictive in the same way as caffeine, alcohol, tobacco, cocaine, and other substances.”

Many dietitians, especially those who work with eating disorder populations, are deeply uncomfortable with the vilification of sugar in our culture. They don’t agree with the idea of sugar addiction. And they worry that fear of sugar can lead to an eating disorder.

“I think that the biggest issue with sugar is that, like everything, once a human is told that something is “off limits,” our brain kicks into deprivation mode,” says Marci. “I frequently hear people talking about food, including sugar, and telling me they feel as if they are addicted, by which they mean they feel they cannot stop themselves, and they would really like to stop. It’s important to note here that someone feeling as if they are addicted to something is not the same as being physically addicted to something.”

The body’s need for food is a biological necessity. The drive for food – including sugary food – is not the same as a drive for optional substances like alcohol, tobacco, and cocaine. Putting sugar in the same category as these substances is chemically inaccurate.

A behavioral addiction

But it’s also true that food can feel addictive. Behavioral addictions are an obsession with and compulsion to do a certain behavior. And eating can certainly become a behavioral addiction. But it’s important to separate behavioral addictions from substance addictions. This is because the treatment for substance addictions usually involves not taking the substance anymore. But most behavioral addictions require at least some continuation of the behavior. 

For example, an eating disorder may be viewed as a behavioral addiction. But recovery is not about never eating or always eating. It’s about finding balance in your approach to the behavior of eating. Recovery from a behavioral addiction is not about abstinence, but acceptance and modulation of urges and desires.

“So far, there is absolutely no scientific evidence that any food is addictive,” says Marci. “Humans must eat food to survive. No specific compounds have been found in food that are like the compounds found in drugs and alcohol. The human drive for food is considered adaptive, while the drive for addictive substances is considered maladaptive.”

What about the rat studies?

“But what about the research showing that rats get addicted to sugar?” asks Brandon. 

“There has been research showing that rodents consume sugar in an “addictive-like” way,” says Marci. “But this only occurs in settings that involve sugar restriction. This is critical because it is the reason I don’t promote restricting any food items, including sugar. When rats are kept in captivity and offered sugar on an intermittent basis, they exhibit binge-like eating, which researchers identify as addictive behavior. However, when the rats are offered sugar constantly, they do not exhibit this behavior, nor do they eat excessive amounts of sugar.”

“From my perspective, the study of the rats actually supports not vilifying sugar, since doing so can lead to binge behaviors that may look and feel like an addiction,” says Marci. “Again, there is no proof that this behavior is based on the substance itself, but rather the restriction of the substance.”

Ah! That is the key here. 

Sugar is compelling

Sugary foods are delicious and compelling for most people, especially children. But there are plenty of children and adults who eat sugar regularly without any signs of addiction or disordered eating. And the secret is that these people are allowed to eat sugar regularly. Without restriction, sugar is delicious, but it’s not compelling. It’s not an obsession or compulsion. We’ve seen this with rats. And dietitians who practice the Ellyn Satter method and/or Intuitive Eating see it every day, too. 

We’ve all seen the kids who dive for the cookies or brownies at the party. What makes them different from the kids who could take it or leave it? Usually it’s the amount of sugar restriction they’re experiencing at home. Because kids who have access to cookies regularly are not likely to feel obsessive, compulsive, or addicted to cookies. 

“Higher weight and binge eating disorder, both of which are frequently associated with “sugar addiction” are far more complex than any single food item,” says Marci. “What I see clinically is that food restriction is a more significant problem and a precursor to weight gain and eating disorders than sugar.”

Advice for Brandon

I can understand why Brandon is concerned about sugar addiction and the potential for an eating disorder. But Michael’s excited behavior around sugary foods is most likely being driven by restriction. We can’t rule out an eating disorder. But we do know that restricting foods at home is a risk factor for eating disorders. So I have some advice for Brandon: 

1. Relax the rules

First, relax your at-home rules around sugar. Remember there is a huge space between no sugar and only sugar. Introduce dessert occasionally or even every day and start normalizing sugary foods as part of a balanced diet. That’s right: sugar can be part of a very healthy diet. Incorporate sugar into your regular diet. This will remove the sense of restriction that may be driving the addicted-like behavior you’re seeing in Michael. 

2. Add in more nutrients, structure, and pleasure

Next, focus more on what you add than what you take away. I’ve said to incorporate sugary foods, but also seek ways to add in more nutritious foods. Expand your family’s daily intake of whole grains, nuts, seeds, fruits, and vegetables. Now, add in is more structure around food and eating. Many families lack feeding structure. But structure has been shown to have a much greater impact on lifelong health than any diet. Do you have at least one family meal per day? If not, add that in! Finally, add in more pleasure! Eating is a social behavior in human beings. Enjoy food, enjoy eating, and enjoy each other.

3. Talk about balance

Once you’ve had sugar incorporated in your diet for a while, if Michael is still acting like he’s “addicted” to sugar, talk about specific behaviors you’re seeing. Make sure you’re coming from a neutral, non-judgmental standpoint. Michael may need help noticing that he is taking more than his share at practice. And maybe one piece of cake at the party is totally OK. But then he could add in something with greater nutritional value and then re-evaluate whether he wants a second slice. These conversations will go much better if you’re already modeling this behavior with sweets at home.

4. Stop food shaming

Finally, stop food shaming and any negative talk about food. All foods fit in a healthy diet. Brandon loves Michael and wants what’s best for him, but badmouthing food and calling it junk makes it feel restricted. We crave foods when they are restricted. When all foods are allowed, they are no longer worthy of obsession and compulsion. And never punish a child for eating. When you punish a child for seeking comfort and joy in food you support a disordered relationship with food that can have a lifetime impact on health.

Up for the challenge

It’s a lot to take in, but Brandon seems up for the challenge. “I can relate most of all to the kids who don’t get sugar at home grabbing all the cookies when they have a chance,” he says. “I remember kids like that when I was growing up. This one kid was on a really strict diet at home and he was seriously crazy about food. Give him access to pizza or M&Ms and he was all over it. The rest of us knew it was because he didn’t get it at home. I guess I’d forgotten about that until right now.”

Brandon’s going to give this advice a try and watch carefully for a reduction in the symptoms of sugar addiction and an eating disorder. Then we’ll re-evaluate whether there’s something more serious going on for Michael. Feeding a child can be complicated in our culture!

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

See Our Parent’s Guide To Eating & Feeding A Child With An Eating Disorder

This is an update to an article published March 13, 2018 called “But, seriously, my kid is addicted to sugar. A discussion about sugar addiction with dietitian Marci Evans”

Marci Evans, MS, CEDRD, LDN, has dedicated her career to counseling, supervising, and teaching in the field of eating disorders. She is a Certified Eating Disorder Registered Dietitian and Supervisor, certified Intuitive Eating Counselor and Certified ACSM personal trainer. In addition to her private practice and three adjunct teaching positions, Marci launched an online eating disorders training for dietitians in 2015 and is co-developing a specialized eating disorder internship at Simmons College.

When you think your child is “emotional eating,” it typically raises red flags. Most parents worry that emotional eating will lead to weight gain and long-term health complications. Some parents worry that emotional eating is an early sign of an eating disorder. So let’s find out what emotional eating is, why it might be happening, and what you can do to help your child. 

What is emotional eating?

Typically when parents worry their child is emotional eating, they report these signs: 

• Weight gain
• Eating more than the parent thinks the child should need
• Snacking a lot
• The child craves carbs and sugar
• Conversations in which the child says they can’t stop thinking about food or can’t stop eating
• Post-eating bellyaches and bloating

If these are your concerns, I understand. Parenting around food and weight is tricky. But also, please be careful! Because if you label your child as an “emotional eater” you risk pathologizing hunger and not supporting your child’s lifelong health.

Emotional eating is considered a bad thing. Parents who say their kids are emotional eaters are worried about their physical and mental health. In our culture having “too much” hunger is greedy and enjoying “too much” food is pathological.

But all eating is emotional because physiological sensations, including hunger, trigger emotions. A lack of food creates an emotional state, most often irritation, anger and a drive to eat. This is biologically adaptive and not unique to your child. All mammals are wired to respond to the physical sensation of hunger with a craving for food and emotions like aggression or anger to help them acquire it. 

Think back to when your child was an infant. Your baby’s first demand was most likely for food. I would guess your baby felt hunger and displayed an emotional response like crying and looking mad to get your attention. When a baby feels hungry, they scrunch their face in anger and cry loudly to attract their parents’ attention and meet their needs. 

Now consider your infant’s emotional response to being fed breast milk or formula. You probably noticed a look of contentment, peace, even joy on your baby’s face when being fed. Eating is inherently emotionally pleasing – it’s meant to be! All mammals have an emotional response when they are hungry an an emotional response when they are fed.

Thus, feeding kids is inherently emotional, and we should avoid pathologizing a natural instinct or suggesting a mental health condition when there is none.

How you address your child’s emotional eating can make a huge difference. Your response may help them learn self-care and intuitive eating. Or it could lead them to adopt maladaptive behaviors like binge eating and restriction. This matters, so I’m glad you’re thinking about it!

The reasons your child is emotional eating

The usual reaction when a child is emotionally eating is to assume something is wrong with the child’s mental health. But often, the solution is far simpler than psychology. It’s most often structural and, therefore, within your control. Here are the main reasons your child may use emotional eating: 

1. Hunger

Hunger is a physiological symptom that triggers an emotional reaction. Think of the term “hangry,” which perfectly demonstrates what happens when a person is hungry. They get grumpy, angry, and have trouble concentrating. They will start to crave highly palatable foods like carbs and sugars because their blood sugar is dipping dangerously low. The first question to ask if your child is using emotional eating is whether they are getting enough food on a regular basis. If you’re unsure, please talk to a non-diet dietitian who can help you figure out how much food your child needs at this stage in their development. Most parents are surprised to find that it’s far more than they thought.

2. Lack of feeding structure

Emotional or chaotic eating is often due to a lack of feeding structure. When there is an inadequate feeding structure, the child’s hunger is out of balance, and they find themselves frequently hungry and dysregulated. Parents should serve kids food every 3-4 hours. This typically includes 3 meals and 2-3 snacks. Having a feeding structure eliminates almost all feeding issues and is the primary treatment for any type of eating disorder. Unless you begin with a solid structure, your child will continue exhibiting signs of emotional eating. 

3. Poor sleep hygiene

Sleep is essential for many reasons, including appetite regulation, digestion, and emotional regulation. Before you worry that your child has any sort of mental health issue or diagnose them with emotional eating, ensure that they have good sleep hygiene. Therapy and nutritional advice will not help a sleep-deprived child. Like a feeding structure, sleep is essential to physical and mental health. 

4. Emotional dysregulation

If all of the above conditions are met but your child is still emotionally eating, your child likely needs help with emotional regulation. It’s our job as parents to help our kids develop emotional regulation by co-regulating with them and building their emotional literacy throughout their lives. We can learn this skill and teach it to our kids. So once all the above conditions are met, emotional regulation is the next area to focus on. 

What can parents do to stop a child from emotional eating?

Most of the time, the best thing a parent can do to stop a child from emotional eating is to attend to our parental responsibilities. Make sure your child is getting enough food on a consistent schedule. Ensure they get the sleep they need with a stable bedtime. And finally, work with them on emotional regulation to help them label emotions and work through emotional dysregulation. 

Once that is covered, learn how to talk about food neutrally. This means not labeling food as good or bad. Instead, talk to your child about how to balance food to feel satisfied and avoid getting too hungry. For example, a meal should ideally include fat, carbs, protein, and fruit/vegetables. A snack should ideally include at least two of those elements. This simple model can help children learn to feed themselves in a way that keeps them satisfied for several hours and will reduce chaotic eating driven by hunger and the associated emotions.

Avoid cutting out food groups unless your child has a medically diagnosed allergy. It is common to restrict foods like wheat and sugar based on non-medical diagnosis, but this can lead to disordered eating for many children. The best diets are balanced and incorporate a variety of food from all food groups. They also include highly-palatable foods like cookies and chips as part of the variety.

This is the prescription for raising healthy children who can regulate their emotions and eat healthfully. It also prevents and treats most eating disorders.

What not to do if your child is emotional eating

Most parents address emotional eating in the wrong direction. They assume the problem lies in the child. Parents believe they should tell the child to eat less or educate them about nutrition and the dangers of weight gain. This is understandable, but it’s also not the right approach. 

Most children who are treated this way will feel shame about their bodies, their hunger, and their character. This could lead to restricting food, which exacerbates emotional eating, binge eating, and a cascade of disordered eating patterns that may develop into a full-blown eating disorder. 

Restricting food and intentional weight loss are culturally normalized behaviors. However, they do not result in improved health. 95% of people who intentionally lose weight gain it back, often plus more. The No. 1 predictor of weight gain is not how much food a person eats but how many times they have intentionally lost weight (i.e., dieted and weight cycled). Additionally, teens who diet have up to 18x greater chance of developing an eating disorder.

Frequently asked questions about emotional eating

I know this is a fraught topic. It’s very hard to parent around food and body issues in our culture, which is toxic to both. Societal beliefs about eating and weight can get between you and raising a healthy child. So here are some answers to frequently asked questions about emotional eating:

1. But what about weight gain?

Children need to gain weight to grow and should continuously gain weight throughout their childhood and adolescence. If you are feeding your child regularly and serving them enough food, and they have good sleep hygiene and emotional regulation, their weight will sort itself out according to their genetic and environmental conditions. Any attempt to intentionally manipulate weight predicts weight gain and eating disorders.

2. But my child is already eating too much food

I encourage you to consult with a non-diet dietitian who can talk to you about the quantity and variety of food your child requires to be healthy. They can help you determine what to serve your child, how often, and when. This structural support will give you the confidence that your child is eating appropriately for their unique body.

3. My kid snacks on chips and cookies all the time but doesn’t eat meals

This is most likely a structural issue. The evidence-based feeding system called Division of Responsibility, developed by Ellyn Satter, lays out exactly how parents can set boundaries around meals and snacks. This includes a feeding schedule and providing adequate eating opportunities and a variety of food in a pleasant atmosphere. If you follow the Division of Responsibility, you will likely no longer have this problem.

4. My child only wants to eat carbs and sugar

See numbers 2 & 3 above. This problem will be resolved once you have the right structure in place.

5. My child says they can’t stop thinking about food or can’t stop eating

This indicates a preoccupation with food. The most likely culprit is a lack of feeding structure and hunger. Once you have addressed the structural issues, work on emotional regulation skills and emotional literacy. Is your child physiologically hungry or hungry for emotional care? Don’t ask them – just tune in and determine whether they need more emotional care from you. Make sure they are getting enough food on a regular schedule. If you’re sure it’s not physical hunger, then fulfill the emotional need. Our children are usually hungry for attention, affection, and acceptance. So give them more of that! 

6. My child eats to the point of having a bellyache or bloating

When a child gets too hungry, they will most likely feel discomfort after eating. So the first thing to address is the feeding schedule and ensuring that your child is eating enough food regularly throughout the day. If the structural issues are addressed, and your child is still eating beyond comfortable fullness, then examine what emotional need they are trying to fill with food. Are they lonely, tired, or sad? Give them more affection, attention, and acceptance throughout the day and particularly before and during meals so they are not trying to fill an emotional void with food. Get some parent coaching and support if you’re trying to do this and it’s not working.

7. What if it’s an eating disorder?

If you are concerned or suspect that your child’s emotional eating is an eating disorder, then please reach out for a diagnosis by a trained health professional, ideally who has extensive experience with eating disorders.

See Our Parent’s Guide To Eating & Feeding A Child With An Eating Disorder

Eating can be really hard when you have an eating disorder, but affirmations can help. Eating disorders are mental illnesses, which means that we need to change our thoughts and beliefs in order to recover. This is where affirmations come in. Affirmations can help us replace our disordered thoughts with healthy thoughts. Over time, this can change the pattern of our thinking and support recovery.

Common thoughts and beliefs that drive eating disorders are:

• If I eat too much I’ll feel sick and/or gain weight
• I can’t eat food/carbs/sugar etc.
• Exercise is required to “burn off” food calories
• There are some foods that are good and some that are bad
• I can’t trust my body to make healthy choices for me
• I’m not hungry
• That’s too much food for me right now

These thoughts all make sense because we live in diet culture, which perpetuates them all the time. But we can overcome these false beliefs and thoughts with affirmations that counteract the eating disorder thoughts and lead us towards health and recovery.

Having an eating disorder can make it really hard to eat regularly and trust your body to be healthy. Recovery doesn’t happen with affirmations alone, but parents can support recovery by teaching their kids eating disorder recovery affirmations. Here are nine affirmations you can teach your child who has an eating disorder:

1. My body needs food every day no matter what I do

My body needs food. And it’s not just that I need food when I exercise. I need food even if all I do all day is sit on the couch. My brain, lungs, heart, and every organ in my body need food every single day just to exist. My body needs me to eat food every day. Food is the best, most essential, and healthy thing my body needs.

2. All foods are good foods

Even though there is a lot of misleading information about food out there, I know that all foods are good foods. Unless it’s moldy or expired, all food is clean. It’s not better to eat a salad instead of a burger if what I really want is a burger. What I eat should be based on what my body wants and needs, not what someone else has told me is “healthy” or “good.” Right now I need to trust my dietitian and my parents to help me make the right choices for my body. Over time, I’ll learn to listen to my body, which will guide me to eat exactly what I need every day. 

3. I can be afraid to eat and choose to eat anyway

Eating is scary for me right now. It makes sense – I mean, I have an eating disorder! But just because I’m afraid to eat doesn’t mean that I won’t eat. From now on I’m going to feel my fear and eat anyway. Trying to get rid of my fear will never work, but showing my fear that I can eat even when I’m afraid of it will help me feel stronger every day. Fear gets to exist in my mind, but I will not allow it to drive my decisions or put my health at risk.

4. I never need to burn off my food with exercise

My mind thinks that every time I eat, I need to work it off with exercise. And that thought keeps coming up for me, but I know it’s not true. Exercise is healthy as long as it’s not being used as a punishment or way to purge what I’ve eaten. Right now I need to take a break from exercising while I recover, but that doesn’t mean I need to eat less because I’m not exercising. I can’t wait until I’m exercising before I eat more food. That’s just not how bodies work. Exercise is not the price we pay for eating.

5. My body is perfectly capable of digesting food

A lot of times I feel as if I won’t be able to handle the food I eat. I worry that I’ll gain weight, that I’ll vomit, that I’ll feel nauseous, and that I’ve eaten the wrong thing or too much. All of these worries show up in my head, but that’s OK. I’m still going to eat with the knowledge that my body can digest so many things. Sure, if my doctor has diagnosed an allergy I won’t eat those things, but otherwise, I’m going to follow my dietitian’s and parents’ advice about what to eat and how much.

6. I can’t really trust my hunger and fullness cues right now, but I will if I keep eating

Right now my hunger and fullness cues are all over the place. With my eating disorder, I put my mind in charge of my body, and it’s kind of messed with my body’s natural signals. But that’s OK. I know that if I keep practicing and eating what my dietitian and parents tell me is good for me then I will slowly rebuild my brain-body connection. Over time, I’ll relearn how to listen to my body and will be able to eat intuitively, without fear, and according to my appetite.

7. My body does not need to be oppressed to be good enough

For whatever reason, I decided that my mind needs to take control of what my body needed. I’ve been treating my body’s signals like they’re naughty children who need to be dominated and controlled. But I don’t want to do that anymore. I’ve become a dictator, an oppressor! I want to treat my body with the respect and dignity it deserves. My body is strong and wants me to be healthy. My body doesn’t need to be a certain weight or shape to be good enough. It’s already good enough. Over time I will learn to listen to my body, but right now I’m going to stop oppressing it with food rules.

8. Counting calories may feel safe to me right now, but it’s not a healthy way to live

I’ve become a master of calorie counting. It happens automatically for me every time I eat or think about food. But this catalog of calorie counts is not making me healthier. It’s part of my eating disorder. Every time I start to count calories I’m going to ask my brain to stop doing that. I mean, I understand that my brain thinks counting calories will keep me safe, but I’m not buying it anymore.

9. Just because I don’t want to eat doesn’t mean I shouldn’t eat

Right now it makes sense that I don’t want to eat most of the time – I have an eating disorder! And eating has become a huge hassle and drama in my life. But I know that if I eat what and when I’m supposed to, I’ll recover from this eating disorder and won’t need to force myself anymore. So I’m going to keep remembering that even though I don’t want to eat most of the time, I’m going to do it anyway. My body really needs food, and I’m tired of my eating disorder hurting my health and controlling my life.

These affirmations should help your child gain confidence in eating disorder recovery. Recovery takes time, but repeating these affirmations supports the process of building new beliefs and thoughts. Feeding a child with an eating disorder is hard, but your approach can make all the difference.

See Our Parent’s Guide To Eating & Feeding A Child With An Eating Disorder

If you want to raise a child who is free from food issues, then it’s time to stop sabotaging their relationship with food. Eating disorders are on the rise, and disordered eating is so common that it’s considered normal. 

But true health is found when a person eats according to their preferences and appetite and knows that their body weight will settle into the range it wants to be. This range is often not the same as the range our society deems acceptable or desirable, which is why food and eating have become so fraught. 

Parents who want to raise healthy kids who are free from food issues and eating disorders have to work hard to counterbalance the cultural misinformation about food and eating, which is driven by the $72 billion diet industry. 

But the effort is well worth it. Kids who are raised with food freedom and body peace are healthier and happier. 

Here are nine ways you may accidentally be sabotaging your kids’ relationship with food:

1. Describe food as good or bad

Kids have a simplistic way of responding to parental guidance. When you set up a hierarchy of food, they assume that if they eat/crave good foods then they (as a person) are good. But if they eat/crave bad foods then they (as a person) are bad. This sets them up for a complicated and disordered relationship with food and poor self-worth.

Instead of doing this, make all food choices morally neutral.

2. Talk about other people’s food choices

When you talk about what other people eat as either good or bad, you’re telling your child what you believe is acceptable and unacceptable. They will automatically apply your opinions about other people’s eating behavior to themselves and believe they can show you their goodness (or badness) through food behaviors.

Instead of doing this, keep your eyes on your own plate and don’t talk about other people’s food choices.

3. Link eating to weight gain

It is completely false that weight is as simple as calories in/calories out. Many people who are smaller eat more calories than people who are larger. Bodies have vastly different metabolic processes, and bodies are naturally diverse in weight. When parents perpetuate the myth that weight is within a person’s control, they set a child up for restriction, which causes harm.

Instead of doing this, tell kids that all bodies are unique, and we should never make assumptions about people based on their weight.

4. Reward good behavior with dessert

Dessert should be available based on your preferences, your kids’ preferences, and lots of other factors. But it shouldn’t be given or restricted based on a child’s behavior. Children are not animals. We have much more complex neural structures, and simple food-based reward systems quickly go awry.

Instead of doing this, offer dessert as often as you feel makes sense, regardless of your kids’ behavior.

5. Punish bad behavior by canceling dessert

When parents use food as a punishment, kids suffer. Food should be given according to preference and appetite, not behavior. Withholding food for bad behavior can have long-lasting impacts on a child’s relationship with food.

Instead of doing this, talk to your child about any behavior you don’t like, but don’t link it to food in any way.

6. Praise kids for making “good choices”

Kids should choose food based on what tastes good, what they want in the moment, and what is available to them. When we moralize the food they choose, we set them up to see food as a reward or punishment, good or bad. Kids who are given a full range of choices will naturally cover their nutritional needs and settle into a healthy weight for their unique body.

Instead of doing this, talk about how food tastes and how much you enjoy sharing food with them.

7. Tell kids they need to limit sugar, carbs, or any other food type

When we restrict food, the most common outcome is binge eating that food. Kids who are not allowed to eat sugar will binge eat sugar. Same with carbs and other foods that are tasty and restricted. Parents who allow all foods notice that their kids rarely (if ever) binge eat because they trust they can always have more.

Instead of doing this, offer a wide variety of foods regularly.

8. Make kids eat their vegetables before they eat anything else

Making kids eat vegetables before they eat anything else is a form of parental control. While parents should be in charge of the options available to their kids, they should not dictate which foods go in their kids’ bodies or in which order they eat it. Dangerous power struggles are much more likely in families where food is controlled.

Instead of doing this, let your child choose the order in which they eat their food.

9. Tell kids their future health is based on what they eat

Telling kids that their health is directly tied to what they eat is factually wrong and harmful. The greatest impacts on mortality and health are genes and environment, neither of which is within a person’s control. Specific food choices have no direct connection to health, but a positive relationship with food is linked to better health.

Instead of doing this, provide your child with an emotionally connected home environment that will support their physical and mental health for life. 

The 1 way to raise a child who is free from food issues

The best way to raise a child who is free from food issues is to trust kids to feed themselves the right mix of food based on what you offer them and gain weight according to their unique body’s blueprint. 

Our culture wants to prescribe a one-size-fits-all meal plan and moralize about good and bad foods. But that ends up being controlling and unhelpful. Trust the body and the appetite to make the right choices for your child’s unique circumstances. 

Our culture also likes to prescribe a narrow weight range for every single body. This is despite the fact that we know that body diversity is natural and expected in any population. We see body diversity even when everyone eats the same things. 

Feeding kids who are free from eating disorders and food issues can be challenging in our culture. Trust your child’s body to grow according to its unique blueprint, and avoid any food restriction or moralization. 

See Our Parent’s Guide To Eating & Feeding A Child With An Eating Disorder

Many parents wonder how they can avoid power struggles over food. Feeding and eating have become very tense in our culture. Food is often restricted, moralized, and made “super,” making it very hard for parents to know what they should do.

The good news is that feeding doesn’t have to be complicated, but it does need to be important. What do I mean by that? I mean that you should prioritize feeding your children as an essential part of caring for them. But feeding should be about connection, not correction. And it should be about being together, not being perfect or eating perfectly (since there’s no such thing!).

Eating and feeding are intimate forms of communication between parent and child. When a child is rejecting food, avoiding eating with others, or eating alone, that can be troublesome and even dangerous. So it’s important for parents to “own” meals. To take responsibility for feeding their kids and prioritize connection and loving communication during meals.

When parents step into their authority by choosing the times and format of meals, they show that feeding and eating are an important part of their role as parents. Feeding our children thoughtfully and with respect is an important part of parenting and showing them our love and care.

Here’s how to avoid power struggles over food:

Note: for each point, I’ve added a brief description of how this works for one family that’s doing it.

1. Have family meals

Make meals an important part of daily life. Food is the first way we show our children we are attentive to them, and feeding serves as an important bonding experience for both parent and child. Don’t let this drop away as they grow up. Eating together should be a family priority, and should be taken very seriously.

What this looks like for Allison’s family: We have busy schedules but we always make time to eat dinner together. We avoid planning meetings, events, and calls from 6:30-7:30. Sometimes we have to eat earlier, sometimes later. But whatever our day brings, we prioritize getting together for dinner.

2. Serve food you know your child will like

Don’t be a short-order cook who makes individual meals for each person. But do make sure that there is always something you are sure each person will eat. Good options include bread and butter, tortillas, a bowl of fruit, baby carrots, etc.

What this looks like for Allison’s family: I’m a creative cook, and I enjoy trying new recipes. But I always make sure there is at least one dish for everyone on the table. For our family, everyone likes tortillas and cheese, so I’ll put that on the table in case the meal I’ve prepared isn’t appealing. I also keep a bowl of fruit on the table just in case.

3. Let everyone serve themselves

Family-style meals provide individual autonomy and choice. This allows each person to feel cared for, in community with the family, and responsible for their own choices. This can eliminate harmful food-based power struggles since everyone is in charge of themselves.

What this looks like for Allison’s family: We eat at the table and I serve everything family style. This way everyone feels as if they are in charge of their own plate, which seems to reduce tensions. Sometimes my kids actually ask me to put a plate together for them, which is fine. But our default is that they get to make their own choices.

4. Keep your eyes on your own plate

Don’t watch what your child is eating or make comments about their choices. Let them eat what they like and how much they like at each meal. Put them in charge of their own nutrition, and empower them to know their body best.

What this looks like for Allison’s family: I was raised in a family where every bite was monitored and I felt bad for either eating too much or not finishing what was on my plate. So that feels pretty natural to me. But I’ve found that since I stopped doing that with my own kids, they seem more relaxed, and I’ve noticed that there’s a lot less waste and grumbling as a result. And they’re even more adventurous, which really surprised me.

5. Keep the conversation light, bright, and polite

Don’t make the table the only place where parent-child conversations take place. Make space for difficult conversations about homework, tests, and other concerns away from the table. During meals, keep the conversation positive and strive to make each person feel seen, heard, understood, and loved. This is a time for connection, not correction.

What this looks like for Allison’s family: We used to spend most of our time at meals managing the household, making sure everything got done and setting up our schedule for the next day. Now we save that for after dinner, and instead, we focus on being together and laughing and sharing stories during dinner. It’s so much more pleasant and I notice the kids linger around the table now instead of rushing to get back to their phones. We end up spending a lot more time together, and it’s much more high-quality.

Feeding without drama

Remember that what parents repeatedly do matters more than what they say. Often parents think they need to instruct children about how to eat and what to eat. But it’s more important to show them that food is important. That our bodies deserve respect and kindness. And, most importantly, that food is something to be enjoyed and savored together.

How you feel about your child matters. If you worry about your child’s eating, they will sense it. This is particularly true if you believe they eat “too much” or only “unhealthy” food. Before you sit down to a meal together, find a space inside of yourself that trusts and believes in your child’s autonomy and ability to eat in a way that serves them. Yes, this requires a leap of faith, but no more so than the leap of faith it takes us to send them off to school or teach them to drive. Autonomy is essential to raising a self-sufficient, healthy person.

What you prioritize matters. When you prioritize feeding and eating as something to be honored and treated with respect, you set your child up for a healthy relationship with food for life.

Family meals are a great place to show your values to your kids. This is where you can show them that you value connection, community, and eating. It’s where you can show them you value respect, autonomy, and togetherness. The family meal offers amazing opportunities for parenting.

Meals should be a place where everyone feels safe and cared for. When that happens, you are more likely to avoid power struggles over food.

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This advice is based on interpersonal neurobiology and attachment theory. The particular feeding method outlined is called the Ellyn Satter Divison of Responsibility, an evidence-based approach to feeding that is shown to prevent eating issues, power struggles, and food battles. Feeding a child with an eating disorder is challenging, but you can do it!

See Our Parent’s Guide To Eating & Feeding A Child With An Eating Disorder

Kids with eating disorders are often prescribed family meals as part of treatment because they can help on so many levels. For example, one study found that more frequent family meals, placing a high priority on family meals, and a positive atmosphere at family meals are positively correlated with less disordered eating.

For example, 18.1% of girls who had 1-2 family meals per week engaged in eating disorder behaviors compared with 8.8% of girls who had 3-4 family meals per week. This means that when we double the number of family meals per week, we cut the risk of disordered eating in half. Researchers concluded that family meals have the potential to play an important role changing unhealthy eating behaviors.

A healthy plan

Feeding kids with eating disorders is tough, but family meals help. Here’s how to get started:

1. Make family meals a priority

The first step is to make eating together a priority. Of course, I understand this can be challenging. But the health benefits are clear.

Prioritizing family meals doesn’t have to mean dinnertime. If dinner won’t work, can you all wake up a little earlier and have family breakfasts? Luckily, the type of food you’re serving doesn’t matter. This is about the action of sitting down together to eat. So load up on easy-to-make foods and focus on the gathering rather than the food.

When you prioritize eating together as a family, you are prioritizing the family unit. You are demonstrating the value of human connection as it relates to food. Don’t let our modern lifestyles fool you: humans have always shared food together as a signal of peace, belonging and connection. Our kids’ health depends on these things much more than the latest superfood.

2. Eat together frequently

The word “frequently” will vary from family to family. In FBT treatment, a parent serves all food and eats with a child 5-6 times every day. But even if you aren’t doing FBT, eating together once per day can be therapeutic for a person in eating disorder recovery. Can’t do that? Can you commit to a minimum of two meals together every week?

You may have to adjust schedules. You may have to mix the times of meals. Sometimes, a “meal” may be an afternoon or late-night snack. The idea is to commit to sitting together with food as often as possible for your family.

This will get easier over time. Once you make the commitment and get over the initial panic over how you can possibly achieve your goal, you may find it surprisingly easy to make it happen. If necessary, start a calendar to track your meals together and give yourselves stickers so you can all see how you are doing in meeting your healthy goals of eating food together.

If you can’t get the whole family together, don’t give up! Gather as many members as possible whenever possible. Even if just two people are in the house, they should eat together, not separately.

3. Get it on the table

It’s not easy to think up meals for everyone. Here’s the easiest method I’ve heard of to plan meals. First, let’s define a meal. Your goal is to serve all four of the following: carbohydrates (~50% of the meal), protein, fats, and fruits/veggies. A snack is defined as any two of those. This balance of carbs, protein, vegetable/fruit and fat is essential to a healthy body and mind. And once you get in the rhythm of planning meals this way, things get easier. Here are some examples:

• Buttered pasta, tomato sauce with meat or tofu, salad
• Baked potato with cheese, turkey chili, coleslaw
• Rice, fish, and stir-fry vegetables with sesame oil sauce on top
• Tortillas, beans, ground meat, cheese, and pico de gallo
• Cheeseburgers, broccoli
• Pizza, chicken breast, sliced cucumber

Those are dinner ideas, but this meal balance applies to all meals of the day. So breakfast might be waffles, full-fat yogurt, bacon, and fruit. Lunch can be a turkey sandwich with mayo and cheese, chips, and a tangerine.

Once you get in the swing of planning family meals, you can mix and match your elements. But every meal should have all four elements. You’ll find that full meals will reduce hunger throughout the day. You should all still have 2-3 snacks to keep you going.

4. Create a positive atmosphere at family meals

Of course, kids with eating disorders don’t usually want to have family meals. That makes sense, and it’s a symptom of the eating disorder. You do not need to accommodate the eating disorder’s wishes – nor should you! Serve family meals anyway.

As long as the eating disorder is active, you may find meals are generally unpleasant. This is unfortunate, but the only thing within your control is your behavior. You can’t control your child’s resistance and bad moods, but you can make sure that you are putting in the effort to make family meals positive. Learn how to respond to your child’s food refusal and mealtime tantrums calmly and assertively.

Encourage everyone to think consciously about approaching family meals from a positive mindset. In fact, make this an explicit goal of the family meal.

5. Remove distractions

A family meal won’t improve your family connection and support eating disorder recovery if people are distracted by other things. Unless you’re doing FBT and have been advised to use it as a tool, turn off the TV. Keep phones, tablets, and other distractions off the table – literally. In fact, keep them at least 10 ft away from the table and switch them to airplane mode if they continue to be a distraction.

It’s important to gather around a single dining surface. It could be a dining table, a kitchen island, a coffee table, or a cardboard box. The goal is to have everyone’s plates and glasses sharing the same surface at the same time. This builds the communal concept of family meals. It makes a difference in how each person perceives the value of your shared meal. Some families may enjoy bringing out the fine table linens, dishes, etc. and (finally) use them. They light candles, set the dining room table, and dim the lights a little bit. Then they bring takeout food to the table and dig in.

Remember, it’s not what you eat, but how you eat (communally) that matters. The idea is that you are making a statement: we are a family, and we are sharing food together. Feeding a child with an eating disorder isn’t easy. But more family meals can help kids recover from eating disorders.

See Our Parent’s Guide To Eating & Feeding A Child With An Eating Disorder

Learning how to handle your child’s food anxiety before, during, and after mealtimes is essential to recovery. Often anxiety lies at the root of meal refusal: worries about eating, worries about the food, and worries about what will happen after eating are common.Parents can help children heal from eating disorders by learning to help them tolerate food anxiety.

Eating disorders very often coexist with anxiety disorders. This means that while the presenting issue is the eating behavior, often the underlying issue is anxiety. And while there is relatively little research and data on eating disorders, which are chronically under-funded, there is a wealth of information about anxiety.

Studies have shown that parents can have a tremendous impact on either increasing or decreasing their child’s anxiety. And the good news is that parents can learn to reliably reduce their kids’ anxiety by acknowledging it and helping kids face, rather than avoid fear.

When parents learn to handle their child’s food anxiety, they can significantly help with recovery.

Anxiety and eating disorders

Anxiety is a nervous system response to a threat. Mammals are biologically wired to seek comfort and security from their parents when faced with a threat. Therefore, when a human child senses a threat, they seek the parent’s comfort and security to feel better. And this can work really well.

But when we’re dealing with an anxiety disorder, a child’s fear can seem overblown or ridiculous, and parents will often brush it off without realizing that the child is seeking comfort and security. In other cases, parents can’t recognize that the problem is anxiety because it often masquerades as anger, withdrawal, and obstinance.

Patti and Ava

That’s what happened with Patti (not her real name), who consulted with me about her daughter Ava’s (not her real name) eating disorder. “She often won’t even sit at the table. She just goes into her room and slams the door,” said Patti. “If she does come to the table she just sits there staring out the window and refuses to do anything.”

This is a tough situation to be in. I explained to Patti that withdrawal is one way a child can respond to stress and worry. I suspected that Ava felt overwhelmed by her feelings of fear about food, and rather than ask Patti for help, she just shut down.

With this in mind, we explored Patti’s feelings about Ava’s big feelings, especially worry. And Patti told me that when Ava was young she was worried about everything. “It was so frustrating and irritating,” Patti said. “I thought the best thing to do is just ignore it, and I guess that’s where I went wrong.”

Patti did what a lot of parents do. It’s not so much that she did something “wrong,” but her behavior taught Ava that she needs to process feelings by herself, and sharing them with her mom wouldn’t help. Without the skills to process her feelings of worry, Ava became stuck in her anxiety, and in those conditions an eating disorder can flourish.

I worked with Patti to help teach Ava to express her worries in lots of small and big ways. This took effort and practice. Neither of them had experience doing this. But pretty quickly, Ava started opening up. She started telling her mom she was afraid of eating.

Sometimes she would yell, sometimes she would cry. No matter what, Patti worked on being present with Ava’s fear even when it was uncomfortable. Patti’s behavior “unlocked” Ava’s anxiety. And once Ava started to express herself, Patti was able to respond to anxiety to help it become less of an impediment to eating.

We need to face anxiety head-on to recover from eating disorders

So what’s a parent to do? How can we help our child handle food and eating anxiety? As I said, we know a lot about how anxiety works, and the most important thing to know is that it’s predictable. Anxiety tells us we must avoid whatever it is afraid of. And this is the key to recovery. Rather than trying to stop the anxiety from happening, we practice feeling the anxiety and not avoiding the thing we’re afraid of.

This is where parents can help. You see, often parents accidentally empower the anxiety by helping the child avoid the thing they are afraid of. We feed eating disorder behaviors when we make accommodations to avoid or step around their fear.

For example, if your child is afraid of fat, you may make low-fat meals. If they reject carbs, you prepare low-carb alternatives. If they’re afraid of restaurants, you stop eating out. These accommodations may seem to help in the short term. But they teach the child that they are not capable of facing fear. Instead of empowering them to walk through their fear, accommodations enable them to avoid it.

Avoiding fear feeds fear. The only way out of anxiety is to walk through the fear, over and over, and see that you can survive anxiety and fear.* When a parent is next to you, holding your hand while you walk through the fear (but not turning back), it’s easier.

We need to face our food anxiety head-on to recover from an eating disorder. We need to see that we are strong enough to endure our anxiety and be OK on the other side.

*Note: if your child has PTSD or a history of trauma, it may not be safe for them to approach fear in this manner. Please check with a qualified trauma therapist.

Prepare yourself first

If your child has an eating disorder, then food is a trigger for their anxiety. They key to handling your child’s anxiety is to be prepared. Expect fear to show up and be prepared to respond without accommodating.

Before you can help your child with their food anxiety, it’s important to calm your own nervous system. As mammals, our children seek us for co-regulation. That means that if our emotional state is relatively calm and confident, our children are more likely to be soothed.

You have to calm yourself to calm your child

This is hard. When a child has an eating disorder, all you want is for them to stop whatever they are doing with food and “be normal.” Also, anxiety tends to be annoying. It can be really irritating to be with someone who is afraid of food. But, as you know by now, your emotional state is contagious.

So how do you soothe yourself so you can soothe your child?

There are lots of options. As a baseline, get plenty of sleep each night, which will hugely impact your nervous system. Next, begin a mindfulness practice. Get enough sleep and practice at least 10-minutes of mindful meditation every day. This will train you to tune into your body and soothe your nervous system.

Then, immediately before you serve your child food, do a 2-10-minute mindful meditation to calm your nervous system.

This may seem like a lot of work. It is. But this preparation will make a significant impact on your effectiveness. If you dive in without preparing yourself emotionally, you may exacerbate the anxiety. Unless it is impossible, make this investment in your child’s recovery. It will also improve your own mental health. It’s draining to talk to someone who has an eating disorder, especially when you are emotionally activated.

When child and parent are both anxious, very little good can occur.

How to co-regulate with your child

Your child is going to experience anxiety around food until they have recovered from their eating disorder. While parents can’t fix their kids’ disorders, they can help them tolerate anxiety around meals.

1. Before a meal beings

Check in meaningfully with your child. Make contact with them however you can, such as:

• Ask them about their day
• Do some yoga poses together
• Go for a gentle walk together
• Throw a ball back and forth
• Massage their hands, back, or shoulders
• Color together

This will help your child and you get in the co-regulation mode. Doing something physical together can help you attune to each other as much as talking does. Once you are co-regulated, it’s more likely that you can help them get on-track if their anxiety flares up.

2. During a meal

You should anticipate and be prepared for anxiety. But avoid allowing anxiety to run the show. It helps to tell your child in advance what you expect from them during meals.

For example, if they have a meal plan, you can expect them to follow it. And maybe you expect them to stay at the table while everyone else is eating.

They will likely complain about anything you ask them to do during meals. Your goal is to compassionately acknowledge their complaints without accommodating them. In other words, don’t let them ditch the meal plan or the table mid-meal. Agreements should be honored even if it’s uncomfortable for them.

3. When they have anxiety during a meal

Your child may do all sorts of things to try and control the meal to accommodate their anxiety. Your goal is to stay steady and acknowledge but not accommodate the anxiety. Here is a great phrase to use during a meal when your child is struggling to eat:

First, acknowledge the anxiety: “I can see that you’re struggling and I know this is hard.”

Next, express trust in them: “And I believe that you can do this.”

It’s important not to get pulled into an extended conversation about this. Calmly and consistently repeat the phrase rather than engaging with the anxiety.

4. After a meal

If things didn’t go well during a meal, you may need to check in after the meal. You can ask your child what they think went wrong. Time this so that it’s well after the meal itself and well before the next meal. Try to focus on creating a plan for tolerating anxiety vs. avoiding anxiety in the future. In other words, if they refused to eat carbs, don’t talk about the carbs or tell them they don’t have to eat them. Talk about the anxiety about the carbs and how they can tolerate the anxiety.

Example: Breakfast breakdown

Here’s an example of a breakfast that’s gone sideways:

Jamie is pushing her plate away without eating.

Mom: “Jamie, it’s on your meal plan that you will eat an apple and peanut butter for breakfast.”

Jamie: “But I can’t. I feel sick. I can’t eat. You can’t make me!”

Mom: “I understand, and I know it’s hard to eat when you don’t want to. But I also know that we talked about this and agreed that you will face your fears and eat what you said you would eat.”

Jamie: “But I can’t!”

Mom: “Jamie, remember that we agreed that we don’t change the plan during mealtimes. This is a mealtime, so I need you to eat. We can re-examine how we handle breakfast another time, but for right now this is the agreement.”

Jamie: “It’s not fair.”

Mom: “I understand, but remember that we made this agreement together.”

Jamie begins to eat breakfast. She puts on a show of gagging and suffering while eating. Mom is compassionate and firm at the same time. Jamie finishes breakfast reluctantly.

Later that afternoon, Mom revisits breakfast:

Mom: “So this morning you had trouble with breakfast. Do you want to talk about it?”

Jamie: “No.”

Mom: “OK, but what I saw is that you felt anxious about eating what was on your meal plan. Would you like me to adjust how I responded to your anxiety about eating, or was it OK?”

Jamie: “I guess.”

Mom: “Jamie, this only works if we’re in agreement. Do you agree that we’re on the same page about following the meal plan and facing food anxiety together like we did this morning?”

Jamie: “Yes.”

Mom has acknowledged Jamie’s feelings and gained agreement to continue facing food fear rather than accommodating anxiety.

What happens when eating

No matter how well you have planned, eating disorder behaviors will probably show up during meals. This is usually not because your child is stubborn or not committed to recovery. It’s usually because eating disorders are rooted in a lot of anxiety, and food is a major anxiety trigger for your child.

Remember that your goal is to handle – not accommodate – your child’s food anxiety.

If your child had anxiety about getting on a plane, you would recognize that going to the airport and getting on a plane will create anxiety for your child. With an eating disorder, meals will create anxiety.

The key is to remember that the anxiety is the root issue, not the food itself. Work on your ability to tolerate your child’s anxiety and help them walk through it. Have a plan for how to handle anxiety when it arises during meals.

And, most importantly, take care of yourself and get the care you deserve. Feeding a child with an eating disorder and anxiety is taxing. We can help our kids so much, but we have to make sure we’re getting help for ourselves, too.

See Our Parent’s Guide To Eating & Feeding A Child With An Eating Disorder

Food shaming is something that happens when a parent or other person makes a judgment or criticism of what a child is eating. Common food-shaming comments include drawing attention to:

• How much someone is eating (e.g. “too much”)
• What specifically someone is eating (e.g. “only sugar,” “all carbs,” “junk food”)

These comments typically stem from popular culture, which generally believes that people who eat certain ways are either “good” or “bad.” These beliefs have been intentionally created by the diet industry, which has a basic template for marketing its diet programs.

These marketing messages have been promoted by the diet industry to great success. And our culture believes them, even though they simply are not true. Weight loss is not effective or healthy. But the weight loss industry has thrived nonetheless and created a culture of parents that instinctually use food shaming without realizing the harm it causes.

The intention of food shaming is typically to help the child. But the impact of food shaming is to humiliate the child and make them feel ashamed of their appetite and desires. Simply put: there’s nothing healthy about that.

Eating disorders, restriction and control

Many people who have/had eating disorders recall being food-shamed by their parents. These people had parents who truly wanted to help their kids. But we live in a society that, egged on by the powerful diet and food industries, tells us that food is either “good” or “bad.” This message is everywhere, and it’s incorrect.

There is significant research demonstrating that Intuitive Eating, a method of eating without following “food rules” but rather focusing on hunger and appetite cues, is the healthiest approach for the body and mind. An intuitive approach to eating with zero weight goals or expected weight outcomes is protective against eating disorders, the second most deadly mental disorder.

That is why we implore parents to never food shame their kids. That means:

• Don’t label food good or bad
• Don’t make moral judgments about food
• Pay attention to your child’s hunger, not caloric counts or other external measures 
• Be aware that food is more than fuel – it is also comfort (and that’s OK)
• Don’t recommend against eating for fear of weight gain
• Don’t assume your child needs to eat less or weigh less 

Examples of food shaming

We ran an informal survey on Instagram and asked people for examples of how their parents food-shamed them. The results were sad, but not surprising. Here are some examples of childhood food-shaming experiences:

• When I was 9, my mom gave me a teacup and a teacup saucer and told me all of my meals should either fit in the teacup or on the plate. I was nine years old.
• When I was your age I only ate salads.
• I think you’ve had enough brownies/cake /cookies/peanut butter/crackers.
• The problem with kids today is that they eat so much more than we did.
• Anytime I wanted to eat ANYTHING my dad would say “oh you don’t want that!”
• At your size, you really need to stop eating that kind of food.
• Really? You’re eating that much?
• Really? You’re getting more?
• You know where that goes.
• You weigh how much? And you’re eating THAT?
• I was deceitful for saying I planned on splitting my Panda Express and then mom threw the whole meal in the trash.
• When they shamed their own food choices and body shape. I learned to do the same.
• You can’t possibly be hungry.
• My mom used the Bible (Adam and Eve) to shame me when I was sneaking maraschino cherries from the fridge because I loved them so much.
• A moment on your lips, a lifetime on your hips.
• That’s a lot of food you have on your plate!
• Your prom dress would look better if you lost 10 lbs.
• I know you love to stuff your face.
• Your brother can order four-cheese pasta, but not you.
• I suggested we make brownies. They said I think about food “too much” and should see a therapist.

Shame is not healthy

Parents who food shame their kids often think they are trying to improve health, but shame itself is damaging to health. Shame can have a significant negative impact and is associated with eating disorders, substance abuse, and many behavioral addictions.

What is shame? Shame is often used as an umbrella term to indicate a variety of emotions ranging from embarrassment to searing mortification. It happens when an individual feels they are at risk of being excluded from a critical social group. It is especially dangerous in family groups, which are essential to a child’s health, safety, and well-being. Unlike guilt, which is feeling bad about an action, shame is feeling bad about who you are as a person.

Belonging to social groups, particularly a family group, is critical to human health. Therefore, feeling shame within one’s family group can be devastating. shame is associated with low self-esteem, hostility, and psychological distress. This is particularly true of body-based shame. [1]

Also, shaming people for behaviors backfires. For example, being shamed for drinking increases problem behaviors for someone who has alcoholism. [2] Many people who are shamed for eating find themselves binge eating or eating uncontrollably in response.

How food shaming hurts

We can see this reflected in our survey. Respondents reported that parental food shaming encouraged them to develop problems with binge eating.

• I started to not want to eat in front of them, which led to my binge eating disorder. Internalized fatphobia, food labeling, and guilt around food in general was the norm. I don’t think I’ll ever have a healthy relationship with food thanks to their hypervigilance.
• I binge eat a lot. Alone, in the dark. Even now that I’m an adult with a supportive partner.
• I started bingeing in secret so they couldn’t shame me.
• Binge eater, secret eater, emotional eater.

For others, parental food shaming led to severe restriction and a full-blown eating disorder.

• I saw them food shaming my sisters so I decided to survive on rice and Diet Coke.
• Developed bulimia and binge eating disorder and struggled with it for 15 years.
• Being food-shamed led me to a long road of restriction instead of trusting my body.
• I struggled with an eating disorder for 8 years.
• I developed an eating disorder which eventually led to psychiatric hospitalization.
• Food shaming was a big reason for my eating disorders.

Most of all, respondents say that parental food shaming led to an unhealthy relationship with food.

• I’m now 31 and still associate food with shame, love, anxiety, and worthlessness.
• I still feel the need to tell people why I”m eating certain food when I’m eating.

What to do if you have food shamed your kids

If you recognize that you have been food-shaming your kids, then take a deep breath. It can be surprising to hear that something you did with the best intentions was harmful. And the good news is that you can make amends to your child. While you can’t erase what is already done, you can attempt to repair the damage.

The best way to get started and help your child be truly healthy is to own up to your mistakes.

Once you can see that you have been food-shaming your child and understand that it is hurtful, you can begin repairing your relationship. The key is to open a conversation without getting defensive or critical of your child. It’s hard to get vulnerable, but it can have a huge impact on your child.

Before you begin, here are a few ground rules for a conversation about food shaming:

• Understand that food shaming is not helpful and is in fact harmful
• Recognize that your child’s body is their own, and they get to decide what food they eat (not you)
• Learn about the harmful diet culture messages we’ve learned that say food is good or bad and that we must be thin to be healthy

An apology script

Once you are ready, you can open a conversation with your child. Here’s an outline for how to approach this:

• Acknowledge that food shaming was a mistake on your part.
• Say that you are going to work on not food shaming in the future.
• Ask your child to tell you in the future if they believe you are food shaming.
• Do not get defensive when your child responds. You made a mistake, and you must own that mistake. Don’t defend yourself. Just say you will try to do better.
• Don’t get into a debate about nutritional content, caloric values, weight, diet, etc.
• Conduct more research and, if necessary, consult with a non-diet dietician so that you can learn about how to prevent eating disorders by learning about weight and diets.

Feeding a child with an eating disorder is tough. Learning to stop vilifying food and shaming people for eating what they enjoy takes time. Just keep trying! Showing up is half the battle.

See Our Parent’s Guide To Eating & Feeding A Child With An Eating Disorder

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[1] Garofalo, C., Bottazzi, F. & Caretti, V. (2016). Faces of shame: Implications for self-esteem, emotion regulation, aggression, and well-being. Journal of Psychology

[2] Randles, D. & Tracy, J. L. (2013). Nonverbal displays of shame predict relapse and declining health in recovering alcoholics. Clinical Psychological Science

New research suggests that Intuitive Eating may help with eating disorders. A recent study found that teens who eat intuitively have better mental health outcomes and eating habits as adults. Most of our kids are not being raised with Intuitive Eating principles. As a culture, we largely embrace non-intuitive eating. Most people follow restrictive diets rather than our body’s intuition.

Study finds Intuitive Eating beneficial for health

Researchers with the University of Minnesota School of Public Health studied people who ate intuitively as teenagers. They found that teens who scored higher on an Intuitive Eating scale were less likely to experience depression and disordered eating as adults. Specifically, the study found that teens who used Intuitive Eating had:

• Fewer depressive symptoms
• Higher self-esteem
• Lower body dissatisfaction
• Fewer unhealthy weight control behaviors (e.g. fasting, skipping meals)
• Lower rates of extreme weight control behaviors (e.g. eating disorder behaviors)
• Less chance of binge eating (71%)

The data applied both to teens who scored higher in Intuitive Eating at the beginning of the study and those who became more intuitive over the course of the study.

The authors concluded that Intuitive Eating in adolescence predicts better psychological and behavioral health across a range of outcomes. They also suggest that Intuitive Eating may be a positive intervention for people who are at risk of or have eating disorders. This is based on the findings that teens who used Intuitive Eating were 74% less likely to develop Binge Eating Disorder.

Treating eating disorders

This is the latest in numerous scientific articles that have found value in using the principles of Intuitive Eating. The approach appears to help treat eating disorders. This is important, because eating disorders and disordered eating are both on the rise. And both can have lifelong mental and physical health impacts.

NOTE: Intuitive eating is considered helpful in the latter stages of eating disorder recovery. But it may not be appropriate for your child in early recovery, especially if weight restoration is necessary. Please check with your child’s RD for insight on how to integrate intuitive eating.

Intuitive Eating is most likely effective because it counter-balances diet culture messages. These messages say that we can and should control our body weight. Diet culture has grown on the wings of the diet industry. The diet industry exploded from $10 billion in annual revenue in 1985 to almost $70 billion in 2012.

In that time, human body weights have not gone down, but eating disorders and disordered eating have increased. Sadly, diet company profit goals play a huge role in our lives. This is despite zero evidence that their programs are effective, safe, or improve health outcomes.

Intuitive Eating may help parents treat eating disorders because it actively works against the diet culture promoted by the diet industry. It specifically teaches people to recognize and reject diet culture. Diet culture marketing says we can lose weight fast and keep it off for life. But Intuitive Eating teaches us to listen to and trust our own bodies.

What is Intuitive Eating?

Intuitive Eating was introduced by Evelyn Tribole, MS, RDN, CEDRD-S, and Elyse Resch, MS, RDN, CEDRD-S in 1995. Their bestselling book, Intuitive Eating: A Revolutionary Anti-Diet Approach is now in its fourth edition. Intuitive Eating is defined as rejecting restrictive diet patterns and instead eating according to feelings of hunger and fullness.

The authors define Intuitive Eating as following these 10 principles:

10 principles of Intuitive Eating

1. Reject the diet mentality: stop using diet books, influencers and blog posts that offer you false hope. No matter what they say, there’s no evidence that you can lose weight quickly, easily, and permanently.
2. Honor your hunger: hunger is a biological instinct, just like blinking, using the bathroom or feeling thirsty. We accept almost all biological instincts except hunger. When you honor your biological hunger drive, you can rebuild trust in yourself around food.
3. Make peace with food: end foodphobia forever. Stop fearing fat, carbs, sugar, and any other foods. The fear of food keeps you locked in a battle with eating, which is both natural and necessary.
4. Challenge the food police: parents, doctors, teachers, coaches, the media, influencers, and peers have all influenced us. They have built an inner dialogue of what we think of as “good” and “bad” food. Stop listening to the voices in your head and instead listen to your body’s natural drive for food.
5. Discover the satisfaction factor: it’s become easy to forget that food and eating are supposed to be pleasurable. Instead of being afraid of eating, rediscover the satisfaction you get from food.
6. Feel your fullness: Give yourself unconditional permission to eat. Now you can tune into your natural fullness, which often has been masked by rules and requirements of diet culture.
7. Cope with your emotions with kindness: food can be a comfort. But food shouldn’t be the only way you respond to uncomfortable emotions. Learn to be mindful and comfort yourself through uncomfortable emotions.
8. Respect your body: understand that your body has a blueprint. This is genetically based on the same factors as your shoe size. It’s also influenced by past efforts to intentionally lose weight. Trust that your body will find the weight that it wants to be (not that you want it to be).
9. Movement – feel the difference: diet culture pushes an aggressive fitness regimen that can leave us feeling depleted and depressed. Focus on enjoying exercise and movement and honoring rest when you need it.
10. Honor your health – gentle nutrition: remember that your health is not dependent on any single meal or day. You can trust that your body will naturally seek good nutrition if you are following these principles.

What it’s not

The rise of Intuitive Eating and the many studies showing the health impacts of Intuitive Eating have led to many people claiming their diet is Intuitive Eating even when it clearly is not. Here are some common ways that Intuitive Eating is being used to sell and promote dieting:

Claim: Intuitive Eating will help you lose weight

Truth: weight loss is never the goal of Intuitive Eating. Anything or anyone that promotes Intuitive Eating as a weight loss method is definitively not actually using Intuitive Eating.

Claim: Intuitive Eating just means eat when you’re hungry and stop when you’re full and you won’t gain weight

Truth: Intuitive Eating is more complex than this. And there is never a goal of controlling weight or avoiding weight gain. That’s diet mentality and therefore not Intuitive Eating.

Claim: Intuitive Eating means you never eat when you aren’t hungry

Truth: many times you will need to feed yourself mindfully before you get hungry to accommodate your schedule. This doesn’t go against Intuitive Eating framework, but is commonly incorrectly presented as the reason why Intuitive Eating is not a realistic lifestyle.

Claim: Intuitive Eating is about eating whatever you want, so it’s not healthy

Truth: Intuitive Eating has been shown to result in better health across many dimensions because it removes food rules and lets the body drive eating patterns. Contrary to popular belief (i.e. diet culture), a body will naturally select a wide range of foods to fit its nutritional needs.

There are many false claims about Intuitive Eating. The best thing is to read the book or find a trained dietitian to make sure you get the correct approach rather than one of the many false approaches.

Diet culture is bad for health

Diet culture has worked hard to convince us that we can’t trust our bodies. Every diet message preaches that our bodies need to be controlled, and our urges for food, rest, and pleasure, need to be eliminated. This is the opposite of Intuitive Eating, and it may be why it can help prevent eating disorders.

Diets restrict food and pleasure, and they all promise that it’s easy and fun to take weight off and keep it off for life. But the data consistently shows that lasting intentional weight loss is virtually impossible for 90-95% of people.

Today’s diets intentionally avoid focusing on how the body looks, saying instead that the main goal of dieting is increased health. But the data don’t support the idea that diets are good for our health. In fact, diets are proven to increase cortisol and decrease metabolism. They have not demonstrated any health improvements. Finally, the most common outcome of intentional weight loss is weight cycling, which is recognized as bad for our health.

In other words, there is no evidence that diets are effective at anything other than reducing our health.

How parents can teach their kids healthy eating

Parents who want healthy kids now have even more evidence that Intuitive Eating is a solid approach to food and eating. Rather than try to control our bodies and force a particular diet, we should follow our intuition and trust our bodies.

Parents can help their kids learn Intuitive Eating by:

1. Stop dieting
2. Don’t allow kids to diet
3. Learn Intuitive Eating for yourself
4. Talk about the Intuitive Eating principles as a family
5. Recognize diet culture and talk about its impact as a family
6. Encourage your child(ren) to listen to their bodies, honor their hunger and fullness, and avoid food restrictions not based on allergies or serious medical conditions (“obesity” doesn’t count)
7. Learn emotional literacy and work with your child(ren) to talk about feelings freely
8. Move together in ways that feel good and make you all happy

Parenting a child with an eating disorder is challenging, but parents can make a huge impact on kids’ lifelong health. When we teach our kids Intuitive Eating, we can help prevent eating disorders and other mental health conditions.

See Our Guide To Parenting A Child With An Eating Disorder

Adapted from an interview with Gina R. Mateer, RD

Most of the time when a parent reaches out to a dietitian for help feeding their kids, it sounds simple. They say “I just want my kids to be healthy.” But feeding our kids has become surprisingly complicated since we live in a culture that is obsessed with being thin, restricting food, and moralizing food behaviors. 

Suddenly, feeding our kids, which seems so simple, becomes a major task. Our kids can pick up on our discomfort, and they often respond to a parent’s stress about food by developing some problematic food behaviors. Here are five ways that I work with parents to help them raise healthy kids.

1. Problematic food behaviors

Problematic food behaviors include picky eating, labeling foods as good or bad (and not wanting to eat “bad” food), maybe even dieting. If you’re noticing these behaviors in your child, then I encourage you to consider your own relationship with food. 

Is it possible that you have a difficult relationship with food? Do you avoid certain foods or restrict food? Do you weigh yourself daily and adjust your behavior based on your weight? Do you make comments, both positive and negative about other people’s weight?

How parents feel about food and weight impacts how kids feel about food and weight. Almost all parents are doing what they think they are supposed to be doing – promoting healthy foods and “watching” weight. But it turns out that these behaviors, and the internal pressure they create, can have negative outcomes in our kids. 

So when a parent comes to me and says their kid has a problem with food, I want to consider whether the parent needs some support with food, too. In fact, I’ll often consider whether we can work with the parent instead of the child. 

Of course, if your child has a very clear eating disorder, there is another path. But if it’s early, and you sense something, see what you can do about your own food fears, weight stigma, and biases that may be trickling down to your kids. 

2. Childhood weight gain

A lot of times parents worry about their child gaining weight, and I see that the weight gain is fine for the child, but uncomfortable for the parents. The parent thinks there is a problem to be fixed, but what’s really going on is internalized fatphobia and fear about what’s going to happen for a child who is in a larger body. 

I get it – parents are worried that a larger child will experience more bullying, be less healthy, and have a less fantastic life. Those are the messages parents are receiving all the time, but it’s not true. Parents can help kids avoid or deal with bullying, be healthy, and live a fantastic life, regardless of whether their kid is thin or fat. 

This is an area that I think parents need a lot of support in. Parents need to know that it’s enough to raise your child in a healthy environment and to allow the child to grow up naturally in the body they were meant to grow up in. So many parents want their kids to be in smaller bodies, and I get it, but it’s also really harmful to carry those beliefs if your child is meant to be in a larger body. 

I can definitely help parents figure out how to feed their kids. I can help them figure out if they are being too restrictive and putting too many rules around food. We can also work together to structure meals for optimum success – nutritionally and emotionally. But the first step is for parents to accept that body diversity is a real thing, and to release their child from thin expectations.

3. Dietitian or therapist?

I think therapy is great, and it’s wonderful when I can work in tandem with a therapist. A therapist can work on issues of self-worth and confidence, while I can work on food behaviors. 

If I’m working with a child who has a serious eating disorder then I’m typically working alongside a therapist and a medical team. Together, we can address the many aspects of eating disorder recovery. 

When a child has disordered eating or just an uncomfortable relationship with food, I can do a lot of work around normalizing all foods and encouraging the child to gain confidence with, and trust in their body. 

Sometimes it seems like parents are more comfortable sending their kids to a dietitian than a therapist. When the focus is food, vs. larger emotional issues, it can seem easier to get started. It can be a less stigmatizing treatment. It is a great place to start, and we can make a big impact on food behaviors with nutritional counseling. 

But if I’m seeing underlying conditions like anxiety, depression, or symptoms of a full-blown eating disorder, I recommend therapy as well. Eating disorders sound like they’re about food, but it’s important to remember that they are mental disorders, so we really need to bring in some psychotherapy to see solid recovery. 

4. Fear of “doing it wrong” 

It’s so common in our culture for parents to be worried about their kids’ body. We’ve been raised in a diet culture that has told us that everyone should be the “right” shape. But there is no “right” shape for bodies. 

We now know that if a parent is concerned about a kids’ body size, there’s going to be so much fear and shame. Even a child who is in a smaller body will develop fear around their body changing. And when it does, for puberty, genetics, or whatever, that can be really difficult for the child. 

Parents do need to learn to work on their relationships with food and bodies as much as possible. Even “nice” comments about other people’s bodies, your own body, and kids’ bodies can cause unintentional harm. It’s not only overt fat shaming that’s a problem. A bunch of small comments that suggest that there is a “right” way to have a body can really hurt. Kids naturally internalize this to mean that if my body is not like that, then I am wrong. 

I’d love all parents to take a good look at their own relationship with food and body. If you know you have issues with food and your body, then get some support! If you are still weighing yourself, restricting certain foods, and worrying about your weight, then now is a good time to talk to someone about that. Because you can tell your kids that all bodies are good bodies, but if you’re treating your body like it’s a problem to be managed, your kids know that. 

I’m not saying this to shame parents at all! We are all raised in this diet-obsessed culture. You’re doing exactly what you think is right. You want what’s best for your child. It’s just that the internalized diet culture that we all live with needs to stop, and we can start with ourselves. 

5. Intuitive Eating for kids

Parents are worried that they’re feeding their kids wrong because all of the conversations around us focus on an intense fear of fat and food. It’s overwhelming to think that a child can really eat intuitively, but I can assure you that I see it happen all the time. 

It can be really scary for parents because when they accept Intuitive Eating and allow all foods in the house, the kids can go a little crazy. It’s very true that kids (and all people) will respond to foods that have been “off limits” by eating a lot of them at first. Parents often think this is evidence that they need to control the food. But it’s actually that the kids are just overcorrecting. 

Kids will eat a lot of the restricted food when it first comes available. They may even eat all of the food when it first appears. They may keep eating it until they really believe – on a deep level – that the food is allowed. And then, once they truly trust that it’s OK, they will not only want the play food. They will naturally balance it out with a whole variety of food. That is the beauty of Intuitive Eating. The body hates it when Doritos are not allowed, but it also doesn’t want to live on Doritos. 

This is the work I do with parents during the Intuitive Eating process. I can help parents trust that their kids will figure out the right balance for their body and grow into the size that they are naturally meant to be. It can be scary because it’s so different from what we’re told in society, but it’s also incredible because it works so much better!

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Gina R. Mateer, RD, LD, CEDRD-S, RYT 200 is a registered dietitian, licensed dietitian in the state of Texas, and is recognized as a certified eating disorder registered dietitian. Gina studied nutritional sciences at the University of Texas. After completing the required internship hours and passing the registered dietitian exam in 2010,  she began working at an intensive outpatient program treating eating disorders and providing individual nutrition therapy. She has a virtual practice serving individuals in the state of Texas as a CEDRD and nutritional coaching/counseling as an intuitive eating counselor worldwide. Website

See Our Parent’s Guide To Eating & Feeding A Child With An Eating Disorder

It’s very common for parents to worry that their child overeats. The most important thing parents need to know is that there is really no such thing as “overeating.” Except in very rare medical conditions, children eat for good reasons. Eating is something people do as a way to meet their physical and emotional needs. It’s best not to pathologize the desire to eat food. Instead, pay attention to what is driving the desire to eat food, and feed that need.

For example, if your child is actually physically hungry, give them food! If your child is tired or stressed, they may need rest and a snack. If your child is lonely and emotionally distressed, they may need a cuddle and some focused attention – as well as a snack.

Food is an easy stand-in for all types of nourishment. Parents should feed a child’s hunger without judgement or criticism while also wondering whether there is another hunger to address.

Also, ask yourself how you know that what your child is eating is “overeating.” How do you know the difference between a child that overeats compared to a child who eats “normally?” You need to dig really deep to separate your child’s experience from your own complicated beliefs about food and weight.

Think of it this way: you don’t question whether your child really needs to pee, or blink, or breathe. Food hunger ideally falls into the same biological category in which we can honor it easily and without judgement. But hunger is complicated in our society, so let’s see what we can do about that.

1. Is my child hungry?

You may think you know how much food your child needs. But your child’s nutritional needs may vary widely from day to day. They may also be different from your own. You may think your child overeats when they are in fact feeding their body appropriately.

If you are someone who controls your own food intake in order to control your weight, you are likely under-eating based on your biological needs. This means you are familiar with a constant hunger and believe that is normal and healthy.

You should know that under-eating is no better than overeating. They both signal a lack of connection with the body’s hunger and fullness cues.

The best relationships with food and body are those in which the person trusts their body and recognizes hunger and fullness cues. This allows them to know when they are physically hungry and also when they have had enough. The sooner you help your child recognize and honor their hunger and fullness cues, the better off they will be.

Teach Intuitive Eating

Teach your child Intuitive Eating. This is a process that honors the body’s ability to eat (and stop eating) based on biological needs. To accomplish true Intuitive Eating, you must accept that your child’s body may not be the size that you wish it would be. It will be the size that it wants to be. Bodies come in a broad range of sizes. When we try to control a body’s weight by restricting food, we set it up for binge eating and poor health.

You can’t turn off a person’s hunger cues without also turning off their fullness cues. This means that if you teach your child to eat less than their appetite, they will learn to ignore hunger cues. At the same time, they will lose their ability to recognize that they have had enough. This is the endless cycle of under-eating and overeating that many people find themselves trapped in. The alternative is that your child learns to ignore hunger cues so completely that they develop anorexia. Neither is a good outcome for your child.

It may take some time to relearn hunger and satiety cues. There’s really no rush. Just trust your child’s body and believe that with your guidance, they will make healthy choices for their unique body.

2. Is my child tired?

Expand your thinking about “hunger” to encompass all feelings of physical and emotional need. Hunger is our very first drive after birth, and it is what supports the survival of our species. There is nothing wrong with hunger – it is healthy and adaptive. Parents should teach their child to notice and listen to physical needs like being tired or needing physical affection. Without this, the child may assume all hunger is food-based.

This doesn’t mean that when your child says they are hungry you tell them to go take a nap. Instead, get curious about what your child’s hunger is telling you. Pay attention to when they say they are hungry and the types of food they are hungering for.

Think about whether they are getting enough sleep or if there are physical disruptions causing stress in their life. Perhaps you have a new infant, an out of town visitor, or the beginning of a new job or school year. All of these can disrupt your child’s sense of physical safety. The solution is not to never have changes. Instead, pay attention to your child and recognize that sometimes food hunger is a mask for a physical sleep or safety need.

Talk about hunger

If you suspect your child may be reacting to a physical sleep or safety need with food hunger, begin by honoring the hunger with a snack. This shows your child that you take their hunger seriously. Once you have given the snack, ask your child how they are feeling in their body. Ask if they are tired, tense, or achy. Try protecting sleep times in your house so that your child gets plenty of rest and relaxation.

Remember that it’s very difficult for a child to separate exactly what they hunger for. It’s often up to the parent to pay attention to the physical conditions and respond accordingly. Feeling hungry varies greatly from body to body. Some people feel it in their gut. Some feel a rumbling. Others feel an emptiness or a tingling. Others feel it in their throats or elsewhere in their bodies.

Help your child tune into their body to identify where the hunger is, and what type of hunger it is (food, physical, or emotional).

Next, talk to your child about their physical sleep and safety needs. Make sure you are feeding their hunger for rest, relaxation, and physical safety. Be aware of physical disruptions and how they can lead to a hunger that needs attention. And always be willing to serve a snack with a side dish of attention and thoughtful conversation about what’s going on in your child’s life.

Over time, your child will learn to distinguish food hunger from other physical and emotional hungers. A child who you think overeats may not be getting their needs met. With your help, they can recognize the difference and nourish themselves with what they need to thrive.

3. Is my child lonely?

Most people it very difficult to separate their body from their mind. This means that often when they hunger for an emotional need, such as attention, affection, and affirmation, they assume it is food hunger. This can become a cycle. If the child doesn’t get their emotional hungers met, they may find that food becomes their greatest comfort.

As a parent, you want to be your child’s comfort. Caloric nourishment is the first form of comfort we give our child. Food can help us connect with them emotionally throughout their lives. Emotional eating has gotten a bad rap, but it’s quite normal for healthy people to sometimes combine emotional care with a snack, a cup of hot chocolate, or a bowl of soup.

Most of our children need more attention, affection, and emotional first aid than we think they do. A child who doesn’t get their emotional needs met will likely learn to repress their emotional needs and turn to coping mechanisms to feel better. In a worst-case scenario, a child may turn to coping behaviors like self-harm, substance abuse, shoplifting, or eating disorders to soothe their emotional disruptions.

This is why it’s so important for parents who worry that a child overeats to pay attention to emotional caregiving. Don’t deny food if your child says they are hungry, but serve it with a side of conversation, compassion, and attention.

Give more love

Give your child more love along with food. Talk to them about how they can get their emotional needs met. For example, do they want to go for a walk with you? Snuggle on the couch? Do they want you to make them a cup of tea in a special mug? Serve them the mac and cheese you made them when they were little? Our kids grow up fast, but they often need us to treat them like children when they’re emotionally vulnerable.

Over time, you can help your child get their emotional needs met without food. But remember that food and eating are not typically a problem for a child who is getting their physical and emotional needs met.

Feeding your child

Sometimes food hunger can be better understood with more structure. A child who you think overeats may benefit from structured meal times and family time. A structured food plan can help the whole family better understand hunger cues and eat in a way that is healthy for both their body and their mind. Feeding your child doesn’t have to be complicated, but it is important.

See Our Parent’s Guide To Eating & Feeding A Child With An Eating Disorder

by Alexandra Raymond, RDN

As a parent, you want your child to grow up happy. You want him or her to make (overall) smart decisions and be successful. You probably also want your child to grow up “healthy.”

The pressure to raise healthy kids

There is no denying that health and wellness are at the forefront of our minds. We are constantly bombarded by health and wellness information and trends. Celebrities are talking about it. Friends and family are talking about it. Doctors are talking about it.

We’re encouraged to eat certain foods and stay away from others. We’re told that certain foods “speed up metabolism,” while others “slow it down.” We have detoxes and juice cleanses pushed on us. And it seems if you don’t try to follow some of these food trends, you’re doing something wrong. Food and diet culture is huge! After all, the diet industry is worth almost $70 billion.

Because of the pressure society puts on us to be “healthy,” many parents worry about their child’s eating habits. Whether he/she is eating too much of one food and not enough of another. Parents worry their child is gaining “too much” weight. Or even worry their child might be “addicted” to food. And who could blame these parents. They are constantly made to feel they aren’t “good enough” as a parent if they aren’t making sure their kids are eating perfectly.

Impossible food standards

I’ve found that many parents become hyper-aware about what their child is eating. Especially if they feel like their child is eating “too much” and their child lives in a larger body. Hyper-awareness surrounding foods may include:

• making comments about good foods and bad foods,
• commenting on the amount of food a child is eating,
• comments on weight, and
• asking a child to eat certain foods before other foods (veggies before dessert), etc.

I completely understand why a parent may do this because of the ridiculous amount of pressure they feel to raise “healthy” families. But, unfortunately, this often backfires. I’ve found this hyper-awareness surrounding food causes children to become more obsessed with their bodies, begin dieting at an earlier age, and possibly sneak/hide food from their parents, especially those foods they consider to be “junk foods.” (PS: I personally don’t use the words “junk foods” with my clients because I believe all foods should be placed on the same playing field. “Good” food / “bad” food language is often harmful for people of all ages).

Overeating and addiction

In my office, I often hear parents’ concerns about children “overeating” or being “addicted” to certain foods. In these situations, as hard as it might be, I ask parents to do their best in avoiding comments and to continue to allow their child to self-regulate.

It’s important we don’t think of any foods as “bad” or “addictive” but instead recognize food as a substance like oxygen and water. You most likely don’t worry about your child overconsuming either of those, and food is equally natural and necessary.

First, children are the most intuitive eaters out there. More often than not, your child is actually not “overeating,” but is fueling his/her body with the nutrients he/she needs. We need to be careful and avoid pathologizing certain eating patterns, to avoid the possibility of a child internalizing that guilt and shame.

Second, food is not an addictive substance and we have research that shows this. People may feel addicted to certain foods if they have been deprived of eating them. For example, you tell yourself you’re not going to have sweets. Maybe you don’t eat sweets for a few days or even weeks or months. But, eventually, you’ll be presented with the opportunity to eat sweets again. The moment you eat sweets, it’s totally possible you may feel like you can’t stop.

But this isn’t because you’re “addicted” to sugar. It’s because you have been physically and emotionally deprived from sugar. This same thing happens with kids. It’s important we allow kids to have a wide variety of foods.

How to feed a child

You may be thinking, but what if my child needs to eat healthier? Or what if I feel like my child is eating too much? How can I promote balanced and nutritious eating without triggering negative body image or food thoughts?

Here are my tips:

1. Feed their appetite: Appetites vary for many different reasons for different people and in different stages of life. Sometimes children will feel more hungry and eat more food than “normal” for no apparent reason. On the flip side, sometimes children won’t feel hungry at all and will eat way less than “normal.” It’s important to let your child eat how much or how little they want according to their individual hunger cues, not an arbitrary perception of what they “should” eat. This will help them to stay more in tune with their hunger and fullness signals and support long-term health.

*There is one caveat. If you notice your child is eating significantly less and cutting out foods they previously used to love, this definitely is a concern. Please talk to a health care provider about this.

2. Have a wide variety of foods available: I recommend having a wide variety of foods in your kitchen for your child to eat. You can present these different foods during snack time. For example, you may want to consider putting out some food for when your child gets home from school. The key here is allowing your child to choose what he/she is in the mood for. So whether they choose animal crackers, chips with guacamole, or carrots with hummus, it’s their choice.

3. Monitor emotional changes: If you notice a change in your child’s eating or weight, I recommend you consider whether you notice a change in their emotions. Is your child more withdrawn than usual? Is he/she stressing about things they may not normally stress about? Are they hanging out with friends less? Are they exhibiting increased anxiety around food? Sometimes a change in eating and weight is a sign that something else is happening. I recommend avoiding commenting on food/weight and instead ask them about feelings. If your child is happy and acting as they always do, then weight gain is typically not a concern.

4. Talk less, model more: Children learn how to eat from the adults in their lives. They also learn how to either appreciate or criticize their bodies. Do your best to eat a wide variety of foods along with your child. This includes meat, fish, veggies, fruit, dessert, fried foods, grains, and dairy products. Also, please be mindful about the negative comments made about your body or someone else’s. Negative body comments are easily internalized by children. It’s important to model body appreciation and respect. You can do this by talking about how much your body does for you and by being compassionate toward the physical aspects you may not like about your body.

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Alex is a Registered Dietitian at the private practice Courage to Nourish in Howard County and College Park, Maryland. Alex’s goal is to assist her clients in discovering a life-long healthy relationship with food and their bodies. Alex is a proud and passionate anti-diet and Health At Every Size © advocate. Outside of counseling clients, Alex enjoys cooking (especially Italian foods), journaling, hiking and exploring Washington, DC. Website

See Our Parent’s Guide To Eating & Feeding A Child With An Eating Disorder

It’s challenging to feed a child when you’re worried about their weight gain. Messages about feeding kids the “right” foods and avoiding weight gain are everywhere.

Many parents worry that they will make terrible mistakes when feeding their kids. They worry about feeding children “too much” so they gain weight. And they worry about creating body image and eating issues. It can seem like an impossible equation.

We live in a dangerous time for body image and eating disorders. Decades of fear-mongering have created conditions in which parents believe they must control or reduce their children’s weight.

Parents believe that if they don’t control their children’s food intake, their children will gain too much weight. They worry that the way they feed a child will either create or prevent weight gain. Many parents believe that larger children result from poor feeding practices.

We think it’s our fault if our kids are larger. Ellyn Satter, a well-known expert on feeding, says the crisis we face today is not childhood weight, but a crisis of parenting and feeding.

Living in diet culture

Living in diet culture has convinced parents that bodies are at constant risk of gaining weight. However, weight is more correlated with genetics and environment than individual behaviors and eating patterns. A parent cannot prevent a child from gaining weight without creating major side effects.

Parents may be surprised to learn that focusing on weight can actually increase weight. Parents who worry about their kids’ weight raise heavier children compared to those who do not. If you feed your child less to try and avoid weight gain, you may accidentally cause weight gain.

Our kids’ weight is not the problem we’re facing in our society. The problem we’re facing is that parents disregard their child’s bodily needs. Parents think they need to control their kids’ food to the point of disregarding their child’s preferences. Parents often attempt to restrict their child’s food intake and accidentally drive dangerous food behaviors.

These problems underlie most eating disorders, which have serious consequences for life. Eating disorders impact at least 10% of the population (NEDA), and are on the rise. And eating disorders have worse health outcomes than high body weight.

Wanting a thin child

From the day of our child’s birth, medical professionals report on our child’s weight and editorializing what it means. It’s always some variation on the theme of BMI. And conversations about weight gain are typically centered on how parents feed a child. Here’s how these conversations go:

• On the “average” curve, which implies perfect nutrition
• Below the “average” curve, which implies more food is needed
• Above the “average curve, which implies less food is needed

But the BMI scale was developed to be used on a population scale. It was never intended to guide individual health. No weight chart can ever tell you what is healthy for your child.

Our healthcare providers spend an inordinate time discussing our kids’ BMI. When faced with an otherwise healthy child, doctors discuss weight because it is one of the only measurements of interest.

But in 2016 the American Academy of Pediatrics told doctors to not talk about weight with children and adolescents. This is because it often causes harm, and very seldom is helpful.

This is because weight is much more complex than most of us understand. Even doctors may have these false beliefs:

• Weight is a simple equation of energy in and energy out (not true)
• Anybody can achieve low body weight with willpower and effort (not true)
• People who weigh more, eat more and move less (not true)

None of these beliefs is true. Our bodies are complex. The only way to override a body’s natural and complex weight system is to diet. But dietary restriction creates significant stress on the body. It also reduces metabolic rate, increases lifetime weight, and leads to poor health outcomes.

“Being thin is not the most important thing for your child. Most important is knowing you love him and accept him for being just who he is—thin or fat, tall or short.” 

Ellyn Satter

Controlling food

Adults who believe that a child will overeat and eat only junk are reflecting their own food issues. This is not the reality of how children naturally eat.

Our children are born with innate hunger and food satiety signals. They have a perfect system of bodily feedback. Children can be raised without food control. They can be encouraged to eat based on their personal appetite vs. external food rules. These children neither overeat nor under-eat most of the time. Their bodies find a healthy homeostasis based on their unique genetics and environment.

“My message—one that not all parents are pleased to hear—is that your child’s eating is determined by the way you feed,” says Satter. “They depend on regular meals and snacks to know they will get fed. If they don’t know they will be fed and allowed to eat as much as they want at frequent and predictable times, they will eat as much as they can whenever they can. Their fear of going hungry will override their cues of hunger, appetite, and satisfaction and make them eat until they can hold no more.”

How we feed our children reflects our own beliefs about control

Many parents live in a state of fear of weight gain. They control their own food, so it seems to make sense to do the same with children. This approach to eating is extremely “normal” in our society today, but it is also maladaptive and unhealthy. Nobody should live in fear of their bodies and food. Typically, this fear begins early and is reinforced often in our society.

Parents who want to raise healthy children must actively resist cultural messages. We must reject the idea that children are not to be trusted with food and should be tightly controlled. Parents need to forget rules like “no sugar,” “only organic food,” and “no soda.”

Parents worry that if they don’t control their kids’ eating, their kids will eat only candy and potato chips for every meal for the rest of their lives. This is rarely the case. In fact, parents who follow Ellyn Satter’s feeding method find that their children naturally have varied and healthful eating patterns.

This only sounds impossible if you have lived in fear of your own insatiable appetite. Once parents learn to trust themselves around food, they realize that they can trust their children around food, too.

“Normal feeding is providing the child with a variety of nutritious and appealing food, then letting him decide what and how much to eat based on his internal regulators of hunger, appetite, and satisfaction.”

Ellyn Satter

Restricting food

Food restriction is the primary technique in all weight loss efforts. It is also the foundation of almost all eating disorders. It may include restricting all calories or certain food items (sugar, fat, carbs, etc.).

The goal of all food restriction is to reduce weight and improve health. However, the willful restriction of food is consistently shown to do neither of those things. In fact, it typically leads to increased weight and lower health.

Parents who restrict their kids’ food put their children at higher risk of gaining weight and developing eating disorders. This is due to the complexity of weight, food, and eating. When our babies are born, the first thing we do is nurture them with food. Feeding our children is closely tied to loving our children. Our children cannot separate their bodies from themselves. This is why parents who try to restrict a child’s body accidentally restrict them emotionally.

“Restricting hurts both emotionally and physically and in the long run will make your child fatter, not thinner.”

Ellyn Satter

A child who feels insecure in their relationship with their parent will develop many emotional side effects. When food is a battleground, kids may eat more than is physically comfortable or less than their body needs. Both ends of the spectrum find their roots in a fundamental lack of self-trust and a parent’s approach to feeding.

“Children whose eating is restrained by their parents lack internal regulators. When they get out on their own, their lack of internal regulators can distort their eating in a variety of ways.”

Ellyn Satter

Ellyn Satter’s approach

Satter’s approach says that parents are responsible for feeding, and children are responsible for eating. This means that parents should provide healthful and delicious food choices. And they should allow the child to determine which and how much food to put in their body. It’s a simple plan, but often requires some major work by parents who are currently stuck in diet culture.

A good first start is to read any of Satter’s books. A great next step is to get support from a professional who can help you implement the program. With this support, parents can learn to overcome their assumptions about weight and food. They can begin parenting their children without fear of either.

We strongly recommend any of Ellyn Satter’s books, including Your Child’s Weight: Helping Without Harming.

“Children have a wonderful way of changing when their parents change—provided their parents really mean it.”

Ellyn Satter

See Our Parent’s Guide To Eating & Feeding A Child With An Eating Disorder

After an eating disorder, it’s important to relearn how to be a “normal eater.” This can be complicated, because eating disorders rob us of our intuitive and natural relationship with food.

Parents can help their child recover from an eating disorder by encouraging and modeling a normal relationship with food.

It is important to define what it means to be a normal eater. Most people in our diet-obsessed culture have at least slightly disordered eating. This includes a range of behaviors from a fear of gaining weight, restricting calories and even eliminating entire categories of food such as animal products, carbohydrates, sugar, fats, etc.

A normal eater does not experience intense fear when eating food. Nor do they experience intense cravings and persistent insatiable hunger. When we eat normally, there’s no need to obsess about food.

Eating normally means you typically eat when hungry and stop when full. Of course everyone has food preferences, but eating normally means recognizing that sometimes we just need to eat what is available. Sometimes we need to eat when we don’t feel hungry because we know that they will be hungry soon. Normal is fluid and responsive vs. rigid and uniform. 

Becoming a normal eater after an eating disorder

Following are five things that someone who has an eating disorder can practice to become a normal eater. We borrow from some of the concepts of Intuitive Eating and Ellyn Satter.

Normal eating doesn’t feel natural or right when you have an eating disorder. When we first enter recovery we need practice and patience. Normal eating can replace our disordered relationship with food and our bodies and help us find peace. 

Each of us recovers from an eating disorder in our own way.We are not suggesting that the following are required for every person. 

1. Be free from diet culture

Diet culture promotes the idea that weight loss is a good and healthy pursuit in life. When we recover from an eating disorder, we must work to eradicate the belief that our health and self-worth are based on our weight. This is hard, because diet culture is absolutely everywhere. 

Most of us who have an eating disorder have a deep fear of weight gain. Even if we can see other people at higher weights and think they look fine, we do not accept that our bodies should do anything other than get smaller. These feelings are complex and go beyond weight. But they are also rooted in our cultural belief that we can and should control our bodies.

To recover from an eating disorder, we must discard our fear of getting fat and face diet culture head-on.

To free ourselves, we must repeatedly assure ourselves that diet culture is a liar based on completely faulty evidence. We must remind ourselves that our bodies can pursue health at any size.

Slowly, we will establish a truce with our bodies. We may never achieve full love for our bodies, but we can definitely achieve acceptance.

2. Stop tracking, measuring and weighing food to restrict

Some of us who are in recovery may need to track, measure and weigh our food to make sure we get enough to eat. In many cases, our eating disorder-trained nutritionist will put together a meal plan that we must follow in order to reach our recovery goals. We should continue with these programs until our dietician tells us we can transition to a more intuitive way of eating.

Once we have the go-ahead from our recovery team, we can get rid of our calorie counting apps, measuring devices and scales that we have previously used to control and restrict our food intake. Normal eaters do not weigh their food. They eat what they want (or what is available), when they are hungry and stop when they are full.

This feels impossible when we have been counting, measuring and controlling in our eating disorder. But we simply must free ourselves from restrictive food measurement in order to recover. We must relearn our intuition around hunger and fullness and practice listening to our bodies, not measuring devices.

If we experience increased binge eating or restriction in response to this freedom from tracking, measuring and scales, then we need to continue to work with a therapist to unpack our underlying psychology. For most of us, after an initial awkward period, we will begin to receive our body’s feedback and trust that we can eat the amount of food we need. We will gradually stop seeing food and eating as a challenge. We will be free.

3. Stop judging food as “good” or “bad”

It’s going to take a lot of time to recover our natural instincts for what we actually enjoy eating. This is because we have trained ourselves with our eating disorders to believe that certain foods are “good” and others are “bad.” Training ourselves to eat normally and in accordance with our appetite instead of a weight-loss plan, anxiety, and fear, will be a long-term process. We can begin by slowly releasing foods from the prison of our judgement.

If our eating disorder fear foods include ice cream and butter, it’s going to be hard to eat those things. We may even say that we don’t like them. But we can try them and practice incorporating them into our diet. After trying them, we may decide that we really don’t like the way they taste, and that’s fine. But we need to make sure that this is really about taste, and not our eating disorder trying to control us. This takes time, practice and, above all, patience.

We have to start by never again calling food “good” and “clean,” or “bad” and “cheating.” Food is just food. It has no moral qualities. Unless we haven’t washed it, all food is clean. The food we eat is not a reflection of our righteousness as individuals.

Eventually, we will believe that any food can fit into our lives. We will learn that we have preferences and we have cravings. But we never feel out of control around food again because we’re allowed to eat anything we want to eat. 

4. Feed hunger

When we need to pee, we don’t wonder whether we really need to pee. We just go. When we are thirsty, we don’t question our thirst. We just drink. When we need to blink, we don’t second-guess our eyes. We just blink.

Hunger is a natural and healthy urge that our bodies use to tell us it’s time to eat. Our culture and billion-dollar companies tell us that we need to “overcome” hunger with tricks, but that’s unnecessary. When we are hungry, we should eat. 

Sure, people who have a tendency to binge eat may need to learn to check in on hunger to make sure that it’s coming from the body and not an emotional need that can be met in other ways, but this has been over-emphasized. Emotional eating has been turned into a condition to be overcome, when it’s actually not. Once we have gone through the first three steps, over-eating, mindless eating and emotional eating will all happen rarely, and when they do, it’s not a big deal.

Hunger cues are a little different for everyone. Most of us who have eating disorders have numbed our normal hunger cues and only notice our STARVING cues (which we can also train ourselves to ignore). Recognizing hunger is actually an advanced skill in recovery, which is why many of us start off with meal plans or at least eating on a schedule to help us in the early stages of rebuilding our mind-body connection when it comes to food. 

So much hunger!

Once we start to learn our hunger cues, we may be surprised or even frightened by how often we are hungry and how many times per day we need to eat. We need to keep snacks available so that we can respond to our hunger cues every time (or at least as often and as soon as possible) we feel it. This is how we rebuild body trust and relearn intuition. When we are in recovery we must feed our hunger reliably and completely as if it were a tiny puppy in our care. We wouldn’t restrict a puppy, and we must not restrict our body’s hunger.

Over time, we will gradually begin to pick up on hunger cues earlier and more reliably. We will begin to trust our body when it tells us it’s hungry. Sometimes we’ll get too hungry, and sometimes we’ll get uncomfortably full, but we try not to get starving, and we can reliably count on the fact that we can eat whenever we get hungry. 

5. Be flexible

Someone who has had an eating disorder has been dealing with disordered eating thinking and behaviors for a long time. We have been actively and forcefully ignoring our body’s intuition, striking it down every time it tries to communicate with us. We have been rigid in our thinking and behavior. 

To heal, we have to find a new pattern, a new way of eating that works for us. This becomes our own personal “normal.” Some of us may stick to a regular schedule and feed ourselves fairly set portions and meals. Others of us may be very flexible and “follow our hunger” every day, eating more some days, less on other days.

Exactly when and what we eat is less important than how we feel about eating. Our goal in recovery is to achieve a peaceful co-existence with food and be neither obsessed or afraid of what we are eating and how much we are eating.

It is natural and normal to experience recovery as a winding road, not a straight line. Sometimes we will under-eat. Sometimes we will over-eat. Some of us may purge. Some of us may really struggle with becoming a normal eater after our eating disorder. What matters is that we observe what’s going on, reach out for help, gather our resources, and begin again.

Parents can help kids become normal eaters after eating disorders

Feeding a child with an eating disorder isn’t easy, and that continues into recovery and beyond. The best thing a parent can do to help their child become a normal eater after an eating disorder is to support and practice normal eating. This means we need to look at areas in which we are restricting and controlling our food, and learn to reject diet culture. It can require changes that we may not like, but our efforts can make a significant impact on our kids’ recovery.

See Our Parent’s Guide To Eating & Feeding A Child With An Eating Disorder