Err on Side of Caution With Suspected Eating Disorder

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(The Vancouver Sun, July 23, 2001)

Q: I’m worried about my 13-year-old daughter. Over the past couple of months I’ve watched her get thinner and thinner. She says she is eating the same amount she always did, but I notice at mealtimes she just picks at her food. I can tell that she is feeling self-conscious about her body because, even though it’s summertime, she wears loose, baggy clothing. Last week when we went to the beach she refused to wear a swimsuit. Do you think she has an eating disorder?

Saleema and Teresa: Since we live in a culture that is destructively obsessed with being skinny and dieting, it is difficult to tell where someone (especially a young girl) falls on the continuum from poor body image to a serious eating disorder. The McCreary Centre Society of British Columbia reported that in the year 2000, 52% of girls interviewed indicated they were trying to lose weight. 14% of girls reported trying to maintain their current weight. Sadly, this means that at least 66% of girls strive to be thin. Indeed, Meris Spence, administrator for ANAD (Awareness and Networking Around Disordered Eating) comments "It is difficult to have a positive relationship with our bodies when our culture has normalized disordered eating. It’s become almost a rite of passage for girls to go on a diet."

From the little information we have, it is difficult to assess how dangerous your daughter’s behavior and way of thinking has become. We suggest you err on the side of caution, and not rule out an eating disorder. The two eating disorders that put your daughter most at risk are Anorexia and Bulimia—over 60,000 Canadians of all ages suffer from these. Anorexia, a serious life threatening disorder, is self-imposed starvation usually the result of underlying emotional causes. Warning signs to look out for include: loss of weight (15% or more of ideal body weight); unnecessary dieting; distorted body image; preoccupation with food, calories, nutrition, or cooking; denial of hunger; obsessive exercising; frequent weighing or measuring; loss of hair and interrupted menstruation. Bulimia, on the other hand, is the repeated cycle of bingeing (overeating) and purging (vomiting). It, too, can be fatal. Warning signs of bulimia include excessive eating; frequent trips to the bathroom; menstrual irregularities; swollen glands; weight fluctuations; failed dieting; guilt about eating and depressive moods.
Here are some specific suggestions of what you can do:

  • Find a time and place that is conducive to discussing your concerns with your daughter. Tell her you want to help, that you are not mad, and that you will not judge her.
  • If an eating disorder is suspected, get professional help as soon as possible—don’t try to handle it on your own. Agreeing to keep it a secret is dangerous, as she will need the support of a physician, a therapist and a nutritionist.
  • Learn everything you can about eating disorders. Reading When Girls Feel Fat by Sandra Friedman, Real Gorgeous: the Truth about Body and Beauty by Kaz Cooke or Reviving Ophelia by Mary Pipher would be a great place to start.
  • Be prepared to hear her deny that she has a problem, as she may be ashamed or embarrassed. Don’t get caught in a power struggle with her about whether or not she is sick.
  • Be aware of your own stereotypes and comments about thin or fat people, and recognize how they could be interpreted by your daughter.
  • Watch out for signs of deteriorating emotional or physical health.
  • Resist focusing on dieting, weight loss or calories consumed. It will only add to her obsession.
  • Avoid forcing her to eat or insisting that she gain weight. She could rebel against the attempt to help her, and see it as control.
  • We know we always say this, but make use of the excellent community resources available to you. Try:
    • Eating Disorder Resource Centre of British Columbia at St. Paul’s Hospital (806-9000) or their website at www.eatingdisorders-sph.org.
    • Awareness and Networking Around Disordered Eating (ANAD) at
      739-2070 or toll-free at 1-877-288-0877.