What Parents Should Know About Fast Food

There are many facts that every parent should know about fast food. Here are some for starters:

1. Fast foods are often heavy in calories

An adult would have to walk for seven hours straight to burn off a Super Sized Coke, French Fries and a Big Mac. Younger kids with smaller bodies are consuming an even greater proportion of unnecessary calories unless they are eating child-sized meals. But even then, these foods have way too many calories. In fact, this is why fast food is a major contributor to the obesity epidemic. Left unabated, obesity will soon surpass smoking as the leading cause of preventable deaths in America. Moreover, even if one doesn’t die from obesity but simply lives with it, quality of life is often impaired. Obesity has been linked to: hypertension, coronary heart disease, adult onset diabetes, stroke, gall bladder disease, osteoarthritis, sleep apnea, respiratory problems, endometrial, breast, prostate and colon cancers, dyslipidemia, steatohepatitis, insulin resistance, breathlessness, asthma, among other serious diseases.

3. Fast foods are high in preservatives and low on nutritional value

4. Most nutritionists recommend not eating fast food more than once a month

5. Fast food is possibly linked to cases of increased inattention and hyperactivity in children

Even with the release of the educational film “Super Size M” in 2004, there has been no real decline in fast food sales in America. On the contrary: fast food consumption is on the increase! And yet, many parents still wish they could feed their kids three nutritious meals a day.

If you are one of these parents, here are a few tips on how to inspire your kids to avoid fast food:

Provide the Necessary Information
Explain why fast food is harmful. Fortunately, there are now some really excellent picture books that can help you get your point across to both young children and teens. The series entitled “Eat This, Not That” provides a wealth of information in a fun format that appeals to kids of all ages. Although one of the books is specifically addressed to young people (“Eat This, Not That, for Kids”), the other books are also highly accessible. Parents can read and discuss the material at the dinner table and/or just leave the book(s) lying around the house. “Dr. Shapiro’s Picture Perfect Weight Loss” is another wonderful educational aid, interesting to the whole family.

Condition Them to Like Healthy Foods
Cook healthy delicious food at home. The trick here is to get your child’s palette used to the taste of healthy food and to come to prefer it over the the taste of commercially prepared fast foods. If your kids are used to the fast food taste already, then help them make a gradual transition to a healthier diet. At first, offer foods that are similar to fast food – for instance, introduce fruit shakes in place of ice teas, sausages instead of hot dogs, pesto instead of spaghetti, tacos instead of chips. Gradual transitions can help kids adjust to a new diet more easily.

Avoid stuffing food in the refrigerator for your kids to heat via microwave whenever they are hungry. Microwaved food tastes a bit too much like fast food. Instead, as often as possible, sit down together and eat freshly prepared meals. Even the act of sitting down together is an important step in developing a healthy food consciousness, regardless of what is being served.

Introduce Your Kids to the World of Good Food
Consider introducing “fine cuisine” into your family culture. Get cookbooks out of the library and experiment with interesting, even exotic dishes. Bake up a storm. Teach the kids how to do the same, approaching them in ways appropriate for their age. When people taste really good food, they often become “food snobs” – preferring quality food to “fast food” any day. All the lectures about health and well-being can’t compete with the impact of the taste of really delicious food!

When Your Child Comes Home Drunk

It is well-known that teenagers are in a stage of experimentation – they are exploring the world around them, the world of relationships and their own inner landscape. What feels right? What creates pleasure? What is meaningful? What relieves stress? What brings social, academic and personal success?

Somewhere along the way, most teens will encounter alcohol. Some will like what they find, indulging the substance more and more in order to gain social acceptance or psychic relief or both. Others will find that they don’t like the feeling that alcohol gives them and will move away from it toward other, healthier forms of stress relief and happiness. And some will find a small place in their lives in which to place consumption of alcoholic beverages – certain social situations like celebrations and other special gatherings. No matter what kids ultimately decide to do with alcohol, however, many will get drunk at least one time.  Some will do so accidentally, simply not knowing their limits. Others will do so intentionally. No matter how it happens, however, parents have to know how to handle the situation.

Below are some tips in handling a teenager who comes home drunk:

Stay Calm
There is such a thing as a “teaching moment.” This is a moment in which the child is calm and coherent and a moment in which the parent is also calm and coherent.  When either child or parent is not fully present due to overwhelming emotions (like anger, grief or fear) or impaired consciousness (i.e. not fully awake, drunk or stoned) no learning will occur.  In fact, talking to a drunken person is futile; alcohol significantly impairs comprehension and inhibition — your drunk teen doesn’t have the mental capacity to process your message, nor the ability to explain things properly. Therefore, when your child comes home drunk, wait until he or she sobers up before you try to deal with the issue. Let the child sleep it off – the best time to talk is likely to be the day after the incident.

Take the intervening time to settle your own nerves. You might be feeling alarmed, enraged, disappointed or otherwise extremely upset. Emotion, especially of an intense, hysterical or dramatic kind, will work against your goals. Remember – you shouldn’t be addressing the issue at all until you are calm enough for your child to be able to take you very seriously. This talk will be an important one – you don’t want to appear off-balance while you are trying to make important, life-impacting remarks. Staying calm, you help give your teen someone to take seriously, look up to and respect. You increase your power to provide education and guidance when you come across as a loving, concerned, firm, clear, knowledgeable and trustworthy adult. Try to get into that state before you hold a meeting with your teen!

Emergency Intervention
Do call your local emergency medical information line if your child’s state concerns you. You can describe your child’s behavior in the intoxicated state and if there is a concern, an ambulance will be sent out. It’s always better to err on the side of caution – there is no reason NOT to call and describe symptoms unless the symptoms are barely noticeable. However, sometimes a child is barely conscious. Sometimes he can’t stop vomiting. Sometimes he is experiencing alcohol poisoning. Unless you already know what to look for, make the call.

Appropriate Response
Even if you think it’s kind of “cute” or funny the first time your child comes home drunk, you should consider the importance of refraining from showing any kind of pride or pleasure in this behavior. Remind yourself that teens are very easily addicted and that addiction will bring them much suffering. Their careers, their relationships and their health can suffer serious negative consequences. Their drunken state can lead to their own or someone else’s death or permanent disability. A teenager may misread your cues, thinking that you are encouraging self-destructive behavior. Be careful to respond seriously and responsibly. Your child’s future is at risk. Everything you say and do at this critical time can have a life-long impact. Refrain from helping your child avoid current consequences of this particular episode – do not cover up. Help him to learn that there CAN be negative consequences. If nothing bad happened during this episode, then make sure you discuss with him at some point, what CAN happen when a person is drunk.

Know Where You Stand
Different parents have different rules on drinking; some demand total abstinence from alcohol, others allow drinking in moderation. Regardless of where you stand on the drinking issue, it’s important you address the situation of your teen coming home intoxicated. Alcohol is an easy drug to abuse. As previously stated, it can also be a dangerous drug leading to life-threatening accidents, legal problems and health problems. You might want to do some research to find out more about alcohol, the state of intoxication, addiction and other issues so that you can talk knowledgeably to your child. Inviting your child to do research WITH you might be even better! It’s best to create rules and guidelines that make sense in the light of the information you have about alcohol – such rules are more likely to be taken seriously by your child. Rules that “make no sense” tend to be defied by older kids. If you and your child do research together, you two can also formulate reasonable guidelines.

First Time Only
If this is the first time your child has come home drunk, education is the correct intervention. Punishment should be avoided. In fact, don’t mention negative consequences at all. If it happens again, however, make a rule that there will always be severe consequences for this in the future. The first two episodes are for education only – not punishment. All other episodes require heavy negative consequences (see the 2X Rule in Raise Your Kids without Raising Your Voice by Sarah Chana Radcliffe).

Seek Professional Help if Necessary
If you think your child is already abusing alcohol habitually, or is at risk of becoming an alcoholic, contract a substance abuse counselor. Alcoholism is an incurable, progressive and fatal disease – it’s best  to intervene as soon as possible.

Your Teen’s Right to Privacy

Today’s teenagers live in a world that their parents often find scary and alien. It seems that there are no protective walls around their youngsters – computers and cellphones open them to a wide world of exposure and vulnerability that the parents don’t even fully understand. Moreover, cialis teens are more independent and are physically away from their parents more hours of the day and night. Parents are losing a grip – they no longer control or even know, what their child is up to. Many take to looking for clues as to their child’s whereabouts and activities, while others insist on constant check-ins and reports on the who, where, what & why of all activities. But how much does a parent really need to know about his or her teen’s activities? How far do the parent’s rights extend – does the parent have the right to full disclosure of all a teenager’s comings and goings? Does a teen have any right to privacy?

If you’re wondering where to draw the line on your teen’s privacy, consider the following tips:

Everyone is Entitled to Personal Space
It is healthy for every child to have a sense of privacy. This helps the youngster develop appropriate personal boundaries, a sense of “me” vs. “you” that helps the child come to know who she is and what she stands for – with the subsequent ability to stand up for one’s OWN values and beliefs. Privacy is attained by maintaining physical privacy – the ability to dress and bathe in privacy and the ownership of a private space (a bed, maybe a bedroom, a private wardrobe, personal possessions that are not for the use of others without permission). Your teenager is at an age where it is inappropriate to rummage through her drawers or belongings. Unless you suspect your teen is hiding drugs, weapons or other dangerous possessions, you have no right to search her belongings. In fact, the kind of privacy you should give your teen is the privacy he or she deserves. If your teen has grown up to be responsible, caring, and trustworthy, then there is no reason for you to watch his or her every move or even suspect impropriety.

Talk about Life
Raise interesting issues for discussion at your dinner table. Raise topics from your weekly news magazine or paper. Talk about what’s going on in the world and in your local community. Talk about violence, crime, sexuality, bullying, materialism, fashion, addictions, war – everything that is out there. Help your kids think about life and clarify their own values. Provide education in discussion format – not lectures and dire warnings. This will help your teen make good, healthy choices.

Be a Good Listener
Kids who can talk about their stresses tend to act out less. Instead of turning to drugs, stealing, sex or other distracting unhealthy activities, your child can turn to YOU for support, approval, comfort and nurturing. Work hard to listen without offering criticism or even education. Just show compassion and trust for your youngster, conveying that you believe in him or her.

Confront Untrustworthy Behavior
Catching under-aged teens drinking alcohol or stashing inappropriate materials are reasons to initiate an intervention, but this response has to be done appropriately. If the disturbing behavior is mild, parental intervention alone may be sufficient – heart to heart talks, discussion concerning consequences and other normal parenting strategies can be employed. If the offence is recurrent, however, or if it is serious, then it’s best to enlist professional assistance. Speak to your doctor for a referral to a mental health practitioner.

After your child has acted in an untrustworthy manner, it is tempting to “check up on him” from time to time. However, acting in a sneaky way is likely to backfire at some point. Don’t do anything that you don’t want your youngster to do. Therefore, if you don’t want to find your youngster searching your purse or your private drawers, refrain from that kind of behavior also. If you don’t want your youngster checking your email or social feeds, don’t do it to him. If something in your child’s demeanor makes you feel concerned, talk about it openly. It’s fine to ask your child to show you (on the spot) his last string of communications with friends if you have serious reason to suspect dangerous or illegal activity on his part. Otherwise, never ask for such a thing.

Some kids who are addicts will act in deviant and sneaky  ways because of their addiction. Work with a professional addiction counselor to create appropriate interventions in the home. If checking on the child is recommended by the counselor, then of course, follow the recommendation.

Checking In
For reasons of common courtesy and safety, it’s reasonable for your teen to let you know when and where he is going. Depending on the age of the teen, it will also be appropriate to ask permission to go there! If you have curfews in place, it is important to expect the teen to comply with them or renegotiate them to everyone’s satisfaction. However, once your teen is out and about, it is intrusive to call and check on him or her. If the child is traveling a long distance, it’s fine for him to call to say he’s arrived (i.e. he has taken a flight), but you don’t need him to call for local trips to friend’s houses. On the other hand, if your thirteen year-old daughter has to walk a few blocks alone in the dark to her destination, you might ask her to call – it depends on the safety of the area in which she is walking.

Act as if your child is completely trustworthy unless your child shows you otherwise. If there is a problem, sit down and try to work it through, explaining your concerns and working towards solutions. If this is insufficient, enlist the help of a professional family therapist. If the child is acting out – engaging in inappropriate and/or dangerous activities – do consider bringing a mental health professional into the picture.

Understanding Your Teen

Teenagers can be challenging to raise. However, knowing what “makes them tick,” can make the job far easier. Let’s look at the typical characteristics of teenagers in order to better understand this period of life.

The following are some of the hallmarks of the teenage years, and some tips on how parents can help navigate them:

Rapid Physical Changes
Adolescence is a time of many physical changes as children gradually transform into young adults. For boys, there is a “growth spurt” — a rapid increase in height and weight, sometimes followed by changes in bone structure. Hair starts to grow in different places: the face, the armpits, the legs and the pubic areas. The adolescent’s voice deepens, and sounds more “grown up.” There are increases in muscle mass and strength as well.

Girls are also have sudden increases in height and weight. Breasts develop, hips become more defined, and body hair grows in the pubic and armpit areas. This is also the time when menstruation begins, often bringing along hormonally induced mood swings.

In both genders, the skin becomes more sensitive and sweaty, making adolescents more prone to pimples or acne. Kids develop at different paces – some making early changes and others making later ones. Often, kids are self-conscious about where they are in the normal distribution. Everyone wants to be “average” but of course, that isn’t possible. As a result, teens can feel embarrassed, inadequate or otherwise troubled by their physical changes: boys with squeaky voices and girls with flat chests can feel temporarily inadequate or self-conscious. Sometimes, the lingering consequences of insecurity can last for decades. Parents can help by being sensitive to their teens, never making rude jokes or unkind remarks. After all, every human being must go through adolescence on his or her way to adulthood. The gentle support and guidance of a parent can make the transition easier.

From Parent Approval to Peer Approval
At this stage of development, your child’s main focus of attention will shift from you to their same-aged classmates and friends. They may now prefer to spend more time with friends than with family members. Some kids don’t even want to be seen with parents in public! It’s all part of the push toward independence. Their “cutting of the apron strings” is a temporary phase: as your child journeys to adulthood, a healthy balance between family life and social life will emerge — and you’ll regain your place in their heart.

Testing Limits
As mentioned, kids at this time are exploring their identity and independence. Testing of rules and limits is all about pushing the borders now, bursting out of the protective shell. Teens might violate curfew, disobey house rules, experiment with various risk-taking behaviors, and constantly negotiate their “rights.” You might bring books home from the local library on subjects like smoking, alcohol, sex, drug use and so on. There are many books for this age group designed to be appealing to teens – with pictures and simple explanations this literature can provide the warnings and education your child needs in a teen-friendly way. Books can be a better method than dire warnings from an anxious parent.

At this point, parents should strike that balance between being understanding of their child’s need to be autonomous, and setting reasonable and consistent rules for their child’s safety and well-being.. As a rule, try to accommodate the new freedoms they ask for, for as long as safeguards are in place. Take the opportunity to teach about responsibility and accountability. It’s important NOT to establish rules that none of their friends have. Instead, allow your child to be a normal teen within his or her community and try to put your own fears to rest. It can be helpful to access the help of a parenting professional or mental health professional to get normal parameters such as age-appropriate curfews on weeknights and weekends, dress codes, use of alcohol and drugs and so on. If you have an accurate frame of reference, your rules will be more appropriate – and your child will probably have a greater respect for your decisions, which might lead to greater compliance with your rules.

An Increased Interest in Sexuality
Your child will now be showing an interest in all things sexual including advertisements, internet porn, and real people. Don’t be surprised if you see your normally “plain and simple” son or daughter dolling up a bit, and taking an interest in grooming, fashion and flirting. This is all a normal part of the growing up process. Modern teenagers may be more open about sexuality than older generations and may want to be sexually active and more sexually active at earlier ages. Many kids in today’s society are confused about their sexual orientation and some may benefit from professional guidance. Your job is to share your values, provide information and establish clear expectations. You probably don’t want your child to be making babies just quite yet but teenagers don’t automatically know how to prevent that from happening. Teach responsibility and safety in sexuality – don’t assume that your child has learned this at school or on the street. Your child needs to know about sexual diseases as well and how to both prevent them and identify early symptoms. Some parents arrange for the child’s doctor to explain the details of contraception and sexual protection from pregnancy and disease.

Marijuana Use

According to recent reports, erectile one in fifteen teenagers is using marijuana on a daily basis. More 10th graders smoke marijuana than cigarettes. On the other hand, order other forms of substance abuse are declining among this group – including alcohol use and other drugs.

What are the Immediate Effects of Marijuana?
Short term cannabis use (marijuana/weed/hemp/pot/grass and other slang names) often stimulates feelings of relaxation and elevated mood.  Appreciation for art and music may be enhanced or at least artistic appreciation might feel enhanced! Ideas can flow rapidly and the user may become quite talkative as well. In fact, pilule cannabis users may experience a variety of effects upon intoxication, including becoming hungry, having the giggles, experiencing hallucinations, experiencing increased  anxiety, suffering impaired motor coordination, experiencing increased fatigue and lowered motivation. However, a user will usually appear more or less normal to outside observers, even when he or she is highly intoxicated.

What are the Effects of Cannabis Intoxication?
Intoxication (getting “high”) is a disturbed state that often begins with symptoms of mild anxiety that can later progress to feelings of panic and might also include distortions in time perception, impaired judgment, impaired learning and problem-solving, euphoria, social withdrawal and motor impairment. Marijuana can also increase feelings of depression. Marijuana’s negative impact on memory and learning can last for days or even weeks after intoxication. Regular users may therefore be in a state of continuous lowered intellectual functioning. Those driving cars while intoxicated on marijuana have slower reaction times, impaired judgment, and impaired response to signals and sounds. Impulsivity increases, as does risk taking behavior. Physical symptoms can include dry mouth, rapid heart rate, red eyes and increased appetite.

The most common untoward reaction to cannabis is the development of an anxiety disorder, but use of the drug can also lead to serious psychotic disorders in those who are vulnerable. Vulnerability is associated with early use of marijuana (prior to age 18)  – in which case users have 2 to 4 times the frequency of psychotic illness occurring by young adulthood.  Also, those who start taking marijuana before age 18 have a much higher incidence of becoming addicted to the drug. Lastly, it appears that adolescent users are susceptible to drug induced permanent brain changes that affect memory and cognitive functioning.

What are the Effects of Cannabis Withdrawal?
When addicted users go off marijuana, they experience unpleasant symptoms such as irritability, anxiety, cravings for the drug, sleeplessness and decreased appetite. The symptoms are unpleasant enough to make abstinence challenging. They peak at 2-3 days off the drug and then subside within a couple of weeks. The most likely people to become addicted to marijuana are those who have started its use while in their teens and those who use the drug daily. Addiction is characterized in part by continued use of the substance despite negative effects on relationships, work or school performance or  other aspects of functioning.

Treatment for Cannabis Intoxication
Treatment can range from in-patient hospitalization, drug and alcohol rehabilitation facilities, to various outpatient programs and individual drug therapy counselling. Narcotics Anonymous (twelve-step programs) and other such group support programs are also helpful treatment options.

The Role of Parents
There’s much that parents can do to help their children avoid experimenting with or seriously using marijuana. Here are some ideas:

  • Bring home education books from your public library and leave them lying around with other books. Alternatively, leave them in the bathroom for “reading material.” Books written for young people on this subject are appealing to the age group with lots of simple information, pictures and user-friendly guidance.
  • Talk about drugs and alcohol at your dinner table. Give your opinions and share your knowledge.
  • LISTEN to what your kids are saying – without criticism, negative feedback or judgment. You don’t want them to shut down and keep their thoughts (and actions) to themselves. Instead, show thoughtful interest and curiosity and try to relate what they are saying to your own adolescent and current life experience.
  • Teach your kids healthy ways of managing stress – don’t assume they know how to process hurt, anger or fear. Bring home books on stress management and emotional awareness and talk about these things at your table.
  • Offer your kids professional counseling when they seem to have too much stress or when they are withdrawing, very anxious, suffering from insomnia, seem to be in low mood or otherwise seem emotionally off balance. You don’t want them to discover the pleasure of “self-medicating” through drugs!
  • Strengthen the emotional stability of your family, the health of your marriage and the happiness of your home through education and counseling as necessary – a happier home environment is preventative as far as heavy drug use goes.
  • Use an authoritative style of parenting – have some rules and boundaries but emphasize warmth (see “Raise Your Kids without Raising Your Voice” for a balanced parenting strategy). Refrain from using too many rules, too much criticism or too much anger.

What is an Eating Disorder?

Eating is a way to get nourishment and sustenance; it is, for the most part, a pleasant and fulfilling act. Sometimes, however, eating becomes part of a disabling or even life-threatening disorder.

What is an Eating Disorder? 
As the term implies, an eating disorder is a mental health condition that is characterized by dysfunctional eating patterns such as overeating, deliberate starvation, binging and purging. Eating disorders are associated with extreme concern or anxiety related to one’s body shape, size or weight. Some family therapists have conceptualized eating disorders as illnesses related to issues of control, like addictions or obsessive-compulsive disorder. Whatever the cause, an eating disorder is conceded as both a physiological and a psychological problem.

Who are at Risk? 
According to the National Institute of Mental Health, eating disorders occur frequently among adolescents and young adults, although there have been reported cases of childhood eating disorders and eating disorders that occur during late adulthood. The disorders are more prevalent among women than men, although in recent years, men are suffering in greater numbers.

What are the Types of Eating Disorders?
Types of eating disorders may include:

Anorexia NervosaAnorexia Nervosa is characterized by the relentless pursuit of thinness despite severe negative consequences. People with Anorexia Nervosa are convinced that they are too fat or too heavy, even if objectively they are already underweight. They may therefore engage in excessive dieting, self-induced vomiting, overexercising, the use of diuretics and laxatives, and abuse of weight management pills. Alarmingly, people with Anorexia Nervosa are ten times more likely to die from the condition than those without the disease.

Bulimia Nervosa. Bulimia Nervosa is an eating disorder characterized by repeated patterns of binging and purging. Binging refers to the consumption of large amounts of food in a short time, e.g. eating several plates of pasta in one sitting. Purging refers to the compensatory action to get rid of the food or calories consumed during the binge episode. Purging techniques include the ones people with Anorexia use to lose weight, e.g. self-induced vomiting, laxatives, diuretics and overexercising. Unlike sufferers of Anorexia, people with Bulimia may have normal body weight.

Obesity. Obesity is a condition of excess weight – essentially the result of consuming more calories than are needed for energy. It can affect a teenager’s self-image and self-confidence and it can also affect his or her health. For instance, obesity is sometimes associated with the development of insulin resistance – a sensitivity to sugars in the blood. This condition can be a precursor to a more serious condition such as diabetes.

How are Eating Disorders Treated?
There are three steps to treating eating disorders.

The first step is the physiological or medical intervention. Eating disorders may be classified under mental health issues, but they carry with them serious medical effects. People with Anorexia Nervosa, for example, can suffer from severe malnutrition that serious and irreversible damage to vital organs occur. Eating disorders may even be fatal if not arrested in time. Therefore the first order of business is to restore the patient to an ideal weight, address nutrient deficiency, and treat the medical side effects of the condition.

The second step to treating eating disorders is psychological assistance. Counseling and therapy must be employed to address the psychological reasons behind the dysfunctional eating patterns. Eating disorders are related to dysfunctions in perception of one’s weight or shape. Often, patients suffer from low self-esteem, obsession about body weight, and a sense of helplessness about their situation. It is also not unusual for other mental health issues to develop because of the eating disorder, such as depression, anxiety and substance abuse.

The last step is maintenance to prevent relapse. Like people with addictions, those with eating disorders must consistently monitor their behavior even after treatment to prevent symptoms from recurring. Joining support groups, on-going family therapy, and education about proper nutrition and weight management are ways to maintain progress in recovery from eating disorders.

How Can You Tell if Your Child is Suffering from an Eating Disorder?
You will not be ablet o diagnose an eating disorder on your own. However, what you CAN do is take your child to a doctor or psychologist for assessment if you suspect that something isn’t right. Most parents are able and willing to do this when they see that their child is overweight. However, kids suffering from bulimia may be a totally normal weight. Kids suffering from anorexia may gradually lose weight and cover it up with clothing (and excuses). However, there are some red flags that can alert a parent to the need to have the child assessed. For instance: consuming large amounts of food without gaining weight is a red flag for bulimia. Playing with food on the plate, cutting it into small bits and moving it around, becoming increasingly picky as to what is fit to eat and clearly not eating much, may be red flags for anorexia. Other symptomatic behaviors include being very cold, growing a thin layer of hair on the skin, engaging in excessive amounts of exercise, buying laxatives and vomiting without being ill. Don’t get into a conversation with your child about whether or not he or she has an eating disorder. Instead, tell your child that diagnosis will be left up to a professional.

Anorexia

The eating disorder known as “Anorexia” has become so common, that almost everyone now knows what it is. When we think of anorexia, we think of excessively skinny people – sometimes with a skeletal appearance of skin and bones – whose lives are at risk due to malnutrition. And this is exactly what the disorder leads to. Anorexia is a condition that causes people to starve themselves.

Anorexia Nervosa used to be a condition that was most commonly found in individuals whose professions demand subscription to particular “body image.” Models, actors and physical trainer, for instance, have long suffered from eating disorders because their jobs require them to look a certain way.

Unfortunately however, the incidence of Anorexia Nervosa is climbing among the general public, with highest rate found in adolescent girls. Furthermore, onset age of the disease get lower and lower each year, with girls now as young as 7 years old succumbing to the illness. It may be that the way the media portrays attractiveness, the decreased focus on healthy eating habits, and the decrease in parental guidance as dual-income families and divorcing couples increase, all contribute to the rise in adolescent anorexia.

What are the Symptoms of Anorexia Nervosa?

Anorexia Nervosa is an eating disorder characterized by an irrational obsession with having a thin body.  A person with Anorexia controls his or her body weight by limiting food intake and also by attempting to “un-do” eating by inducing vomiting, using laxatives or exercising excessively. When kids start restricting their diet to very low calorie foods, start obsessing about and avoiding “bad” foods like fats and carbs, cut up their food in small pieces and shuffle it around their plates, wear baggy clothing to hide protruding bones, claim they’ve eaten when they haven’t, exercise way too much, and so on, it’s time for parents to be concerned.

People with Anorexia suffer from a distorted body image. Regardless of their actual weight and height, or of their objective appearance in the mirror, they still feel that they are “too fat” and need to lose some weight.

Types of Anorexia Nervosa

There are two more common types of Anorexia Nervosa: a “restricting type” and a “binge-and-purge” type. Those who belong to the first type obsessively lose weight by fasting or eating extremely small portions. Those who belong to the second type alternate between binging (eating large quantities of food), and then later finding ways to remove the eaten food before the food is digested.

A Serious, Even Fatal Disorder 

Anorexia, like all eating disorders, must be taken seriously. It is not a “teenage fad,” but rather a serious health risk.  Aside from the psychological impact of the disease, Anorexia Nervosa can result to many serious physical conditions — even death. Starvation alone may result into cardiac arrhythmia, hypotension, gastric issues and low blood pressure — not to mention various complications resulting from many nutritional deficiencies. Anorexics may require hospitalization, and a full physiological therapy, before they can even start dealing with the emotional issues associated with the disease.

What Can Parents Do? 
Given the seriousness of this disease, what can parents do to protect their children?

Preventing Anorexia Nervosa in one’s home begins by promoting a healthy body image for the family. Contrary to what the media promotes, there is no one measure of attractiveness and beauty. Similarly, body size and shape doesn’t necessarily equate to health — ethnicity, bone/muscle mass and body structure must all be taken into account before one can be considered as underweight or overweight. While parents are recommended to be health and diet conscious in the home, they must also be affirming of their child’s natural beauty so as not to encourage a pre-occupation with body image. Neither parent should praise a child for being skinny. A thin body type is simply an inherited characteristic – as is a softer, bigger look. As long as your child is not eating poorly (i.e. living on a diet of coke and cookies, munching chips and ice cream instead of eating dinner), then just help him or her to learn the basics of dressing well. For instance, a “square” shaped child will look better in a certain type of sweater/pant or skirt combination than in a different kind of outfit – teach your adolescents about dressing to highlight their own good looks. Much can be accomplished with a few library books on the subject. If your child is actually eating poorly, encourage good eating habits without becoming so intense about it that the child swings the other way; many anorexics were once overweight and compensated by going too far in the other direction. When parents are too invested in the child’s “look” they may accidentally nurture the seeds of disease.

Even more important, however, is the emotional climate of the home. Kids act out their stress with eating disorders, so try to create and maintain a fairly low-stress environment. This means, work on your marriage (or even your divorce) so that there isn’t a lot of hostility being displayed, refrain from raising your voice or using very stringent punishments, keep demands light and reasonable considering the age of the child, bring laughter and love into everyday interactions EVERY day, and don’t get too stressed yourself. Although nothing a parent does can guarantee that a child won’t succumb to eating disorders, taking these steps can reduce the chances.

If you suspect that your child is developing symptoms of anorexia, then go with the child to a medical appointment to obtain a formal assessment. You can tell your child, “I’m not an expert. I don’t know if the way you are eating and the way you look is fine or not. I am, however, feeling concerned. So I’ve made an appointment for us to see Dr. So and So, who can tell me where things stand. If there’s no problem – great! I’ll leave you alone. But if there is any problem, then we can help you with it.” Such an appointment should never be optional. If you thought that your child’s lump on her skin was suspicious, you wouldn’t ask her to please come for a biopsy. You would TELL her that she needs to be seen by a medical professional. You would not allow your child to refuse to go, knowing that untreated cancer can be life-threatening. In the same way, you need to use all of your parenting power to get your child to a doctor when you suspect the life-threatening disorder of anorexia.

Only Eats Junk Food

Is your child a junk food addict? It’s not really surprising. Junk foods are readily available these days and can tempt anyone – especially children. While junk foods may be enjoyed as a special treat – as part of a birthday celebration or some other special occasion – regular ingestion of these products is unhealthy, leading to an array of issues ranging from cavities to diabetes. But how can parents get their children to enjoy real food that can truly nourish their bodies and souls?

If your child only eats junk foods, consider the following tips:

Start Early
If you can instill a love for healthy foods as early as toddlerhood, your child is less likely to jump on the junk foods bandwagon. After all, kids crave what their taste buds are used to. Introduce soft drinks, cakes and chips early in life, and you’ll be battling them for years. But introduce healthier alternatives like grains, seasoned vegetables, tender meats, cheese and yogurt, and fresh fruit to your young child, and they’ll enjoy these healthy foods for a lifetime. Since you have more control over your toddler’s diet than you will have at any point in the child’s life, it’s up to YOU to get your child started right with food. However, your child will also be exposed to your own diet and to the foods of others around him. If sweets and empty foods are being consumed by others (as they most likely are), don’t deprive your child! Rather, offer the occasional sugar-free look-alike (homemade cookies sweetened with juice, Stevia or agave), sugar-free candies and the occasional actual sugar treat. Junk food in moderation will not harm your child, just be careful that it is not consumed in excess.

Refrain from “Doctoring” the Food
Something that parents learn quite early is that making food sweeter increases its likelihood of being ingested. They put (sugar-based) ketchup on food and magically, their youngster eats it. They put chocolate chips on it, chocolate syrup in it, spoonfuls of sugar all over it and it suddenly becomes appetizing. Although most parents are aware that the sugar is not good for the child, they are just happy that the child is eating the good food along with the not-so-good food. In their mind, it is worth a bit of empty calories to get their child to eat some nutritious foods.

Unfortunately, in their enthusiasm to have the child eat something, parents have sacrificed long-term good eating habits for short-term meal solutions. They are soon dismayed to find that their child no longer likes anything that isn’t sugar-coated. Now they have a toddler who eats sweet cereal, chocolate milk, candy and french fries, but little that is actually good, normal, nutritious food. When the problem gets so out of hand that parents can no longer justify doctoring the food to make it palatable, they want to know how to retrace their steps and get their child eating right.

Serve Junk Foods Only When Kids are Full
Some parents believe that junk foods can be consumed as an occasional guilty pleasure. After all, an ice cream cone now and then can be a great treat. However, if you’d like to treat the family to occasional junk foods, try to do it after your child has eaten a full meal. This way kids won’t be tempted to eat too much of the bad stuff – as they have already eaten something. Allowing your child the occasional junk food treat – instead of letting junk food be the staple food of your child’s diet – will also make your child appreciate it more as the treat it is meant to be.

Limit the Processed Sugar in Your Child’s Diet
Research has shown that the more we eat sugar, the more we crave sugar. As most junk foods are rich in sugar, they are a natural choice to manage sugar cravings. To limit your child’s junk food intake, stick to sugarless alternatives (and there are many). To satisfy that sweet tooth, use dried fruits in moderation, fruit juices, Stevia (a herbal product), xylitol, palm sugar, coconut sugar and other low glycemic alternatives. None of these produces the sugar spike and sugar cravings that real sugar creates.

At first, your child may refuse to eat what you offer – don’t worry about it. In fact, you WANT the child to reach a state of hunger. Don’t worry – you’re child won’t let him or herself starve; rather, when hungry, he or she will be much more willing to try a new food. All food actually tastes a lot better when a person hasn’t eaten for awhile – when the person is really hungry. Now that the child has had even a small amount of real food, he or she will eat it again (because it was, at least, edible and perhaps even, good). Research has shown that after just one week of eating a food, it will start to taste really good, even if the person didn’t like it originally. For instance, a child who is used to drinking cow’s milk finds that cow’s milk tastes good. When offered a milk substitute for the first time (soy, rice, hemp or almond), the child will often balk. However, if cow’s milk is withdrawn from the diet and only the substitute is offered, the substitute will indeed indeed begin to taste good and normal, after only a few days. If the substitute is continuously given, then cow’s milk will be the unusual and odd-tasting food.

Using these principles, parents can re-train a junk-food addict of any age. However, the job is easiest with toddlers. Toddlers can’t help themselves to food, so they are totally dependent on what they are fed. As long as parents are willing to be firm and consistent, withdrawing sugar from regular meals and limiting it to rare snacks given at specified times during the week (i.e. the child gets a cookie snack in the afternoon daily, but never gets any other sugar in her diet), the child will soon be eating and enjoying real food!

Make Simple Rules
Instead of fighting with your child about junk food, make simple rules about its permissibility and stick to them. For instance, you can have a rule that candy is served only on Saturday – never at any other time. Or, you can have a rule that plain cookies and pretzels can go in a lunch box, while fancier cookies and pastries are for Sunday brunch only. Perhaps you want a rule that states that potato chips and colas are only served at family gatherings (birthday parties and celebrations). You can make any rule you like, but try NOT to make a rule that permanently and totally prohibits all junk food – such rules tend to cause kids to become obsessed with getting their hands on candy and other unhealthy snacks. Serving it in moderation at predictable times helps prevent obsession and other nasty behaviors like stealing other kids’ snacks. If children are served delicious healthy foods most of the time, they tend to have little craving for the junk.

Prepare a Healthy Lunch Box
If the school canteen has an array of tempting junk, try to provide school snacks from home. Eliminate the need to visit the cafeteria by packing your child a healthy snack box. Health food stores carry a large selection of delicious junk-food look-alikes and, if you have time to bake, you can control your own ingredients to make nutritious and delicious treats that your kids will love. They really won’t be pining for the canteen. Does your child yearn for cool packaging? Maybe you can even wrap your goodies in an appealing way. Here’s your chance to be creative!

Be Firm, Consistent and Patient
Don’t be swayed by your child’s tantrums and tears. Instead, simply remain calm and firm. No need to scream back! Just learn to say, ‘No.’ Don’t worry – as long as you don’t start yelling, your child will still love you plenty even if you stop feeding him or her tons of junk food. You needn’t be afraid of your child. You are NOT hurting your child by limiting junk to a small percent of the diet. On the contrary, you are helping your child be healthy life-long. Your child is too young to appreciate that right now, but YOU know the truth. Your child needs to learn to gracefully accept your guidance and limitations and is much more likely to do that when you remain calm, firm and consistent. Eventually, your child will stop protesting, settle down and enjoy his or her food. Patience will pay off.

Bulimia

Bulimia is an eating disorder – but one that is not necessarily easy to spot in one’s own child. Other eating disorders are more visible. For instance, pills almost anyone can recognize obesity – a condition in which the sufferer is significantly overweight. People can also often recognize cases of anorexia nervosa – the condition in which a person is severely under his or her ideal weight (and may therefore look painfully skinny and boney). However, it is not possible to identify someone with Bulimia Nervosa just by looking. The sufferer of this eating disorder may be a perfectly normal weight. It is not the WEIGHT that is disordered in this condition, but rather the way in which the person maintains that weight.  A bulimic (one who suffers from bulimia nervosa) eats way too many calories in one sitting (for example, a number of grilled cheese sandwiches, a full tub of ice cream, a box of crackers, a bag of chips and a plate of waffles). This episode of overeating is called “bingeing.” It is normally followed by feelings of panic (about gaining too much weight), shame and guilt and an intense effort to “undo” the eating behavior by engaging in excessive exercise or using laxatives to empty the gut, or inducing vomiting for the same purpose. Episodes of bingeing and purging (over-eating and then “undoing” the calories somehow) can sometimes occur many times a day. On average, people with Bulimia binge 12 times a week, consuming as much as 11,500 calories. Foods rich in processed sugar and fat, such as pastry, ice cream, bread and donuts are the most common objects of binges.

Bulimia Nervosa is more common than Anorexia, and affects girls more than boys.

Signs of Bulimia
Although parents can’t tell from LOOKING at their child that the youngster is suffering from bulimia, they may be able to discern a problem by observing their child’s behavior. Those suffering from bulimia usually feel a lack of control when it comes to eating. While most of us stop eating when we feel full, those with bulimia keep on eating to the point of feeling pain.  This inability to control their eating can be very embarrassing and typically bulimics try to hide their binging and purging.  Some typical symptoms that may indicate bulimia are:

  • Wanting to eat alone
  • Eating very little in public
  • Frequent trips to the bathroom after meals
  • Disappearance of food
  • Hidden stashes of junk food
  • Eating large amounts of food without putting on weight
  • Excessive exercising
  • Using laxatives, enemas or diuretics

People with bulimia may also have physical symptoms caused by purging.  These include:

  • Puffy cheeks caused by repeated vomiting
  • Discoloured teeth caused by exposure to stomach acid when throwing up
  • Frequent fluctuations in weight
  • Calluses or scars on knuckles and hands caused by putting fingers down the throat to induce vomiting

An Impulse-Control Issue
Are sufferers of Bulimia Nervosa aware that their eating pattern is dysfunctional? Yes. However, they have difficulty controlling themselves; the act of binging and purging is a compulsion. In fact, many Bulimics report that they only stop a cycle of binging or purging when they feel physical pain. Otherwise, they can’t help themselves. They have a compulsion that is too strong for them to overcome, much like an addicts relationship to his substance.

Bulimia Nervosa has been linked to emotional stress as well as body image issues. Low self-esteem, a history of abuse, a difficult life transition, traumatic experiences and other stresses have been found to be higher in those suffering from Bulimia. In addition, there is a higher rate of bulimia in those who are drawn to a body-conscious hobby or profession like modeling, ballet, gymnastics or physical fitness training. It is not clear whether the activity and peer pressure found in the activity actually induces bulimia or whether those with bulimic tendencies (obsession about body image) may choose those activities to begin with.

A Serious Health Threat
Bulimia is a serious health issue. Chronic bingeing and purging can cause serious gastro-intestinal diseases. The purging (in the form of vomiting, laxatives, and diuretics) can lead to electrolyte imbalances, usually in the form of low potassium levels. Low potassium results in symptoms such as lethargy, confusion, irregular heartbeat, and cardiac and kidney dysfunction. In severe cases it can even cause death. Other effects of bulimia may include:

  • Weight gain
  • Constipation caused by chronic laxative use
  • Abdominal pain and bloating
  • Tooth decay
  • Chronic sore throat and hoarseness
  • Broken blood vessels in the eyes
  • Weakness and dizziness
  • Loss of menstrual periods
  • Acid reflux

Risk Factors
Bulimia generally begins in adolescence and 90 – 95% of those with the disease are women.  There is no single cause for bulimia but low self-esteem and poor body image are often contributing factors.  Some of the more common risk factors for bulimia are:

  • Dieting – people who diet on a regular basis are more likely to develop an eating disorder than those who don’t.
  • Involvement in professions/activities that emphasize weight control – the pressure placed on gymnasts, dancers, models, actors, and other athletes to maintain a certain weight can lead to the development of eating disorders.
  • Low self esteem – this can be a result of abuse, depression, a critical home environment, and a desire for perfection.
  • Poor body image – young women are often influenced by our culture’s glorification of thinness and beauty.
  • Major life changes – bulimia is sometimes a reaction to stress, which can accompany a major life change.  Examples of major life changes may be; moving away from home, puberty, divorce, and the break-up of relationships.
  • Biological factors – since eating disorders run in families there is likely a genetic component.  In addition, research indicates that low serotonin levels play a role in bulimia.

Treatment for Bulimia
Treatment for Bulimia should be a combination of a medical and a psychological program. At times, an in-patient weight management program needs to be implemented alongside counseling in order to address the two critical aspects of the illness. Most often, however, bulimia is effectively treated on an out-patient basis. People do heal from this disorder. They may have relapses occasionally but when they learn effective stress-management techniques they can usually prevent relapses over the long-run. Seeking counseling and using self-help strategies are both important for long term recovery.

Psychotherapy is the main form of treatment for bulimia.  Specifically, cognitive behavioural therapy is often used to break the binge-and-purge cycle and change unhealthy thought patterns.

Medication such as anti-depressants may also be used.  These help to reduce binge eating and treat the depression that is often a part of bulimia.

Suicidal Feelings

A certain number of people kill themselves each year, most of whom were suffering from severe depression. Fortunately, 90% of people with depression are able to live full lives while managing their episodes of depressed mood. Only about 10% will end their lives (this number depends on where a person lives – countries vary in their availability of effective treatments and support for depression, so there is a wide international variability in suicide rates).  The pervasive sad mood that comes with depression, as well as the increased tendency among the depressed to obsess on negative thoughts, makes them susceptible to the hopelessness and irrationality characteristic of the suicidal person. People do not “choose” suicide; they fall victim to it as part of their illness.

What are the Implications for Parents?
The link between suicidality and depression should serve as alarm bells when helping our children deal with mental health issues. If we have a loved one who is suffering from depression, it is always prudent to watch out for signs of suicidality. A depressed child is at risk for succumbing to suicidal thoughts; it is up to parents to help prevent this. Vigilant parents can be familiar with the warning signs of suicidality and take action. Moreover, they can do everything possible to get their child the right kind of help. In addition, they can work hard to reduce the other stressors in the child’s life – like school work (negotiate accommodations with the school) and conflict in the home. In fact, when the parents work on their own marriage and parenting skills to increase peace in the home, this can help tremendously.

What are the Warning Signs?
According to the American Academy of Child and Adolescent Psychiatry these signs are:

  • Change in eating and sleeping habits
  • Withdrawal from friends, family, and regular activities
  • Violent behavior or running away
  • Substance abuse
  • Neglect of personal grooming
  • Personality change
  • Difficulty concentrating, persistent boredom
  • Drop in academic performance
  • Marked personality change
  • Frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc.
  • Loss of interest in previously enjoyable activities
  • Speaking positively about death or romanticizing dying (“If I died, people will appreciate me more.”)
  • Writing about death, dying, or suicide
  • Engaging in reckless or dangerous behavior; being injured frequently in accidents
  • Giving away or discard favorite possessions
  • Saying permanent sounding goodbyes to friends and family
  • Seeking out weapons, pills, or other lethal tools

A child or teen  who is planning to commit suicide may also:

  • Complain of being a bad person or feeling rotten inside
  • Give verbal hints with statements such as: “I won’t be a problem for you much longer.”, “Nothing matters.”, “It’s no use.”, and “I won’t see you again.”
  • Become suddenly cheerful after a period of depression
  • Have signs of psychosis (hallucinations or bizarre thoughts)

The risk of suicide is high among those who have attempted suicide before, know someone who has killed themselves, and are pessimistic about the chances of getting relief from chronic depression. Also, teens who have a family history of mental illness and suicide are more likely to attempt suicide as are teens who have clinical depression or who suffer from active addiction. Teens who’ve already made a suicide attempt have a higher chance of committing suicide successfully. Vulnerable teenagers who suffer a serious loss (like the breakup of a romantic relationship) may try to stop the pain with suicide. A history of physical or sexual abuse, incarceration, alienation from parents and refusal to access mental health services all increase suicidal risk. Males have a higher “success” rate for suicide than females, but females make many more suicide attempts than do males. Also take note if your depressed child suddenly seems unusally happy. Sometimes this switch in attitude happens because a child has decided to end his suffering and he is actually experiencing a state of relief. Remember that depressed mood is a serious and potentially life-threatening condition and should always be professionally treated.

The American Academy of Child and Adolescent Psychiatry recommends taking a child’s suicidal statements seriously. If a child or adolescent says, “I want to kill myself,” or “I’m going to commit suicide,” ask him what he means. Don’t be afraid of saying the word “suicide.” You won’t be giving the teen an idea that he hadn’t thought about. Instead, you’ll help him or her think things through. Ask about depression, anxiety and unhappiness. Don’t just tell the child no to talk that way.  Show interest and concern and get your child to a qualified mental health professional (such as a psychiatrist or clinical psychologist).

Suicidal Behavior in Teens
Teenagers are a vulnerable group. They experience tremendous pressure from all sides: from inside their changing bodies, from their parents, from their schools and from their peers. No one can be perfect in every area and so everyone is doing poorly in something. But teenagers can feel isolated with their failures and setbacks, lacking the perspective that older people have that “we’re all in this together.” Teenagers are intent on fitting in, looking good, being acceptable. If the only group they can fit into is a violent, drug-ridden street gang, then that’ll be the group they might very well join, especially if they have little support elsewhere or few sources of success and strength.

Because the pressure is so intense, many teens do not cope well. Their survival strategies depend to a large extent on their genetic make-up and the strategies they learn at home. Some teenagers have “hardy” genes that help them survive and thrive under stressful conditions. They can laugh their way through almost anything or simply tough it out. Others are genetically vulnerable to bouts of depression. However, the depressed teen is more at risk than depressed adults. Teens are very focused in the present. They have trouble imagining that in a few years life can improve tremendously. Their impulsivity can lead them to put an end to it all right now because they just can’t see any way out.

What You Can Do
Parents can also help buffer teens from stress by keeping the doors of communication open. Make it easy for your kids to talk to you. Keep criticism to a minimum; instead, give praise and positive feedback generously. Have fun with your teenager and try to make your home pleasant, comfortable and safe. Keep conflict down with your spouse. Avoid drama. Take care of yourself and create a healthy model of stress management strategies for your kids to learn from. Create a positive atmosphere. Have a dinner table several times a week and use it to have discussions on politics, human nature, interesting things in the news or whatever—keep talking with your kids. Make your values clear. Bring tradition and ritual into your home.  Accept all feelings without correction or disapproval. Ask for behavioral change gently and respectfully. Never yell at your teenager. Never insult, name call, use sarcasm or any other form of verbal abuse. Instead, be sensitive to your teen’s feelings at all times. Discipline when necessary but only after you’ve warned a child that discipline will occur and only with mild discipline—never affecting the teen’s social life (see Raise Your Kids without Raising Your Voice for safe and effective ways of guiding teenagers).

If your teen demonstrates any of the symptoms of depression or suicidality, talk to him or her about what you are observing and arrange an appointment with a mental health professional. You can call suicide helplines in your area to get information about how to help your child. You can take your child for a mental health assessment. If your child is uncooperative, seek mental health guidance yourself. Since a suicidal person feels isolated and hopeless, any steps that family members take to address the situation can be powerfully preventative. Remember, too, that many parents have walked this road before you. Access on-line and community support if your child has been threatening suicide.