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Problems with Mental Health

How to Help Your Teenage Daughter Overcome Her Eating Disorder

It is estimated that 2 to 4 % of female teenagers and young adult women suffer from eating disorders. The commonest types of eating disorders are anorexia nervosa and bulimia nervosa.

Anorexia nervosa is characterised by:

  • Refusal to maintain a body weight consistent with one’s age and height.
  • Intense fear of gaining weight or becoming fat.
  • Disturbance in the perception of one’s body size and shape.
  • The absence of at least three consecutive menstrual cycles.

Bulimia nervosa is characterised by:

  • Recurrent episodes of binge eating (which is eating, within a discrete period of time, an amount of food that is larger than normal without any self-control).
  • Engaging in inappropriate behaviour to prevent weight gain. For example, misuse of laxatives, diuretics (chemicals that induce excessive urination), enemas or other medications.

Warning signs of eating disorders

Before your teenage daughter develops a full-blown eating disorder, she usually exhibits a number of behaviours that are different from her normal self. When you are able to recognise these behaviours and encourage her to seek help, she may avert the course of a long and complicated illness.

These behaviours are early warning signs of an impending eating disorder: 

  1. She displays an unusual preoccupation with food. For example, she pays excessive attention to the different food groups and their calories, strenuously avoids different food, is over concerned about the ways that food is prepared and has a heightened awareness of type of food other family members eat.
  2. She develops unusual eating habits. For example, she cuts her food into very small pieces and takes a long time to finish her meals, gives excuses why she is not hungry, delays joining the family for meals during normal mealtime, skips meals and disappears for a long period of time into the bathroom immediately after eating (she may be vomiting in the bathroom).
  3. Her exercise schedule is increased and rigidly adhered to at the expense of other work commitment and social obligation. Sometimes, she displays a real urgency about exercise. For example, she may insist on jogging in the rain because she has not exercised for the day.
  4. She appears withdrawn, sullen, moody and isolated.
  5. She has an increased interest in her weight. Sometimes, she compares herself with others and appears to be envious of those who are thinner than her.

What to do when your teenage daughter has an eating disorder

Once your daughter has developed an eating disorder, you need to encourage her to seek professional help. It is very unlikely that she will get better by herself. It is inevitable that you need to be involved in her treatment. Positive contribution from you will go a long way in helping her to recover.

These are some of the things that you can do:

  1. You need to accept the fact that she is suffering from a serious illness that may take a long time to recover. She needs more than just simple advice and insistence from you about a good diet to get better.
  2. You need to support her treatment program that may involve you attending some of the counselling sessions and working closely with the doctors, nutritionists, nurses and other health professionals who are looking after her.
  3. You must allow her the space to explore and understand her feelings about the family and yourself who is the parent. You have to deal with your insecure feeling that she may be talking about her relationship with you to her therapist.
  4. Her eating disorder would stir up mixed emotions of guilt, anger, frustration and sadness in you. These feelings are normal. It is better for you to talk to your own spouse, a confidant or therapist about it than to take it out on her.
  5. You have to remain firm but loving. It is very confusing for her when you fluctuate between the attitudes of being too rigid and overpermissive. Do not become punitive.
  6. Your primary goal is to help her get better. So, stop worrying about her school grades and work performance.
  7. Maintain a normal and good diet for her and the family. Do not compromise the other members of the family just because you do not want to upset her.
  8. Seek professional help if you have parenting or marital problems that are affecting your children.

More positive actions to minimise her chance of a relapse 

The short-term outcome for eating disorders is good. The long-term outcome is not so encouraging. For example, in the case of anorexia nervosa, 50% of the sufferers are still struggling with eating and weight problems five years after their treatment.

Your contribution in ensuring healthy eating habits and positive parent-child relationship will help her to maintain her gains and decrease the likelihood of a relapse. The followings are some simple but effective actions that you can undertake:

  1. Continue to provide a good, balanced and healthy diet for your family.
  2. Make mealtime and eating out a fun and enjoyable time for the entire family. Do not fuss over and argue about the food during mealtime.
  3. Do not use food as punishment or reward.
  4. Be a good role model. Do not go on a diet unnecessarily and obsess over your own weight.
  5. Do not criticise her body shape, size or weight. Do not call her names like “fat child”, or “pork chop” even though you mean it as a joke.
  6. Help build her self-confidence by getting her involved in things that she is good at.
  7. Teach her to value herself as an individual irrespective of her abilities and physical appearance.
  8. If she is involved in activities such as acting, modelling, dancing and gymnastic, she is at a higher risk of a relapse. Teach her to deal with peer pressure.
  9. Maintain an open communication with her about her emotions.
  10. Teach her stress management skills.

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