Your daughter has an Eating Disorder, now what?
From Ginger Haas, SHS Social Worker
We live in a society where thinness seems to be honored and admired. People who are
thinner or “in shape” tend to be more readily accepted by others. During the adolescent
years friends become an enormous issue. Most youths are greatly influenced by their
peers. They are more interested in their friends or having friends than they seem to have
been before. It is critical, especially for an adolescent, to feel accepted. Coupling this
desire to be accepted with society’s admiration for thinness may add to the development
of an eating disorder. There is often no one reason for the development of an eating
disorder. Typically it develops subtly and gradually. Occasionally it begins at the onset
of a traumatic episode. Because of the progressive nature of an eating disorder it is often
difficult for parents, siblings and friends to accept that their daughter or loved one has an
eating disorder. People seem to think that it would have been noticed. One of the most
important things you as a parent can do to help your child deal with her eating
disorder is to focus on solutions rather than analyzing their person or their problem.
Eating disorders are commonly broken down into 3 categories – Anorexia Nervosa,
Bulimia and Compulsive Overeating. I have briefly described them for you below.

Anorexia Nervosa – “Anorexia” in the medical language means a person who does
not eat. This is often a factor of surgery or medication. “Anorexia Nervosa” on the
other hand includes a psychological component. A person with anorexia nervosa is
hungry but she denies the hunger because she is fearful of becoming fat. This fear is
usually irrational, but to an anorexic it is real. “Anorexia nervosa is often
characterized by self-starvation, food preoccupation and food rituals, compulsive
exercising and often an absence of menstrual cycles.”{ANAD} Anorexia can be fatal
if it goes untreated. Although many people believe it is a fad what will be outgrown,
it is a gamble far too risky to take. Karen Carpenter is an example of how anorexia
can kill. One misconception is that an anorexic looks skeletal. This is true in the late
stages of anorexia. However, for a person to get to this skeletal point they become
involved in anorexic behaviors and thoughts earlier than the physical body portreys.
Just because your daughter does not look like a skeleton does not mean she is not
anorexic.

Bulimia Nervosa – Bulimia is actually a term that means “ox hunger” or “animal
hunger.” It essentially refers to a condition where a person rapidly consumes large
amounts of food in an unusually short period of time. Today this term has come to
include a pattern of purging after consumption of food. Purging may take the form of
self-induced vomiting, laxative abuse, fasting for several days, or even overexercising. Bulimia usually begins as a form of weight control for the overeater. In
an effort to rid themselves of the uncomfortable feelings of overeating (both
physically and emotionally) the bulimic purges. This cycle becomes addictively
repetitive because of the relief it brings. Gradually this method of relief is used by
the bulimic to also aid in dealing with the stresses and discomforts in life.
Progressively what started as a method for relieving the physical feelings
(overstuffed) and emotional feelings (guilt of eating that much) has become a method
of dealing with life’s problems big and small. A bulimic comes in all shapes and
sizes. Some look too thin, others look just right and others tend to look slightly or
mederately overweight. They perceive themselves as looking and being much larger
than others perceive them as.

Compulsive Overeating – a compulsive overeater often eats more than she needs,
wants or can comfortably consume. It is her way of handling stress and coping with
life’s discomforts. Like the bulimic, the compulsive overeater may binge. Rarely
however will the compulsive overeater purge. Remember that we are not talking
about obesity. Obesity is defined as a person who is 25 % or more over their ideal
body weight. Compulsive overeating refers to a person’s behavior towards food.
THE ISSUE OF FOOD
Many people I have worked with focus on the “food” in an effort to help their daughter
with her eating disorder. It is not about food. If your daughter sits down for the next 5
days and eats a well-balanced, amount-appropriate dinner it does not mean that she has
beaten her eating disorder. Remember, for quite awhile now she has mastered the art of
keeping this a secret. Although you may not be aware she is purging after a meal it does
not mean that she isn’t. Purging takes on several forms. Instead of self-induced vomiting
she may starve herself for the next 3 days or overexercise beyond her athletic
involvement. She has come to rely on this method as a mechanism for dealing with her
insecurities, her pains and emotions. Although it is easier to focus on the food and to fill
your house with only low-fat food and eliminate junk food that will NOT help your
daughter find a new alternative for coping.
So what is next?

The first thing I urge you to do is give yourself a hug. Your daughter has worked
very hard to keep her eating disorder a secret. She has an invested interest in not
being found out. Don’t kick yourself for not noticing it earlier. Hindsight always
seems to be 20-20 doesn’t it? Be comforted that your daughter wants to help herself
now before things get worse. She may not have shared with you before but she is
now! Her first step was to tell you. It is extremely difficult to share a secret that you
have worked so hard to preserve.

Second, give your daughter a hug. Although she needs your strength in the months
and years to follow she needs your unconditional love right now. Every girl I have
worked with is so fearful of disappointing her parents with this news. A hug from
you is simple way to say I Love You and I Care.

Next, don’t ask questions today - wait. Believe me when I tell you… she will not be
able to answer them. Most likely you want to know “When did this start?” and “Why
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did it start?” and perhaps even “Why didn’t you come and talk to me?” Your
daughter probably can not pinpoint answers to either of the first two questions.
Right now she is nervous. She just revealed a BIG secret and is nervous that she has
destroyed any relationship you have shared. That is why she did not disclose to you
earlier. She does to want to disappoint or hurt you. If she knew why she had
developed an eating disorder she would have included the reason when she told you
she had an eating disorder. To be bombarded with unanswerable questions is going
to build walls between the two of you right now. However difficult, try not to ask
questions today. Write them down and save them.

Another scary aspect for your daughter is how this revelation about her disorder will
change things. Your daughter has invested a great deal of effort in keeping her
disorder a secret. To now become the focus of the family is nerve wrecking. Several
kids I have worked with use this as their excuse not to tell their parents. They do not
want the spotlights to shine on them every moment they are home. They are not
looking for everyone’s eyes to follow their every move, especially at and after meals.
I know you want to give your daughter all the attention she needs and deserves right
now (and always.) As challenging as it is, try not to treat her as different. SHE is not
any different today than she was yesterday. The only difference is that you have
learned about a new side to her. Don’t hesitate to tell her your feelings, acknowledge
your care and concern. Simply don’t go overboard or walk on eggshells around her.
Together you and your daughter will get through this. Now that the secret is out in the
open you can help your daughter and yourself. As mentioned earlier, your daughter does
not know why she has this eating disorder. To help answer these questions she needs to
go on a voyage of self-discovery. This is not easy task. As with any voyage, she will
coast over peaceful waters and grab a life jacket when the turbulent waters surface. For
her sake she needs to find someone “safe” to help her. As children we want the love and
pride of our parents. This usually continues into adulthood doesn’t it? This is one reason
a person outside of the family often offers more safety to your daughter. It eliminates or
lessens the fear of rejection. No matter how close of a relationship you share with your
daughter I urge you to let her talk with someone outside the family, preferably a therapist
who has training in eating disorders. I have worked with many therapists in our
community that are skilled in dealing with eating disorders. In addition to the referral I
can give you ANAD (National Association of Anorexia Nervosa & Associated Disorders) can also
provide you with a list. A good therapist will want your involvement in the therapy. As
your daughter learns more about herself she may be able to begin sharing it with you and
thus answer some of those questions you have. This involvement is another opportunity
for you to show your daughter your support and your unconditional love.
My experience has shown that the kids often want you to set up the initial appointment
for them. Ask your daughter if she has a preference of a male or female therapist. From
there you can find a therapist for them. Many people need to talk with their insurance
companies to learn what benefits they have or who their insurance will cover. Once you
have a list, call the therapists. Spend time on the phone with each of them. Typically
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your gut will tell you if the person on the other end can build a rapport with your
daughter.
Another point I’d like to point out is, as your daughter begins to voyage over those
turbulent waters she may try to retreat by stopping therapy. This is not uncommon. Most
of us do not like to deal with uncomfortable issues. Try to encourage her to continue. A
good compromise may be to make her appointments less frequent. Also remember, that
when times are good therapy is used to plan for the handling of future bad times. I’ve
seen far too many families stop the counseling “because everything was better.” I wish
they had continued so that the next bad time to arise wouldn’t have been so difficult. If
you have concerns that the therapy is not going well, make an appointment to see the
therapist and share this concern with them. It usually takes 3-6 weeks for people to build
a strong enough rapport and trust. Don’t assume it isn’t working while your daughter is
still learning getting to know and trust her therapist.
Another professional you should make an appointment with is your daughter’s
pediatrician or internist. Tell them that your daughter has disclosed that she has an eating
disorder and you would like a consult. In speaking with other physicians I have come to
understand the importance of blood work. Blood tests will inform the doctor and you of
your daughter’s internal health. Although lab tests do not reveal everything information
about electrolyte imbalance etc. is helpful. It may also indicate what type of program
will best suit your daughter right now. Unfortunately not all doctors are current with all
aspects of eating disorders. Be prepared to ask them to look at certain things or to request
tests. It will be helpful for you to meet with the doctor to share your concerns. Allow
your daughter some time alone with the doctor to share hers as well. Some girls are more
open when their parents are not within earshot. Also, ask about her menstrual cycle.
Women need enough body fat to support their menstrual cycle. Be thorough with
understanding why she does not have her period before putting her on the birth control
pill to regulate her cycle. She might not have her period because her body is sending her
the message it needs more body fat to work!
I appreciate the time you gave to listen to your daughter. I admire parents who work
together for the sake of their children. Unlike the common cold, an eating disorder can
kill. It may take months or years. The sooner treatment can begin the sooner your
daughter can learn more effective and safer coping techniques. Please do not hesitate to
call me with ANY concerns or questions you may have. Your daughter and I thank you
for caring about her and loving her.
Sincerely,
Ginger Haas MSW, LSW
(847) 755-4636
Schaumburg High School Social Worker
Eating Disorders Support Group Facilitator
Graduate Certificate in Eating Disorders
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