Educational Coaching for Parents and Caretakers of Children with Eating Disorders.
Cristen E. Haltom, M.A., Ph.D. (607) 272-6750
215 N. Geneva St., Ithaca, N. Y. 14850
Fax: 607-266-6414, Email: Cris@DrHaltom.com

   EATING DISORDER SURVIVAL GUIDE FOR PARENTS(tm)
           
Paper reprints of Volumes 1-12 available.
(See information at the end of the newsletter
for details.)
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EATING DISORDER SURVIVAL GUIDE FOR PARENTS(tm)
'Support for parents when their child
 is in treatment for eating disorders.'
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PARENTS' RELATIONSHIP WITH FOOD AND
BODY IMAGE
 
Kindly reviewed by Sue Travis, MS, RD, CDN.
(Sue Travis is a lecturer in the Division of Nutritional
Sciences at Cornell University, a private nutrition
counselor, and President of the New York State
Nutrition Council.)
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IN THIS ISSUE: 
 
1. Ways parents' relationship with eating and
body image influences their children.
 
2. TWELVE DO'S AND DON'TS for parents to
support your child's recovery by setting a
good example and improving your own relationship
with food and body image.
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Recently a new subscriber to this newsletter
asked about ways elements of the  family system
could contribute to an eating problem in your child.
Parents'relationship to food and body image may
influence a child's relationship to food.
 
Recall that it is important for parents NOT to blame
themselves for their child's eating problems.  And keep
in mind that every child's reasons for developing an
eating disorder are multiple, often in a unique
combination, and, most importantly, their own.
With this in mind, one way parents can support
their child's recovery is to examine their own eating
history and the "eating climate" provided at
home. Parents eating patterns and attitudes
about eating behavior and body image can contribute to-
BUT NOT CAUSE - the onset of an eating disorder.
 
In  1997, Debra Waterhouse, nutritionist, wrote a
powerful book about women becoming aware of
how their mother's relationship with food and their
bodies influenced theirs and how this,  in turn, gets
passed on to daughters.  Mothers worry
about their daughters being healthy, lean and having
a socially accepted body shape and size. Mothers
often have modeled this by holding themselves to
this same standard:  They may have a history of repeated
diets, exercise compulsion, and/or reconstructive
surgeries.  When this is the case, the message to
daughters may be that a successful future may
be dependent on having a thin, well-toned body.
Women are enculturated to pass on their anxieties
about body image and their dieting behaviors to their
daughters.
 
Abigail Nathenson (1999),  psychotherapist, in her
book for parents of children with an eating disorder,
points out that parents can 'condone and model
misconceptions about food and eating'.  Modeling
bad eating habits, such as skipping meals, can encourage
disordered eating and hinder recovery. It stands to reason
that modeling good eating habits, such as eating three
balanced meals a day, can encourage recovery.
 
Judi Hollis, Ph.D. (1988) is a psychotherapist and
recovering overeater.  In her pioneering
book about families and eating disorders, she describes
how family members sometimes inadvertently
and unintentionally get caught up in trying to cure
their loved one's eating disorder.  Since a parent
would like to - but cannot - cure their child's eating
disorder, parents who attempt to cure or control
the eating disorder sometimes get caught up in their
own eating problems.  Faced with the stress of
fighting with the sufferer to"straighten up" and eat
right, parents sometimes begin to binge eat
to cope, or even get caught up in "opposite" eating
patterns from the sufferer.  A binge eating son or
daughter, may meet with a restricting, dieting mother,
herself made sick by anger and frustration
with the sufferer.  Or a restricting child may encounter
a bingeing parent.  Sometimes an "opposite disordered
eating" parent may be attempting to bribe or scare
their child into health by making a point with their
own eating habits and their own (growing or shrinking)
bodies.
 
Dads and Daughters (www.dadsanddaughters.org) is
an organization dedicated to helping girls value and
develop their inner selves, as opposed to basing
self-esteem on outer appearance.  They report that
when Clinique Laboratories, Inc. surveyed
500 mothers of teenage daughters their top New
Years' resolution was to lose weight and eat less. 
Yet among top concerns of 22 % of the same mothers
was the fear that their child would develop an
eating disorder.  Debra Waterhouse advocates
that women should give up dieting (to look good)
and their daughters should never start.  If a mom
or dad doesn't want their daughter or son to
develop an eating disorder, it stands to reason
that dieting for better looks sets a dangerous example.
Waterhouse sites a study indicating a dieting
daughter is eight times more likely to suffer from
an eating disorder than one who has never dieted. 
 
Lock et at (2001), in their radical new approach
to refeeding an anorexic daughter, empower
parents to take a strong hand, under the direction
of an experienced therapist, in overcoming
their child's self-starvation. Although not the main point of
their treatment, they stress the importance for recovery
of parents working in unity, deciding their family values
about food, and reinforcing each other's knowledge about
what constitutes healthy, non-diet eating.
 
TWELVE TIPS FOR PARENTS:
 
1. DON'T DIET YOURSELF OR ENCOURAGE
YOUR CHILD TO DIET, unless it is for medically-
supported health reasons.  Research suggests that
the younger a girl starts dieting the more she'll weigh
as an adult.
 
2.  ROLE MODEL A POSITIVE RELATIONSHIP
WITH FOOD.  Teach your child to enjoy food and
eat a moderate amount of whatever he or she wants.
All foods can fit in a healthy eating plan.  And food and
eating can be fun.
 
3. TREAT YOUR OWN DISORDERED EATING.     
If you have an eating disorder or the remnants
of a partially-treated one, take responsibility
for treating it.  Your child has over-active antennae
for sensing any disordered eating in the house and
may be negatively influenced by your disordered eating.
 
4. REINFORCE THAT ULTIMATELY FOOD
PREFERENCES ARE INDIVIDUAL.  Although
you as a parent may provide nutritionally sound
food choices in the home, and you may influence
and teach good nutrition, what tastes good is up to
each individual.  Encourage your child's autonomy
in cultivating and honoring their food preferences.
(The exception, again, is when particular foods are
medically documented to be a poor choice for
your child, such as a food allergy.) Point out that
just because you might enjoy a certain food your
child may not and vice versa.  Avoid classifying
foods as bad or forbidden. Keep in mind all food
can fit in a healthy diet.
 
If your child is suffering from anorexia and remains
underweight, he or she may have forgotten or
suppressed what tastes good.  For these children,
food preferences based on taste will return slowly
as recovery progresses.
 
5. AVOID BEING A DIETMATE WITH YOUR SON OR
DAUGHTER.  Remember dieting does not reflect a normal
relationship with food.  Eat regularly scheduled meals
four to five hours apart each day. 
 
6. SET A GOOD EXAMPLE REGARDING
YOUR OWN RELATIONSHIP WITH YOUR
BODY.  Your adolescent boy or girl is developing
an identity.  Adolescents typically look to their parents
for parts of their own identity.  Are you role modeling
combat with your body?  Is your relationship with your
body tied up in trying to find ways to trick it,
control it, hold it down, shape it up, hide it, or avoid
looking at it? Try role-modeling a more self-respecting
relationship with your body. For example, experiment
with foods and exercise activities that make your
body healthy and feel good.  Or, rather
than hiding a body you think doesn't look "right",
wear- don't avoid - bathing suits and shorts when
they are appropriate for an activity.   Your child is
watching how you relate to your body.
 
7. RESPECT EACH FAMILY MEMBERS' BODY
SIZE. Avoid teasing family members about
size and weight. If you suspect a medical problem
for yourself or child related to size and weight,
go to a professional for advice and treat the problem
accordingly.  For adults in the family other than yourself, 
report your size-related concern, not your teasing,
to them.  Respect each individual's body size.
 
8.  PAY SPECIAL ATTENTION TO THESE TIPS
IF YOU STARTED DIETING EARLY ON.   Debra
Waterhouse points out that the younger you started
dieting the younger your daughter may start dieting.
 
9. EVALUATE WHETHER YOU ARE AN
EMOTIONAL EATER.  We all know that a
parent who picks up a glass of alcohol or a
cigarette to cope with emotional 'upsets' role models
the same kind of 'self-medication' for their children.
The same is true with a pattern of eating to self-comfort.
 
10. IF YOUR ADOLESCENT CHILD WITH
AN EATING DISORDER IS TRYING TO
MONITOR YOUR FOOD, SUPERVISE YOUR
EATING, OR TRACK YOUR WEIGHT
tell them 'hands off.'    
 
11. AVOID ROLE-MODELING FOOD AND
EATING "COMPENSATION" BEHAVIORS. 
There are lots of ways to purge a big meal. 
You may exercise some hours to "get rid of it." 
You may self-induce vomiting - the old Roman
vomitorium concept. Or you may use a laxative
or eat laxative-like foods, e.g., prune juice,
dried fruits, in excess. This is bulimic-like behavior.
Don't do it and don't encourage it. Take an 'oh well'
attitude if you stuffed yourself and chalk it up to
learning to better monitor your satiation level
next time.
 
12.  WORK TOGETHER AS PARENTS. 
Resolve couple conflict about appropriate
mealtimes, appropriate food intake, and appropriate
attitudes about weight and shape. For example,
couples need to work together AGAINST the eating
disorder by reducing their own preoccupation with
weight and size ideals.  Otherwise, one or both of you
may be colluding with your child's eating disordered
thinking. If one of you is 'secretly' supporting your
child's symptoms, your child will recognize your lack
of unity and be less willing to change.
  
SUMMARY:  You have heard it a thousand times: 
What you do and say influences what your
children do and say.  Your attitudes and behavior
around food, eating and your body influence,
for better or worse, the same in your children.
When your child suffers from disordered eating,
you can support and positively influence recovery
by promoting, role-modeling, and cultivating in
yourself a positive body image and a healthy,
non-dieting approach to eating.


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REFERENCES
 
Dads and Daughters: www.dadsanddaughters.org
 
Hollis, Judi.  Fat is a Family Affair. (Center City, MN:
Hazelden, 1985)
 
Lock, J., Le Grange, D., Agras, W.S., and Dare, C.
Treatment Manual for Anorexia Nervosa: A Family-Based
Approach. (New York: The Guilford Press, 2001)
 
Natenshon, A. H. When Your Child has an Eating
Disorder. (San Francisco, CA: Jossey-bass Inc., 1999)
 
Waterhouse, Debra.  Like Mother, Like Daughter.
(New York:  Hyperion, 1997)
 
NOTE: Anorexia and related eating disorders
are serious disorders.  Every person with
an eating disorder has a different story to tell,
a different background, and a different
personality.  Thus tips and guidelines in
this newsletter may or may not apply to your
child.  The professional(s) treating your child
should identify the optimum guidelines
and treatment plan for your child.

...............................................................................
 
Your comments are invited. E-mail Cris Haltom
at cris@DrHaltom.com.
 
FOR THERAPISTS: I encourage you to distribute
copies of this newsletter to appropriate clients if
you find the contents useful.
..............................................
FOR PARENTS: You can print out this newsletter
and show it to your child.  Then ask for comments
about which tips your child agrees with.
..............................................
IMPORTANT INFORMATION:
The Anorexia Survival Guide for Parents(tm),
published by Cristen E. Haltom, Ph.D., is a
free monthly newsletter intended for parents
whose children are in treatment with
appropriate professionals for anorexia and
related eating disorders.  Related coaching
for parents is intended for the same
audience.  The Anorexia Survivial Guide for
Parents(tm) and coaching are meant
to offer practical tips and educational information
that will support the child's and the parent's
involvement in treatment.  The information
presented is NEVER a substitute for professional
intervention.   Further, tips and guidelines
offered in newsletters and coaching teleclasses
may or may not apply to the individual
circumstances of readers/participants. Only a
professional physician, certified mental health
professional, and/or registered nutritionist can
determine the best guidelines for each individual
child and family.
 
...............................................
CRIS E. HALTOM
 
Cris has a Ph.D. from Cornell University
in Ithaca, N. Y. 14850.  She is a licensed
psychologist in private practice in Ithaca.
She has published articles, co-edited a
text book, appeared on cable television,
taught workshops, and taught academic courses
as adjunct faculty at Cornell University
and other colleges.
 
As part of her psychotherapy practice, she works
on a team with physicians and nutritionists
to provide treatment to children, adolescents,
and adults with eating disorders.
...............................................
REPRINT INFORMATION:  Permission to reprint
this newsletter, in part or in its entirety,
will be freely granted only upon written request.
...............................................
 
SUBSCRIPTION INFORMATION:
 
To subscribe to this newsletter go to
http://edsurvivalguide.com
              OR
send an e-mail to cris@DrHaltom.com
and write SUBSCRIBE in the SUBJECT
LINE.
 
CONTACT INFORMATION:
 
Cris E. Haltom, Ph.D.
Voice: 607-272-6750
Fax: 607-266-6414
E-mail: cris@DrHaltom.com
Web: edsurvivalguide.com
 
For hard copy reprints of Volumes 1-12, please
send $17.00 (includes tax and postage)
by check to C. Haltom, Ph.D., P.O.
Box 804, Ithaca, N. Y. 14850-0804).
 
 
 
 
 
 
 

 
 
 
 

 
..............................................
Your comments are invited. E-mail Cris Haltom
at cris@DrHaltom.com.
 
FOR THERAPISTS: I encourage you to distribute
copies of this newsletter to appropriate clients if
you find the contents useful.
..............................................
FOR PARENTS: You can print out this newsletter
and show it to your child.  Then ask for comments
about which tips your child agrees with.
..............................................
IMPORTANT INFORMATION:
The Anorexia Survival Guide for Parents(tm),
published by Cristen E. Haltom, Ph.D., is a
free monthly newsletter intended for parents
whose children are in treatment with
appropriate professionals for anorexia and
related eating disorders.  Related teleclasses
for groups of parents are intended for the same
audience.  The Anorexia Surivial Guide for
Parents(tm) and teleclasses are meant
to offer practical tips and educational information
that will support the child's and the parent's
involvment in treatment.  The information
presented is NEVER a substitute for professional
intervention.   Further, tips and guidelines
offered in newsletters and teleclasses may or
may not apply to the individual circumstances
of readers/perticipants. Only a professional
physician, certified mental health professional,
and/or registered nutritionist can determine
the best guidelines for each individual
child and family.
 
...............................................
CRIS E. HALTOM
 
Cris has a Ph.D. from Cornell University
in Ithaca, N. Y. 14850.  She is a licensed
psychologist in private practice in Ithaca.
She has published articles, co-edited a
text book, appeared on cable television,
taught workshops, and taught academic courses
as adjunct faculty at Cornell University
and other colleges.
 
As part of her psychotherapy practice, she works
on a team with physicians and nutritionists
to provide treatment to children, adolescents,
and adults with eating disorders.
 
TELECLASS REMINDER: E-MAIL cris@DrHaltom.com
to register for four FREE teleclasses on 
Thursday nights from 8:00 P.M. to 9:00 P.M.
from March 9 to March 30.  The topic will be
'COPING WITH YOUR CHILD'S ANOREXIA.'
...............................................
REPRINT INFORMATION:  Permission to reprint
this newsletter, in part or in its entirety,
will be freely granted upon written request.
...............................................
 
SUBSCRIPTION INFORMATION:
 
To subscribe to this newsletter go
http://edsurvivalguide.com
              OR
send an e-mail to cris@DrHaltom.com
and write SUBSCRIBE in the SUBJECT
LINE.
 
CONTACT INFORMATION:
 
Cris E. Haltom, Ph.D.
Voice: 607-272-6750
Fax: 607-266-6414
E-mail: cris@DrHaltom.com
Web: edsurvivalguide.com