Ask the expert

. February 22, 2013.

Q I worry that my 10-year-old may have an eating problem. She often eats for pleasure, and it's hard for me to redirect her away from food. She is overweight for her age; I’m worried this will lead to a more severe binge cycle as she grows older. How can I guide her towards a healthier relationship with food?

As parents, the best way to guide our youngsters towards a healthy relationship with food is to have one ourselves. This means taking an anti-dieting approach that includes the promotion of fruits and vegetables as well as the inclusion of "snack foods" or "indulgent foods.”  Binge cycles of eating usually form out of periods of deprivation — dieting — so I strongly caution against limiting her food intake. I encourage incorporating activity into her daily routines and trying to make it fun! If she is eating for "comfort" to avoid uncomfortable feelings or emotions, this could also be concerning and you may want to consult with a professional to address those emotions so that she does not develop an unhealthy pattern of eating whenever she is upset.

Q My daughter overeats when she is stressed out, then refuses to eat at mealtimes. She is a perfectionist who constantly compares herself to other girls. In my opinion, she sets unrealistic goals for herself. I try not to put any pressure on her. What are the symptoms of anorexia? How can I tell if her behavior is something to be concerned about versus normal teen angst?

Teens in our society are bombarded with unhealthy and unrealistic messages about dieting and body shape. While goal setting can be highly productive, it can become destructive if taken to extremes. Life is about balancing work, health, school, family and social life. If any one area becomes too emphasized, then a person will experience a loss in another area. Encouraging positive behaviors, recreational activities and a healthy social life can help perfectionists find balance. Adolescence is a time of finding oneself, developing independence and autonomy; however, this can be incredibly difficult in a school environment when conformity ensures acceptance. Highlight your daughter's unique strengths and abilities and introduce her to new things that may be fun and enjoyable so that she has the opportunity to relieve herself from internal or external pressures. Many perfectionists have a personality that can drive an eating disorder such as anorexia. Some symptoms to look for include significant weight loss (or failure to gain weight during the growing years), dramatic weight fluctuation, denial of hunger, a significant reduction of the amount or type of food eating, unusual rituals at mealtime such as cutting food into small pieces, and storing or hoarding food, among others. The River Centre Clinic hosts the Eating Disorder Support Network (EDSN) meeting on the first Thursday of each month as a free
resource to the public to learn more about eating disorders.

Q My teen is an advanced/ level 7 gymnast. I realize she is in a sport that is very weight conscious, but recently she has reduced her food intake and constantly checks the scale. Is this behavior part of being in a high stress sport or should I be worried?

It is concerning that your daughter is reducing her food intake, especially if she is burning calories through exercise. Athletes need to fuel their bodies, not deprive them. I encourage you to talk to her coach and get an understanding of messages that are being sent about dieting, weight loss, and performance. Many coaches are willing to help re-direct their players with positive messages about these concepts. Your teen’s “constant” scale checking is an unhealthy behavior and could lead to an obsession in which she judges herself by her weight. I suggest sharing your concerns with your daughter and seeking advice from a professional if the behaviors persist.

Symptoms to look for

    •    Significant weight loss (or failure to gain weight during the growing years)
    •    Dramatic weight fluctuation
    •    Denial of hunger
    •    A significant reduction of the amount or type of food eaten
    •    Avoiding eating, skipping meals
    •    Dieting becomes the most important part of the person's life
    •    Rigid eating patterns (only diet foods or foods that are perceived to be low in calories are consumed)
    •    Dividing food into "good" (fruits and vegetables) and "bad" (meats, sweets) categories
    •    Unusual rituals at mealtime such as cutting food into small pieces, moving food around the plate and disposal of food so that it will not have to be eaten
    •    Preoccupation with food, collecting recipes and cooking for others while finding excuses to avoid eating
    •    Storing or hoarding food
    •    Marked fear or anxiety before eating and guilt after eating
    •    Complaints of bloating and unusual fullness after eating small amounts of food
    •    Signs of self-induced vomiting (e.g. leaving the table immediately after eating in order to vomit)
    •    Signs of laxative abuse or diuretic abuse
    •    Excessive exercise to burn off calories
    •    Loss of menstrual periods
    •    Dry skin and swollen salivary glands
    •    Muscle spasm, numbness and tingling in the arms and legs
    •    Sore throat and erosion of tooth enamel caused by vomiting
    •    Social isolation, low self-esteem & depression

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