Preventing an eating disorder in children

First of all I have a daughter that has always eaten light meals. I just took it as she didn't have that big of stomach because she is a small girl but lately it seems like she doesn't want to eat. We have to force her to eat meals. Last night she told my wife that she didn't want to eat dinner because she had lunch. In April she will only be 7 years old so am I just overreacting or could this easily slip into an eating disorder when she gets older? If it is the beginning stages of an eating disorder does anyone have any recommendations on how to get her to eat more? Do you use the same calorie intake formula for children?

i was a scrawny kid with a tiny appetite, and if i were growing up now, i have no doubt that people would be worried.  as it was, i'm pretty sure that some people thought my mother wasn't feeding me enough.

given the culture we're living in, it's more than possible that your daughter has absorbed the idea that thin is good and fat is bad.  luckily, she's only seven, so you have a few more years during which you and your wife will be the most potent influences in her life. 

i think you need to talk to her about all the good things that food does for her body: giving her energy to learn and to play, helping her to be strong and happy, allowing her to be a good friend, etc.  it's important to put as little emphasis on body size and shape as possible, but you can't completely ignore it, because she may be already thinking in those terms.

don't leave a window for skipping meals (you're the parents, after all, and you still make the rules), but talk to her about her reasons behind not wanting to eat.  hopefully she'll be honest with you.  a kid that age doesn't need a lot of food, but it's important that she's eating five or six times a day.

i think it's perfectly reasonable to talk to her about the food groups and energy, but i wouldn't go near calories, macro- and micronutrients, etc.  she needs to see food as a positive thing, not as an onerous obligation or a threat.

edit: is she an anxious kid generally?  are there things going on in your family and elsewhere that could be causing her stress?  i don't expect you to answer those questions here, but ask yourself.  an ED can start that young, if she's using not eating as a coping mechanism.

It's unusual for small children to want voluntary skip meals but that's a long way from an eating disorder.  My son (8) will sometimes seem to be eating everything in sight one day, constantly asking for extras and the next I have to remind him it's lunchtime.  I don't think totting up their calories is helpful at this stage.

As to how to get her to eat more... Whatever you do, don't turn it into a battle of wills or make mealtimes stressful  If she can see you and your wife are anxious she'll be anxious so when you eat together, laugh, smile, talk about your day at work... be 100% normal.   Be relaxed at mealtimes, don't talk about the food, push it in her face or keep saying 'come on eat up'... but when she clears her plate, give her lots of praise.  Serve her relatively small amounts... too much on a plate can be offputting to a small girl.

One good technique is to invite some of her friends over and organise a picnic for them on the carpet.  Lots of plates of tempting goodies scattered about.  Fussy eaters will eat more and try new foods if they see their peers doing so.  And a picnic is a fun and relaxed way to eat

Another thing you can try is to start her with cooking...  Rolling out dough and making pizzas or biscuits is a great way to get children engaged with food and more comfortable around it.  If she decorates the biscuits or chooses her own pizza toppings... that's also putting her in control and keeping a food event fun.  Another good one to do with friends.

Healthy eating is on the syllabus in UK primary schools these days and I find that my son responds well if he thinks a food will make him 'big, strong and faster at running'   You could maybe adapt that and tell your daughter that eating nice foods will make her 'tall, strong and better at ballet dancing (or whatever she likes doing)'.

Good luck... I'm sure it's just a phase.

i have to disagree with a couple of things, here, jane (unusual; i usually agree with you without reservation).

first, the fact that she's not hungry for dinner once in awhile isn't a big concern, but the rationale cited above is: dkm says that his daughter didn't want dinner "because she had lunch."  having lunch is definitely not a good reason for not eating dinner, and she needs to know ths.

second, i don't think it's at all necessary for a kid (or anyone) to "clear her plate."  epecially for children, who don't usually get to decide how much food goes on the plate in the first place, knowing when we're ready to stop  is crucial, and there's no reason we should need or should eat exactly the same amount from one day to the next.

personally, i think it's much more important for kids to eat regularly than that they eat a lot.  if she sits down for dinner and only eats four bites, it's probably because she only needs four bites, but if she doesn't sit down for a meal at all, who knows what's going on?

i would aim for three meals and at least two snacks a day, and provide quality food, but i wouldn't worry much about quantity.

Thanks for the ideas. I think it will help out. There has been a lot of stress in our family lately and that is one reason I started thinking it could be the beginning stages of an ED. 

I've never forced my children to clean thier plate but I have always wanted them to make a good effort at it. When I grew up it was drilled into me that you never left the table without cleaning your plate and I think that is one of the driving factors for my weight problems today. It's a compulsion for me to clean my plate even if I feel stuffed. I don't want this for my kids so I don't make the kids eat everything but it drives me crazy when they don't clean thier plate and then five minutes after dinner I see them with a candy bar or a bag of chips in their hands.

It seems hard for me to gauge the amount that she should be eating. I have another  daughter and a son that eats everything in sight but she barely eats anything. I know no two kids are the same but the things that she has said and her attitude toward eating is a little alarming to me. So once again thanks for your suggestions. I'll try them out and hopefully they will work.

This might not relate to you at all, but this reminded me of a story.  I have a friend who constantly obsesses about food, calories, losing weight, etc.  She referrs to herself as fat alot and at mealtimes will often times eat a totally different "diet" meal from the meal that she serves the rest of her family.  Then she comes to me upset that her 9 year old doesn't want to eat because she's "afraid of getting fat."

I finally had to point out to her what she was doing.   She was puting the food fear into her daughter without even meaning to do so.  I have no clue about your home life, so I don't know if any of this even applies to you.  I just know that some people who are on diets and diet websites tend to go about dieting in a way that may give their children a wrong impression about food.  Once I realized this and was aware of it, I started seeing it more and more in how some of my friends reacted to food in front of their children.

I just want to add a few points.

Firstly I think one of the most important and mentally beneficial thing a parent can do for their child is show them love. seems obvious doesn't it, and i hope you don't take offense because i am not accusing anyone of being an UNloving parent not at all. Its just I think sometimes i think you have to tip the scale inoverdoing it rather than underdoing it- lots of hugs, kisses, affection and attention including conversation. I know my parents love me and i have always thought of them as loving but it's wierd although i give my dad a kiss when i see him i would never feel comfortable to just go over to him sink my head into his chest and give him a big hug. and the only time i really hug my mum is when I'M comforting HER.

This leads me on to my next point the thing that most people with eating disorders share is the need to be 'perfect'. I was expected to be a lot more mature than my years growing up and i think this led to an unintentional pressure put upon me. I think making sure children know that it doesn't matter if they're not the best at everything or that its ok if they make a mistake. Sometimes you have to make this really obvious and not just assume they know it, similar to showing them love, for example if they do well in an exam it would be great to say well done but i'd love you even if you didn't do the best in your class things like that.don't just assume they know youlove them tell them-alot!!

Now i have no idea if the issues with your daughter is something to worry about or not so i can't shed any light on that i'm sorry but even if she does just have a small appetite showing her even more love and letting her know imperfections are normal and wonderful won't hurt anyway!!

oh also one more thing you might want to try- find her absolute favourite meal in the world- be it cake it doesn';t matter here. then after she's eaten a fairly substantial lunch and doens't want dinner ask her if she wants this fave meal/pudding. if she says 'YES YES YES' then you know she's just fussy. My little sis will eat like nothing at dinner- she'll pick at the meal and say she's not hungry. the second i bring out sticky toffee pudding suddenly she's capable of eating a bigger serving of the pudding than me!!! of course you shouldn't then bribe her with cake everytime she won't eat dinner but its a good little test i reckon!

My wife and my daughter don't seem to get along very well and my wife has always had, in my opinion, an unhealthy eating habit. She has always been skinny but thats because she will starve herself for a couple days when she gains a couple pounds. She doesn't work out she just starves herself. I mean she will eat nothing for a couple days unless I catch her doing it. Then she'll eat something to make me happy. 

To add on to the problems, my wife was diagnosed with cancer a few months ago. She's lost 24 lbs since her diagnosis so now I have to fight with her to eat even more. Since my wife has had several Dr. appointments during the day I was put on the night shift. Now the only time I actually see my daughter is on the weekends. Her eating habits changed after I started working the night shift but there is so much going on in our family right now I don't know what exactly is causing the change.  I get along with her much better than my wife so this could be a reason for her lack of interest in eating.

I have always shown my kids lot's of love and given them lot's of praise for good things that they have done but one problem is that I am in the military and I just finished a 15 month unaccompanied tour. I saw them once in 15 months. Now that I am back with the family I get put on night shift so it is almost like I'm still deployed. I am going to do everything that I can to give her a possitive self image but it is going to be a very difficult task for me right now since I have such limited contact with her.  Wish me luck!

Original Post by dkm1014u:

 my wife has always had, in my opinion, an unhealthy eating habit. She has always been skinny but thats because she will starve herself for a couple days when she gains a couple pounds.

 Unfortunately the  'I won't have dinner because I've had lunch' remark.. is probably something she's heard her mother say?...  I'm sorry about your wife's illness and I hope she recovers.

dkm, your daughter also may see you bugging her mom around food and eating and feel like that's the way to get your love and attention.  this is especially worrying if you're not able to be around much and give her attenion in other ways.

honestly, it sounds to me like the whole family needs to be in therapy.  your other kids may not be acting out, but they must be feeling the stress.

I was always the scrawney underfed looking kid.  I loved fruits and vegetables and sweets.  Pulling the clean your plate rule didn't work so well with my sister and I, the one time my dad tried it we still refused to have the leftovers for breakfast.  Letting a child choose a small helping and then return for seconds if they're still hungry is generally a good idea.  Make sure that she samples a little bit of everything unless she's tried it before and knows that she has an aversion to it.   Dessert is generally not the best bribe as far as food goes, I certainly would have skipped dinner in lieu of ice cream frequently if given the option.  I'd recommend saving dessert for later in the evening and mostly making it fruit.

I think if there's great influence in the household on dieting, then there may be a problem.

I think my ED (starting at around 13) was from seeing my parents obsess over new diets/workouts. All the diet books with photoshopped people with beautiful abs made me want to lose the fat I had... and it all went downhill from there.

My recommendation (for whatever its worth) is to talk to your family physician and ask his/her opinion...maybe weaved into a annual school physical visit.  It should dispell any concern you may feel.

most physicians know very little about eating disorders beyond the physical effects, and by the time those are apparent, you've got a very sick kid.

I have two experiences with this i would like to share

1.  I grew up in a house where this food was good, bread apples, and that food was evil....almost everything else.  all my life my mom would never deny me something but it would be followed with.  oh i am so happy you like that cake, ice cream, cookies, prezals, chips if i ate it i would be fat.  Also almost everyone in my extended family suffers from an eating disorder so i think so much of it is in the family,  we must be very careful what our children hear  the other  is

2. I teach preschool,  i tell my kids if they dont eat a good amount of lunch they may not have the cake or dessert if someone has brought in something to share.  its usually my way of getting them to eat something because they are awful pickey.  i had 2 girls tell me they did not want my cake because they did not want to get fat...they are 4 years old.  i told them i wanted cake,  ate a small piece told them i love cake and asked them if i was fat. they said yes,  i was 5ft 6.  100 lbs and suffering from anerexia.  i ate that cake, forced it down with a smile to show them and they were already so distorted they thought i was fat.  What Do These Children Hear At Home?

Apologies if someone's already said this, but...

dhm wrote:

"There has been a lot of stress in our family lately and that is one reason I started thinking it could be the beginning stages of an ED."

Your daughter may be one of those people who react to worry, stress, or depression by losing their appetite -- my ex-brother-in-law and I are certainly like that, and I know I was even as a kid.

I didn't make the connection, back then, between stress and lack of hunger -- so when someone asked me why I wasn't eating, I would usually say something like, "I'm not hungry because I had a snack at school," because that seemed logical to me.  I didn't make the connection that I was usually hungry at x time of day, or that I didn't want to eat because I was worried or stressed out.

OTOH, children are also much more perceptive than we realize.  It's possible that your daughter has picked up on your wife's issues with food -- and even though they don't get along very well, on a subconscious level, it's still possible that not wanting to eat is a way of connecting with her Mom.

Your daughter may also be more worried, afraid, or concerned than she lets on -- kids are pretty tough, and if they think their parents don't need more stress, they'll often hold their own worries in rather than talk about them.  You schedule might make this hard, but maybe you could make a 'date' with each of your kids individually, and go do something relaxing and fun, but fairly quiet, so you could have a chance to let them talk about their worries to you. 

Edit: If your daugher is the 'holding things in' kind, you might have to find gentle ways to convince her that it's okay to talk -- sometimes it helps if you share your own concerns a little, within reason, while pointing out ways they've been helpful and strong.  My Dad and my sis used to do this with me when I wouldn't talk about stuff, and it worked pretty well.

When everyone is trying to keep a brave face forward, that kind of thing can really help.

It sounds like you guys all have it really rough right now :(  I hope things will get better for you.   You sound like you really care about your wife and kids, and I think it's great that they have a husband and father like you.

#5: thank you so much for that. I have begun doing this and will stop. what an eye opener

I would like to thank everyone for their advice. I had a long talk with my wife about her realationship with our daughter and my worries about ED. She in turn had a long talk with my daughter. They seem to be getting along better and my daughter even ate much better this weekend. She actually asked for seconds. I also had a talk with my supervision and they are letting me go back to a split shift.  I think I should be able to see my kids more often then.