Parenting & Eating Disorders in Kids: When Healthy Goes Too Far

By Heather Russo, LMFT

parentingYou’ve heard medical experts extol the virtues of healthy eating. You’ve been told to keep your children away from sugar, salt and processed foods, and have started to focus on healthy eating and nutrition for yourself and your child. With all this attention to healthy eating, you’ve certainly helped safeguard your child’s health.

Or have you? Is it possible you’ve put them at risk?

Unfortunately, when the focus on healthy eating goes too far, it can actually create unhealthy food beliefs and behaviors. Children may become so focused on healthy eating that they become distressed, limit their food choices and exclude too many foods. The term that researchers use for this is “orthorexia.”

While there is nothing wrong with developing healthy food habits early in life, an obsession with healthy eating can stop children from eating cake at their own birthday party or having even a slice of pizza at a sleepover. When a child refuses to eat anything on a road trip because healthy food options are not available or they feel shame and anxiety about having eaten a burger and fries, there might be cause for concern.

While technically not an eating disorder, orthorexia can be debilitating. Those who struggle with an obsession to eat only “clean” foods tend to share many of the same characteristics as those with anorexia and obsessive-compulsive disorder. Statistics aren’t readily available about orthorexia, but it appears that the longer an individual is preoccupied with healthy eating, the higher the likelihood that the child will develop a clinical eating disorder. The effects can become so severe that malnutrition becomes a risk.

Signs of Orthorexia

  • Significant weight loss as a result of food limitations
  • Self-worth or identity is dependent on making healthy food choices
  • Eating unhealthy foods causes distress
  • Judgment of others is based on their food choices
  • Avoidance of “unhealthy” foods

A child with orthorexia talking about food can begin to sound like a broken record. Their obsessive thoughts about nutrition and how to distinguish between healthy and unhealthy foods can become painfully repetitive.

Children struggling with orthorexia have difficulty going with the flow at mealtime. They will request meals be made without the ingredients they deem unhealthy. Requests for meals made without forbidden foods can become increasingly limiting and lead a parent to prepare one meal for the family and a separate meal for the struggling child. Mealtimes can become a battle. Eating at restaurants can become almost impossible.

Everyone in the household is affected when power struggles happen like clockwork. Parents might be lured into taking on the role of the food police, only to have the child become increasingly rigid. This increase in stress permeates the home. The over-focus on the struggling child can often mean less time for other children, spouse or responsibilities. Siblings may come to resent the attention being directed towards the struggling child. Age-appropriate dialogue that affirms the importance of balanced eating and self-acceptance can go a long way to ease this. Using mealtimes as an opportunity to connect, catch up and laugh lightens the mood for everyone at the table.

Treatment Options

Someone struggling with orthorexia will benefit from treatment similar to that offered for other eating disorders. As treatment progresses, it is important that the child is exposed to social eating, since this is something that those with orthorexia might never allow themselves to do.

Challenging your child’s food beliefs head-on might cause a power struggle in which no one wins. A better plan is to understand the child’s fears about being unhealthy, and the feelings that they experience when they eat foods considered to be unhealthy. It is helpful to remember that orthorexia is usually more about anxiety than it is about food.

Check in with your own food beliefs. Do you berate yourself in front of your child for eating less healthfully than you would like? Do you find yourself passing judgment about others’ food choices? If so, work on developing compassion for yourself and others. Remember, moderation is the key to healthy eating, not abstinence from foods you love.

As a parent or guardian, do not underestimate the importance of your role is in your child’s recovery. The more information you have, the better prepared you will be to help your loved one through the recovery process. If your child has cut out major food groups or seems to be evidencing fatigue or weight loss, consult with your with your primary care physician or a treatment facility that specializes in this type of care.

Heather Russo, LMFT, is the Site Director at The Renfrew Center of Los Angeles specializing in the treatment of adolescent girls and women struggling with anorexia, bulimia, binge eating disorder and other behavioral issues. Russo is a Licensed Marriage and Family Therapist and has extensive experience working in all levels of care within the field of eating disorder treatment.

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