“I didn’t just want to be thin,” said Madi O’Dell, whose battle with an eating disorder began in her freshman year of high school. “People think you choose to have an eating disorder because you want to lose weight. But that’s not how it was for me. I wanted to be in control.”
February is Eating Disorders Awareness Month. I talked to Madi, a former patient at the Children’s Hospital Colorado Eating Disorder Program, and to Dr. Jennifer Hagman, medical director there, because while I feel as if I’m “aware” of eating disorders — what adult who grew up in the last couple of generations isn’t? — I’m not sure I know as much as I think I do. I may think I know the basics of “prevention” (don’t emphasize weight and appearance, don’t obsess about your own weight in front of your children), but there’s one thing I’m certain that I don’t know: how to spot a developing eating disorder before it takes hold of a teenager’s life.
I asked Madi and Dr. Hagman to offer some specific advice for parents who might be “aware” of eating disorders, but still might not know how to recognize a disorder in its early stages. Both agreed that it isn’t easy, but each said that the signs are often there. Their advice:
Watch for little changes. “I was weak. I was tired. I had shin splints, I got sprains, I couldn’t run as far,” said Madi, who is now a freshman in college and a soccer player with a healthy diet — and an outspoken advocate for awareness of eating disorders among teenagers and their parents.
Listen to what your teenagers are saying. Children who are beginning to obsess about food might talk a lot about eating healthily, or avoiding fat, Dr. Hagman said, or they might begin to say a lot of negative things about foods or their body.
Schedule meals as well as activities. “It was easy for me to hide that I wasn’t eating because I was so busy,” Madi said. “It was normal to eat in the car, it was normal to eat on the road.” Teenagers with an eating disorder may avoid meals by saying they have too much homework, or they’re too busy, or they already ate, or they will eat at school, when really, they’re not eating at all.
Notice new food obsessions. After visiting a nutritionist, Madi became obsessed with avoiding “bad” foods. Many teenagers with eating disorders will demonize certain foods or food categories, or they will binge on particular foods, or eat only a very limited selection. Dr. Hagman has seen teenagers take a sudden interest in cooking and prepare meals for their entire family that they don’t eat.
Act on your own instincts. “Parents do notice,” Dr. Hagman said. “They just don’t know what they’re noticing.” Suddenly, they’re buying less at the grocery store, or having different conversations with their child, or seeing changes in appearance or physical ability like those Madi described. “If something has changed, say something,” Dr. Hagman said. “Ask what’s happening. Don’t be afraid to talk. Sometimes teenagers will say, ‘No one noticed anything, so I thought I must be fine.’ Notice. Open the door to the conversation.”
Keep talking. Ask about meals. Ask what your child thinks about certain foods. “Ask about their friends,” Dr. Hagman said. “Friends are often the first to know that another teenager has a problem.” Talking about friends might also be easier than talking about themselves, and might allow a teenager to absorb a parent’s advice and concern more easily. “And talk about yourself,” Madi said. “Tell us how you feel instead of asking how we feel. It helps to feel like it goes both ways.”