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Parent Role in Eating Disorders

Frequently I read articles of interest and make a mental note; occasionally I respond with an opinion. Recently I came across this article about the parent role in eating disorders, posted by a colleague from the Eating Disorders Coalition of Tennessee.

It seems that when it comes to eating disorders, there is a need to understand where it came from: what caused it and who is to blame. Those of us who work with these patients know all to well that a myriad of mixed factors create the perfect storm (family environment, peer pressure, child temperament, genetics, media, community, and the list goes on)—the development of an eating disorder. In some respects, the development of child obesity is subject to the same questioning, rendering the search for someone or something to blame.

We’ve offered a series for parents on The Nourished Child, to help parents understand their role, how much influence they have and steps they can take to prevent an eating disorder in their child.

Below is my response to the article, Children with Eating Disorders: Are Parents to Blame? which appeared in the Huffington Post recently. I’ve included the link in case you want to read the article first.

Here’s What I Think:

The environment a parent creates is the environment a child grows up in. This includes what kids eat, how they view food and their body, as well as how they deal with problems. As you know, research shows when it comes to food, and attitudes about food and eating, parents are the strongest influence over a child, even in the face of growing outside influencers. If a parent diets, a child is more likely to diet; if a parent struggles with weight, a child is more likely to struggle with weight; and if a parent has a poor or negative relationship with food or his/her body, the apple doesn’t fall far from the tree. This is the unspoken (or maybe spoken) environment a child is growing in.

While parental influence becomes diluted as a child ages, parents still wield a powerful influence, more than other outside factors. So how can we not assess the role of the parent and the environment created by the parent in the evolution of an eating disorder?

This is not to say a parent causes an eating disorder, but the environment and the interactions in that environment form the child’s attitudes, beliefs and actions around food and eating (as well as other lifestyle behaviors). Even if a parent feels afraid or powerless to address eating disorder suspicions or concerns for their child, isn’t that a contribution to the development of the disorder in and of itself?

I feel a great empathy for parents in today’s world—there is a lot of pressure to be a great parent, to raise smart achievers, and bring up healthy, great eaters who are at a healthy body weight (oh, and with no hang-ups about food)—those are some big shoes to fill.

Meanwhile, our society does a very poor job of preparing parents for the job of parenthood, especially with regard to feeding kids (and I am not just talking about food here—but how to interact around feeding and food, what to say and how to answer and approach nutrition questions/concerns, why kids behave the way they do around food, and so on).

Our society also perseverates the thin ideal and “healthy” mantra, leaving parents to struggle with how to get their kids there.

We expect great things from parents but we give them few tools; and parents are trying to achieve more and more in the world everyday, which takes away from their time to connect and interact with their kids.

While I don’t think it is useful to blame parents, parents are part of the puzzle—and if you don’t assemble all the pieces of the puzzle, you never get the complete picture.

What do you think about this?

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  1. My wife shares a story similar to “PMD”. Her entire life her father was fixated on fat and weight. He regularly commented on his daughter’s (and wife’s) weight and physical appearance, and by her late teens she was bulimic. He is a somatic narcissist who derived a self-aggrandizing feed from her and her sister’s physical appearance. Her mother dieted each year like an annual purge. Never did she stand up to his fixated talk and references, if anything her frequent dieting validated them.

    A study by Temple University and the University of Minnesota ( showed that “among girls whose parents never commented on their weight, 4.2% reported use of any extreme weight control behaviors, while 23.2% of girls whose parents frequently commented on their weight reported use of any of these behaviors.” A six fold increase in extreme weight control behaviors associated with parental weigh talk. A recent Harvard study investigated the impact of “weight talk” by parents and found “significant” correlation between the reported amount of such talk by parents reported and the incidence of disordered eating of all types. Such studies almost seem to show what common sense would dictate about the impact of parents on such things as a child’s self-worth and priorities.

    My wife has been bulimic for 20 years. Now with his granddaughters, he continues the fixation on what and how much they eat that even before my wife’s bulimia was revealed to her siblings they each berated him at different times to “be quite before he causes and eating disorder!” He continued, and now that my wife’s disorder has been revealed, he still focuses on fat and weight with the granddaughters. I know he (and wife) are an extreme example, but the simple fact they represent is that parents have an unavoidable and significant impact on how children perceive themselves and the values they prioritize. With fat and body image, they through their actions and inaction, far exceed the impact of media and peer group. Bad parenting skills leaves the child open to those other outside influences instead of insulated from them by proper priorities and a healthy self worth based on internal unconditional value.

    I have read far too much that seeks to advance the “no blame” agenda that represses accountability where it often exists and confuses the issue further for the person suffering from the eating disorder and others who may later be affected. In undoing their self-image and problematic thinking, the sufferer needs to identify and de-validate the core of the beliefs and this means understanding their origin. When you know for example that your drive to maintain an image at all costs is really not in line with some sort of absolute external value but rather the mere personal fickle value (flaw) of a particularly superficial nature held by a parent, it begins to get easier to unwind it. These are core beliefs and they don’t change easily – even less easily when we say certain truths at their root are off limits. The argument is that a stigmatizing of the disorder will arise if family is held accountable. The disorder carries its own stigma for the victim regardless. But if the causal role of the parents were accurately assessed, perhaps a stigma on the harmful prioritization of weight ideals by them would curtail such behavior in parenting in the first place. Avoiding family accountability may make repairing the problem feel easier (for everyone but the sufferer), but it comes at the cost stopping the problem at one of its key sources, before it even becomes a problem.

  2. I should have edited before posting. I obviously didn’t include the details of my eating disorders (for a couple years after I dropped out of college I was taking 30 Correctol in a sitting once a week, which would last a good 3 days).

    You may wonder how I managed to stand up and get anything done in my haze of a world. Although I got extremely skinny in those years from 13-15, the rest of the time I was just “thin.” Not alarmingly thin like the first two years. Even in those first two years I never looked like I was “anorexic” like you see in pictures. I remember I got my weight to 95 and I was probably 5’4″ 5’5″ in those years, ending up being 5’6.”

    The laxatives stopped before I had children, but the throwing up or compulsive exercising went on until I was 36, even though I stayed at a “norma” weight (around 118-125). Thin yes, but not skinny.

    I make these additions just so you can understand how I could possibly hide all of this from my family.

    Also, minor point but since I tend to obsess over details (lol), as you can imagine my dad was no longer just “chubby” by the time he lost that 80 lbs when I was a child. His immense fear of this happening to me is pretty much what started all of this, although he has an unhealthy obsession with everybody’s weight, Im the only one he “worried” about with it.

    1. Thanks for sharing your story. I agree that parents have an important influence on a child’s self view–so glad that you have recognized how to stop the “cycle” with your own children and for yourself. Again, thanks.

  3. Not to sound too bitter, as I am a 50 year old wife and mother who has a good relationship with my parents. That said, if I am to blame anyone for eating disorders I suffered from starting around age 13 until I was 36, it would be primarily my dad, and my mom to a point, for not countering him.

    He was a chubby child and teenager who was teased. He eventually lost about 80 lbs and became obsessed with staying thin, and obsessed with everybody else’s weight as well.

    When I was 9 years old and becoming the tiniest bit “chubby” he panicked and started me dieting. I remember if I lost 4 lbs I could go go Girl Scout Camp (if I had not lost it I would have still gone, but it put pressure on me at 9 years old!). My dad would blow up his cheeks if I ever ate a sweet or took second helpings. He was convinced milk was “fattening” and suggested I not have it (and I didn’t, from age 11 until I became pregnant at 21. No dairy at all). He never “forced” any of this on me, but I was a shy “people pleaser” who craved his approval to no end. I completely took his opinion of myself as my opinion of myself. He also jokingly teased me for my white skin all the time, which caused me to burn myself endlessly as a teenager, hoping to one day tan – and thinking red was better than ghostly white.

    By age 13 I was running 6 miles every single night. I didn’t miss one day the first year, even if I had a cold. Going to make a long story short, but by the time I was close to anorexic, my dad told me for the first time that he was proud of me.

    To make a long story short, I made it through high school obsessed and exercising daily eating so little. My journal shows me eating 600 calories for those first two years – because my dad told me I needed to burn as many calories as I ate, and six miles running burned 600 calories. I also rode my bike to school and back.

    By college, living in the dorm I learned how to purge – and my life became a nightmare as a druggies might. I couldn’t concentrate, my whole entire day was planning what my fantastic dinner would be that I could (finally) eat and then throw it up each day. So little food and no nutrition sticking, I was unable to do any homework or study at all. I was also drinking (like college students do) on weekends to add to my poor nutrition.

    Managed to have 2 children, but I did miscarry 3 times. I ate what I “thought” was normal during my pregnancies, gaining 65 lbs the first and 30 the second. I didn’t diet or throw up. However, up until I became pregnant and afterwards I did. I had a few years of exercising 4 hours a day as well. I managed to raise two healthy kids who never knew of my eating disorder, nor did my husband. I was normal weight through my twenties, although a little thin, nothing alarming. Finally at 36 I woke up and changed it all and turn my life around.

    However it took me until around age 40 to realize the damage was caused from my dad’s comment. Joking, not joking, his “concern” over my weight and appearance made me consumed with it, and I’ll never get past that. I can get past his influence and I’ve forgiven him for that in my heart. However, I will never ever be comfortable in my skin. I had a face lift at age 40 – and nobody “needs” a facelift, but my skin was falling off my face from so many years of poor nutrition and sun damage in those teen years of self burns.

    What bothers me most isn’t that my dad made me feel uncomfortable about my appearance – rather that he made my appearance important. If I can be proud of only one thing in my life, it’s not doing that to my own kids.

    Parental influence speaks volumes, because to a child, their words are truth. A child has no reason to doubt what a parent tells them, and if it starts young enough, it’s set in the mind forever.

  4. I agree that there are many factors involved in children having eating disorders, but yes parents/guardians have a very important role. Obviously they can not necessarily stop children developing these disorders but they can go a long way to promoting healthy attitudes to food, nutrition and their benefits. What happens in the outside world, i.e. school and in the media etc is mostly outwith parental control – where children are at the mercy of their peers and unattainable, unrealistic celebrity body images. To lessen the frequency of children developing disorders we would really have to eliminate the media so celebrity skinny minnies were no longer thrust down peoples’ throats as the perfect image…as well as reprogamming all children to understand real body image and shedding any ignorance they have gathered from parents or other factors in judging others.

    1. Doubtful that the food environment and media will change. So, we need to prepare children to interpret these messages and work hard to counter-balance them.

  5. I think there are so many factors involved in the development of eating disorders. Parental attitude toward food and body image definitely plays a role, as do teachers, peers, media, and our society’s view on weight and appearance.

    1. You are right–a myriad of influences exist. As I said, no blaming parents–that is a waste of time–but an appreciation for all influences can help to address the disorder (both kids and parents) in a more comprehensive way.
      BTW–I’ll have a post soon about your awesome cookbook!