When Food Feels Scary: Eating Disorders in Kids & Teens (Early Signs & What Helps)

0:00Dr. Erin Parks:One thing I see over and over with parents is just how much we're carrying. The data backs this up. Most parents spend nearly every waking hour focused on someone else. So if you feel exhausted, stretched thin, or like your brain never really shuts off, that makes complete sense. I've seen how powerful it can be when families have more support. When parents have trusted caregivers, the mental load lightens, and they're actually able to be more present. Not because they're doing more, but because they're not doing it all alone. Care.com makes it easier to find trusted, background-checked caregivers, whether that's support for a newborn, before or after school help, or even care for an aging parent.

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2:37Dr. Erin Parks:Eating disorders and disordered eating are far more common than most of us realize. They affect an estimated 30 million Americans over the course of their lifetime, which means if you're listening to this, this topic probably touches your life. as a parent, maybe in your childhood, or as a partner or friend. Today, I'm joined by Dr. Erin Parks. Erin is a clinical psychologist who specializes in eating disorders. She works every day with teens and families navigating these concerns. And importantly, Erin and I both struggled with eating disorders in our earlier years, so this is personal to both of us.

3:16Dr. Erin Parks:Erin is thoughtful, grounded, and tuned into the deep emotional experience underneath food struggles. This conversation isn't about diagnosing your child. And it's definitely not about perfect meals or saying the perfect thing. It's about understanding. Understanding what's really happening underneath. Understanding what our job is as a parent. And understanding next steps we might take. I have a feeling that at the end of this episode, you're going to feel more oriented, more aware, more empowered, not more panicked. And I'm so excited for you to meet Dr. Erin Parks. I'm Dr. Becky, and this is Good Inside.

3:58side.

3:58Dr. Erin Parks:Okay, so many things I want to ask you, but I just want to kind of ground this conversation around eating disorders, disordered eating, with what you're really seeing right now, with families, teens, younger kids around food, like what is showing up most? And what's kind of most pressing, most relevant right now? I think the two things is that first of all, it's increasing and more of it. And I hear parents worrying about either their child's picky eating. Is this a problem? Is this not a problem? It seems to be getting worse. Or about how their kids are feeling about their bodies and trying to eat healthier and control what they eat.

4:38And parents are asking me, should I worry or should I be celebrating? So the two things I'm probably hearing the most.

4:44Dr. Erin Parks:Increase in picky eating. Increase in picky eating. And in eating disorders. And in eating disorders. Yeah. The rates of eating disorders have been steady for about 100 years. And since 2020 have been going up and up. And then this other category of things, not to say that there's not overlap. I just want to see if I'm getting this right, Tamir, back. There's this category of like my kid wants to eat healthier. And is healthy something to celebrate? Is healthy sometimes a cover for control or rigidity? Is that kind of the debate, the space you're seeing a lot of as well? Exactly. because there's so much content coming out right now about the correct way to eat, the correct way to feed your kid.

5:20And I'm having parents say to me, my kid is freaking out because they're like, if kale is healthier than spinach, should I not eat spinach and only eat kale? And they want to do the right thing as parents. And then the kids want to do the right thing as kids. And yet what is right is very much in air quotes because there is no one right way to eat.

5:40Dr. Erin Parks:I want to actually take what you said in the categories then and maybe jump into them one at a time. Let's start with what you just ended with healthy eating or rules around eating. Or one of the things I think about a lot is morality around eating. I always think with parents, it's like morality is often the thing we want to avoid. Right. What are the good foods? Right. What is it kale and spinach or is it no carb or no this or fat or there's always some latest thing. And so just when a parent comes to you and they're like, is this something I should be concerned about or how should I intervene?

6:10Dr. Erin Parks:Just walk me through. Like if I'm saying that to you, I'm seeing my kid come. I don't buy that anymore. And this isn't good. And I read this thing online. I saw this thing on TikTok. My friends aren't eating this food anymore. And I'm saying to you, OK, is this a good thing? Is my kid becoming more empowered? Is this a concerning thing? Just talk to me. By the time a parent asks me, even if it's just on the soccer field, is this a problem? Answers almost always yes. I really can count on one hand how many times the answer is no. There's something about us as parents that when our gut says something is off about food, we don't listen to it right away because we're consuming the same diet culture.

6:46We've been drinking from this fountain of look different, look younger, be smaller since we were also born. And so when we see these behaviors in our kid, our gut says something's wrong. And then we start saying, OK, it's probably just a faith, probably making too big deal, too big of a deal out of it. So by the time I finally say it out loud to someone, the answer is yes. Yes, you should be trusting your gut. Yes, something is wrong. Yeah.

7:11Dr. Erin Parks:And my guess is also it's not always a binary. No, it's not a problem. Yes, it is a problem. Hey, there's something rising to the level of your gut thing. You're thinking about it. You're wondering about it. Like, let's just be more curious about it. Let's look into that together as opposed to either or. Exactly. So if your child is saying, I want to eat healthier, and what that looks like is they start eating a wider variety of food. They start eating what you are eating at dinner. They start ordering new things on the menu when you go out to a restaurant. That probably doesn't make you worry, and that is a form of eating healthier.

7:47But when your child says they want to eat healthier and they're no longer eating birthday cake at their cousin's birthday party, they are stopping eating their favorite foods. You're concerned they might be losing weight. That's when your gut is saying, wait, this eating healthier isn't a good thing. So your gut naturally goes off when you're picking up on them taking away things they used to do instead of simply adding.

8:10Dr. Erin Parks:And I'm just picturing this parent with this kid. What comes next? Like, let's say a parent's thinking, OK, this whole shift is maybe under the cover. It's been labeled healthy. But there's something in me saying, I don't know, seems a little different from just that. Do I do I just notice for a couple of weeks? Do I collect some kind of data? Do I talk to my kid right away? If I do, you know, what would that be? I'm going to put out another option. Do I say I made an appointment with a therapist and a nutritionist and you need to do that? Like how what are the next steps? I would talk about it frequently and I would start now because it's something that all of us are constantly receiving information about how we should eat, how our bodies should look.

8:52And so it can also be a constant conversation in your home. So when your kid tells you they want to be healthier, I usually ask, well, tell me what that means. I'd love to help. We all want to be healthy. Healthier can mean going to bed at an earlier time, which is usually not what a teenager means when they say they want to eat healthier or be healthier. but reminding people that eating healthier is one aspect of health and seeing is health what they're really after I also like to ask them why and I will hear things like oh I want to be faster at my sport or well I don't really know but everyone's just I mean I should shouldn't I and that tells me something too this I should they're already shoulding themselves they're already deciding that there's a good way to be and a bad way to be and they think that eating a certain way.

9:40And it goes to your earlier point around the morality of food. And we need, I mean, I am a human who grew up in America and a woman who's trying to embrace aging while not wanting to age, right? So I get the mixed messages that we all receive. But it's really, really difficult. And we accidentally say, I ate well, I ate poorly. I'm going to eat so poorly at the Super Bowl party or I ate bad at the party. And so kids are around this moralization and the behavior that they claim to want, like eat healthier, be healthier, is sometimes about trying to be perfect, to be better. Yeah. Find a binary that doesn't really exist.

10:20Dr. Erin Parks:I just want to double click on this morality thing because I know I've talked to parents who will say to me, and I'm sure you hear this all the time, but sugar is bad. But my kid doesn't have celiac, but gluten is bad. Gluten leads to inflammation. And I'm not here to debate any of those truths, but I'm sure that comes up a lot where how how do I figure out food and morality, especially if there are families and adults who who really do believe and maybe with good data like. But but why can't we talk about things as good or bad if there's certain data or science to support that. How do you manage?

10:59Dr. Erin Parks:I'm sure. Do you see that? I see it constantly. I mean, I live in Southern California, land of no sugar and no gluten. It's hard. I really, really personally struggle with it because I remember the 90s when bagels were a healthy breakfast item and I miss it. My 14-year-old son came home and he's newly at high school and I can feel him picking some stuff up and he has been more cautious around the sugar. And so I asked him, I'm like, Max, what's going on here? And he's like, I'm like, I know friends who just don't eat sugar. Yeah. And you seem to feed us so much sugar. And I'm like, you're welcome.

11:36I would like to hear it. Thank you. No, but I, kids want to do the right thing. And so when I talk to other kids or parents about it, I remind them that while you are still developing, the number one thing you need is calories, period. and where are calories? They're in sugar. They're in carbs. That's where calories are. If you were anemic, I would be figuring out how to get you more iron. But what you are doing is going through growth spurts. They have so much movement between walking to classes and all the activities they're in and the sports and they are growing. So what they need is calories.

12:09So the healthiest thing is calories and the easiest way to get that for them is carbs and sugar. If as a family, you're deciding to be gluten-free or sugar-free, there are all sorts of different ways to feed your kids. We do a lot of cancer metaphors in the eating disorder community. And I like to remind people that we would never give our child poison unless they had cancer and needed chemotherapy. So similarly, if in your household, you're like, we don't eat gluten or we don't eat sugar, but I'm going to make this change because my child now needs something that is different because they've developed an eating disorder or their disordered eating is making us worried about their health.

12:45Dr. Erin Parks:I think that's really helpful. And one more level practical for the parents who are thinking, how do I manage a situation actively where it's true, my kid notices I'm not eating a certain thing, but I don't want that to be fully absorbed by them. Like what language do you recommend people use or what type of conversation starters? I think it's two things. Sometimes it's what you say and sometimes it's adjusting your behaviors. My child once saw me not finish a milkshake and I heard about it for a month. You know, he knows that I have struggled with disordered eating before and eating disorder before.

13:16And it made him hyper aware. And I had no idea that he knew any of these things, that he even paid attention to what I did for a living. And so they're always observing, even when we think they aren't. Yeah. So sometimes the solution is to talk to them about it and say, hey, you know, I use the sports metaphors as well. You're going to have kids on your soccer team who have knee issues. They're going to do stretches that you don't do before and after practice. And that kind of stinks for them. Like they have to spend this extra 30 minutes doing this and that. That is what they have to do because of their knee issue.

13:46Well, maybe there are people in our household who eat different for different reasons. Maybe dad is watching his cholesterol for health reasons. And so he has eliminated some foods. That's what he has to do. And though sometimes the solution is also examining your own food habits and the ways in which they're communicating things you don't want your kids absorbing.

14:05Dr. Erin Parks:I just want to say, and I really love. The very reality based part of that answer. And there are times when, yes, we can label it to our kids. You're right. I'm not eating this. And I have my reasons and look in our family in general. We believe that the way I do things shouldn't always be the way you do things. We actually love the way you guys do things differently as kids. And then there's other times where it is true. If you never eat certain types of food or if it feels very rigid, that behavior sometimes speaks louder than anything we say. And if you have a kid who's especially observant or especially people pleasing or especially looking at me all the time and becoming rigid, sometimes there's nothing that I can say that's going to be as powerful to my kid as saying, I'm going to have dessert tonight.

14:49Dr. Erin Parks:Right. And and there's a reality of that that I think it's like, OK, to just name. So we're kind of along this topic and I want to transition to it. Control. How do you see the relationship between disordered eating, eating disorders proper, control? What? Are there any signs that a kid way before eating stuff develops might be prone to them given their relationship with control in general? A lot of people who struggle with eating disorders also struggle with anxiety. So they want to do things right. They want to do things perfectly. So that might be something you see early on. They see anxiety around perfectionism, anxiety, rigidity.

15:29We also see something, it's a fancy word for knowing when you need to pee, but this altered interoceptive awareness. So these are the kids who can play sports through an injury. They can stay up studying through the fatigue. They can ignore the calls and the social plans of their friends and just keep working on that project. That is an incredible skill. I think a lot of success comes from having this tunnel vision. And if you take that tunnel vision and direct it towards changing your body or changing the number on a scale, that's exactly what I think is so hard as a parent is you're like, I want to praise that they stayed in the gym the extra hour.

16:06I want to praise that they stayed up late working on that project. And at what point are we praising behaviors that we don't want to see in ourselves as adults? We all talk about trying to figure out how to turn off, about how to know our own intrinsic worth. But what we're doing is praising behaviors that can lead to burnout, can lead to an eating disorder. I really caution people around exercise. When you see your kid exercising despite having an injury, exercising longer than their friends, especially in boys and men. So I just want to remind people that 40 % of people with eating disorders are male.

16:41So this is affecting teen boys just as much as teen girls. But it's usually missed in boys because when a boy stays longer in the gym, it's praised. And then especially if you're at the gym instead of going to a social activity, what's better for a 15-year-old's development than going and seeing friends in person? Something we want all of our kids to do more of? Not being in the gym.

17:00Dr. Erin Parks:And look, and just for all the parents listening, right? I think, look, there's part of that that, of course, at moments you're going to say, wow, you're working really hard, right? So I think, again, and I think we're similar, no rigidity there either as a parent. But it's just such a good moment as a parent to pause and say, OK, if I have a kid like that and it's like, oh, my goodness, Aaron, are you talking about my kid? Huh. Is there just a nuance there I want to reflect on, even if I don't change anything yet? Yeah, it's kind of amazing. My kid pushes past the type of signal or pain that would stop someone else in their tracks.

17:33Dr. Erin Parks:that can be used as a superpower. But, ooh, that also, that could flip on them too. And if I think about it in that nuanced way, maybe there are moments instead of just praising, I say, hold on a second. One of the things that's unique about eating disorders is we haven't really found a gene per se that's passed from parent to kids. But we know it's very heritable, like 86%, I want to say 85, 86. But what we have found is that it's a neurobiological-based illness. And so that the pathways in the brain that are in charge of things like interoceptive awareness, attention to detail, that is what's being passed on.

18:11So if your kid has these behaviors, there's really high chances you do too. And it gives you an opportunity to say, like, I'm sure our children have seen both of us push through fatigue and get work done. And I'm proud of that. I'm glad that they've been able to see that. But how can I also make sure I'm saying to them, I'm burnt out and I'm exhausted. Mom's been on too many planes. Mom stayed up too late too many nights in a row. I'm going to go hang out with my sisters. I'm going to skip work tomorrow and do something fun. And so it's modeling for them, figuring out when to use it as a superpower and when it's starting to hurt my quality of life.

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20:32Dr. Erin Parks:Can you help us understand? I know parents, they see a kid restricting, obsessing about food, binging, these things that logically it feels like, why are you doing that? Like, stop doing that. But there's something kids are getting from that or something it's doing. One of my favorite things and how I fell into eating disorders is because they really are about regulating emotions. And as someone who has very big emotions, I love just the honest talking about the ways in which eating disorder behaviors really serve people. They work until they don't work anymore. So what we see from a lot of the kids and teenagers that we work with is that they experience the same emotions as everyone else, but just at a louder volume.

21:11And if you are genetically predisposed to have an eating disorder and you might find that when you're really stressed out, not eating actually makes you feel better. So for most people, if you don't eat, you maybe get hangry, you get grumpy. But for people who are prone to have an eating disorder, not eating actually relaxes you. I tell parents, I'm like, imagine you're going to go on stage and give a presentation to 100 people, 500 people, whatever is going to terrify you. And if someone offered you your favorite breakfast right before you went on stage, you'd be like, absolutely not. Your stomach would be in knots.

21:45You want to eat that afterwards. Well, that's what the stomach of someone with an eating disorder or who's prone to have an eating disorder often feels like. So not eating actually relaxes them, regulates their emotion. Yeah. For kids who struggle with binge eating and purging behaviors, they also tend to also struggle with self-harm behaviors. When they feel that really big emotion, making themselves vomit numbs them out instantly. It just brings them from a 10 out of 10 to a zero. Now usually shame comes after that and then they're back on the wheel of having really high emotions. But really reminding parents that these are serving a purpose and not to vilify them.

22:21even in the eating disorder community people are like well I have anorexia that's the good eating disorder whereas you know bulimia making yourself vomit is the bad eating disorder that is not true and I tell parents if you think your kid is vomiting they are by the time you think that they are they are because eating disorders are so secretive but don't freak out don't act as though that's the worst thing your kid could ever do they there are no worse eating disorder behaviors and they're serving a purpose for them. So give them an opportunity to share with you when it's coming up and let's help them to not give in on that urge.