February 19, 2012

Eating disorders are learned from parents

Why do people assume parents on diets and self-conscious about weight give their kids eating disorders?

Mostly, it seems to be a very unsophisticated view of mental illness. People confuse disordered eating (a behavior, and all too common), with an eating disorder (the very-poorly conceived name for a brain disorder with symptoms and perpetuating factors around eating). This is similar to believing eating a lot of sugar leads to Type I Diabetes. Or eating eggs will make you fertile.

Reframe: the symptoms of self-consciousness, body image distress, drive to avoid food can all happen without outside influences at all. The brain can be wired that way, or wired to think that way when precipitated by energy imbalance. Often, the environment DOES send all these messages, and even in healthy people they have an effect, but not to the hallucinatory and rigid way seen with eating disorders.

WIthout the genetics and predisposition our kids could, as many do, try on all sorts of disordered behaviors but they won't be able to sustain them. They may believe all sorts of wacky ideas about food and weight but logic and persuasion still work for them. In other words, we're talking about a genuine mind-altering brain disorder and not a set of bad choices.

So it can be true that a mother was on a diet and the daughter developed an eating disorder, of course. It did in our family: I'd been fighting the spread of middle age just as my doctor and media and friends told me I should: eating less, eating different things, choosing different activities. When my daughter developed extreme versions of those same thoughts and behaviors it seemed obvious where they came from. I wasted precious time backpedalling and trying to get her to be only as disordered as me, which at the time I referred to as "balanced." Now I realize my dieting was stupid and unhealthy but I also know it no more made my daughter mentally ill than it made me fit into my high school jeans. (a cheap knock off of the designer jeans I really wanted my mom to buy)

I did disordered eating, but I didn't have an eating disorder. I was just a fool. My daughter was not.

I now know that it is more like Obsessive Compulsive Disorder. You can't catch it or be pushed into it. A mother who keeps a clean house doesn't push her children to develop compulsive hand washing. Can you imagine demonizing that mother as "setting unrealistic standards of cleanliness?"

9 comments:

  1. I absolutely agree, Laura. My mother 'beat herself up' mentally when I was a teen (actually 'tween') with AN, thinking it must somehow have been her 'fault'. She and my father actually were on a diet at the time I developed AN, but my descent into AN had already begun. I was already over-exercising to relieve high levels of inherent anxiety.

    As a geeky child I found the charts in her diet book fascinating. I liked numbers. I liked the idea of counting calories, just as I had liked ordering my books by size on my bookcase as a younger child. I already had OCD so it was easy to see how my calorie counting became a rigid, obsessive-compulsive behaviour.

    However, it was not my mother's fault that I got stuck in anorexic behaviours. If she hadn't been on a diet I would have discovered calorie counting elsewhere, just as do the millions of kids who don't develop an ED.

    I don't know as much about other EDs, but I can tell you that AN is not 'copycat' behaviour. It's not copy parents, friends or celebrities. The behaviours come from within the person and the problem is that they readily stick; especially if the person is in a state of semi-starvation.

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  2. A wonderful post, Laura. I totally agree with you, especially as I have never dieted or exercised and my daughter still developed anorexia nervosa.

    The point of eating disorder treatment should not be all about why it happened - you can't change the past - but how to treat it - you can shape the future.

    Charlotte Bevan xx

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  3. If having a parent on a diet causes eating disorders, at least 50% of children would have them since, in the US, something like 60% of women are on diets at any given time. (Numbers not verified but the idea is valid.)

    Like you, I was middle-aged and fat (yes, I'm still fat). On yet ANOTHER attempt to "be healthy", i decided to adopt more "healthy" behaviors, including changing my eating. I never called it a "diet" because I didn't want to be one of those mothers who caused their daughters to develop an eating disorder. (Ironic, huh?)

    My daughter was going through puberty and had gained some weight, probably temporarily, but we'll never know. Five months later, it became obvious that, not only had she lost a LOT of weight, but she was very restrictive in what she would eat. That started 2 years of the "traditional" (i.e. useless) approach: therapy so she would "want" to get better, two stints at residential centers, etc.

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  4. Extra, I love the compassion with which you speak about your mother. I wish I could sneak a message back to her in the past to let her in on the "not your fault" bit!!

    HDIGH, these red herrings are dangerous distractions from what we really need: good information, and clear instructions!

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  5. Laura, my mother is awesome. I would never allow anyone to suggest that she caused my AN - including when I was sick as a teen and living at home. I, too, wish she hadn't felt unnecessary guilt.

    We talk more about my AN nowadays. She now knows about FEAST and is impressed!

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  6. I agree that Eating Disorder is a poor name for the illnesses we have all seen. Disordered eating is not in the spectrum which in my mind should run from ED Nervosa through ED Fatalis. This would more accurately describe what is out there and MAYBE get people to treat patients quickly and appropriately, and reduce the death rate.

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  7. Leaving aside cause, dieting by parents is unlikely to be helpful in a child's recovery. It's probably worth addressing if it's part of a patient's environment.

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  8. Agreed!

    I'd like to get EVERYONE to stop dieting, frankly.

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  9. Although my mother's dieting clearly didn't 'cause' my eating disorder and I absolutely do not blame anyone, I do think her lifelong dieting and her negative attitudes towards overweight helped set the scene...and more importantly, I've found these things very problematic in my recovery, despite the immense amount of support and love that my mother gives me. If such things can be addressed sensitively in family therapy, I would encourage that.

    P.S 'I'd like to get EVERYONE to stop dieting, frankly' - amen to that!

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