Patient Stories

Eating Disorders: Supporting the Overlooked Tween

Posted In: Anorexia Nervosa Dr. Dina Zeckhausen | January 9, 2014 | 08:40 AM

When most people think of eating disorders, most imagine starving teenaged girls dealing with the pressures of high school. But unfortunately, these disorders are nowhere near limited to that selected group. Recently, there’s been a growing awareness of the problem of eating disorders among women who are middle-aged and older. Guidebooks have been developed for the adult offspring of these moms to help them support their ill parent.

But what if the child of the eating disordered mom is just a kid? And what about the young siblings of teenage eating disorder sufferers?

Children between the ages of eight and 13 often end up as collateral damage in these families.

At a highly tumultuous stage of emotional, cognitive and physical development, tweens who live in a family wrestling with an eating disorder may be anxious, confused and overwhelmed by conflicting messages about food and their growing bodies. Often the needs of these kids are subsumed by the family’s total immersion in the illness and recovery of the “sick” family member.

Imagine these scenarios from the child’s perspective:

A 10-year-old girl attempts to eat dinner but feels guilty when her mom serves a substantial meal to the family while only allowing herself dry lettuce and black coffee.

A 12-year-old girl notices her body changing. Dealing with this normal pre-pubertal weight gain is challenging enough around her skinny friends, but she’s mortified to discover that her exercise-addicted older sister wears smaller jeans than she does.

An 8-year-old boy feels an ineffable sense of dread when he hears his mom vomiting in the bathroom after dinner every night. Afraid something is terribly wrong, he takes his cues from his Dad, holding his fear inside since he’s learned that “Mommy’s problem” cannot be discussed openly.

Fast forward 20, 30, 40 years.

These are the adults suffering from depression, low self-esteem, addictions and eating problems. Being raised in these families profoundly shapes their self-concept, their relationship with food, their interpretations about their emotional needs and their body image. They may struggle with feeling “too needy” in their intimate relationships. They may be driven by a chronic need to please and take care of others. They may wrestle with drug addiction or develop their own eating disorders, having never learned to relate to food in a healthy way.

Thankfully, even kids in these trying family situations can be remarkably resilient if certain needs are met. Here are ten fundamental needs of these kids:

Additional sources of emotional support outside of the immediate family

1. An intellectual understanding that eating disorders are an illness so they don’t blame their family member or themselves
2. An awareness of the ups and downs of the recovery process
3. The knowledge that their feelings about the situation are normal, along with appropriate ways to manage sadness, anger, fear and envy
4. Healthy ways to deal with boredom, anxiety and perfectionism
5. A vision of Normal Eating
6. An understanding of the complex connection between food and feelings
7. A dose of media literacy to inoculate them to “eating disorder messages” in the culture
8. A knowledge of why restricting food (i.e. dieting) could be potentially dangerous for them
9. A positive body image based on their body’s functions and abilities, not based on weight, shape or size

It’s important to help these kids understand what is happening to their loved one and normalize their response to the crisis in the family. They need permission to have their own needs and feelings about the situation, while learning healthy coping skills and how to support their loved one.

Focusing on the needs of these kids is vital prevention work. The combination of Nature plus Nurture puts them at high risk for developing eating disorders or other addictions. With the proper help, they need not become collateral damage in a family’s war against an eating disorder. By engaging with them and addressing their needs directly, these tweens can grow into resilient teenagers and mentally healthy adults.

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