001 - Where to Start: Recognizing and Responding to Your Child’s Eating Disorder

Artwork for podcast The Other Side Of The Plate

Episode 1 • 26th September 2025 • The Other Side Of The Plate • F.E.A.S.T.

Episode 001 - Where to Start: Recognizing and Responding to Your Child's Eating Disorder

A conversation with Jenni Gaines and Laura Cohen from FEAST

FULL TRANSCRIPT

Host:

Welcome to The Other Side of the Plate, brought to you by FEAST—Families Empowered and Supporting Treatment of Eating Disorders. This podcast is for moms, dads, and caregivers searching for answers, the kind that can feel so hard to find when your loved one has an eating disorder. I'm Jenni, and along with my co-host Laura, we're here as caregivers with lived experience who supported our loved ones through an eating disorder.

Together we'll share personal insights, connect you with professionals, and point you toward helpful resources. And as we say at FEAST: We're here because we've been there.

NOTE:

The content contained in this podcast is not a substitute

for professional or medical treatment, and it may not represent

the views and beliefs of FEAST. Always consult a medical

professional for medical advice and treatment recommendations.

Jenni:

Welcome everyone to our very first episode of this podcast. I'm Jenni Gaines and I am the director of programs and services at FEAST, and I also have lived experience as the mom of a daughter who has been through the journey of anorexia. And I'm going to now turn it over to my wonderful co-host, Laura, to introduce herself.

Laura:

Hello, my name is Laura Cohen and I'm also a FEAST volunteer and a board member, and I'm also a mom with lived experience helping my loved one through treatment of her eating disorder. I also have been a family or parent mentor for the past three and a half years. So I've been helping hundreds of families through the whole process and experience of their loved one going through eating disorder recovery and treatment.

And I'm really excited to do this podcast. Jenni and I have been talking about it for a while, and we keep saying there is a need. We have so much to offer with FEAST and how can we get out to more people with more topics and more experts by experience? So here we are, and I hope that you really get a lot out of what we have to say.

Jenni:

Thank you, Laura. And today we're going to start at the beginning. We're going to talk about where do I start recognizing and responding to an eating disorder in your child? We're going to talk about noticing the signs of an eating disorder, taking action when we notice those signs and what to do after a diagnosis.

We'll start right here at the beginning with that first question that most parents ask themselves. How do you know if your child has an eating disorder? Laura, when you think back to the beginning, what were the first things that made you wonder if something was wrong?

Laura:

I look back and I realize that I missed each and every sign, which we'll get into as we keep chatting.

I knew something was wrong. I just didn't know what was wrong because I was a professional. I had been a registered dietitian in the past. I thought I knew what the signs for an eating disorder were, and I never even put that in my head. But I did notice that my daughter was having a lot of anxiety.

And we thought it was just anxiety and that was it. It never showed up that I saw where I was thinking, oh, she's going on a diet and wow, she's just eating this, or she's just eating that. I didn't notice any of that or what I thought an eating disorder was.

So I was just trying to figure out what was going on and in the end, she started crying after every meal. And that was weird. And it actually took her telling me—we'll get into more of this later, but she actually told me.

Jenni:

Wow. So she told you that she was having issues before you noticed what they were. Okay.

Laura:

Yeah, I knew something was going on, but that was not what I thought was going on. But other warning signs that caregivers often see is a noticeable weight loss. Sometimes, when your kids are getting to those teen years, you may not see your child undressed as much as you did when they were little and running around after the tub.

But when they start to be teenagers, they're not doing that. And often they're wearing big and baggy clothes and you don't realize it. And sometimes it could just be maybe one time you see your loved one with their shirt off and you're thinking, oh my gosh, I can see how much weight they've lost.

So sometimes there is a noticeable weight loss. One thing that we see a lot is dieting—I say with heavy air quotes—or a sudden interest in "healthier, clean eating." And often parents are really happy to see that. They think that it's great that their kid has this interest in healthy eating and maybe wanting to lose weight, or "cleaning" because maybe that's something in your family that the adults do. And then when you see your child wanting to do it, you think it's awesome. But that often can be a beginning sign of an eating disorder.

Cutting out entire food groups, becoming a vegetarian or vegan. I see this a lot. And your kid will still say, no matter what, this is not an eating disorder. I care about animal rights. Yet they're still wearing leather shoes or carrying a leather pocketbook. So we often really have to think about things globally and really why are they becoming a vegetarian.

Increase in exercise, especially when it's tied to food intake. Maybe your kiddo just asked for a membership at Planet Fitness, which I think is $10 a month, which most parents would be thrilled about if that's something that they can financially swing and before you know it, they're insistent on going every day. Or maybe you have a big barbecue one day and then your loved one wants to go to the gym afterwards, and you start to see these patterns.

Food being left uneaten, especially packed lunches. I will say that was happening in my house. I just thought my daughter was picky. But it definitely was lunches that were not eaten. Different times when she just kept saying she wasn't hungry. I just wasn't aware of why. So definitely seeing that lunchbox come home with the food uneaten.

Loss of interest in previously loved foods. So maybe your kiddo was a foodie and would eat everything and anything, and then all of a sudden they're saying, yeah, I don't really enjoy ice cream. Ice cream makes my stomach hurt. I don't really enjoy pizza anymore because it's too chewy. You'll just hear a bunch of different excuses and not think twice about it.

Jenni:

Thank you for explaining all of that, Laura. I think a lot of us, I know for me, I did not have the obvious signs that you just described. And I didn't know enough about eating disorders when my daughter was first developing anorexia. Looking back on it now, I can recognize so easily that there were a lot of less common signs or maybe just less well known. They probably are common. They're just not as well known, and I certainly had no idea that they were signs of an eating disorder.

The one I remember the most, I thought nothing of it. My daughter started becoming so interested in cooking shows. She was watching all kinds of cooking shows. We watched them as a family together because we all thought they were interesting and fun. And she became obsessed with cooking really difficult recipes and was very exacting about the way they were finished. Very perfectionistic about it. And I didn't notice at the time until after I realized this was part of her eating disorder, but she was providing all of us with this beautiful food and she wasn't really eating it herself.

I remember one Father's Day, she even baked the bread for my husband's Father's Day picnic and spent the whole day in the kitchen and then she really didn't eat very much and I just didn't think anything of it at the time, but it was a really big sign.

Also another thing that you might not see because they're hiding food and they're lying about eating. You might not even realize that's happening, but it could be happening. They might spend extra time in the bathroom after meals, suddenly get up from the table and go straight to the bathroom. And that could be a sign of purging.

Also just the emotional changes around puberty, preteen teenage years. I think all of us parents, Laura, at least I did, I kind of expected all of my kids to have some mood swings, to have some teenage rebellion, a little bit of defiance. Looking back again, my daughter had some major mood swings right around the time she was developing her eating disorder. But because I didn't see the weight loss yet, I had no idea that's what it was. I did wonder what was going on.

If you start noticing that they get distressed around food and food experiences, food situations, or they're avoiding food situations.

Laura:

A hundred percent.

Jenni:

Yeah. If they are wearing baggy clothes, as Laura said, you may not notice they've lost weight already, but they may be cold all the time. They may be feeling really cold. You may notice they are not sitting down when they used to sit down. A lot of times there will be standing and pacing. Doing their homework standing up, writing a paper standing up. Everything that they do, they're standing up instead of sitting down, and they don't want to sit down. When you ask them to sit down, they could have other forms of compulsive movement and exercise, even secret exercise.

I've heard more than one parent at FEAST say that they've woken up in the middle of the night to pounding above their heads and it's their child with the eating disorder doing secret exercise in the middle of the night.

And then also something that probably is not as unclear is negative body image and frequent body checking behaviors. Lots of time in the mirror, looking in every window to check their body as they walk by and seeing just really negative things about themselves and their bodies.

And I think one thing I learned and that I've heard from a lot of other parents is trust your gut. I would say that's probably one of the biggest pieces of advice I would give any parent who's going through this journey. If you are thinking that something is off or something's wrong, you are most likely right. And it's really good to listen to that.

Laura, that makes me wonder, I'm really curious. Do you remember a time early on in your daughter's journey where you either trusted your gut because you're a mom and you knew something was wrong, or you look back and wish that you had trusted your gut but you didn't do it?

Laura:

Oh gosh, yeah, so vividly. So my daughter, the year that she was diagnosed had—and sometimes you hear things this—she did have a tragedy. She was a gymnast and her gymnastics coach that summer before had dropped dead. So she had a very big loss, was really struggling emotionally, and months went by and months went by and it was like she—I don't want to say she couldn't get over it because I don't mean to sound cold and callous because it's not that way at all. But it was to the point that it was just continuing to be very upset all the time. And anxious all the time. And she didn't want to go to therapy. She was very against therapy.

And somehow I don't exactly remember the details, but she started seeing—I was seeing a business coach and when I was chatting with this coach about my daughter, I was explaining that I don't know what's going on with her. And long story short, she said, well, my husband does athletic coaching for gymnasts, you know, more athletic coaching, kind of a sports psychology angle.

So I was thinking, oh, I bet Alexa would do that, you know? Because she wouldn't go to a therapist. So she met with this guy and I'll never forget, he called me and said, you know, I just want to talk to you about my session with your daughter. And he said to me, your daughter's only eating about 500 calories a day.

And I was thinking, oh, I never thought about that. But when he said it, I was thinking, you're probably right. Again, no one mentioned eating disorder then at all. But it was that first time that I thought about it and I was thinking, oh, I bet that's why her moods are so bad, because she's hungry. That's where it went in my head. It never went to the part of, oh, she's eating that little. That could be a problem.

And it was interesting because I did bring it up to her that day of saying, you know, I think it could really help your mood if you're eating more. And I remember driving and she said, "Well, not if I get fat." And even with that comment, I remember going, oh, that was kind of weird. I still didn't put it together. So yes, mom, past registered dietitian professional, missed all the obvious signs. So that's the time that I really, really wish that I understood what my gut was telling me.

Jenni:

That was a really good example. That kind of makes me think of something that we're probably going to get to later, but it's such a great opportunity to just remind everyone that if your child has developed an eating disorder, it has nothing to do with your parenting. You did not cause it by something you did or didn't do. And it's also not your child's choice to get an eating disorder.

So once we notice these signs, all the signs and symptoms that Laura and I have talked about, what is the next step? The very next step if you are noticing these serious signs and symptoms, the weight loss, the moods is, and if you are already starting to suspect an eating disorder, is to see your pediatrician quickly as the first step.

And from my experience, I highly recommend that if you do strongly suspect it's an eating disorder, to get your hands on some really good eating disorder medical resources before you go into the pediatrician, because a lot of pediatricians, they have so much on their plates, but medical school does not prepare them to diagnose and treat eating disorders.

So you want to make sure that that first visit when you're really a worried parent, that you're actually getting to the core of what's going on. And so having some resources on hand of what to look for when you go in so they'll really listen to your concerns, is a really good idea. And FEAST does have some resources that we can link in the show notes.

One of them is the Academy of Eating Disorders Purple Book. It's a medical standards guideline list of what kinds of assessments need to be done at an eating disorder assessment appointment. I know that I did not have that information when I first took my daughter to the pediatrician. And also my pediatrician was actually really nervous about eating disorders because she didn't have a lot of experience with them. And so I absolutely didn't feel I knew what to expect. I put all of my trust in the pediatrician. And I already by that point was pretty sure that she had anorexia just based on her really rapid weight loss while she was away from us for six weeks at a ballet intensive. By the time she got home, all of the signs that I missed before she left were in full blown effect. And I could see by looking at her that she wasn't okay.

So that makes me wonder. That was my experience. But did you feel prepared when you took your daughter to the doctor for the first time, Laura, and what do you wish you had known going in?

Laura:

Yeah, I want to back up for one second. Because as Jenni knows me, I'm real and raw and I just want to prepare people that the pediatrician, I hear more times than not that someone will bring their child to the pediatrician, worried about an eating disorder, and the pediatrician says that their child is just fine because their weight looks okay.

So pediatricians are awesome. We need pediatricians. And sometimes because they don't have that eating disorder experience, and by looking at someone we know, because we're professionals, we know that just by looking at someone, you can't tell if they have an eating disorder. And I know so many stories of just the pediatrician just saying the parents are overreacting, the kid is fine. I've even heard stories, the pediatrician telling the parents actually, your child could lose some weight.

So I just want you all to be aware that when you go to your pediatrician that they may tell you there's nothing wrong with your kid. You are the parent, you know what's wrong with your child.

So to the question that you asked was I prepared, I think I'm an anomaly. Because I walked in and I said to my pediatrician, it was over the phone. My daughter has an eating disorder. I didn't ask, I just said, this is what I'm seeing. I finally figured it out, because he had been working with me as to what was going on with her. He had even prescribed some medication thinking it was anxiety. I said, I figured out what's wrong. She has an eating disorder. And he said, okay.

But so I did know what to go in with. However, looking back at it, knowing what I know now, I wish that I would've advocated for her, for him to have run labs on her right then. Because by looking at where she was, you wouldn't have known the amount of malnutrition that she had. And the labs were not done right away. So I wish I had that knowledge going in.

You know, one other thing I say to parents is just I walked in and I said, my daughter has an eating disorder. I know a lot of parents who will wait for an official diagnosis to start anything. And there's nothing wrong with starting to advocate for what your child needs until you get that official diagnosis from someone. Because sometimes that takes a while. I don't even know when I ever got one or if I did, I just said she had one.

Jenni:

That was a great answer because you and I kind of had opposite experiences where there was no doubt that my daughter was going to be diagnosed when we took her in, just based on her significant weight loss. But in your case, I have also heard of pediatricians, especially if you have a child that is naturally in a higher weight body that comes in and the pediatrician could even possibly compliment and say, good for you. You've lost some weight. When the parent is there terrified and worried because they know their child is not okay, because this is not the weight that their body is meant to have. And also there will just be some kids whose growth just stalls. So they're not losing weight, but they also are not growing any taller and they're not gaining any weight, and that can really delay diagnosis and treatment. And so that's where that gut instinct comes in. Again, if you know something's wrong and your doctor's saying, no, I think everything's fine. It's really hard to push up against that medical professional to say, no, please listen. I know something's wrong. But based on all the stories that I've heard through my work with FEAST, there are so many parents who didn't do that, and they really wish that they had because their kids were a lot sicker than what the doctors realized they were.

Another really frustrating thing, Laura, is some of these appointments take weeks and weeks to get, and your child is continuing to get sicker and sicker as you're waiting for the appointment. And so one thing I wanted to touch on today while we're together is what do you do if the medical appointment is delayed?

And this is not something that I was prepared to do at the time. I really didn't know how do I monitor my child? I'm just really worried about her. How do I know when to go to the emergency room when I know absolutely nothing about eating disorders? How do I even know the next step?

And that's where FEAST comes in. As you know, we're not here as medical professionals. We're not qualified as medical professionals to give specific medical advice. I can tell you from my personal experience and from my experience with FEAST Resources, that FEAST has some wonderful resources that if you just start while you're waiting for the appointment, you will be worlds ahead by the time you get to that appointment and you'll know what you're looking for.

So just briefly, I'm going to touch on when do you consider going to the ER? But again, this is not medical advice. If there are signs of serious medical risk if your child is fainting, if they have bradycardia, which is a very slow heart rate, they aren't taking in food or water, or it's such a significant and dramatic weight loss that you're really concerned. Those are all reasons to consider going to the emergency room. And again, I recommend the AED Purple book for some medical guidelines on that. And we are going to definitely link in the show notes a program called FEAST 30 Days, which I would say is the go-to start with resource for parents who are at the very beginning of this journey, and it's a free email educational program, you'll get one email in your inbox a day for 30 days, and you'll get the comprehensive guide on all of the best, the most important eating disorder topics, and you'll be so much more empowered to start advocating medically for your child.

Laura:

So what should a proper medical assessment look? What should it include? And I think this is really important, you know, back to thinking, does your pediatrician, are they equipped to know what to do? Heart rate is something really important. What people don't often understand is it's not just their resting heart rate. But we need other vitals. We need something called orthostatic vitals. And I'm really bad at explaining this, but it has to do with when you sit to stand or stand to sit if your blood pressure drops too much. And that is something that a lot of pediatricians or medical professionals may not know to assess for, but very important when you're assessing for an eating disorder within the vitals.

We will put this in the show notes. I think you had talked about the AED Purple book. We also have a webinar that we did at FEAST from Julie O'Toole on what constitutes good medical care and eating disorders. Because as you know, Jenni and I have alluded to, it's not always great care. And it's not that practitioners are bad practitioners. It's because they just don't know. I do feel that, you know, do no harm is what the majority of medical professionals believe in, and sometimes the harm is done when they just don't realize that either their beliefs or their knowledge are incorrect.

Your child should have labs, a full panel of labs, including electrolytes. One thing that's super important is their weight history, their growth charts. I have worked with families who, for different reasons, don't have growth charts. Maybe they've grown up in different countries, pediatricians have retired, whatever it is. So it makes it really challenging and we're always thinking, gosh, we wish we could see that growth chart. But often what you'll see in someone, let's say my daughter was diagnosed at 16. Or, you know, say someone's diagnosed at 15, 16, 17, if you look at their growth charts often, you may see a drop in their trajectory, maybe at 11, 12, 13, but they were not diagnosed at that time. But that could have been the beginning of the eating disorder.

So growth charts are really important because the way that they figure out what your weight restored weight is. It's not an exact science, but what they use is they use growth charts. So if your kiddo was always in the 50th percentile for weight and all of a sudden they're in the 30th percentile. Or maybe they dropped to the 30th percentile when they were 13, but the rest of their life they'd been in the 50th. And then at 13, you remember? Oh yeah, that's when they went on that little crazy health kick, you know, even if it was a couple years ago, and then they've kind of stayed in that 30%. Chances are they need to get back to that 50% to get back on their growth chart. So that's why historical growth charts are really important. Not a deal breaker. As I said, sometimes you can't get them. But I know that I got mine by looking in the children's hospital chart because my daughter had been followed for different injuries. She was a gymnast throughout the years, and I was able to get so many weights from all the different orthopedic visits.

PS some of those orthopedic visits and their stress fractures were also warning signs. Some of them were not. But some of them definitely were. But I was able to get a lot of her weight history just from old charts, and then I put it together.

Again, we can't offer medical advice. That is not what our role is. We're not medical professionals. We are experts by experience. So please, make sure that when you look in our show notes and grab the FEAST resources, you can share those with your medical providers, especially if they're not trained in eating disorders. And we've got some good resources for you.

Jenni:

Thank you so much for that, especially the emphasis on the weight history and the growth charts. That's really important. We definitely want to make sure that no one's going on BMIs and things that. It really depends on your individual body and your individual growth curve. What is going to be the right weight for you, and it's going to be a moving target. It's going to keep changing. Our kids, usually when they develop eating disorders, still have so many years of growth and development ahead of them. And so the target's not going to stay static. It's going to keep increasing as they get into all the way up into their mid twenties really. And that's something I didn't really take into consideration. I was looking for if we can just get her up to that growth curve and a little bit above that, that'll be fine. And you just want to make sure that they stay on that trajectory once they get that back up there.

Laura:

My daughter did grow in her twenties

Jenni:

and that's so reassuring to hear for parents to hear. Yeah. So she probably was a little bit height suppressed.

Laura:

Yeah. I think she was a late bloomer and height suppressed, but yeah, she grew last year. She's 21 right now. She was very excited to be taller than her mother.

Jenni:

That is very exciting. That's great.

At this point, I think it's good to think about what are some key questions that we should be asking as parents if we've been worried about our kids, we've noticed these signs. We've gone to the pediatrician or to family practitioner, a medical provider, and hopefully we got the medical information and the diagnosis, started along the treatment path. But what else do we need to be thinking about and what are some key questions that parents should be asking right about this time? Laura, do you mind sharing some of those?

Laura:

Sure. I mean, the biggest one is, is my child medically stable? And yeah, there's obviously different levels of that. Because sometimes lab results can look okay, but your child is really struggling. So medically stable is really important. Making sure they do those vitals, those orthostatic vitals.

Is school attendance safe is another important question and the word safe, I think means a lot of different things. Because parents will think that that's crazy if I'm saying, you know, your child should not be going to school. That's unheard of. Why would my kid not go to school? And here's how I explain things. If you're trying to restore weight on your child, on your loved one, and you know that when they go to school they can't eat lunch because they won't eat in front of their friends or they just won't go to the lunchroom or you know that they're restricting because no one's watching it. To me that is not a safe school attendance. If you're sending your child to school having breakfast at seven o'clock, and then maybe you're not seeing them till three o'clock and they're not eating anything or you suspect it, that is not attending school safely. That doesn't mean they can't attend school. You just may need to figure out how you can get that lunch in or get some snacks in. So school attendance being safe is really, is my child able to eat? Are they able to get nourishment during school? If they're continuing to lose weight? School's going to be one of the first things, or school lunch, that may mean that you pull them, someone has to supervise their lunch. Or maybe if you're in a situation that you, or someone else in your family can go and have lunch with them, even sitting in the car, then they can go back in. So that's a little bit more what I mean by attending school safely.

Should they stop physical activity? Definitely something to talk about with your doctor. Sometimes pulling that physical activity really shows that you're taking the eating disorder seriously. I know a lot of parents that will not pull their kids from sports because they say that the sports are their lives. And I often will say, you know. I hear you. I get that. I know sports are really important and our children have other lives outside of sports, and if that is keeping your child—I always say if your child broke their leg and they ran track, would you still make them run? And of course, the parents said, well, of course not. That's the most ridiculous question in the world. There is no difference here. I say treat the eating disorder an injury, and they may need to miss a season. If they're not able to meet their caloric needs, if your child has volleyball practice but refuses to eat an extra snack, which is the rule, then right there, they're not ready for a volleyball practice. If they're not okay to add that extra snack, are they hiding or compulsively engaging in exercise? Again, another thing—are they really at track or at gymnastics? Are they doing extra exercise? Are they coming home? I know people whose loved ones will come home and do an additional workout and the parents think, oh my gosh, they're so committed. This is awesome. They're so committed to their sport and don't really realize that this is actually more of a compulsive exercise. Or are they able to take rest days if you go on a family vacation, do they need to find the gym so they can exercise every day? So those kind of things, Jenni was talking about earlier about when you notice that your kid just can't sit down and watch a show, or they can't sit down and do homework. I actually did work with a family that the kid had a pretty big movement compulsion, and she would not sit down to do her homework and all she kept saying, and she'd be standing on her head or she was doing this and that, and she would literally just say to her parents, this is just me. This is just me and her parents fought that. And the truth was, it was all part of a movement compulsion. And it was tricky and we had to do it little by little, but she did not need to be jumping around and doing jumping jacks while she was doing her English homework.

Jenni:

Yeah. And when you were talking Laura, it just made me think that for a lot of our kids, school and sports or school and dance and whatever, their extracurricular activities are so important. And they have the type of personality that's a high performance personality, perfectionist. They'll always get the good grades, always excel at whatever they do. And so as parents, if we have identified our kids as that being who they are, this can be so difficult for parents to let go of that a little bit. And I think that's a really important thing to be able to accept that maybe my child's trajectory is going to look a little bit different, at least temporarily, because we have to prioritize recovery.

And I am speaking from my own experience that it was really hard for me to not allow my child to go to school, to not allow her to be in school for the beginning of her sophomore year, to not allow her to be in the ballet company that she had worked so hard to do, to not allow her even after six months to audition for Nutcracker and to, at the very best, possibly attend and watch all of her friends in the big parts that she would've had if she had not gotten the eating disorder. I had to really check myself on those things. I had to truly be okay with, this is going to be something we're going to have to step back from for safety reasons and for health reasons. And if I could give any positive spin on that, as hard as it was for everyone, those two things, school and ballet, were the incentives that gave her what she needed to recover.

And so I think letting go of those things, knowing that it's just temporary, they may or may not go back to how they were before, but they will be healthy when they do go back. A lot of parents report that I've talked to at FEAST, that their kids don't go back to their sport. That could have very well been for a very long time, part of the eating disorder. And then there are just as many others my daughter who danced from age two was her passion and she worked really hard to get back to it. She didn't go back probably as at high of a level long term as she would have, but she went back and she enjoyed it. And so I just wanted to share that.

Laura:

One other reframe I just wanted to say is that, you know, you think you're taking all this away from your kid because that's what it feels like, right? It feels we're punishing them and we're taking all this away. And how that's not what good parents do. Right? And I tell all my parents, this is, you have to reframe it, that this is not punishment, it's protection. Most of us would lay down and do anything to save our kids. And sometimes that's hard to do with anything. Right? And this is something that, it is 100% not a punishment. It's protection.

Jenni:

That's a really powerful reframe, Laura. Thank you. I think that'll be really helpful for parents. So getting that first diagnosis, or confirmation that your worries about an eating disorder are true can be really overwhelming. And so next, let's talk about that moment, that kind of terrifying moment when you realize my child has an eating disorder. What's next? Laura, will you share a little bit about your experience when your daughter was diagnosed and what that was for you?

Laura:

Yeah. So as I said earlier, I didn't know what was really going on. My daughter was really struggling with anxiety. She was crying a lot. It was the beginning of COVID, so it was lockdown at this point, and she would just have these emotional breakdowns every night. And often it was after dinner. You know, all we're doing is we're cooking because that's what we're doing. There's nothing else to do. So we're focusing on all these fun activities we could do during meals. And she would just be crying after every meal. And we would actually sit in the green chair that's right here. And I was showing Jenni before, before we started recording, and I would say every night, okay Alexa, let's go sit down and talk.

Finally, you know, this went on for a couple weeks and then there was one night that we sat down in that green chair after dinner. Well, I don't think she ate, but after dinner was supposed to be over. And I said, what is what? What honey? What's going on? And she looked at me and she said, I'm not eating on purpose.

And that sentence changed the entire trajectory of the past, almost six years. I remember going. I'm going to say a bad word. Oh shit in my head. And I knew enough right there professionally that, oh gosh, Laura, you are an idiot that didn't notice any of this going on. I thought I was going to throw up right there. I was gutted. And my thought was, wow, this is going to be a big thing. So I was shocked. And also it all made sense. Oh, and then as I went to Dr. Google and learned everything, all the dots started to line up.

But it definitely was not something where my daughter started doing healthy eating and dieting that went wrong and it wasn't anything that, although that happens all the time. But that's not always what it is. People have eating disorders for many different reasons.

If every single person who went on a diet had an eating disorder, you know, if diets caused eating disorders completely, then anyone who's ever been on a diet would have an eating disorder. With that being said, people that are programmed genetically to be predisposed to eating disorders, that's when a diet can turn into an eating disorder. So that's a really important distinction to understand. It's not everyone that goes on a diet that gets an eating disorder, but people that are predisposed to an eating disorder who go on a diet are at a very high risk of that turning into an eating disorder.

Jenni:

Very good point to make. Yeah, definitely. There are so many different components to eating disorders. It's now scientifically shown to be a psycho metabolic disorder that doesn't have one root cause. Just as you were saying, Laura, there are genetic risk factors and there are environmental risk factors and when I learned about eating disorders and I looked back on my daughter's genetics and her environmental risk factors. I could see how it was basically a perfect storm. And I think one of the biggest things that happened, I think I'd already mentioned that she went away to a ballet intensive, a summer ballet intensive, and for six weeks was not where I could see her. And I think what happened was that her energy balance got to where it just went a snowball out of control. She was not fueling enough for the amount of exercise that she was getting and all of those genetic and environmental risk factors kicked in. And it was the perfect storm for her to develop an eating disorder.

This is a great point to emphasize again, that this is not anyone's fault. It's not your child's fault. It's not your fault. There could be some environmental risk factors mixed in there, but as Laura said, it's not because, say you have always been someone who's really health conscious in front of your kids and you exercise regularly and you maybe watch what you eat a little bit. That's not going to be the reason that your child gets an eating disorder. You may start modeling different behavior once you see that your kids are at risk for eating disorders, but it's not because of that, that they got the eating disorder. It's a pretty complex combination of factors.

Laura:

erstand eating disorders past: 1989

Jenni:

Yeah, I mean, I was in complete shock and I remember even in my head saying anything but anorexia. I mean, I don't know why that was one of my first thoughts, but I just was thinking, I think I didn't know very much about it, but I just knew that it was a really hard diagnosis and it was going to be a battle for her to overcome it.

In that moment of shock, I think it is going to feel the world has kind of been pulled out from under you, and it will continue to feel that way for weeks. And I agree exactly with what you said is to take a step and if you turn to FEAST, it took me a long time to find FEAST and immediately when I found FEAST, when I started reading on the Around the Dinner Table Forum, which is one of the peer support services that FEAST offers. I felt that, wow, I'm not the only one experiencing this. I thought my daughter's case must have been the worst in the world by watching her behavior. And when I saw there are other moms and dads right now experiencing this, and there are other moms and dads on this forum supporting these people who've already been through it and they're on the other side of it. And it didn't make it any easier, but for some reason it made me feel I'm just going to borrow their confidence. I'm going to borrow the confidence of the parents that have already been through this and I'm going to look at the things that they did to help their kids get better. And I'm going to try my best. And I, at the beginning, I didn't know if I could do it. Because it takes a lot of ability to tolerate your child's distress. And I would say I was not very good at that at first. So there's some skills you have to learn. But that's probably a whole other podcast episode.

Laura:

Yes. We have a lot of episode ideas coming out of this one.

Jenni:

And so, yeah. Laura, what about you? Is there anything that you wish that you had known early on? Before you answer that, I was going to say I also thought my child needs psychological help. That was what I thought. So I was really concerned with getting her an appointment with a psychiatrist. So if I could share one thing I wish I'd known early on, it's that I wish I had understood how important the nutritional rehabilitation was and that food was going to be her medicine for a very long time and that it was going to take her a lot longer to have her brain healed. I didn't know that. And I spent quite a bit of time thinking I need to get her counseling and I need to get her on psychiatric medication. And I really needed to be prioritizing the food intake. Food, food, food. So that's one of the things I wish I had known. How about you?

Laura:

so over the summer, summer of: 2020

But other things that I wish I'd done early on, well, I did, but educating myself really quickly. I became an expert. Whatever I could get my hands on, I needed to make sure the resources were really good. Once I found FEAST, I was thinking, oh, what is this? So FEAST was a huge one. There's also a couple of books that I looked up and then through when I joined FEAST and then I went, we have a Facebook group. I became really involved in that Facebook forum, and got different names of different books and that was my lifeline. I needed to find other parents that got it because my friends definitely did not get it.

I had a dear friend of mine who was a fellow registered dietitian, and I was sharing with her all about how I'm feeding my daughter all these really high fat foods and heavy whipping cream and butter and eggs and all of that. And I'll never forget her saying to me, so Laura, you're going to replace one problem with another. We're not friends anymore and a lot of it's because of this kind of stuff. But I will never forget that because then of course I started to be thinking, well, well maybe she's right, right? When someone starts to question, because you have your own cognitive dissonance about things, you know, I felt uncomfortable doing all of that. Now I know it was the right thing, but then when someone starts to question it.

So really surrounding yourself with parents that understand it, that are able to tell you that if you went to your pediatrician and your pediatrician told you not to worry about it, and then you talk to other parents and they're thinking, no, no, no, no, you actually may need to get a second opinion there. So really finding people that truly understand it.

et that involved. That's very: 1980

Jenni:

Yeah. Laura, so important. Thank you for sharing that. And it, as you were talking, it reminded me of how I kind of lost my confidence as a mom. And so we keep telling everyone, listen to your gut. Trust yourself. I recognize how difficult that is, but something that came up for us where I listen to my gut, but I listened to it after months of not listening to it and looking back, I wish I had acted sooner, but I got that feeling that I was not being allowed into treatment, and that was before I found FEAST. So I didn't really understand what a comprehensive treatment team looked . And I got my daughter into treatment with a dietitian and a therapist, and we were doing FBT at home. It was before very much telemedicine was done, but through an FBT therapist who was out of state and we were doing it virtually, and I was following what she was telling us. Little did I know that I should have been all in on that. And I was still trying to get my daughter the help with the dietitian and the therapist thinking I'm doing the whole, you know, surrounding her with everything that she needs. And I started to realize that they were keeping me completely out of the loop and almost encouraging my daughter to not listen to myself and my husband telling her things your parents shouldn't be the food police. If you're not hungry, don't eat. Listen to your food, listen to your hunger cues. Well, she didn't have any hunger cues. She was never hungry. Anorexia, they're never going to say that they're hungry. And so she was going to listen to that and not eat and go against all of the things that we were trying to do to help her eat. It took me a while, but I listened to that and I knew once I started getting educated, I was being left out of treatment. I was definitely not on the treatment team. And I fired that treatment team and it was really hard to do, but that's, it's a learning experience and I think, you know, I don't beat myself up for that and no one here who's listening to this should second guess themselves. You learn as you go and it's definitely a trial and error process, but you're constantly learning and every little piece that you learn is another piece of the puzzle that fits in and you keep making progress.

Laura:

Yeah, definitely.

Jenni:

Yeah, so everything that Laura said, learning everything you can, getting support from others who've been there before you, on the FEAST forums, and then just understanding you have a really important role in the treatment and recovery of your child, and it's okay to advocate for that.

So Laura, we've talked about so many things today, I think we're kind of touching on a lot of the important topics, and we don't really have time to go that deep on it, but if there's a parent who's listening today and they're just starting out on this journey, they're either worried that their child has an eating disorder or if they've just gotten the diagnosis of an eating disorder, what would you say to those parents?

Laura:

I think the first thing I would say is, you got this as well as advice that was given to me by another ED Warrior parent was put on your armor because you got to go to battle for your kid and you absolutely can. And the best way to start the battle you're going to go into. Because I don't sugarcoat things is to get educated. There's so many amazing resources out there. And I would just really read everything you can again, make sure that the resources are legit resources. FEAST does a great job with that. And that's what I would do. Find parent support, you know, parent support somewhere, and just get educated and just know that you can do this. Recovery, full recovery is possible. And it's worth it. And you are going to have ups and downs in treatment. It's going to feel—I felt it was a big game of whack-a-mole that every time I felt I had something figured out, then something else popped up. And it was really exhausting for a really long time. And eventually that game slowed down.

Jenni:

Yeah, and I couldn't have said anything better, Laura, with what you said… we have spent quite a bit of time talking about what do you do when you suspect an eating disorder or you know that your child has an eating disorder and you're at the beginning of the journey.

So quickly before we go, I'll just recap what we talked about today are the takeaways from our first episode. Notice the signs and symptoms that we talked about. Trust your instincts. If you think there's something wrong there, most likely is, and then take action. Take action and take your child, whether it's an adult child, encouraging them to go to the doctor or a child that still lives in your home, getting them that pediatrician appointment. And if you have to wait. Taking them to the ER if they're appearing to have any signs of medical instability. And then what Laura has so beautifully described about learning as much as you can, as fast as you can about eating disorders and then getting that peer support.

I would love for you after this podcast to check out the resources on the FEAST Web website. It's feasted.org, so FEAST spelled F-E-A-S-T. ed.org, you will get some great educational resources there and peer support resources and we were talking about taking small actions, just taking that one step forward. I would recommend that that small action be to register for FEAST 30 days. As soon as this podcast is over. And you can do that on the FEAST website, under Get Educated and Under Programs, and click on FEAST 30 days and you can register right there. Do you have anything you want to leave our listeners with today?

Laura:

Yeah, I mean, I think the biggest thing is you all are not alone. You're just not, there's such a supportive community. And I actually got a tattoo a couple years ago and after my daughter was in recovery and the tattoo says you can't see it, but it says hope on it. And not only is hope my middle name, but I really felt that doing the work professionally that I do, I always want to remind caregivers that there is hope. You know, we will be here. We have a ton of different topics that we want to talk about. We're really excited about it. Our next episode is going to be talking about food as medicine, the importance of nutrition and eating disorder, treatment and recovery. It's a topic that is near and dear to my heart as the former dietitian. So look for that episode and, yeah, I'll give it to you, Jenni.

Jenni:

Thank you Laura, and thank you everyone for being with us on this first episode, and we're really looking forward to exploring a lot more topics with you in the future.

Host: Thank you for joining us at The Other Side of the Plate. If today's episode gave you hope or guidance, we invite you to explore more resources and peer support at feasted.org. Remember, you are never alone. For more conversations of hope and help for families facing eating disorders, please join us for our next episode.

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