By: Annie Penrose, M.Ed., RD, LDN
This is the third and final article in our series on eating disorder care for adolescents and families. In part 1 and part 2 of this series, we provided an in-depth look at eating disorder treatment for children and teens and what this means for families, parents, and caregivers. This article takes a step back to discuss a slightly different angle: what can parents and caregivers do on a daily basis, whether they’re trying to prevent an eating disorder or support a child already in recovery? Wherever you are in this journey — noticing changes in your child’s eating and feeling worried, supporting a child in recovery, or simply wanting to create a food and body positive home environment — this article will provide you with actionable guidance you can bring into your household.
As an eating disorder dietitian who works frequently with kids and teens, I am often asked by parents and caregivers what they can do on a daily basis for eating disorder prevention. Often the idea of prevention can feel very pointed or overwhelming – as if it’s entirely one person’s responsibility to keep a very complex disease from developing. This is impossible! Research is clear that no single factor – including parenting – causes an eating disorder. My hope is that releasing that pressure creates space for you to feel empowered instead, focusing on what you can do to reduce eating disorder risk factors and help your child build resilience.
Eating Disorder Prevention at Home
Here are some tools and strategies that parents and caregivers can implement at home to build confidence in their child’s relationship with food and body as they grow.
- Prioritize family meals. In the era of busy family schedules, this doesn’t have to look perfect. Maybe it’s a few times a week or family breakfast rather than dinner – whatever feels doable. Research suggests that consistent family meals can be protective. Family meals that model safety, calmness, and flexible structure can offer a low stakes environment for kids to talk openly, feel connected, try new foods, and learn that food and eating are worthy of time and space.
Every child and every family is different, and family meal setups will look unique based on individual child needs. That said, I encourage families to consider utilizing Ellyn Satter’s Division of Responsibility as a guide to feeding your kids and teens at meal times. In this model, it is parents’ job to decide the what, where, and when of food, and the child can be trusted to determine how much and whether to eat. This structure shifts based on a child’s age and development, but provides useful scaffolding for meal times. **Please note that if your child is in eating disorder treatment, this approach may not yet be appropriate. Please follow the model and meal plan your dietitian has recommended. **
- Provide scaffolding for teens. In my work with families, I see some parents worrying their teens aren’t doing enough in the kitchen, and I see others leaving meal times totally up to their teenagers to figure out. While it’s important for your teen to build basic cooking skills and have some responsibilities in the kitchen, I want to normalize continued parent support in food preparation in this phase of life. I promise this support isn’t stealing their independence or making them ill-fitted for adulthood. In today’s day and age, teens are busy and have a lot on their plates! It is perfectly acceptable, and encouraged, for parents to continue to play a role in helping their teens meet their nutritional needs. This can include support in packing school lunches, having snacks easily available to grab and go (cut up fruit, trail mix packs, protein bars), or gentle check-ins about how they plan to feed themselves that day. Of course, parents can still hold reasonable expectations of their teens – being home for family dinner or up in time to have breakfast – but it is important to preserve a parental role for food support. This support can ensure teens understand the value of adequate and consistent eating patterns.
- Consider how you talk about food. Kids pick up on how their parents talk about everything, including food. When we use terms like “good vs bad” or “healthy vs unhealthy” to describe a particular food or meal, children learn to think about food dichotomously. This in turn can create fear, confusion, or a black and white mindset around eating, all of which can be contributors to the development of disordered eating. Instead, focus on talking about food in a developmentally appropriate way: where food comes from, how it tastes or smells, or how it connects to certain traditions and memories. We want to encourage curiosity and exploration around food and reduce labeling and misassigning value.
- Consider how you talk about bodies, in general and your own. Just like how you talk about food, how you talk about bodies also matters. Humans aren’t born disliking their bodies, it is something we learn over time. And while you cannot always protect your kid from how the outside world scrutinizes bodies, you can shape what they learn at home. Talk about bodies in terms of what they can do, how to kindly care for them, and celebrate and normalize the existence of body diversity. If your child or teen makes comments or has questions about their own body or another person’s body, I’d encourage you to approach with curiosity and open-ended questions. For example, if your child tells you they want to lose weight, I’d strongly encourage that you first get curious and ask if they can tell you more. Understanding what’s underneath this statement allows you to respond thoughtfully and help you normalize their changing, growing body.
- What you do matters. Modeling matters. How you talk about your own body and how you feed yourself – not just how you talk to your child about bodies or food – has a measurable impact on your child’s body image and food relationship. When a child watches their parent criticize their own body or skip the carb at dinner, they internalize this information. Talking about your own body kindly and modeling regular, varied eating patterns (as best you can) are probably two of the most important ways you can help your child build resilience in these arenas.
- It’s okay to ask for help. Your influence at home is paramount to your child having the tools to build a peaceful relationship with food and body that can carry them into adulthood. But, there will always be factors out of your control that can contribute to the development of eating difficulties. If these things come up, there is zero shame in getting help. You don’t need to wait until things feel severe to ask for support either. In fact, early intervention is one of the most powerful tools we have.
When to Ask for Help
Here are just a few signs it may be good to reach out to your pediatrician or consult with a dietitian.
*Every child is different, and none of these signs alone is cause for panic – but they are worth paying attention to.*
- Sudden or dramatic changes in eating pattern
- Weight loss (weight loss in children and teens should always prompt a doctor’s visit)
- Preoccupation with nutrition labels, calories, or nutrients
- Emergence of selective or picky eating that varies from their baseline (especially when paired with weight loss)
- Avoidance of meals in social settings or sudden/increased distress at meal times
If you want to learn more or get in touch with a registered dietitian to help your family, please go to the “Contact Us” link on our website, or send us an email at info@lutzandalexander.com.
Additional Resources:
References:
Harrison, M. E., Norris, M. L., Obeid, N., Fu, M., Weinstangel, H., & Sampson, M. (2015). Systematic review of the effects of family meal frequency on psychosocial outcomes in youth. Canadian family physician Medecin de famille canadien, 61(2), e96–e106.
Rodgers, R.F., & Chabrol, H. (2009). Parental attitudes, body image disturbance and disordered eating amongst adolescents and young adults: a review. European eating disorders review : the journal of the Eating Disorders Association, 17 2, 137-51 .