In the wake of Covid-19, an equally deadly wave has been gaining momentum: the pandemic of mental-health issues among young people. Eating disorders, and more specifically anorexia nervosa, have the highest mortality rate of any psychiatric illness and are characterised by severe physical, psychological, interpersonal and social impairment. Peak onset occurs during adolescence and the average duration of illness is often from five to eight years depending on specific diagnosis.
While the causes of eating disorders are complex, with research indicating that 50 per cent could be down to genetics, body-image dissatisfaction and internalisation of beauty standards play a key role. Research has shown that by the age of 16, . Moreover, studies from the Centre of Appearance Research at UWE Bristol highlighted that . Young people who feel worse in their bodies are , and are also at .
Teenage years have always been a challenging time for body image, with changes to body shape and weight, acne, body hair and the onset of menstruation occurring with puberty. Image-focused social media platforms and the ease and frequency with which people can take and share photographs have put an increased value on physical appearance as a key part of self-worth. For many teens, their primary means of evaluating themselves is based on how they look. Moreover, the manipulation of photographs creating unrealistic beauty standards through Photoshop and filters means that teens are continuously comparing their bodies to an impossible standard.
Coupled with the promotion of diet trends such as ‘clean eating’, intermittent fasting, calories on menus and a toxic, #fitspo/exercise-at-all-costs culture, it’s no wonder that teens are falling prey to disordered eating behaviours that can quickly escalate into full-blown disorders. There has been a .
As parents, there are plenty of ways we can help buffer some of the challenges faced by teens and help them to cultivate a kinder relationship with themselves and with food. Most important, however, is to begin with offering ourselves some compassion. As parents, we’re always aiming to do our best for our children, all while existing in the same appearance-focused diet culture that they do.
Diet culture isn’t dieting per se but rather the culture of dieting, such as persistently striving for weight loss, to look a certain way or to ‘be good’. More specifically, it’s a belief system that values thinness and a socially constructed ideal of beauty above our health and wellbeing. While it often claims to be about ‘health’ – for example, juicing, ketogenic diets and intermittent fasting – when we scratch away at the surface, a lot is about dieting and weight control.
Parenting against the backdrop of diet culture can make it challenging to see our teens gaining weight or eating sugary foods. We don’t want them to be teased or singled out, and we know that weight and appearance is the number one reason a child will be bullied – another risk factor for eating disorders. It is very normal for teen bodies to change when undergoing puberty, and intentional weight loss during adolescence has long-term consequences such as the development of disordered eating behaviours, including bingeing or purging. Parents encouraging their child to diet has also been found to be predictive of risky weight-control behaviours and increased weight gain in later life, so it may have the opposite effect of what was intended.
When it comes to nutrition, we similarly want to take the best care of ourselves and our families, but this means it can be easy to fall for misinformation and scaremongering, and I know I have done this countless times myself. As a nutritionist working in the field of eating disorders and disordered eating, I can vouch that a healthy relationship is going to be more beneficial for overall wellbeing than avoiding sugar. I would recommend accredited information from the British Dietetics Association or Association for Nutrition and following individuals affiliated with these organisations on social media (they may use the qualification abbreviations RD, ANutr or RNutr online). Many doctors will talk about nutrition despite receiving very little education in this area, so please be mindful of this too.
5 top tips to support your child:
- Model your own healthy relationship with food, exercise and body acceptance. This doesn’t mean that you have to have it totally figured out or feel 100 per cent about your body all of the time, but try not to complain about your physical appearance, diet or eating around impressionable ears. You might also like to model body appreciation and gratitude – for example, saying ‘I’m so grateful to my body for that wonderful swim/bike ride’ or discussing the importance of food for growth, wellbeing, socialising and energy for hobbies.
- Help your teen expand their definition of health to include mental, social, emotional and psychological wellbeing. This can help us celebrate the multifaceted roles of food in our lives, and how different foods nourish different parts of our health – for instance, pizza with friends to feed social health. You can also model health-endorsing behaviours that do not focus on weight and appearance, such as visiting the doctor for routine appointments.
- Take a neutral approach when talking about food to remove the morality that’s been tied up with eating. For example, avoid labelling food as ‘good’, ‘bad’, ‘junk’ or ‘rubbish’, or saying you’ve been ‘good’ or ‘naughty’ depending on what you’ve eaten. Instead, just refer to food as food, without any qualifiers.
- Support your child with media literacy skills and thinking critically about the information they read online, especially around ‘health’ and nutrition. Have regular conversations about photo-editing and the marketing of products. Call out the lack of representation in media around race, ethnicity, ability, sexual orientation and age, as well as weight stigma. There is a lot of sizeism in kids’ films and books. Encourage awareness, appreciation and celebration of body diversity.
- Don’t brush off your teen’s concerns. If they say, ‘I look fat,’ be cautious about replying, ‘You look fine.’ Instead, validate how they are feeling and elicit conversations about what’s affecting them, such as social media images, difficult times at school, feeling different to peers or general stress. This can be a great opportunity to bring in media literacy and unrealistic beauty standards. You can ask where they learned that fat was a ‘bad’ thing and discuss the benefits of body fat and why all bodies are worthy.
Isa completed her masters in Eating Disorders and Clinical Nutrition at UCL, and has gone on to undertake reputable training in body image, intuitive eating and nutritional psychiatry. Her recent research on the impacts of eating disorders on caregivers was published in the European Eating Disorders Review in 2020. Alongside her clinical work, Isa is passionate about working with teens to educate on nutrition misinformation, media literacy and body image. , speaking with staff, parents and teens as part of a whole-school approach to eating-disorder prevention and to help young people foster a healthy relationship with food and body image. / isa@isarobinsonnutrition.co.uk
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