Eating disorder resources for families & friends

You’ve made the decision to enter eating disorder treatment — a brave, life-affirming step. But now you’re in the in-between: after the decision, before the first day. It’s a space that can feel disorienting, hopeful, exhausting, or all three at once.

You might feel like you’re waiting for your real healing to begin. And while it’s true that the full support of treatment is just ahead, this part of your journey matters, too.

Here are a few thoughts and tools to help you stay grounded, connected, and focused while you wait.

1. Name what you're feeling — without judgment

This time before eating disorder treatment can bring up a wide range of emotions: fear, relief, second-guessing, anticipation. You may wonder if you’re “sick enough,” if treatment will help, or if you’re making the right choice. These thoughts are natural and not uncommon. They're signs that you're human.

Try jotting down what you’re feeling — not to fix it, but simply to witness it. Journaling, voice notes, or talking it out with a trusted person can help make space for your emotions rather than letting them take over.

2. Practice gentle structure

You don’t have to start “fixing” anything before eating disorder treatment. But establishing some gentle structure in your day can support your sense of stability. That could look like:

• Getting outside once a day, even for five minutes

• Eating meals or snacks at consistent times (whatever that means for you right now)

• Limiting time spent researching recovery or scrolling triggering content

• Creating a small routine for morning or bedtime to help your body know you’re caring for it

This isn’t about perfection. It’s about planting small reminders that you’re worthy of care now, not just when treatment starts.

3. Connect with the part of you that chose recovery

Even if you’re feeling unsure or disconnected right now, there was a moment when you said yes to healing. That part of you still exists and can be nurtured.

You might try writing a letter to your future self in eating disorder treatment. Or gathering a few reminders of why you said yes: a voice memo, a text you sent, a photo that helps you envision a life with more freedom. These can be anchors when the eating disorder voice tries to pull you back.

4. Use the support you have

You don’t have to wait until day one of eating disorder treatment to reach out. You can ask your admissions counselor questions. You can say, “I’m struggling.” You can be real. This space isn’t about proving anything. It’s about being held through uncertainty.

5. Remind yourself: This time has purpose

Waiting for eating disorder treatment to start can feel like limbo. But it’s also a space where you're already beginning the work of recovery.

Your decision matters. Your effort matters. The days between now and your first session are not lost time. They are part of the story you’ll tell later — about the moment you chose to keep going.

You're not alone

We’re honored to be alongside you — even now, before the first eating disorder treatment session. We're looking forward to meeting you and to continue your journey through healing, even when it felt uncertain.

You’ve already started.

Body image in adolescence is a growing concern for parents and psychological experts, whether their focus is on eating disorders or not. Congressional hearings in 2020 examined the role social media plays in teenagers’ self-esteem (among many other aspects of life). Clearly, body image impacts our mental health, and through that our happiness.

Body image isn’t created by social media alone, of course. It’s a complex factor in our personalities, easily affected by outside and internal factors, and in many cases, the people closest to a teenager impact their self-image. Although peer pressure, the media, and society at large all influence how we perceive ourselves and our bodies, there is one major influence that overrides all the others: the parents.

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Are Parents a Large Factor in How Children Perceive Their Bodies?

According to USA Today, body image in teenagers is most impacted by their parents – specifically, their same-sex parent. Beginning from the first days of an infant’s perception of the world around them, and especially accelerated in puberty (when the child begins to see themselves as an adult and usually begins dating), parents serve as role models, inadvertently or not. Social media is not to be blamed completely, and neither are the Hollywood starlets with their impossible-to-attain bodies and figures.

Thus moms tend to influence their daughters’ self-image, and fathers their sons’, although both parents play a role.This makes perfect sense in regard to how children develop their personalities and self-identity. Our parents are our role models, caregivers, heroes, and villains all rolled into one. With that in mind, here are a few reasons why parental influence is the most prominent factor in a daughter’s body image. 

3 Ways Parents Influence Their Children’s Body Image:

1. Children Pattern Their Behaviors and Attitudes After Their Parents

The foundation of a person’s adult body image begins to form well before adulthood – even before adolescence. Little girls do a lot of things like their moms do, especially if they spend a lot of time with them. Just like a young woman may learn how to dress from her mother, she will also pick up on certain personality traits. For example, if a mother is constantly concerned that she needs to lose weight, her daughter may mimic those same concerns throughout her teenage years.

Fathers’ attitudes also influence their children’s attitudes. Although the prevailing stereotype is that women care about body image and men don’t, self-perception in males is just as linked to their feelings about their bodies. They may influence their sons by mocking a slight build or for being overweight, for example, which can lead to disordered eating or exercise patterns. Both parents’ attitudes about their partners can inadvertently affect the children’s thinking about “acceptable” body sizes and shapes too. A parent who criticizes their parent’s weight might inadvertently spark an “anti-fat” bias that can lead to disordered eating.

2. Disordered Attitudes About Food Can Be Taught

Our favorite activities, our politics, even the kinds of food we like to eat – so many things are influenced by our parents. This, of course, influences our feelings about weight and how to stay in shape. When a parent is outwardly concerned about losing weight and dieting or has a noticeably poor body image, impressionable children often begin to copy these attitudes.They also might begin to project them onto themselves. It’s a cycle that begins in childhood but can carry into adulthood.

A distorted and negative body image and preoccupation with weight are prime causative factors in the development of virtually every eating disorder. Directly or indirectly, parents’ weight-loss attempts and attitudes toward eating drip down to their children. In a direct sense, parents criticizing their children’s weight or forcing them to go on a diet can negatively affect their self-esteem and lead to disordered attitudes about food and eating. Indirect influence happens, too. A child observing a parent constantly counting calories usually begins to show the same tendencies when they reach adolescence and adulthood.

As a parent, you shouldn’t let fear of passing on disordered eating prevent you from taking care of your health and trying to eat well. Certainly, eating well is a huge part of living well. However, it’s worthwhile to be cognizant of how undue stress on weight loss can negatively affect a child’s self-esteem. Building an attitude of HAES (healthy at every size) will help young people balance good eating with a positive and realistic body image.

3. Many Eating Disorders Are Related to Genetics

Although eating disorders can come from a variety of factors, including sociocultural factors like race, gender, and economic status, several studies have shown that there is a genetic factor as well. One of these studies estimated that children of parents with an eating disorder developed anorexia nervosa or bulimia nervosa at a rate of 7 to 12 times higher than children whose parents did not have one of those disorders.

This means that in the nature vs. nurture debate, both parts have some influence on whether a person will present an eating disorder.  On the other hand, it’s important to remember that having a parent with an eating disorder is not a guarantee that an adolescent will be subject to the same fate.  The overall rate of eating disorders is about 1% of the general population.  That’s a significant number, being roughly 3 million people in the US, but many of those parents will not pass an eating disorder on to their children.

Keep in mind that eating disorders rarely occur without another form of mental health disorder also presenting. The most common are depression and PTSD. Coping with the negative emotions caused by trauma is indeed one of the most common triggers for disordered eating behaviors. These co-occurring disorders also have a genetic component to them; parents who suffer from depression or anxiety disorders should watch for signs of these syndromes as well as disordered eating.

What Parents Can Do to Promote Healthy Eating Practices and Body Image

With or without the presence of an eating disorder, parents should promote a healthy relationship between their children and a positive attitude about food, eating, and body image. They should put some focus on eating for pleasure and satiety, and encourage open communication about body image and self-esteem. The best way to do so is to lead by example; parents can match back up their lessons by eating well themselves – a child that sees mom and dad getting a nutritional food intake will be more likely to do the same.

In the same vein, parents should demonstrate body acceptance and the concept that people can be healthy at any size.  HAES philosophy is a major concept in the world of eating disorder recovery, but it is also useful to any parent that wants to promote positive body image. It’s best to involve kids early and often in meal plans, cooking, and enjoying meals together. Encouraging open lines of communication about self-esteem and body image is also helpful.

Of course, kids don’t always want to talk about these topics. Parents should allow for privacy, and forcing a lecture can be a tipping point or trigger for disordered behavior. Let them know about other resources such as support groups, peer groups, or even school resources. Avoid being critical and judgmental about your weight or your child’s – if weight is becoming a medical concern and you feel it must be discussed, remember to stay non-judgmental and open to discussion.

Help is Available if Your Child Develops an Eating Disorder

No parent wants their child to develop an eating disorder – but it happens. As a parent, the key to helping your child recover is to stay calm and non-judgmental. Panicking and having a confrontation lecture won’t help anyone. 

Remember that there are options. Treatment is available, and it begins with gentle, non-judgmental conversations about the problem. Enlist the help of a professional if it’s beyond your capacity; many parents wisely contact a child therapist before committing to further action. These individuals can help diagnose the problem and make further recommendations.

Because eating disorders often begin during adolescence, specialized treatment for teenagers with eating disorders is widely available. These programs can be in residential, outpatient, or even virtual formats. In any format, adolescent eating disorder treatment addresses psychological factors that cause disordered behavior and work on changing behaviors to be healthier. Parents shouldn’t worry about their child missing school; aside from eating disorder treatment being the most important step they can take for their child’s health; most programs contain tutoring and other educational components. Day treatment and virtual programs can be scheduled outside school hours as well.

Finally, these programs almost always involve the client’s parents. Education about the disorder itself and how to maintain the client’s recovery is offered to the parents, and the lessons imparted here can be used years after treatment ends. Family therapy is also standard practice, which can help both parties gain an understanding of the causes of the eating disorder. If your child is showing signs of disordered eating, don’t let a reluctance to talk about it get in the way. Reach out for help – recovery is possible.

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ADHD is on the rise

ADHD, or attention-deficit/hyperactivity disorder, is one of the most common mental health conditions among children in the U.S. The diagnosis rate of ADHD has increased over the past 20 years due in large part to increased awareness, decreased stigma and greater access to healthcare.

This brain disorder is associated with difficulty concentrating, staying organized and controlling impulses. Although children and adults with this diagnosis may appear to be bursting with energy, they experience trouble channeling that energy effectively and controlling their impulsivity.

They may act before they’ve thought things through, speak out of turn or say things they later regret and thus both personal and work relationships may suffer.

The connection between ADHD and overeating

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We live in a culture where we are constantly enticed with high-caloric foods. This can be particularly challenging for those who eat in reaction to environmental cues rather than due to feelings of hunger.

Like those with disordered eating, people with ADHD often deal with boredom, stress and intense feelings by overeating in order to soothe themselves. Those with ADHD may be likely to forget to eat and to binge later. They may also have trouble planning and shopping ahead, which can result in spur-of-the-moment and uncontrolled eating.

According to a national 2016 parent survey, 6 in 10 children with ADHD had at least one other mental, emotional, or behavioral disorder (source: Data and Statistics About ADHD | CDC).

Research focuses on connections between ADHD and overeating in adolescents and adults. A recent study conducted by researchers at the Child Study Center at New York University’s Langone Medical Center found that men who were diagnosed as children with ADHD were twice as likely to be overweight in a 33-year follow-up study compared to those who were not diagnosed with the condition.

The researchers attributed the higher incidence of obesity occurring in adults with ADHD to lack of impulse control and poor planning skills leading to poor food choices and irregular eating habits.

Armed with data like this, it’s critically important that children and adolescents with ADHD are taught healthy eating habits in order to help avoid developing disordered eating patterns.

Neurotransmitter deficiencies and ADHD

Experts agree that ADHD is caused by an imbalance in brain chemistry. More specifically, the neurotransmitters norepinephrine and dopamine may be in short supply in the brains of those with ADHD.

Although too much norepinephrine can contribute to anxiety, too little can cause problems with concentration and learning. Those with a deficiency in norepinephrine have trouble blocking out distractions and organizing their lives.

Dopamine is essential for controlling impulses and enabling a person to sit still and wait. People lacking dopamine can act impulsively, blurt out opinions, burst out in anger and later feel regret. As dopamine is an essential part of the body’s reward circuit, a deficiency in this neurotransmitter intensifies the urge to indulge in behaviors such as overeating, substance abuse and other risk-taking behaviors to achieve the same reward others get from less harmful behaviors.

People whose brains are low in dopamine often self-medicate with high-caloric food because of its ability to activate dopamine in the common reward pathway.

A deficiency in the two neurotransmitters norepinephrine and dopamine can lead to the following behaviors related to eating:

• Poor awareness of internal cues of hunger and satiety, or fullness
• Inability to follow a meal plan
• Inability to judge portion size accurately
• Inability to stop bingeing or purging
• Distraction by continual thoughts of food, weight and body shape
• Increased desire to overeat, especially high calorie, “reward” type foods
• Poor self-esteem due to repeated failures of self-control

Does ADHD cause eating disorders?

In patients with coexisting psychiatric and eating problems or co-occurring disorders, which came first?

Is ADHD the switch that turns on disordered eating, or does the eating disorder leave the brain so undernourished that it can’t function optimally? This varies depending on the individual person.

In some people, eating disturbances evolve with other psychiatric symptoms. In others, signs of a psychiatric disorder are not apparent until the disordered eating patterns are firmly established. And still in others, problems with mood and problems with appetite seem to have always coexisted.

Regardless of the order of onset, the simultaneous presence of disordered eating and a mental illness means that effective treatment for the disordered eating must address both conditions. This is the only approach that can lead to recovery and prevent the all-too-common patterns of relapse.

ADHD is commonly missed in eating disorder diagnoses

The relationship between psychiatric disorders and disordered eating is complex. ADHD is the most missed diagnosis in relation to food and appetite problems. Adults seeking treatment for binge eating or obesity should be screened for ADHD. Effective treatment for ADHD can significantly help patients off the roller coaster of disordered eating.

Often the strong urge to binge or to self-medicate with food subsides once the impulsivity and inattention of ADHD are treated. A person can experience a new ability to tune into the body’s signals, control cravings and improve impulse control.

Seeking help for ADHD and eating disorders

We know finding care can be tough. Monte Nido is here for you. If you are concerned that you, or a loved one, may have an eating disorder, please reach out to us.

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