Fed Is Best
How To Feed Your Kids When You’re Bad At Feeding Yourself
For parents with eating disorders, the default advice on feeding children glides right past the reality.
After struggling with an eating disorder for most of her teen years, Emma Wright was determined not to pass it on to her two children. She decided that the best way to accomplish that was “to feed them healthy and tell them how gorgeous they were,” she recalls. “I thought it was about nutrition, and praise.” But Wright, who is now a body-image-focused parenting coach in her native New Zealand, quickly became obsessive about the “healthy” part. “In my mind, ‘healthy’ meant a lot of restriction. Restrict the processed food, restrict the sugar, restrict the food coloring, whatever.”
She imposed this structure religiously. “I was doing this with all the dedication of, well, someone with an eating disorder,” she says. Then she noticed that her kids were becoming obsessive, too. They were guilty when they ate certain foods and sometimes hid them. Her daughter started making critical comments about her own body. “I was like, I need to do something different here.”
Unfortunately, Wright couldn’t find much guidance on what she should be doing instead, especially as a person in eating disorder recovery. It was only a few years ago that researchers began studying how parents with disordered eating feed their kids, whether it’s as hard for them as one might think, and how it affects their children.
“What happens when a mom, in order for her child to survive, needs to give them the one thing that she dreads the most?” says Shiri Sadeh-Sharvit, Ph.D., whose research at Stanford became the basis for Parent-Based Prevention, a treatment plan that helps families work out issues that tend to arise when one parent has an eating disorder.
Some parents with these issues spoon-feed their children long past the age when most kids can eat independently. Others insist on plating their child’s food rather than allowing kids to serve themselves. Few have regular family meals. A parent with a past or present eating disorder might offer food when kids are bored or having difficult emotions. As a result, the kids may demand treats between meals, then refuse the food served at the table. A parent who struggles with restriction might offer their children the same dinner every night, composed of the few, strictly portioned low-calorie foods the parent is comfortable eating themselves.
“Underfeeding unfortunately is the most predominant pattern that we see,” says Sadeh-Sharvit, who chronicled these patterns in her 2018 book Parents With Eating Disorders: An Intervention Guide. “If you're feeling disgusted by foods or uncomfortable around certain foods, you're less likely to offer these foods to a child.” Consequently, when those kids go to a birthday party or another child’s house, they might steal food or binge.
“What happens when a mom, in order for her child to survive, needs to give them the one thing that she dreads the most?”
And there may be effects beyond food. Feeding your child in ways dictated by your eating disorder can strain your relationship with your partner or co-parent. You might face conflict over your feeding choices or, conversely, the other parent avoids bringing it up because they don’t want to make you feel bad. Struggling to feed your kids can make the parent with the eating disorder doubt their overall worth as a parent — is there anything more primal, especially in the early days, than the desire to feed your children well?
Eating disorders can also be hugely distracting, making it harder to connect with others, including your children. You may be physically present at the playground or getting them dressed or reading them a book, but mentally you’re elsewhere, counting the calories you’ve taken in so far that day, meticulously planning a future meal or workout or berating yourself for a past one, or otherwise engaging in the all-consuming rumination these diseases are known for. “Food obsession is a full-time job,” is how Isabel Foxen Duke, a body image coach based in San Francisco, put it.
Eating struggles are so common in adults, particularly women — and so frequently go unaddressed — that the usual advice to parents with eating concerns is to take care not to “pass it on” to their kids. For example, take this advice on an eating disorder treatment center’s website warning of the ways parents “teach” kids disordered eating: “If you, as a parent, are trying to lose weight make sure you keep it to yourself... If being on a diet is a normal way of life, your children may adapt to that lifestyle which places them at higher risk for developing an eating disorder.” The default advice glides right past why a parent might have these issues to begin with, instead instructing people to hide their struggles from their children and “model healthy eating” (which, by the way, is an idea with many wildly different definitions).
Experts I talked to offered different advice:
Acknowledge for yourself the seriousness of your issues — and that your kids probably know about them.
Many parents with eating disorders recognize when these conditions negatively affect their kids’ eating habits, and family life in general. “Parents mostly understand what bothers them and how much their own preconceptions and misconceptions cloud their thinking and decision-making,” Sadeh-Sharvit says.
For others, denial may be a part of the eating disorder. Foxen Duke has encountered clients who claim to have walled off their eating disorder so it can’t influence their kids — “mothers coming to me and saying, ‘Oh, don't worry. I would never talk poorly about food or bash my own body in front of my kids.’"
“I was projecting my disordered eating brain onto my idea of what feeding my baby should look like.”
Leslie Moniot, a blogger and public health educator, considered herself recovered from years of binging and restricting when her daughter was born in 2015, but when it came time to feed her baby solids, she found herself offering exclusively unprocessed, low-calorie foods. “I was going to feed her the most pure, everything organic, nothing harmful: no sugar, no pesticides, nothing toxic.” In retrospect, however, she thinks her unconscious motivation was to restrict “all these things I was afraid would lead her down a path of gaining weight.” At her next pediatrician checkup, the baby had lost a pound. Suddenly Moniot realized, “I was projecting my disordered eating brain onto my idea of what feeding her should look like. If you'd asked me then, I would have said this is what's best for her developmentally. I would have said I'm an intuitive eater, I never diet, I don't restrict food, but I was totally doing it — for my kid.”
The reality is that if you are still struggling with an eating disorder, it’s almost impossible to insulate your partner and children from it. “Kids are just smarter than that,” Foxen Duke says. “Generally speaking, if you are engaging in disordered eating, and you're struggling with body image stuff, that will affect your kids, regardless of how well you try to hide it.”
If you’re unsure whether your kids have been impacted, think back to whether your partner or extended family members have expressed concern about you overly controlling your kids’ food. By the time Sadeh-Sharvit sees parents, “most of them have received feedback [that] they're highly anxious about food.” Also observe how your children behave at a gathering where treats are offered. If you go to a barbecue or birthday party, and there are snacks on the table, are your kids the only kids not allowed to eat them? Do your kids focus mainly on the snack table, over playing with the other kids? These behaviors could mean that something is going on.
Address the family impact.
There is not a tremendous amount of research on how parents’ eating disorders affect their children, but researchers have observed developmental issues in kids whose parents have eating disorders that other kids don’t manifest. A systematic review of the most relevant scientific literature published between 1980 and 2018 found that kids whose mothers have a diagnosed ED, past or present, demonstrated higher rates of eating, social, cognitive, and emotional problems than kids whose mothers didn’t.
That doesn’t prove that your eating disorder is hurting your kids; research has also shown that those developmental issues resolved in later childhood, and no research has demonstrated that parental behavior causes eating disorders. Eating disorders have a strong genetic component, and a 2014 study found cognitive, behavioral, and feeding issues present as early as 18 months.
However, there is quite a lot of clinical evidence that parenting with an eating disorder can make feeding and meals really unpleasant for both parents and children.
The good news is that both mealtime and overall family dynamics improve hugely when parents address the role the eating disorder plays in their lives. Sadeh-Sharvit and her team are currently writing up the findings of a randomized controlled trial that investigated the effectiveness of Parent-Based Prevention. The study, which has not yet been submitted for peer review, showed that when families follow the treatment plan, kids “have less conflicts with their parents around the dining table and beyond it, and parents themselves felt more optimistic,” Sadeh-Sharvit says. It also positively impacted the way parents with eating disorders communicated with their partners.
Practice Division of Responsibility.
If you follow many family-oriented therapists or nutritionists on Instagram, you’ve likely encountered Division of Responsibility, a model for family meals developed by nutritionist Ellyn Satter. It goes like this: the parent decides what, when, and where meals are served. Meals are family-style, so the child decides what to put on their plate and how much of it to eat.
The rationale is that kids inherently have agency over what they eat — we all do — and most feeding issues arise in reaction to parents trying to undermine that agency. It also helps children stay attuned to their hunger, fullness, and taste preferences.
For kids, “There's this connection between what I feel in my tummy, what I see on the table, what I prefer,” Sadeh-Sharvit says. “They have to start learning the connection between all these aspects, all these variables.”
Division of Responsibility helps parents with eating disorders by outlining in black and white what they have to be vigilant about — and what they don’t. “There are steps. There are rules,” says Carol Danaher, Ph.D., a registered dietitian and educator at the Ellyn Satter Institute. The parent with an eating disorder can say to themselves, “OK, if I do this, I'm doing my job. If the child doesn't want to eat, that's not my job, and I know she's trusting her internal drives of what to eat and how much. My job is to make sure I have this meal on the table.”
Take a night (or a bunch of nights) off.
For parents whose disordered eating has made them hyper-vigilant about what their kids eat and who are exhausted by the subsequent mealtime battles, putting a partner or grandparent in charge of a meal one night (or more) per week can provide a much-needed break. “Our patients said often that they liked having a day off from worrying,” Sadeh-Sharvit says, adding that this is much more helpful than offering that parent unsolicited advice around feeding. “It's not a good way to support someone just to criticize them.”
Don’t beat yourself up.
Americans in particular have a long history of blaming parents, mostly mothers, for any major difficulty a child faces in life. As a result, parents with eating disorders often feel tremendous guilt when their behaviors impact their kids. When her infant daughter lost weight, Moniot remembers, “I was so ashamed of myself. To be wrong, and to be wrong with something you care about as much as your baby!”
Experts urge parents in this situation to remember that they were parenting through the lens of an eating disorder, that kids are resilient, and that their intentions were almost certainly good. “If [a] parent thinks that their kids would be better off if they would control their foods or have smaller portions, they [will] do anything in their power to communicate that to the child, or even engineer the child's environment to make that happen,” says Sadeh-Sharvit. “They want to manage the situation not because they gain gratification out of controlling their kids — it's because food is equated with possible danger, and they want to control it. It is for most parents [with eating disorders] an act of protection and care.”
Be open to the possibility that feeding your kids may improve your own eating.
Helping parents with eating disorders to feed their kids often ends up helping those parents in their recovery, Sadeh-Sharvit says. “The overarching intervention is helping parents accept their kids the way they are,” she says. “For a parent who highly values slender silhouettes, having a child that is genetically more chubby or round could be highly anxiety-provoking. Your child represents something that you dislike about yourself or about your family of origin, or you just don't think that it's good to have this type of body in the world.” Once they begin accepting their child’s body and right to feed themselves, they sometimes begin to “accept parts of themselves that they dislike or disapprove of, or parts that had been disapproved of in their childhood,” she says. Gradually, some begin to believe, says Sadeh-Sharvit, that “you have a beating heart, you have a body. It's entitled to occupy space in the world.”
Talk to your kids openly (and age-appropriately) about your issues.
Experts advise being honest with your kids about your eating struggles (since, again, they are likely aware of them), but presenting them in a way that doesn’t frighten your children or make them feel they need to take care of you. That could be as simple as saying, “I’m having problems with food, [but] I’m trying to get better, and it's not healthy for me," suggests Alissa Rumsey, a New York City-based dietitian, intuitive eating coach, and the author of the book Unapologetic Eating.
“I think vulnerability is a good thing to model to our kids. It's good that they see a whole person with struggles, and successes, and challenges, and resilience, and skills, and difficulties at the same time,” Sadeh-Sharvit says. “I do think that a parent is always a parent. It's not an equal relationship. Even when you talk with a child about your concerns, try [to] communicate them in a way that would leave the child optimistic with a sense that their parent still knows what to do.”
When Aileen Whyte, Ph.D., a clinical assistant professor at Stanford University School of Medicine who treats children and adolescents with anorexia, has a patient whose parent has an eating disorder, “It doesn't mean the parent can't help their child.” On the contrary, Whyte suggests the parent share their struggles honestly in family therapy to motivate the patient to push on in their recovery. “We talk about the parent’s problem. We talk about what the eating disorder has done to them and how difficult eating disorders are, what they take from a life.”
Photo Credit: Vera Livchak/Getty Images, Victor Torres, Studio Firma, Bisual Studio, Carey Shaw, Dmitry Borovikov/Stocksy
Shiri Sadeh-Sharvit (2015), Child feeding perceptions among mothers with eating disorders, National Library of Medicine, https://pubmed.ncbi.nlm.nih.gov/26145278/
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Shiri Sadeh-Sharvit, Ph.D., clinical psychologist and the Associate Director for Training at Palo Alto University Center for m2Health, California
Carol Danaher, Ph.D., registered dietitian and educator at the Ellyn Satter Institute
Alissa Rumsey, New York City-based dietitian, intuitive eating coach, and the author of the book Unapologetic Eating
Aileen Whyte, Ph.D., clinical assistant professor at Stanford University School of Medicine
Isabel Foxen Duke, body image coach
Leslie Moniot, public health educator