It’s not your fault.
We want all parents to know that you are not to blame for your child’s eating disorder. Eating disorders stem from the interaction between your child’s genes and his or her environment. These genetic and environmental factors are largely uncontrollable — there is no one cause of eating disorders — and it’s certainly not your fault. That is not to say that some environmental influences are not related to interactions with parents and siblings — or that parenting styles do not matter. They do.
It’s not your child’s fault, either.
Your child came into this world with a number of unique traits and tendencies. Traits commonly associated with eating disorders include perfectionism, stress reactivity, high sensitivity, low distress tolerance and more. These unique personality traits, combined with genetic and environmental influences, combine and contribute to the development of eating disorders. But, just as parents do not cause eating disorders, affected people do not choose to have eating disorders.
Eating disorders run in families.
As mentioned above, genetics play a key role as risk factors for the development of eating disorders. When a child has a close family member diagnosed with anorexia nervosa or bulimia nervosa, they are significantly more likely to also be diagnosed with an eating disorder as compared to the general population. That is not to say that if you or a parent struggled with an eating disorder at some point that your child will automatically develop an eating disorder.
Environment also plays a role.
One’s environment also influences the chances of developing an eating disorder — approximately 20 to 50 percent of the “cause effect” in studies of inheritance. But it’s not how one has been brought up — or how a child has been parented — that makes the difference; what matters more is how each individual child internalizes his or her experiences. Life experiences matter but what matters more is how each individual uniquely processes things or how, at different times in their development, different experiences may affect them positively or negatively.
Society plays a role, too.
Society and the media continue to promote and encourage “thin” body types. Diet ads run rampant and weight loss is a common topic for many. Social media incites a “compare and compete” culture in our youth and, sadly, many young people lack the developmental and coping skills necessary to process the images they see in a realistic way. Perfectionistic and high-achieving individuals are particularly at risk for succumbing to cultural and media messages proclaiming that “thin is best.”
Disordered eating habits change the brain.
The altered nutritional status (starvation and nutritional chaos) that occurs with eating disorders triggers a neurobiological response or “brain change,” which can have lasting impacts for some. Brain changes from eating disorders include:
Cognitive changes (thinking differently)
Psychological changes (processing information differently)
Emotional changes (feeling differently)
Bingeing and purging behaviors are also known to add layers of “brain change.”
Other behaviors can also change the brain.
Gateway behaviors (like over-exercising) must also be viewed with caution for those who are susceptible, because even these behaviors can potentially change an individual’s brain structure and function. Any recommendations for diet and exercise must be considered in context with each individual’s genetic risk, individual vulnerability and environmental factors. Participation in “judged sports,” for example, can be risky for the most vulnerable — as opposed to team sports or activities in which there is less focus on size and shape.
The brain can recover.
Thankfully, the brain can recover and we can bring the brain back from a compromised state. But, the longer an eating disorder continues, the more serious the resulting brain change will be. This is why it is so important to seek treatment early on. Early recognition and timely intervention are the best tools for a successful outcome. There is always hope for recovery — no matter how long an eating disorder has been in place.
Full weight restoration is key to recovery.
Weight restoration helps us achieve many goals in treatment, including:
Bringing the brain back from its compromised state
Switching off starvation signaling
Promoting tissue repair and repairing organ system function
Once the above takes place, one’s hormones, body composition, growth, development and stress response will normalize. Complete weight recovery (as close to 100 percent of ideal body weight as possible) by end of treatment is the best predictor of recovery for adolescents with anorexia nervosa (Lock, et al., 2013) and is what we strive for in all patients. Thankfully, there is more hope in the world of eating disorder treatment today than ever before, supporting the full recovery of your children.
Help is available.
When your child is suffering, you may feel helpless. However, there are so many resources and treatment options available today to help your child get the treatment they need. In treatment, we individualize care through trait management — addressing each person’s unique temperamental traits to meet their unique needs as well as addressing all physiological and psychological issues.
Ovidio Bermudez, MD, FAAP, FSAHM, FAED, F.iaedp, CEDS is Chief Clinical Officer and Medical Director of Child & Adolescent Services at Eating Recovery Center.
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