Body image and eating disorders: what to say, what to skip, and when to worry

Maybe your daughter asked if she looks fat in her jeans. Maybe your son has started skipping lunch and spending hours at the gym. Maybe you caught yourself saying, again, that you "really shouldn't" have that slice of cake, right in front of your eight-year-old.

Body image is one of those topics where kids learn more from what we do than anything we say. The good news is that home can be a real counterweight to everything else they're seeing.

What kids are up against

The Surgeon General's 2023 advisory on social media found that 46% of teens ages 13 to 17 said social media makes them feel worse about their bodies. Filters, edited photos and "what I eat in a day" videos give kids a warped idea of what normal looks like, and the algorithm keeps feeding them more of whatever they linger on.

You can't wall all of that off. But you can talk about it. Ask your kid what they see in their feeds. Point out edited photos together. Help them notice how certain accounts make them feel, and unfollow the ones that leave them feeling worse.

What to say, and what to skip

Skip talking about weight, theirs or anyone's. Comments like "you've filled out" or "she's let herself go" land harder than we think. Even praise for weight loss can teach a kid that their body is up for review.

Drop the "good food, bad food" talk. Food doesn't need a moral rating. Try "this gives you energy for practice" instead of "that's junk."

Watch how you talk about your own body. Kids notice when a parent skips meals, stands on the scale every morning or criticizes themselves in the mirror. You don't have to love your body every day, but try not to narrate the hating.

Praise things that aren't about looks. Their humor, their kindness, how hard they worked at the tryout, the way they stood up for a friend.

Eat together when you can. Family meals are a chance to model eating normally, without commentary, and to keep connected. They're also where you're most likely to notice if something changes.

What eating disorders actually are

According to the National Institute of Mental Health, eating disorders are serious illnesses, not choices, and they can be life-threatening. They can affect people of any age, sex, background or body size. Someone can look healthy, or be at an average or higher weight, and still be very sick.

NIMH describes several common types:

• Anorexia nervosa: severely restricting food out of fear of gaining weight or a distorted body image.
• Bulimia nervosa: episodes of binge eating followed by trying to get rid of the food, such as vomiting, laxatives, fasting or over-exercising.
• Binge-eating disorder: regularly losing control and eating unusually large amounts of food, often in secret and with a lot of shame.
• ARFID (avoidant restrictive food intake disorder): limiting the amount or variety of food because of fear, such as of choking, or strong dislike of textures. It can look like picky eating that keeps getting worse.

Warning signs to take seriously

Based on NIMH's lists, watch for things like:

• Restricting food, skipping meals, or cutting out whole food groups.
• Intense or excessive exercise.
• An intense fear of gaining weight, or a distorted view of their body.
• Eating in secret, food going missing, or signs of binge eating.
• Signs of purging, such as vomiting or using laxatives.
• Dramatic weight loss.
• Feeling tired all the time.

A few of these on their own may be nothing. A pattern is worth acting on.

How to bring it up

Choose a calm, private moment, not mealtime. Lead with care, not food. "I've noticed you seem really stressed lately and you've been skipping dinner. I'm worried about you, and I love you." Expect denial or anger. That's common and doesn't mean you were wrong to ask.

Don't try to fix it by arguing about calories or forcing food. Eating disorders aren't about willpower.

Getting help

Start with your child's doctor. NIMH says early detection and treatment are important and that eating disorders can be treated successfully. Treatment usually combines therapy, medical monitoring and nutrition support. NIMH also notes that family-based treatment can improve outcomes, particularly for adolescents. In other words, you're not on the sidelines. You're part of the treatment.

People with eating disorders are at higher risk for depression, anxiety and suicide, NIMH notes. If your child talks about hopelessness or self-harm, call or text 988, or read our guide to mental health warning signs. For the social media side, our first phone guide has a family agreement you can adapt.

Frequently asked questions

Can boys get eating disorders?

Yes. Eating disorders can affect people of any gender, age, race or body size, and boys sometimes get missed because people aren't looking for it.

Should I comment if my kid gains weight?

Usually not. Growth spurts often come with weight gain first. If you have health concerns, bring them to the pediatrician privately rather than at the dinner table.

Is ARFID just picky eating?

Not quite. Picky eating tends to ease with time. ARFID keeps getting more restrictive, can affect growth, and is often driven by fear or strong sensory reactions. Ask your doctor if you're unsure.