Q & A with Eating Disorder Specialist Sari Fine Shepphird: Part 2
In the second half of our interview (check out part 1 of the interview here), Sari Fine Shepphird, Ph.D, clinical psychologist and author of 100 Questions & Answers about Anorexia Nervosa, offers important information about eating disorders and their treatment. For more information about Shepphird and her book, please visit her website.
Q: Can you talk about the warning signs for eating disorders?
A: Some of the more obvious signs include: the person avoids eating with others; starts to restrict the types of foods they eat (not just the quantity); becomes secretive (e.g., is evasive when asked what they had for lunch); skips meals; makes frequent trips to the bathroom after meals; starts to exercise excessively; begins to weigh themselves frequently; makes negative comments about their own bodies or other people’s bodies; seems to idealize thin celebs or thin friends; compares themselves to others (which actually isn’t a normal thing to do, even though we’re conditioned to do this by our society); starts to count calories frequently; comments about certain foods being “bad” foods and feels like a “bad person” for eating these foods.
The more subtle signs include: the person starts to dress in very baggy clothes to hide their frame; develops strange behaviors around food (e.g., only eats at a certain time of day, or in a certain order); shows great concern about weight gain and makes a lot of weight-related comments; loses or gains a significant amount of weight; begins to make general self-critical comments; develops perfectionistic tendencies; shows signs of low self-esteem; is embarrassed or ashamed after eating; puts pressure on themselves to exercise, even when they’re tired or injured.
Q: Recently, the news has reported that kids as young as five are being diagnosed with eating disorders. Why do you think patients are getting younger? Aside from general warning signs, are there specific things to watch out for with kids?
A: It is disconcerting indeed that patients with eating disorders are seemingly getting younger. Interestingly, older patients are being diagnosed with greater frequency as well. The emphasis on thinness in our culture has only gotten stronger in the past decade. Children are exposed to greater amounts of media and role models, including children’s role models, are themselves feeling a greater pressure toward thinness. Parents also feel that pressure to a greater degree and perhaps unwittingly convey their own body image concerns to their kids through their actions and words.
Parents may want to let their child’s pediatrician know if they notice any unusual behaviors around food. Picky eating is normal for children, but any behaviors that persist or seem odd or extreme should be brought to their doctor’s attention. Feeding disorders of childhood can be ruled out by their doctors, and treatment is important. Such disorders can also be precursors to later eating disorders.
Parents should be sure to start their kids off early with a healthy approach to eating, rather than a restrictive one. Children naturally have hunger and fullness cues that help to regulate their eating. These cues can become skewed if children are made to feel guilty for eating a healthy diet, or if unhealthy behaviors around food are modeled in the home.
Q: What are some ways family and friends can approach their loved one if they notice warning signs?