Eating Disorders Are Not Always Obvious to Parents
Kim Umble, MSW, LCSW, Program Director, Remuda Ranch Programs for Eating Disorders
Anorexia and bulimia may be difficult to detect in adolescents due to two factors: personality characteristics common to girls who get these disorders and the secrecy and dishonesty intrinsic to eating disorders.
Adolescents with eating disorders often see themselves and behave as “good girls.” They are often high achievers, straight “A” students, engaged in school activities and sports, popular with peers. They often find personal identity through achievement and performance.
They are often behaviorally compliant—they get along well with their parents and rarely cause problems. Because adolescents with anorexia tend to “stuff” and internalize emotions, they often don’t verbalize feelings. Those with bulimia rid themselves of emotions through purging. Either way, girls with eating disorders do not express their feelings, especially the so-called negative feelings such as anger and shame. The wearing of a “positive mask” is common. Therefore, at least in the initial stages of an eating disorder, everything looks so good. It’s no wonder parents can’t recognize what may be occurring behind their child’s façade.
Though anorexia and bulimia manifest somewhat differently, one key component of both disorders is secrecy and dishonesty. For those with anorexia, dissembling centers on food consumption. Girls claim, “I don’t want dinner because I ate a huge lunch,” or “I ate at my friend’s house”—when neither statement is true. These girls also become sophisticated at making it appear as if they’ve eaten by cutting up their food into small pieces or pushing it around on their plates. They are also adept at getting rid of food during meals, by offering it to family pets or secreting it away in a napkin. Girls also hide the physical ramifications of their eating disorder. As adolescents with anorexia become progressively thinner, they wear baggier clothes with longer sleeves in order to disguise a dwindling body.
Those with bulimia consume huge quantities of food followed by activities intended to purge the caloric intake. Therefore, secrecy centers on the binge/purge cycle. Often, girls with bulimia binge and purge at night while the family sleeps. A great deal of deception is also involved with the food itself. If family food is ingested during a binge, the loss will be noticed. Patients may steal money from other family members to replace the food consumed from the home, or may shoplift the food. These behaviors—extreme food consumption, purging, and stealing–cause tremendous shame and guilt, which intensifies the need to maintain the deception.
One area of shared secrecy for both disorders is exercise, which is often compulsive. Not only do girls with anorexia and bulimia lie about how much they exercise, but they frequently exercise in secret, usually at night so no one will know.
Clearly, certain aspects of anorexia and bulimia contribute to the difficulty in detecting these illnesses. Yet one factor that parents can control is their personal time and attention. Sometimes parents get involved in their own lives, and because everything seems alright with their daughter, they may simply fail to notice changes in their daughter’s physical appearance or behavior. Just because everything seems alright does not mean that everything is alright. It is a good idea for parents to educate themselves about the warning signs of eating disorders and to observe their child’s behavior fairly regularly as a precaution. This is especially important for adolescents going through life transitions—starting a new school, moving to a new neighborhood, adjusting to a divorce or loss, beginning puberty. Life transitions are critical times of risk during which adolescents often develop eating disorders. But eating disorders may arise at any time and affect as much as 1 in 10 adolescent girls. Ongoing attentiveness—and early intervention in the event of warning signs—are the best course of action.
If you are concerned that your child may have an eating disorder, please call Remuda Programs for Eating Disorders at 1-800-445-1900.
