Recognizing Early Warning Signs of Disease
By Abigail Natenshon

By the time parents see obvious signs of eating disorders, such as rapid weight loss, compulsive over-exercising, skipping meals, disappearing into the bathroom during or after meals, etc., it is likely that disease has already become entrenched.

Additional visible indicators of early disease may include:

• Dieting
  
• Reaching puberty at an early age
  
• Picky or idiosyncratic eating
  
• Interest in reading food labels and in counting fat gram and colories
  
• Becoming a vegetarian
  
• Avoiding sweets
  
• Drinking lots of water or diet pop.
  
• Reluctance to eat in front others
  
• Spending a lot of time in front of the mirror
  
• Involvement in weight conscious activities, such as ice skating, gymnastics or dance.
  

Recognizing the early warning signs of disease allows parents to nip the disease in the bud before it takes hold or to facilitate a timely and effective recovery. Parents must understand that eating disorders are not about food, but are the individual's misuse of food to solve emotional problems. They may observe less obvious signs of pre-disease in emotions, behaviors, and attitudes that do not necessarily concern food and eating at all. Early signs of disease will cluster, taking form in the child's
- problems with self-control or self-esteem
- behavioral excessiveness or inflexibility
- black and white thinking
- attitudes and values
- difficulty dealing with stress
- fatique, depression, loss of motivation and social withdrawal
- body image concerns
- difficulty resolving problems courageously and effectively

The resourceful child who is a good problem-solver is an unlikely candidate to develop a disease whose primary purpose is to supply pseudo-solutions for real problems.

An example of a non-food related excess is an anorexic high school senior who wrote term papers two months before they were due, then edited them daily, 60 times each, before handing them in.

Remember that not every eating quirk is a disorder. Pathology is present when the individual ceases to have voluntary choice in these behaviors, when once benign behaviors begin to interfere with the child's life at home, at school and with his or her friends.

Taking Action - What Parents Can Do

Excerpted from When Your Child Has an Eating Disorder; A Step-by-Step Workbook for Parents and Other Caregivers (by Abigail H. Natenshon, Jossey Bass Publishers, October, 1999: page 57)

1. Set standards for a balanced eating and exercise lifestyle at home. Everyone in your household should be eating three nutritious meals a day.
   
2. Prepare meals and expect your family to enjoy them together as often as possible.
   
3. Discuss your thoughts, feelings and values with your children. Speak until you are heard.
   
4. Understand how your own attitudes about food influence your child, and try to keep them separate from your child's issues.
   
5. Hear the feeling messages behind your child's statements; respond to your child, not to the food she consumes.
   
6. Learn as much as you can before reaching out for help. Knowledge is power.
   
7. Keep expectations realistic for yourself, your child, the treatment process, and the professionals. Remember that you are dealing with a highly imperfect science.
   
8. Set goals for yourself and meet them. They will keep you focused and productive.
   
9. Remember that there are many "right" ways to do things.
   
10. Begin your foray into the community of health care providers knowing that your child deserves the very best and that your purpose is to make sure she or he gets it.

• Parents must take a positive role to play in identifying problems.
  - Educating their child about the disease
  - Encouraging their child to get treatment
  - Helping to find expert professional assistance
  - Participating with the family in the treatments
  - Evaluating the recovery process
  - Troubleshooting problems in a stalled recovery
  - Making changes alongside their child.