Advice for Parents by Doris Smeltzer

Dieting: How do I respond to my child’s request to go on a diet?

My husband Tom and I stood on the makeshift stage of the boarding school’s cavernous and echoing gymnasium. Intently looking back at us were the eyes of nearly 200 teens of middle and high school age. We had just finished our Andrea’s Voice presentation and were being peppered with questions about our words regarding the deleterious effects of dieting.

The majority of these bright young minds had never questioned our culture’s dependence on, or belief in the effectiveness of dieting. The notions we’d just shared seemed a more foreign concept to them than living on the moon may have seemed to young people a half century ago.

“But obesity is at epidemic proportions.” Exclaimed one intense young man. “Certainly, you don’t mean to say that Weight Watchers is a diet?!” Queried a hopeful young woman. For some reason the university students to whom we most often speak, do not struggle near as much with our exhortation of “no more diets.”

Ovidio Bermudez, M.D., and Medical Director of Laureate’s Eating Disorder (ED) program calls dieting “the gate-way drug to an ED.” The majority of researchers agree that although every person who diets does not develop an ED, nearly every ED begins with some form of weight-loss diet. [1]

As parents we need to respond to our child’s request to go on a diet with the same amount of concern and seriousness as if we were being asked for permission to use steroids to improve athletic ability. Dieting is not an innocent behavior. It alters brain chemistry and for those susceptible to the development of an ED, it can be the doorway into a lifetime of misery. [2]

Often though, it is not our child who requests permission to go on a diet. With no mal intent, parents can be the first to bring up this possibility. We, just like that gym full of teens, often have not questioned our culture’s faith in dieting as a solution to our many ills. We must examine our own behaviors: Are we dieting? We must ask ourselves if we need to become more informed about the “hidden” effects of dieting. If the answer to either question is yes, we have some homework to do. A good place to begin is at the Gürze website, http://www.gurze.com/index.cfm, for a number of valuable resources on the topic: subscriptions to The Health at Every Size Journal, Margo Maine’s The Body Myth, Glenn Gaeser’s Big Fat Lies and many others, as well as Evelyn Tribole's site, http://homepage.mac.com/etribole/Menu6.html or http://www.intuitiveeating.org/ and Francis Berg’s website, www.healthyweight.net.

A well-respected Napa, California physician who specializes in eating disorders maintains that weight loss in a growing child is NEVER normal. This fact appears to be a well-kept secret from many of us. Now that we know it, we need to let our children in on the secret, too.

Blessings until next time,

Doris
[1] Patton et al, Onset of eating disorders: population based cohort over 3 years.BMJ. 1999;318:765-768.
[2] Ovidio B. Bermudez, MD, FAAP, FSAM, FAED, Medical Director, Eating Disorders Program, Laureate Psychiatric Clinic and Hospital in Tulsa, Oklahoma and Adjunct Associate Professor of Pediatrics, Vanderbilt University School of Medicine in Nashville, TN at NEDA conference, September 14, 2006.

Treatment Resistance: Do we wait for our child to be ready before beginning treatment?

In the last few days I've received several phone calls from parents of sufferers as well as therapists asking for consultation on how to proceed if children or clients are resistant to treatment.  Although each individual is unique and what works for one may not work for another, I would never delay getting a child into treatment. This response is based on our experiences with our daughter Andrea as well as conversations with sufferers who made a number of statements that will be forever embedded in my memory:

"As my parents dragged me to treatment, kicking and screaming, secretly I experienced a gigantic sigh of relief.  I thought to myself, ‘Thank God, someone else is taking control.’" 

"I didn't start to take healing seriously until they stopped being “nice,” stopped walking on eggshells."

"Why didn't my parents ever notice?  Why couldn't they see I needed help?"

I brought up the topic of “resistance to treatment” in recent email conversations with two remarkable young women, from two different continents. These women are dedicated to helping those who suffer move toward healing and gave their permission for me to quote them. From Canada, Sharon Hodgson, the creator of the web site, We Bite Back (http://www.webiteback.com) shares her perspective:

If you try and "stop" behaviors, sometimes you can effectively stop communication ... recovery often involves a lot of paradoxical thoughts, even when the person really wants it. She needs reassurance it's going to be okay.

There is a difference between getting help and attempting to “stop” behaviors. We cannot make our children “stop.” But we can get them the help that may bring them closer to developing their own desire to stop. 

Lucie Beardwood, who lives in Wales and who has also created a web site, At War With Ana http://www.at-war-with-ana.co.uk/ states:

Help needs to be sought. Although ideally when the patient is ready, this is not always possible. There were many patients at the hospital I attended who were obviously not ready, they often relapsed and returned whilst I was still in treatment, but it saved their lives for that short time they were there, and also every time they came back they learnt more tools and techniques to help themselves - and went away a little stronger each time.

Our children need us as their advocates. Eating disorders cause distorted thinking that does not allow for rational thoughts and informed decision-making. We need to find a skilled professional who can meet our child’s denial in a non-judgmental way: someone who can create discrepancies between our child’s life goals and their behaviors. Someone who can plant the seeds of doubt around their behaviors, seeds that when germinated will allow our child to become more receptive to help. Eating disorders are deadly illnesses that require immediate, intensive and ongoing skilled professional help. Please do not wait to get that help for your child.

Blessings until next time,

Doris

 

Secrets: Do we keep the eating disorder a secret?

A few weeks ago, my husband Tom and I sat in the well-appointed living room of a family we had met face-to-face just a few moments before. We agreed to this meeting so that we could talk about what we had learned during the very short duration of our 19-year-old daughter Andrea’s struggle with bulimia. Her 13-month battle tragically ended in her death, but through this tragedy we have gained knowledge that we feel compelled to share with others. Our hope is that families may learn from our experience so that their children may live.

As we sat with this family and watched them grapple with the reality of their own daughter’s struggle with an eating disorder, we recognized our prior-to-Andrea’s-death selves in their words: "We have been careful to honor our daughter’s desire for privacy…we’ve told no one of her illness."

Tom and I glanced at each other and smiled. We, too, had honored Andrea’s request that we not speak to others about the bulimia. We now realize that this is a request made by the eating disorder: it thrives in secrecy and silence.

When I look at this request with my newly focused eyes, I see it as if through a multi-faceted prism. One side of the prism contains our desire to do as our child requested. Yet, this isolated us at precisely the moment when we needed as much support and information as possible. If my daughter had been diagnosed with cancer I would have talked to everyone I knew in the hope of learning from someone else’s experience.

I know that if I am completely honest, I must admit to another side to this desire to remain silent: the shame I felt in having a daughter who would “choose” the behavior of bulimia…how could she do such a thing? The guilt I felt in wondering what I might have done to cause this behavior in her: How would others judge me as a mother?

Yet another side to the acquiescence with our child’s request for silence is the fear of the anger and even rage that may be directed at us for our plan to “share the secret.”

Today, I feel no shame about my daughter’s illness. She did not choose bulimia—it is an illness that invaded her body and mind because of many complicated factors—it was not her fault. Today, I feel no guilt. Yes, I made mistakes as a mother, but I did the very best I could with what I knew at the time. Today, I would be able to withstand whatever anger or rage was directed at me, knowing that the eating disorder was the one railing at me, not Andrea.

As we sat sharing these thoughts with this desperate family and their suffering child, I recognized their hesitation to believe that good could come from talking openly about their child’s illness. Their daughter filled the silence that sat between us. She wisely observed, “Seeing you have the courage to speak so openly and without judgment has allowed me to feel that I can do the same.”

Today, I would not keep secrets or remain silent if for no other reason than to give my daughter permission to do the same.*

Blessings until next time,

Doris

*If we plan to share our child's "secret" the first person we must tell is our child.  We are not asking their permission, we're just informing them that the suffering we see is beyond what anyone should ever endure.  In that light, we're letting them know that we plan on sharing their illness so that, with a community of support, their suffering may be lightened.  We then give them the choice of joining us when we tell others or not.  Their response may be one of intense anger, but by informing them first we may be able to avoid losing their trust.