An essay written by a clinical social worker titled “Surefire Ways to Give Your Kid an Eating Disorder” has received a lot of attention in the blogosphere over the past week, including brilliant rebuttals by Laura Collins and Carrie Arnold. I wrote a reply to this essay on Ms. Lewis’ blog, but unfortunately she did not post it. I am not sure why my reply wasn’t posted, but I did notice that there are no posted replies from clinicians who strongly disagreed with the essay. Therefore, I have chosen to post my reply on my own blog. If you have attempted, unsuccessfully, to post a reply on Ms. Lewis’ blog, please feel free to post here. As a general policy, I post all replies except spam.
As a psychologist specializing in the treatment of eating disorders in children and adolescents, I was profoundly disappointed to read this essay. I have grown accustomed to hearing myths about eating disorders from lay people and from the media, but I hold professionals to a higher standard. Professionals who write articles for public consumption have an obligation to be accurate, up-to-date, and straightforward.
Ms. Lewis’s essay confuses the common problems of body dissatisfaction, perfectionism, and poor self-esteem with the psychiatric illnesses called eating disorders. Without question, parents have a major influence on their child’s self-esteem and body image, for better or for worse. Parents influence their children’s development in a variety of ways, and bad parenting can cause tremendous pain to impressionable children. However, there is no reliable evidence to indicate that parents cause eating disorders. The Academy for Eating Disorders recent position paper on The Role of the Family in Eating Disorders concluded that “There appears to be no consistent structure or pattern of functioning in families with a member who suffers from an eating disorder; rather, eating disorders evolve in a multiplicity of family contexts.”
For decades, psychologists and psychiatrists theorized that cold, withholding parents caused their children to develop autism, that erratic parenting caused schizophrenia, and that overbearing or perfectionistic parenting caused eating disorders. More recently, these theories have been disproven. While the precise causes of these illnesses are unknown, we do know that these are highly heritable, biologically-based brain disorders that are definitively not caused by any particular type of parenting.
A parent who is a “neat freak” – who uses hand sanitizer before every meal and requires his child to clean his room thoroughly twice a week – cannot give his child OCD. A child cannot acquire a parent’s mental illness by imitating his behavior.
By stating that encouraging perfectionism, withholding emotionally, and using food for rewards and punishments are “surefire ways to give your kid an eating disorder,” Ms. Lewis reveals her ignorance about her own area of expertise. She conflates body dissatisfaction with eating disorders and thereby inadvertently trivializes the most deadly of all psychiatric illnesses.
I respectfully urge Ms. Lewis to educate herself on the most recent scientific knowledge about eating disorders and to revise her essay to reflect this knowledge.