“How much should I weigh? I know I’ve lost 20 lbs, but I still think I weigh so much. I don’t feel like I lost any weight at all. Yes, I know my clothes fit so loose, but…”

There is a lot of talk about overweight children and teens in this country. There is even more talk about how overweight teens become overweight and even obese adults and then their health issues are complicated by all these other medical diseases like diabetes, joint disease, heart disease, and stroke to name a few. There is a lot of talk about the overweight group of teens, but there is little about what happens if we make them so aware of their weight they think life will become a walk on petals if they just lose the weight by any means necessary. Skipping meals, diet pills, shakes and excessive exercise and worse, when they have done something as significant as dropping 20 lbs they treat the accomplishment like it was only a pound. This is a huge red flag to me. This reminds me of body dysmorphic disorder (BDD). These teens never see their body as okay and that’s even when they are at a healthy weight. This is why anorexics feel and appear so fat to themselves and that is why Michael Jackson could never get that nose right. They always see something wrong with their body no matter how perfect it really looks.

The medical community is asking for healthy weight loss not so your teen looks “skinny,” but so your teen doesn’t have all these medical complications associated with being overweight or obese. It’s a slippery slope to anorexia and other eating disorders not to mention BDD, but if we pay attention to red flags we can often stop them in the early stages. Anyone who doesn’t like themselves at 200lbs won’t like themselves at 135 lbs and those are the teens whose weight loss can benefit from therapy before the healthy weight loss can really begin.

Related posts:

1. Struggling With Your Overweight Teen?
2. Are You Calling Your Teen Fat?
3. The Fat Girl In The Family

In anticipation of all the food, a teen with an eating disorder may begin to accommodate the overeating by starving themselves before the festivities begin. They may have anxiety about family and friends who mean well, but remind the anorexic teen to, eat. For the bulimic, the reverse may occur with secret overeating and hording  food then purging or excessive exercise to rid of the calories.

If your teen has been doing well distracting themselves and developing a more positive body image, the thought of family who have not seen them for a whole year commenting on weight gain or loss might send them into a tail spin. Be prepared for this and have some protective measures in place for your teen.

1. Avoidance

Keep anorexic family members away from your teen or excuse yourself from those gatherings.

2. Rules

Establish rules with extended family to eliminate body image discussion or appearance with your teen. If they can’t do this well then they probably shouldn’t be around your teen, but if they can, they are part of the buffer that should help protect your teen from other family.

3. Time-out

Let your teen know they should make you aware of what they are feeling especially if they’re overwhelmed or anxious. You can even have a secret code to help remove them from stressful or anxiety producing situations (e.g. a thumbs up from across the room). Discussing the plan and establishing a back-up plan can help reduce anxiety.

4. Medical Team

Check-ins with therapists and clinicians increased as needed. These resources help hold your teen accountable as well. They also serve to echo your rules, which give you a break from being the “bad guy.”

The holidays can be stressful for several reasons although they don’t need to be. With good communication and anticipation of potential pitfalls for your eating disorder teen, you can avoid unnecessary setbacks that could have your teen restart treatment or be hospitalized over the holiday season. Your preparation will keep them healthy and safe, home with you.

Related posts:

1. Social Skills
2. 4 Mental Health Issues For The Holidays
3. 5 Healthy Coping Skills To Try