When 'Healthy Eating' Becomes Disordered Eating

We all want our kids to eat well, make "good" choices with food, and care about their health.

So when they start choosing salads over pizza, or asking about ingredients, or saying they want to eat healthier - it can feel like a win.

But what if those "healthy choices" aren't actually about health at all?

What if they're early warning signs of something more concerning - something that's easy to miss because it looks so positive on the surface?

The truth is... disordered eating in kids doesn't usually start with dramatic restriction or obvious weight loss. It starts with things that get praised. Things that seem responsible. Things that look like discipline or being health-conscious.

And we're seeing these behaviors show up earlier and earlier, not just in teenagers, but in elementary-aged kids.

In this episode, I'm sharing what disordered eating usually looks like, why it's so easy to miss, and what signs are worth paying attention to... because the earlier we notice, the better the outcome.

I also share my own story with disordered eating and why this work is so personal to me.

We talk about:

• How eating disorders and disordered eating are showing up in younger kids now
• The early signs that often get disguised as "healthy choices" or discipline
• Changes in eating behavior, anxiety around food, body image concerns, and exercise patterns to watch for
• Why an eating disorder doesn't look like not eating
• How the way we talk about food at home can either plant seeds for protection or chip away at trust
• What to do if you're noticing patterns that feel concerning

This is not about creating fear or walking on eggshells. It's about knowing what to watch for so we can support our kids early - and so we can be intentional about the messages we're sending about food and bodies at home.

If you just want to be more aware of what these behaviors can look like, or if you're already wondering if something might be off, this episode is for you.

Foundational Episodes Referenced:

It's Not a Food Free-for-All

All Food is Not Equal

What the Heck is a Relationship with Food?

CONNECT with Nicole:

- Instagram: @nicolecruzRD
- Book a FREE Eating Alignment Call with Nicole to learn more about our approach and how we can work together: Eating Alignment Call

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Thank you for tuning in and see you next week!

Transcript

SPEAKER_00 0:01

Welcome to the Intentional Table Podcast. This is where we go beyond nutrition to not only talk about how to help your child eat well and get the nutrients they need, but how to also support them in having a healthy relationship with food. If you want your child to eat a variety, listen to their body cues, eat the amount they need, and not be obsessed with sweets or any food. Or you just don't want to fight about food, you're in the right place. Here you'll find practical tips and compassionate guidance to support your family in navigating food with more joy and less stress. I'm Nicole Cruz, registered dietitian and mom of three, and I can't wait to dive in to today's episode with you. Welcome back to the intentional table. Lately, I've been having more and more conversations with parents about disordered eating signs, body dissatisfaction, and food behaviors in kids that feel a bit concerning. And what I'm noticing is that these conversations are not actually about teenagers. We're talking about younger kids, kids that are still in elementary school. And I think that's really important because a lot of people still assume that eating disorders or disordered eating behaviors are something that show up later, that it's more of a middle school or high school issue, which it absolutely is. But we're also actually seeing more and more of these behaviors in younger kids now. And the truth is that even if kids aren't showing full-blown eating disorders, some of the thoughts, behaviors, and body concerns that can contribute to disordered eating can start showing up much earlier than many of us realize. And I also want to say that no one is immune to this. This is not something that only affects one type of child, one body size, one gender, one personality. It can happen to anyone. Anybody can struggle with disordered eating. And while I don't want to create fear or make you second guess every single thing your child does around food or their body, I do think this is something that we need to pay attention to. Because often these struggles can be really serious, even if they don't look dramatic at first. And the earlier that we notice the signs and can make some changes, the better the outcome typically is. So the goal of this episode is really to help you better understand what disordered eating can look like, what signs might be worth paying attention to, and how you can think about this in terms of your child, just so that you can best support them and know when something might be going down a road that we want to pay more attention to, the sooner the better. Because some of the earliest signs of disordered eating are often disguised as, you know, quote unquote healthy choices or discipline or clean eating or just eating, quote unquote, good or healthy. Now, if you're newer here or you don't really know much of my story, uh this conversation is also really personal for me because I struggled with an eating disorder in my teens and early 20s. And like a lot of disordered eating, it spanned a lot of different behaviors and different looks, which is super common. And that's also why sometimes we can miss the signs. For me, it went back and forth between, you know, restricting, feeling out of control around food, trying to manage my weight, not really feeling good in my body. Like for many people, for me, it did include things like trying to eat really quote unquote healthy. And that's how it started, combined with wanting to look different, wanting to control or manage my weight, which leads, you know, down rabbit holes of then restricting food, but feeling out of control around food, feeling worse and worse and obsessing about what our body looks like. And I think it came from where a lot of disordered eating does come from, which is kind of like the perfect storm of all of these things coming together, like the cultural messaging around food and bodies, anxiety, perfectionism, not feeling good enough, wanting to fit in. And usually there's some genetic predisposition there as well, along with how we watch other women in our in our lives model, you know, their relationship with food in their body. And it's not necessarily one single thing. It usually isn't. And for me, it was a lot of things coming together. And I share this because I think it's really important to recognize that no one is to blame, there's not one perfect right or wrong thing. A lot of kids and individuals in general are affected in different ways. But when we put things like the way that we talk about food or model food together with, you know, a perfectionistic kid or somebody who has anxiety or who doesn't feel good enough, we can create that perfect storm. So for me, I ended up, you know, going down this rabbit hole of trying to eat better, trying to control my body. I ended up dropping out of college to get to get help. And then through my own healing process with food in my body, I knew that I wanted to support others on the same journey because I knew what was on the other side of it, the freedom, how much better I felt. And so now I've spent nearly 20 years supporting teens and adults and healing their own relationship with food in their body. And partway through this work of supporting teens and adults, I started noticing something when I had kids myself. I started seeing all of these loving, intentional, well-meaning parents who were also struggling with feeding their kids. They wanted their kids to be healthy, to get the nutrition they need. They wanted them to eat a variety of foods, not, you know, overdo sugar and sweets and eat enough to grow and thrive and feel good in their body. But what I noticed was that the way that they were trying to manage their food to help their kids eat healthy and feel good often sounded a lot like the same kinds of thoughts and behaviors that I was hearing from my eating disorder clients in my office. And honestly, it mimicked a lot of the thoughts and behaviors that I had struggled with in my own eating disorder as well. Things like, you know, feeling that certain foods needed to be limited, like you shouldn't have too much of the foods that you really enjoy, that you need to stop after one piece of pizza or not even have it at all, just get the salad, that you need to earn food or eat the quote unquote healthy foods first in order to deserve a little bit of, you know, the dessert or whatever it might be that you really wanted. And that really struck me because I realized that these parents were trying to do what they thought was the absolute best thing for their kid. But some of the strategies they were using were actually making food more charged, more emotional, more complicated for their kids. And that can show up in the short term as more stress and tension around food, but also kids not wanting to eat their vegetables or obsessing over sweets or sneaking food or feeling out of control and trying to get as much as they can. But it can also contribute to more disordered eating patterns, body dissatisfaction, and a really complicated relationship with food long term. And this happens because a lot of disordered eating doesn't start with kids just thinking, I want to lose weight, I want an eating disorder. It starts with fear around foods or feeling guilty, with having some food rules, maybe with wanting to be good or eat healthy or wanting to be more in control. And that's why I think we also need to start talking about this earlier so that we can hopefully prevent planting some of those seeds unintentionally. Now, even though eating disorders are more common, they more commonly start in the teen or adult years, they can start much earlier, and the thoughts and behaviors underneath them often do. And research shows that even in elementary-aged kids, body and weight concerns are already showing up. In one study of children in third through sixth grade, half of them said they wanted to weigh less, and 16% had already tried to lose weight. And that's just one study. There are multiple more studies, and I'm not going to go into reading you a bunch of facts and statistics, but we are seeing that kindergarteners also don't like their body or think that their body is too big, and that a good portion of girls under 10 have already tried to diet. So we're not here to plant the seeds of, you know, guilt, fear, or shame for us as parents either, not to scare you or anything like that, but so that we can all recognize that these things can begin earlier and often in ways that are easy to miss. And oftentimes it's not going to show up at first, is what we think an eating disorder is, like not eating or restricting your intake. And so that's what I really want to talk about today is knowing what to watch for. And a lot of these things can be subtle or even look quote unquote healthy on the surface. So I also want to note that we're not really looking for just one isolated behavior, but we want to notice patterns, changes, intensity, whether there seems to be anxiety, rigidity, or distress underneath some of these behaviors. Because kids will have preferences. Kids will not be hungry sometimes. Kids will change their mind about different foods. They are allowed to feel weird about clothes not fitting when they've grown out of them, or if they don't, you know, they can't wear their favorite shorts anymore. All of that is normal. But we really do want to check in with whether it seems there is some sort of fear, avoidance, secrecy, distress around any of it, or whether it's becoming a pattern, or it seems like it's increasing in intensity. So let's break some of these behaviors down into different categories, behaviors that we might be looking for that could signal that something's a little bit off. So, first of all, let's talk about changes in their eating behavior. This could look like they're skipping meals more often, or saying that they're not really hungry in a way that feels more frequent, or maybe intentional. Maybe they're actually pushing food around on the plate without really eating, or seeming like they're taking a really long time to eat while not eating very much. Maybe they are making excuses to avoid meals, or they're actually hiding food or throwing it away but acting like they ate it or pretending that they were eating or lying about what they've eaten. Now, again, not being hungry sometimes is normal. And appetite changes from day to day are normal. So your kids saying they're not hungry at one meal or starting to eat less at breakfast because maybe their appetite has changed, that can be normal. But we really want to notice if it feels like a shift, if it feels intentional, if it feels like it's loaded in any way, or if you ask a question about it, they become defensive. Now, the second thing to watch for is that sense of anxiety or rigidity or fear around food. Maybe they're seeming really anxious before meals. They're asking a lot of questions or seeming a little bit stressed about what's being served or how you're making it, what the ingredients are. Or maybe they're suddenly trying to avoid meals, or maybe they're no longer eating or getting foods that they used to genuinely enjoy. Maybe your child used to always get a frappuccino at Starbucks or split dessert with you or order pizza when you went out. And now they're suddenly not getting those things, or just saying that doesn't sound good, or I don't want to eat that, or maybe they explicitly say, you know, I'm trying to eat less sugar, or I'm trying to make quote unquote healthier choices. So be aware of things like suddenly being very concerned about sugar, carbs, ingredients, calories, or quote unquote, you know, junk or processed foods, wanting to avoid foods because they say they're, you know, bad or unhealthy or they're not clean, that they seem anxious about eating foods they used to enjoy, or something maybe doesn't seem like it's quote unquote healthy enough, or maybe it's that they won't eat anything unless it's organic now. And again, they might be actually telling you this because it feels positive to them, or they think that you might even encourage them, or that somebody else will encourage them, or maybe it does seem a little bit secretive, and both can actually be concerning. Now, another category to watch for is body image. And this might look like they are checking their body in the mirror often, that they're making more negative comments about their stomach, their thighs, their arms, or their body overall. They're saying that they feel fat or they wish that their stomach was flatter. Maybe they're comparing their body to their siblings or their friends or somebody that they see in a video online. Maybe they're covering up their body in a way that they didn't used to, or that you can tell seems like because they feel some distress over it, or they don't want people to see them. And that might be in a bathing suit, it might be them only wanting to wear baggy or loose-fitting clothes, or just getting really upset about how their clothes fit. And again, there's nuance here because a lot of this is completely normal for a child to feel upset about their clothing, to not like the way something fits, to grow out of a favorite pair of, you know, shorts or a shirt that they loved. That can feel frustrating or emotional. And bodies are supposed to grow and change, and we constantly want to be normalizing that. But what we really want to pay attention to is whether that distress seems to go beyond, I'm sad this doesn't fit me anymore, and into I don't like my body, I wish I were smaller, something is wrong here, that it seems like the degree is more intense. Now, the last category we're going to talk about is their changes in exercise or movement. And again, moving our bodies is a positive behavior. And if your child has been quite sedentary and they're wanting to take some walks around the block or maybe do a fun video for kids on YouTube that's a yoga video or a movement video of some other type, that can be okay and that could be positive. But if it feels like it's really sudden or rigid, that they're hiding it in any way or doing workouts in secret, that they're getting upset or guilty if they can't exercise, that it seems like they're tying it to food in any way, or that it seems like it is about, you know, aesthetically changing their body, or if it's if it's um paired with, you know, them checking in the mirror a lot. That is absolutely concerning. And again, we want to encourage health-promoting behaviors, but we do want to have our antennas up if something seems a little bit off. So a kid getting interested in sports or movement or fitness is not automatically a problem, but we want to see if there's anxiety attached to it. Does it seem like it's compulsive at all? Does it seem like it's increasing in, you know, intensity or the amount that they need to do it? Or does it seem at all tied to trying to control their body or linked to what they're eating? And I do want to acknowledge the nuance here because not every child who shows one of these signs has an eating disorder. I am not suggesting that at all, or that they are on their way to one. Kids can go through phases, they can have preferences, they can have emotional reactions to food or their body that still fall within the range of what we, you know, consider quote unquote normal. All of us are going to have feelings about our body, especially in a culture that tells us that it should constantly be changing or that it's not good enough, or that puts a lot of emphasis on it. So some of these things are just a normal part of being a human. Eating disorders and disordered eating often happen when there's a particular combination of risk factors, including personality traits, environment, experiences that come together. And again, you know, one kid could go to a doctor's appointment and the doctor makes a comment about their weight or about quote-unquote healthy eating, and that kid walks out of there kind of thinking about it, or maybe not even caring about it. And another kid feels like, I need to make major changes, or I'm gonna do everything I can to be as healthy as possible right now, and it has a different effect. So usually there are multiple compounding factors. So this is not about, you know, us being alarmists or always on the edge of our seats, but we do want to pay attention to when patterns start to emerge, or if we notice that our kid has a particular reaction to something that somebody says, or if we're just noticing multiple signs. And I think it's also really important to say that when someone is struggling with disordered eating or even a diagnosable eating disorder, they are most likely still eating. So often parents come to me and they say, but they're still eating, or but they still do have ice cream sometimes, or they'll still eat mac and cheese when I make it. So if we are seeing some risk factors or some behaviors that feel concerning, we don't want to negate them because we're picking out these other little things that do look normal. Disordered eating is not black and white. It's not either they are totally restricting, counting calories, have cut out all quote unquote junk food, they're losing weight, they're X, Y, and Z, or they're just eating normally and everything is fine. Right? Behaviors can show up in all different ways. And so if something feels off, try to trust that and not justify it because they're still eating or they still do get their Starbucks. And we also want to recognize that sometimes the surface level behaviors do still look somewhat normal. But if we're sensing that there's something underneath them, like we are noticing some anxiety, it does seem like there's more focus on looking at package labels, or that it seems like our kid is not really wanting to come to the table, or like I said before, maybe pushing food around a bit more. Sometimes that's showing us that there are underlying things going on for them and the way that they are thinking about food or processing. What they're eating, and we don't want to ignore the emotional impact that has as well. And what can also feel really tricky is that what often gets praised as quote unquote healthy eating is actually something much more concerning or that can become concerning. Oftentimes, the earliest disordered eating behaviors that we're noticing are getting that attention around, doing a good job, taking care of their health, being conscious, making quote unquote better choices. So even if it feels like maybe there are some health-promoting or positive behaviors happening, we still want to keep an eye on our child's demeanor around them, their mental and emotional state around those behaviors, as well as if they seem to be coming, if they seem to be getting more ingrained or becoming obsessive in any way. Now again, dis disordered eating and eating disorders, they can develop for a variety of reasons. But this is exactly why the work we do around food at home and with our families matters so much. A lot of what we talk about here on this podcast around reducing pressure, building neutrality around food, helping kids listen to their bodies, respecting their hunger and fullness, their appetite, creating safety instead of control. These are the things that are planting seeds for more protection, right? For more body trust. They're not a guarantee. We cannot fully control whether our child will ever struggle with food. There are so many influences. But the way that we offer food, talk about food, talk about bodies, respond to their requests for food or when they say they're hungry or full, they can create trust around eating and be one protective piece, or they can start to chip away at that trust and make our kids question themselves. So as we continue to navigate food with our families, it's really helpful for us to think about how can we plant seeds for food and body trust, for flexibility with eating, safety, neutrality, respect for all bodies. Because the way that we eat is influenced by our beliefs about food and our beliefs about ourselves. And one of the biggest belief systems that fuels disordered eating is some foods make me good and some foods make me bad. Or the way that I eat makes me worthy or deserving that I'm being good, I'm being bad, I'm enough, I'm not enough. This can come out in food. Now, I'm not going to go through our whole feeding approach in this episode because I've covered that in other foundational episodes. And I'll point you to those in the show notes. But I do want us to recognize that the way that we are approaching food as a whole, not every single sentence you say, but our overarching approach and the message that we're sending does matter in shaping our kids' relationship with food in their body. Now, if you're listening to this and feeling concerned about your child, I want to encourage you to not ignore that. I also don't want you to question every single thing or feel like you're walking on eggshells. But if you are noticing patterns that feel concerning, I would recommend that you seek out support because there are different kinds of support and different levels of care depending on what's going on for your child. And having the right professionals help you assess the full picture can make a really big difference because the earlier we notice and support our kids or any individuals in our lives, the better. And truly, that is the whole point of this conversation. It's not to scare you or make you hyper-vigilant, but to help you notice what can so easily get missed or to make small shifts now in the way that you're talking about food and bodies and eating. Because even though our culture as a whole might be modeling disordered eating behaviors and trying to change our bodies in the name of health, our kids are also watching and learning from us. And we want to be that safe space where they can have these conversations and open dialogue and also be the ones who help them think more critically about diet culture, our perception of food and bodies. We can be the ones that show them a different perspective than the norm. So I want to reiterate: please trust your intuition. If anything feels off with your child, it's not too early to seek out some guidance. And if you don't have concerns about disordered eating right now, the best thing you can do to help prevent it is to plant the seeds for food embody trust in the way that you offer food, talk about food, and model your own relationship with food in your body. Now, I trust that this was helpful and gives you some food for thought, some things to ponder, to recognize in your own family, and even to consider in your own relationship with food. Now, let's take a second as we wrap up. Take a breath and remind ourselves, as we always do, that nourishing a healthy relationship with food is just as important, if not more, than the food itself. Thank you for joining me at the intentional table, and I'll see you next time. Thank you again for tuning in today. And if you have a quick second, truly takes less than a minute, can I ask you to take that moment, write a rating or a review, or share this with another parent who might find it helpful? The more parents we can reach, together we can help our kids have a healthy relationship with food.