Counseling Vegetarians and Orthorexia

Posted 12/4/15 in [Nutrition "Nesaykwa"] | Comments Off on Counseling Vegetarians and Orthorexia

PLEASE NOTE: The following is not all-inclusive advice concerning disordered eating. However, because my passion is to help those struggling with this condition in the services side of Liquid Body Life Co., I wanted to give a brief overview of what I tell certain people who contact me for services. It does not replace the advice of a trained professional, nor is it diagnosing anyone. If you suspect someone you love has an eating disorder, please contact the National Eating Disorder Association’s hotline 1-800-931-2237.

My daughter, who is 16, has decided she wants to be a vegetarian. The problem is that she doesn’t eat vegetables or many fruits, and is living mostly on carbohydrate-heavy foods, such as pasta and processed grain foods. She has lost about 15-20 lbs, and frankly, I am worried that she is developing an eating disorder. She tells me that she can’t eat because she feels nauseated, and when she does eat, it is only a small amount. I don’t think she is getting anywhere near enough protein, and it is mostly from beans. She has started to not eat certain foods and is making excuses for why which seem suspicious. She will eat cheese and yogurt every day.

Please allow me to share my sadness with you and what you’re facing with your daughter. And it certainly sounds like she is dealing with some sort of disordered eating, although I couldn’t make a formal diagnosis without meeting with her and asking her some questions.

If your daughter (and/or her friend) are not ready to admit there is a problem, I could help her by befriending her and being a guide, but it would be a limited therapy until she was ready to admit there is an issue. Often, it can help if the parent tells the teen that “you’re bringing a professional in to help with the new dietary choices she is making as a vegetarian,” but if your daughter is trying to assert her individuality, it has to be sold that it is her choice, so that when advice is given, she is not feeling like this is just another adult trying to tell her what to do.

However, I believe I can help you and your friend negotiate these waters just a little, even in this email. The basic thing you need to understand about any eating disorder is that it’s rooted usually in just one or two things: 1) The child has been raised an extraordinarily strict circumstances, and is trying to have control over any part of their life they can; or, 2) The child is aware of the demands of being an adult, and is seeing all the changes in his or her body, especially with puberty and sexuality, and/or other “adult” situations (like a divorce, death, or even the looming reality of responsibility) and feels extraordinarily out of control of the situation. He or she then chooses to control the one thing they have to control.

What your daughter needs is someone to sit her down, tell her of those concerns, tell her that you are respecting her as an adult, and want to support her. Then, she needs to hear a game plan/practical pathway that affirms her as an individual, but sets boundaries for her as well. This will not be easy for you, because what you are doing as a parent is letting go of the ability to protect her from herself, and from her mistakes. It also means that everything you’ve trained her about good nutrition will likely go out the window for a season. However, doing this intervention now can prevent a deeper tragedy in the future. Because, when she gets down to 85% of her ideal weight, she is no longer physiologically and chemically in control of the hormones that are guiding her thought patterns right now. That’s when you have to consider inpatient intervention.

How this might look could go like this:

  1. You set an appointment with her. “Honey, I would like to have a half hour of your time of your choosing to talk with you about some concerns I have. Would you be able to do something Wednesday around three, or Thursday around 10 AM?” (communicates respect for her time, communicates that she is in charge of the appointment communicates that she can say no.)
  2. When you sit down, you tell her explicitly what’s going to happen in the next half hour. “So, sweetie, I’m only going to take a half hour of your time right now. I just wanted to have an adult-to-adult talk with you concerning some things I’ve seen with your eating patterns. I am not here to lecture you, and you may stop this talk at any time. Also, this is the last time I’m going to express any of these concerns with you. In just a couple years, you are going to be an adult, and I want you to know that I’m here in that time to support you. So, from here on out, I’m going to try to let you do more decision-making and will be available for any input you would like, but I want you to feel like you are in more control of important life decisions.” (respect for her as an adult, communicates you are seeing her as an adult and not a child, reinforces that reality is coming, reinforces that she won’t be alone in it)
  3. Select 3-4 things you most want to tell her, and phrase it as, “I have observed this… And it concerns me because…” For instance, “I have observed you have certain foods that you will not eat at all, and it concerns me because all foods are good for our bodies, as long as their whole foods.” (conveys that you are being observant about her more than she knows, conveys to her that there is something wrong about having fear foods, conveys to her nonjudgments about what she’s doing)
  4. After each one, you ask the question, “So, in healthy relationships, usually it’s discussion that goes on. I’d like to know how you feel about what I just said?” Whatever she says, you respond back to her with “so what I hear you saying is… Is that right?” And this will be hard – you do not respond to that. All you say to that is “OK thanks for that information. I respect that.” Even if she comes back with some sort of terrible accusation, or is angry, or whatever, all you are saying is, “OK I’ve got it. Thanks for that information. I respect that.” (Initiates a more mature, healthy communication pattern with her, conveys that she is allowed to have differing opinions than you or her upbringing, conveys that she’s allowed to get angry, and conveys that you are respecting her opinions)
  5. If you get the half hour mark, make sure that you tell her that it’s been a half hour, you want to respect your time, and can you continue this discussion now or later? (conveys that you’re willing to lay down your agenda for her)
  6. At the end of the time, you need to lay down some boundaries. I recommend some or all of the following: you may eat anything you wish, whenever you wish. However, if you’re if you want to eat something that I do not normally buy in a grocery trip, you have to buy that out of your own funds; you may now have the shelf in the cupboard for your own personal food, and you may have this shelf in the refrigerator for your own personal food. We will not eat or touch the food in these areas; if you are asked by a sibling why why you got to, say, eat ice cream for dinner, you are simply to say that this is something that we worked out together. You are not allowed to invite other people to eat whatever they want whenever they want or join you. This is our special agreement we are making here today. The other people in the family are still under the rules concerning food that I serve; you must eat at least 1200 cal every single day. If it anytime you are not consuming at least 1200 cal per day, what would you like me to say to remind you that you need more intake? (this is very important. It makes sure that she understands that she is going to be held accountable for her own words, and she gets to decide what you say in order to hold her accountable.); if, at any time, you are below the low end of your recommended weight range by 85%, I will take you over to Hershey medical center and check you into their eating disorder inpatient program. Period. You need to understand that this is me telling you that I am your parent, and I respect you enough to give you freedom with your food choices, but you are not allowed to kill yourself while you live here. It is not fair to me as your mother, nor your siblings, who love you and want the best for you, to watch you die. Mark my words, this is a nonnegotiable.; this can be a wonderful time for our relationship to grow and mature. I hope you will choose to do your part, and I am going to change as the Holy Spirit shows me and do my part. I would like you to tell me every single time you do not feel respected by me. When you do, please allow five minutes for us to discuss it like adults.

    And then, comes the hard part. You have to walk it out. You have to watch her make tons of mistakes. You have to bite your tongue about 6000 times a day. However, I promise you that it will bear fruit. These are just guidelines, and of course I don’t know your complete situation, but this is something you can do to start to negotiate these troubled waters. If she feels supported by you, we can make a lot of difference. However, she will test you at first to make sure you mean what you say. She will have ice cream for dinner and watch to see if you see anything. She will not eat enough in one day and then see if you use the word she told you to use and nothing else. It’s just part of the illness, but if you do your part in God’s strength, you will see that the victory is very sweet.

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