The number one question that other mothers ask me is “how do I know if my daughter has an eating disorder”?  More often than not, the mothers go on to describe their daughters as adolescent girls who have adopted a healthy eating regimen. They insist on eating whole grains, they cut sugar out of their diets, they load up on vegetables, and they stick to an exercise schedule. In other words, they are committed to living a healthy lifestyle. In this day and age where obesity has become pandemic, dietary change with a focus on health is an excellent initiative and should be encouraged, as should a daily workout. So when you look at things on the surface it’s all good, right?

Not necessarily. If it was all good, then these “mother radars” would not be activated. In most cases it really is all good. Healthy eating which leads to maintaining a healthy weight is critically important for all sorts of reasons both medical and psychological. However, as with so many things in life, moderation and perspective are crucial. What has some parents justifiably concerned is when teens develop an unhealthy obsession with healthy eating. There is a fine line between commitment and obsession. When that line gets blurred, “mother radars” start going off.

Bear in mind that eating disorders don’t start as full blown illnesses, they evolve. The earlier you catch and treat them, the better the chance for recovery will be. My daughter’s anorexia evolved from a diet where she proclaimed her desire to eat healthier food.  

Healthy eating is a great cover for an eating disorder because it’s almost impossible to argue with. Few parents out there would find fault with their child wanting to eat more salad and less junk food. For most teens, adapting a healthy lifestyle is just that—it’s healthy. But if a teen is predisposed to developing an eating disorder, then a seemingly innocuous, even healthy, change of diet can turn into something dangerous. Be aware that eating disorders are on the rise among the male population as well. 

Studies show that there are different types of predispositions to anorexia such as genetic, neurobiological, environmental, and personality. Yes, personality. Many anorexics share common personality traits such as perfectionism, a relentless drive for achievement and success, high self expectations, self criticism/intolerance for making mistakes, suppression of one’s needs in favor of others, rigid thinking, and conflict avoidance.

Obviously not all people with the above personality traits will develop anorexia. Relatively few people will. In the same vein, not all people who diet and exercise excessively will develop anorexia. I have triplet daughters, all of whom have dieted and exercised during their teenage years, and yet only one of them developed an eating disorder; the daughter who fits the anorexia personality profile to a T. Coincidence? I don’t think so.

When mothers ask me whether I think that their daughter may have an eating disorder, I ask them questions about their daughter’s behaviors such as whether she skips meals, whether she exhibits compulsive behaviors regarding food or has strange food rituals, whether she is flexible about the foods that she will eat, whether she avoids social situations that involve food, whether she cooks and bakes for the family but does not consume what she makes, and whether she exercises excessively. These are indicators that there may be a problem, especially if the perfectionist/high achiever personality is in the picture as well.

My mission in writing this blog is to raise eating disorder awareness. I can’t do that without pointing out potential risk factors. I want parents to know what to look for. It is not at all my intention to play Chicken Little here. The sky is probably not falling; but if it is, you sure as hell want to get your kid out of the way. I wish that I had gotten my kid out of the way before our sky fell.

Anorexia can be hard to spot since it is cunning, insidious, and crafty. It can be like a shadow; you think you see it but then the light shifts and you wonder if you were just imagining it. Don’t be afraid to be proactive even if your suspicion is just a sneaking one. Monitor what your kids are eating and make sure that they are getting adequate nutrition. Use a dietitian if your teen wants to lose weight. If you think that your daughter may have an eating disorder, make an appointment for yourself to speak with her doctor alone and lay out your causes for concern. After you have done this, take your daughter to the doctor for an evaluation. If your doctor doesn’t know enough about eating disorders to diagnose one or to help you find the right treatment, find another doctor who is more qualified in this area. Trust me, when it comes to early diagnosis, intervention, and treatment, you are definitely better safe than sorry.