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How do you know?
with Karen Danielson, RN
How do you know if your teenage daughter has an eating
problem? (Or your son-- rarer but it happens.) So many
girls and young women have written in to the Sneaky Kitchen with eating
disorders, or mothers or other loved ones asking for advice dealing with picky
eaters, that I asked Karen Danielson what to look for. Karen is a
Registered Nurse and is in charge of the Student Clinic at a college in
Karen, as I do, feels food is health, food is pleasure and
food is love, and while she isn't a specialist in eating disorders, she
certainly encounters it frequently while counseling students. In
fact, this problem is so pervasive in our society that their college has a
specialist in eating disorders on staff, as many probably do. I can tell
from the tone of Karen's answer that the cases of bulemia, anorexia and other
eating disorders she handles grieve and outrage her for the sake of the
sufferers, as they do me. Here's her comments on eating disorders in
general and some specific advice:
Most anorexics, for instance, have a control issue.
'You can control what I wear, who I date, where I go, where I go to college,
but you can't control what I put in my mouth!!!'. They are usually in
denial, i.e. 'I always eat meals. I'm not denying myself food in any
People with eating disorders are great at manipulating those who try to
intervene. Girls often are great at telling you what you want to hear;
they try to be the perfect daughter; they try to excel in everything they
do, especially academics. They are genuine people pleasers and they
please everyone but themselves. They usually have 'hungry hearts'.
They often work in fast food places, pizza places, anything to do with food,
and all the while they won't touch it. They love to be in the midst of
the temptation of food and be able to not eat it. Again, it's an
exercise in control. And when they succeed they are very pleased with
themselves. They may feel triumphant!! They may make every
excuse in the world as to why they're not eating like, 'I just ate',
'I'm going out for a big dinner and I want to be hungry', 'I'm a
really picky eater and I don't eat meat', 'Oh no, I don't eat anything
like that, I'm a vegetarian', on and on, ad infinitum. But it's
all a cover-up for the root problem.
Food is basic. It's life-sustaining, it's comfort, it's enjoyment and
pleasure. People with eating disorders often withhold food from
themselves because they think they are undeserving of the pleasure food
Eating disorders are a fascinating (although
distressing) subject to me, because I have this perpetual love affair with
food and I just can't even imagine going with out it. I have a hard
time doing a 12 hour fast for blood work for heaven's sake!!
There's an excellent resource at
www.gurze.com. But while
do-it-yourself help manuals are helpful adjuncts, at times, I would never
recommend them as the only source of help.
An excellent explanation, Karen. As you mention
elsewhere in our correspondence, most colleges and universities have qualified
and confidential counselors. For Junior High and High School girls, a
first choice may well be a dietitian who can assess the problem and make
recommendations for other counseling if required. Or visit your
family physician first and explain the problem, asking for referral to a
specialist, especially if you are are member of an HMO. Insurance
sometimes covers some or all of the cost, but if money is a problem, almost
every community has clinics that base their fees on ability to pay.
"Most professionals who deal with people who have
eating disorders are not judgmental and will not think a person is stupid or
unlovable. Depending on what your religion or faith is, of course, I
know there are many wonderful Christian counselors out there in our area and
many do an especially effective job with this particular problem. But
if you get hooked up with someone that makes you or the person with the
disorder feel uncomfortable, or someone who isn't having some kind of
positive effect after several sessions, drop him or her immediately and find
Thank you, Karen, and good advice. It can happen;
sometimes it's simple incompatibility, sometimes incompetence, but don't stick
with someone who isn't helping, and don't let a bad experience keep you from
Whatever you do, if you strongly suspect a loved one has a
problem (or you yourself do), don't let it slide, and don't engage in denial of
your own. Eating disorders can be health- and life-threatening.
If you're in doubt, make an appointment with a specialist yourself; they can
either confirm there's a problem or ease your mind!