July is mental health awareness month and so I thought it would be great to hear from an expert about this broad and mostly unspoken field. Following on from Part 1 about eating disorders, Karlien discusses the three main categories of eating disorders and how to ensure that your children are more resilient in the world they will enter bombarded with magazines of perfect, skinny models and countless health fads.
There are 3 main categories of eating disorders according to the DSM 5 (which is the diagnostic and statistic manual of mental disorders, 5th edition and is the way all mental disorders are classified and diagnosed). I’m sure most people are familiar with these categories, so I will just run through them very quickly;
Anorexia nervosa: In this disorder, there is a failure to maintain a normal weight, as measured by our BMI. The person is obsessed with food, weight, and body image and severely over-estimates their own size and weight to the point of delusion. This results in the menstrual cycle stopping in women, arrhythmia of the heart, gastrointestinal problems, loss of bone mass and much more. Even so, the person still really struggles to eat a normal amount of food and generally restricts their meals or certain types of food.
Bulimia nervosa: In this disorder, people eat more than is normative for the circumstances and their body, and can binge very large amounts of food in a single sitting. The binges often happen in secret and there is a feeling of complete loss of control- they cannot stop themselves. There is a huge amount of feelings of shame and disgust following the binge and usually leads to purging (throwing up) but can also involve other compensatory behaviour like laxatives, over-exercising or restricting for a few days. They usually maintain a normal weight and one might never know how much they are actually struggling.
Binge-eating disorders: In binge-eating there are binges, as in bulimia, but without the compensatory behaviour and people with binge-eating disorder are often overweight. As you can imagine, there is also a huge amount of shame felt internally around this disorder.
New research has shown the very different way in which a person with an eating disorder’s brain experiences and processes food. Dr. Laura Hill has a lovely TED talk (Eating Disorders from the inside out) which explains the brain of someone with anorexia nervosa.
There is reason to believe that this is a neurological/brain illness as much as a psychiatric and social illness. The uptake of serotonin (our “happy” chemical) and dopamine (our “reward’ chemical) is also affected in the brain of someone with an eating disorder.
Eating disorders come in all shapes and sizes (pardon the pun), people from all socio-economic backgrounds, and although it is more prevalent in women, can affect men too. Anorexia nervosa usually starts between ages 12-22 and bulimia nervosa a little bit later, from ages 14- late 20’s. However, this doesn’t mean someone younger and older cannot develop these illnesses. A combination of genetic factors which we call genetic pre-dispositioning, as well as the social environment we live in today, are all contributors to the rise of eating disorders. Children as young as primary school as placed under immense pressure to perform, to conform, to plan their futures, to step in line, to achieve, to be the same (but not too much), to be different (but not too much) and often the only way they can control these conflicting demands and emotions are through their food.
So what can I do to make my children more resilient?
- Teach them to think critically. If your child is taught to only do as he/she sees others do, to conform to those around them and to follow the crowd, they will be more susceptible to unhealthy eating habits and body image that they learn from other children. They need to be able to hear the information, process it in their own way, and check against their values if this fits in with who they want to be.
- Don’t be restrictive around food. I cannot emphasise this enough. I have seen so many moms and dads that, with the best of intentions, helped grow this seed of obsession around food. Structure and healthy balance are good- rigidity is not. If you follow rules like NO gluten, NO sugar, NO carbs under any circumstances, you teach your child rigidity in thinking and they will learn to be hard on themselves. Instead, they should know balance. Don’t eat too much sugar, but have a piece of cake without feeling guilty every now and then. Don’t overindulge in carbs, but sjoe, lasagne can be delicious.
- Don’t talk about your own diet in front of your child. You are an adult and you may have decided to follow certain prescriptions around food, but your child is growing and needs ALL the categories of food. When they are adults they can decide what they want to do with their bodies, but for now, they will follow what you do, so if you are rigid, they will be rigid too. It is very important to critically evaluate our own thoughts about food and body image and guard against letting this spill over to our child’s image of themselves.
- Talk about emotions! Eating disorders are actually emotional disorders. Evaluate the time you spend on food/diet/weight vs emotions/values/personality development. It is much more important for a child to develop emotional intelligence, healthy value systems, and a well-rounded personality. Then they will be able to decide what is good for them in a healthy way and process their emotions without necessarily using food as their main self-soothing mechanism.
- Unconditional love. Your child needs to know that they are loved, always, no matter whether you are angry at them, or whether they achieve in school, or whether they are popular or not. Make sure your child hears you say you love them, even in the more tense and difficult parts of your relationship with them. This is how they will learn love is not conditional on looks or achievement.
I’ve been facilitating a group for people with eating disorders for almost a year now as well as seen many individual clients, and from personal experience, I have come to see that they are some of the kindest, loveliest individuals that I’ve met. So if you know someone with an eating disorder, treat them kindly. They are struggling with something you might not always be able to understand or that might make engagement very difficult at times, but in the words of one group member of mine, “be soft with me”. Know that they are 100 times more critical of themselves than you can be of them. In that, I’m not saying that you can’t be honest. You can tell someone in a kind and compassionate way that you’ve noticed they struggle around food, or help refer them to someone that can assist them in a professional way. But ensure them that they are loved, no matter what. People at different places in their illness might need different kinds of support, so the best is to ask “how can I support you?”
And lastly, check in with your own eating. How is your relationship to food doing? Even though you might not be diagnosed with an eating disorder, most of us have some kind of disordered eating pattern, especially in this world with mixed messages around food, healthy, achievement and love. So today, go and apply all the above guidelines to yourself. And mostly, learn to love yourself regardless – you have value and worth!
I am so grateful for Karlien’s post and her message of love and support. This is what Becomeing is all about – being the best ME you can be.
Until next time,
Be Kind, Be Awesome, Be You!
Disclaimer: The information in this article is for informational purposes only and is not intended to diagnose or treat any illnesses. The author of this article is not liable for any losses or damages that may occur in relation to the article. If you need to consult with the author about any of the content covered in this article, please consult with her directly or with an expert in the field. Information on the blog remains the intellectual property of becomeing and the guest contributor and cannot be copied without permission.