Family and the signs of eating disorders

Sarah Blake, Social Worker and Outreach Coordinator at the Center for Eating Disorders at Sheppard Pratt, offers insight on what factors may cause eating disorders, and associated with signs and symptoms.

Eating disorders can develop for a number of reasons, and loved ones should be watchful for the signs that may lead to a family member developing such a condition.

Although the physical signs of having an eating disorder may vary depending on which condition your child or family member may have, here are some potential characteristics, or historical personal issues, that may lead to the development of an eating disorder:

Interpersonal signs
• Troubled family and personal relationships
• Difficulty expressing emotions and feelings
• History of being teased or ridiculed based on size or weight

Psychological signs
• Low self-esteem
• Feelings of inadequacy or lack of control in life
• Depression, anxiety, anger or loneliness

It’s important to note, that while all of these signs should be closely monitored, there’s no exact recipe that dictates which specific factors may lead to an eating disorder. The more we can do to build awareness of the causes and risks, the better.
The following are tips for parents to help prevent eating disorders among their children:

• While it is wonderful to praise your child, it sends a mixed message when you tell them they are beautiful and then negatively critique your own body in front of them
• Do not allow family members to tease one another or those outside the family about body size, shape or appearance
• Encourage and engage in healthy eating
Educate your children about the media images they see, and teach them to be informed consumers

Most importantly, get help and support for yourself and if necessary, for your child and/or family. Getting into a treatment program at an early stage of the disorder, increases ones chances of a positive experience in the recovery process.

Please call the Center for Eating Disorders at Sheppard Pratt at 410-938-5252 to speak with someone in confidence.

Parent/Child Co-Current Eating Disorder – Q&A with Janet Treasure

Dr. Janet Treasure, an internationally renowned expert in eating disorders, offers her insight on parent/child co-current eating disorder – a topic she will be discussing at the upcoming symposium on April 12, 2008, hosted by The Center for Eating Disorders at Sheppard Pratt.

The symposium will serve to educate the professional community on how to support and promote eating disorder prevention efforts. Keep an eye out for interviews with other experts as we get closer to the date!

How common is it to have parent/child co-occurring eating disorders?

Though there are no concrete figures, about less than 5% of eating disorder cases are parent/child co-occurring. This is not to say, however, that a parent’s eating disorder does not have a monumental impact on how a child perceives eating habits and body image.

Are children of parents with eating disorders more or less likely to receive treatment?

The good news is that preliminary findings show that children of parents with eating disorders are more likely to get treatment early. However, there is also evidence that the outcome of treatment is less successful if there is a family history of an eating disorder.

How does one intervene when the parent of a child is identified to have an eating disorder?

Unfortunately, there is no simple answer to this question. It depends on numerous things and its important to consider such things as:

  • Whether the parent themselves has acknowledged that they have an eating disorder;
  • Whether it is thought that the parental eating attitudes are acting as maintaining factors for the child’s eating disorder;
  • Whether or not the co-parent is involved.

The most important step is ensuring that the entire family is involved. Sharing common goals, such as working together to ensure that they are not maintaining the illness by enabling behaviors, and aiming to help the individuals with an eating disorder overcome eating disorder behaviors. Families need to make sure that the individuals are eating socially with sufficient amounts and nutrients. It is especially important for the parent without an eating disorder to play a key role. This may involve several stages:

1. Coming to terms with guilt or avoidance in the feeling that they have not been able to provide a safe protected environment for their child.

2. Understanding that their child’s eating disorder is different than that of their spouses and the realization that management plans in dealing with the eating disorders will have to be different.

3. The role of a spouse is very different from that of a parent in supporting an individual with an eating disorder. Developmental stages and emotional maturity will need to be factored at all times.

4. Understanding that while a spouse is dealing with an eating disorder, it will make it difficult for them to play a balanced care-giving role.

5. Providing balance in dealing with both eating disorder cases.

Read more about Dr. Janet Treasure.

If you are a mental health professional and are interested in hearing Dr. Treasure speak on this subject, you can register for the April 12th symposium.

Night Eating Syndrome – Q&A with James Mitchell

 Dr. James Mitchell, an internationally renowned expert in eating disorders, discusses the two most common types of night eating syndrome.  He will be presenting this topic at the upcoming symposium on April 12, 2008, hosted by The Center for Eating Disorders at Sheppard Pratt.

What is night eating syndrome? 

There exist at least two forms of night eating syndrome, or NES. The first, most commonly referred to as NES, involves people who overeat late in the day and/or get up during the night to eat. These people also have marked problems with insomnia and are fully aware of what they are doing when they wake up to eat. The other form of night eating is usually related to a sleep-related eating disorder. Those individuals wake up and eat during the night, but many times are amnestic for it and are only partially aware of what they are doing. This type of night eating is a parasomnia, much like sleepwalking. 

How does an individual identify that they are struggling with this issue?

People with NES are usually fully aware of their problem. Those with a sleep-related eating disorder may be amnestic for the eating episodes, but may discover evidence the following day that they have been eating during the night; such as food that has been left out, or that the oven has been left on.

Is there effective treatment available for NES? 

There is a structured form of counseling which has been manualized and is available as a self-help manual by Allison & Stunkard for NES.  For sleep related eating disorder, medications are usually indicated and can be quite effective.

Read more about Dr. James Mitchell.

If you are a mental health professional and are interested in hearing Dr. Mitchell speak on this subject, you can register for the April 12th symposium online at

Borderline Personality Disorder – Q&A with Randy A. Sansone

Dr. Randy A. Sansone, an internationally renowned expert in eating disorders, talks about borderline personality disorder and the unique challenges those who suffer from it may face.  He will discuss this topic at the upcoming symposium on April 12, 2008, hosted by The Center for Eating Disorders at Sheppard Pratt.

What is borderline personality disorder? 

Borderline personality is a longstanding dysfunction in personality that is characterized by three fundamental features: (1) a superficially intact social facade or veneer; (2) longstanding difficulties in self-regulation (i.e., an inability to effectively regulate oneself, which might emerge as eating disorders, alcohol/drug problems, promiscuity, difficulty regulating money, chronic pain syndromes); and (3) chronic self-harm behavior (e.g., self-mutilation such as cutting, hitting, burning, or scratching oneself; suicide attempts; engagement in abusive relationships; high-risk hobbies/behaviors with the intent of gambling with death).

How frequent does this co-occur in individuals with eating disorders? 

The data indicate that about one-quarter to about one-third of individuals with eating disorders have co-morbid borderline personality disorder. The disorder is less common among those with restricting anorexia nervosa and more common among eating disorder syndromes characterized by impulsivity (such as anorexia nervosa, binge-purge type; bulimia nervosa, purging type).

What unique challenges face this population in learning to manage their eating disorder? 

While standard eating disorder treatment is helpful, it must be augmented with psychotherapy intervention for the personality disorder. In many cases, the function of the eating disorder symptoms extends beyond food/body/weight issues and may relate, in addition, to self-harm behavior. In addition, there are oftentimes adjunctive self-regulatory and self-harm issues that must be addressed in treatment (e.g., substance abuse, suicide attempts). Because borderline personality is oftentimes associated with early developmental trauma, these issues must be taken into account, as well. 

**Some data suggests that individuals with eating disorders and borderline personality may have more severe symptoms as well as less robust treatment outcomes, compared to individuals with eating disorders, alone. Other data suggests that the treatment response to the eating disorder symptoms may improve equally well, but the individual’s overall functionality is less.

Read more about Dr. Randy A. Sansone, M.D.

If you are a mental health professional and are interested in hearing Dr. Sansone speak on this subject, you can register for the April 12th symposium online at

“Your Child Registered at Miss Bimbo.”

Here lies the subject line of a confirmation email sent after registering at Miss Bimbo – the world’s first virtual fashion game, approved for nine year old girls, where young women aspire to become the world’s most famous and beautiful bimbo.

Miss Bimbo allows girls as young as nine years old to choose outfits, accessories and boyfriends for their respective Miss Bimbo avatars. Once they have settled on a boyfriend who “brings them money for all their girlie needs – earning them more bimbo attitude,” they can flirt or dance with them at Club Bimbo. They can also search for an apartment, enlist a personal trainer and visit a plastic surgeon for a face lift or even breast augmentation, if they’re feeling adventurous.

Numerous news outlets have gotten word of the website and developed their own take on it. The site recently removed the option to purchase diet pills for one’s respective bimbo, citing an influx of negative media attention.

But we’ve seen at least one comment, praising the site, arguing that it teaches young children how to take care of their bimbo and instills values concurrent with the “real world.”

Although the removal of the diet pill feature is a step in the right direction, Miss Bimbo still refers to young women as “bimbos” and touts an unrealistic weight standard, encouraging the use of a personal trainer to get rid of “love handles, packed on by excessive eating.”

As we write this post, it’s our intention to bring to the forefront the negative impact this controversial site could have on young women. We believe values such as responsibility and taking care of oneself can be instilled in ways other than channeling a website that infiltrates negative body image within the impressionable mind of today’s youth.

We’d like for our readers to sound-off about this website. Does this website sound like the “real world” to you? Having our voices heard will strengthen the online community as we resist the “values” society places on young women and men.