In the thin of it: understanding adolescents and eating disorders
Our 15-year-old daughter Stacy has almost stopped eating. When she does eat she cuts her food into tiny pieces or just pushes it around her plate. Her weight has dropped dramatically. It started with us encouraging her to go on a diet, as she was feeling insecure after a comment that was made at school about her weight. But now she is obsessed with food and fearful about getting fat. At first we thought it was a healthy choice, but now we are concerned she is taking it too far.
Today's cultural obsession with thinness and appearance is having an adverse effect on teenagers. They are bombarded by television shows and magazines promoting weight loss and the glamorous lives of the rich, thin and beautiful. For most teenagers, adolescence is an insecure time when fitting in and being accepted is essential to their well-being.
Comparing themselves to peers and celebrities, some teenagers feel they are failing to measure up. Bombarded by digital age media, it is important for teens to develop an identity that is not based on purely superficial ideas. They should have an array of interests and hobbies, and definite guidelines about important values. It is important that parents become acquainted with their children's friends, tastes in music, and television shows. They should try to discuss these topics.
Finding out about your children's influences and being able to combat some of the messages they are being sent is critical to staying grounded. Try to avoid shows and magazines that portray unrealistic depictions of people, and remind them that celebrities have personal trainers, hairstylists, make-up artists and personal chefs. Sometimes they are airbrushed.
Low self-esteem can result when a person's self-image differs from their ideal. When children have confidence issues and low self-esteem, they become vulnerable to developing mental health issues. Stacy is showing signs of anorexia in her refusal to eat, her obsession with fat and her fear of gaining weight.
If we look more closely at Stacy, we will find traits of perfectionism and unrealistically high expectations. Stacy believes she is not good enough as she is. She has a voice in her head telling her she is worthless and that others don't like her. In therapy, I help clients to try to ignore their critical voice and combat it with a stronger healthy voice. It can be unbelievable at first but, like a muscle, the more they use the healthy voice, the stronger it gets.
Most people with eating disorders feel in some way defective, or not as good as others. This is perpetuated by perfectionism. Perfectionism is a shield and form of protection from judgment or rejection, but it also serves to keep others out and results in feelings of extreme loneliness.
What Stacy needs is to be seen flaws and all, and be shown that she is still loveable and acceptable. It is extremely important that parents love and accept children for who they are and watch to see if their expectations are having a negative impact.
Stacy says that by not eating she is able to manage her emotions better. For those with an eating disorder, restricting food or over-eating are ways to numb emotions.
Stacy says: 'If I could just get to my goal weight, I would be happy.' It is imperative that people with an eating disorder realise that the idea of losing weight to feel better is an illusion. It is not about the food or the weight. There is usually dissatisfaction and distortion about appearance, but underlying issues have led to the problem. These need to be worked on.
People's ideas of food have been tarnished by a billion-dollar dieting industry. Eating consciously is key to anyone wanting to develop a better relationship with food and their body.
Conscious eating guidelines
Eat when you are hungry.
Try not to go for more than four hours without food. It makes it difficult to stop eating.
Allow yourself to eat all kinds of foods and what your body wants.
Remember that all calories are equivalent.
Be aware of your fullness and eat until you are satisfied.
Most importantly, eat for pleasure.
These guidelines are not only for those with eating disorders. They work for everyone. When left to the wisdom of the body, you can eat without risk of mental or physical harm. Parents should avoid putting children on diets or excessively restricting what they eat. Also try to stay away from weighing your children and focusing on clothing sizes, as it can become something they will feel measured by and possibly use against themselves.
Stacy will need to learn to connect with her feelings, challenge her thoughts and reach out to others. She will need to gain more insight into her expectations and accept herself for who she is, learning to embrace her strengths and weaknesses.
For anyone going through a difficult emotional time, I recommend keeping a journal (writing your thoughts, feelings and experiences down on paper), as it can be beneficial for making sense of what is happening and to release stored emotions.
There are many things that contribute to the development of an eating disorder, but teaching your child to think about the media and helping them develop conscious eating habits can protect their self-esteem and health.
Hayley Thomas is a family therapist who specialises in eating disorders. For more information, go to www.relatehk.com