Eating disorders are a serious mental illness that impact nearly 30 million people in the U.S., a growing number of whom are adolescents. As with many mental health problems, the causes are complex and not fully understood, yet most experts agree that, at least in the U.S., a “culture of thinness” (norms, beliefs, and attitudes around food, weight, and eating) plays an important role.
“In our culture, it is common to believe that thinner is better,” explains clinical psychologist and eating disorder specialist Dena Cabrera, Psy.D. “For tweens and teens especially, having an ideal appearance is an essential goal. Kids want to be approved of and well-liked by their peers. It is easy for them to think that if they’re thin, everything else will be okay.”
Girls with ADHD are particularly vulnerable to eating disorders. They may use or avoid food to help cope with ADHD symptoms and/or related issues such as depression, anxiety, low self-esteem, and unhappiness with their bodies and the way they look.
While eating disorders among adolescents has been steadily rising for several decades, cases have spiked since the pandemic disrupted young lives, leaving many feeling isolated, anxious, depressed, and with little to do but scroll social media platforms—all risk factors for eating disorders.
What You Can Do
Addressing the problem, Cabrera suggests, will ultimately require a shift in our “culture of thinness.” You can begin the process in your family by using the following strategies to counter the damaging messages your child may be internalizing:
- Challenge the notion that fitting in and being popular are all-important. Instead, promote the idea that being their unique self is best. Focus on integrity and inner values and champion individuality, being healthy, and self-care for physical and mental well-being.
- Shift the conversation away from weight, measurement, numbers, and what your child looks like. Move from talking about the body as an “ornament” to conversations about the body as an “instrument” that should be well-tuned and cared for. Instead of saying, “You look so good, you lost 20 pounds,” focus on how much you love your child’s spirit, smile, and smarts. Concentrate on having a wholesome relationship with food and healthy behavioral patterns, and being active for the joy of moving.
- Set an example by curbing self-criticism of your body and diet talk. Kids are impressionable. If they see you change your mindset to one of acceptance, and your approach to food from dieting to one of balance and moderation, they will begin to do the same.
- Promote acceptance of people of all shapes and sizes, and shut down conversations that describe others in terms of shapes and sizes. Instead, encourage emotional awareness, compassion, tolerance, inner values, and strengths.
Talk It Out
If you think your teen may have an eating disorder, is stressed about how she looks, or is involved in harmful social media communities, Cabrera recommends the following:
Sit down and talk. Have a real conversation with your child from a place of concern and support, without anger, judgment, blame, or wanting to “fix” things. Listen carefully as they talk. Ask about stressors, how they feel after engaging in social media groups, and if they want to continue feeling that way.
“I’d like to understand what’s going on. Help me appreciate how social media might be impacting your mood or eating issues and how these friends may be influencing you.”
“Let’s not focus on weight, honey. Let’s focus on balanced meals, moving our bodies, and being healthy regardless of shape and size.”
“You know, I’ve noticed you might be eating when you’re bored” or “I’ve noticed you’ve been more upset lately and haven’t been eating as much. Are you feeling balanced? Are you eating a variety of foods?”
“I’m worried about you. How can I support you and understand a little more about what’s going on? Can we talk it through so we can get you any help you might need?”
Find the right time and place to talk. Sometimes it’s an opportune moment to talk to your kids about sensitive issues while you’re in the car, suggests Cabrera. Bedtime is also a vulnerable time when kids are winding down from their day and may be open to caring conversations about delicate topics.
Validate what they’re feeling. Let your kids know you are hearing them and empathize with what they’re going through.
“Wow, that must be really difficult.”
“That must be sad because you counted on that friend and valued her friendship—now it sounds like she upset you.”
Social media pushes kids to feel that someone else is always better looking, more perfect, and happier than they are and to have disordered eating thoughts—to want a certain “perfectionist” look they can only get by being thinner. Consequently, after time on social media comparing themselves with others, kids often end up in a dark place, feeling worse about their own bodies, believing they’re not good enough, and having lower self-esteem.
Cabrera adds that algorithms used by popular social media platforms target kids who click on eating disorder adjacent information with an endless loop of harmful and dangerous content. There are also secret online communities that discuss crash diets, how to look skinny, and numerous unproven and unhealthy ways to lose weight.
This article is based on an ADDitude webinar, Mental Health Out Loud: Eating Disorders and Body Image Among Teens, by Dena Cabrera, Psy.D., a clinical psychologist, certified eating disorder specialist and the co-author of Mom in the Mirror: Body Image, Beauty and Life After Pregnancy. Eve Kessler, Esq. a retired criminal appellate attorney, is Executive Director of SPED*NET, and a Contributing Editor of Smart Kids.