Question: My 11 year old daughter is a very competitive and talented ballerina. She is entering into puberty and she is struggling with her changing body shape. She is very concerned about gaining weight and changing her lithe shape. Her coaches seem to encourage her to stay slim. She is not fat at all but she has put herself on a 2100 calorie per day diet and she is very careful about writing down everything she eats and sticking to her limit. This may sound like a lot but she trains for 3 or 4 hours on an average day. I don’t know whether to applaud her determination or to worry about her obsession. Should I be concerned?

Jill Palmer Says...:

I would definitely keep watch over the situation. At 11 years old, we don't have the maturity to understand what these choices mean for us. Her body will change and evolve with puberty and you don't want her to try harder and harder to avoid it. 

There are a few things to think about in this type of situation. First, she is exercising multiple hours a day with not very many calories. Her body could potentially be starving which can cause problems with muscles and internal organs. We need nutrition to grow healthy and she may not be getting what her body needs to function and grow properly.

Second, anorexia and general eating disorders is common among dancers. You can't tell yet how she will process or internalize the messages she is getting about being slim. You definitely don't want her to acquire an eating disorder and we usually can't tell it's happening until it's already happened. 

Another thing to think about is her identity. If she identifies with being slim, she could have problems in the future when her body does change or when she is no longer a dancer. Will she be able to go back to normal eating at some point in time or is she creating habits that will be difficult to break later? Will she be accepting if her body gains weight as she develops? It's hard to answer these questions with such a young girl since there isn't much life experience to use as information.

I would also take a look at how rigid she is being. Extremes aren't useful in too many areas in life, whereas the grey area and being flexible take us a long way. Is she able to be flexible, in general, or is she more rigid? People with eating disorders tend to be very rigid (black and white thinking).

I would also applaud her determination and her strength. Those are great qualities that will help her through life. I would praise her for her strengths and watch out for her attitudes on eating and her body. 

The bottom line is trust your intuition. You know her better than anybody. Good luck to you and your daughter.

Question: My son is a very good high school wrestler trying to get a scholarship this year. His coach wants him at 160 and he is very strong and competitive at that weight but it is very hard for him to maintain it and it is probably 20 pounds less than he would be normally. He will use laxatives and make himself throw up to get to weight before weigh ins and now he is obsessed with what he eats all the time. I want to see him succeed but it is starting to feel wrong to put his body through this. Is it dangerous for him to try to stay so far below his natural weight for wrestling and how will I know if he is doing himself harm. I am worried he is becoming mentally unwell about eating.

Jill Palmer Says...:

I do believe that using laxatives and throwing up to manage weight is damaging. I don't know how damaging it is for your son and how damaging it could be in the future. The biggest problem with this is you have no way of knowing if this will turn into a life long eating disorder or not. It is possible that he does what he needs to do for school sports, then goes back to "normal" afterwards with minimal damage. It is also possible that he uses his new skills for weight management and coping in the future.

It scares me that coaches push for weight loss (good reason for the sport) but don't also talk about the down side and how this is only for this short period of time. There are consequences for using too many laxatives and there are consequences for excessive throwing up. You, as the parent, will need to weight the pros and cons so you can feel good about this decision. I see how difficult this situation is for you. You want to support and encourage your son but don't want an eating disorder on your hands. 

I think it's important that you feel good about how you proceed so you don't have regrets in the future. You can only make the best decision on this situation based on the information you have today. You can do research on consequences of eating disorders so you have the information and way the facts with what you know is true about your son. You can also have him see a counselor to discuss how he feels about food and his body to get a professional opinion (who has more information from your son).

I wish you the best of luck with this. I wish there was an easy answer for you.

Question: My friend is 6 weeks pregnant and still binging and throwing up. She swears she is going to stop soon. She does not want to lose the baby. How dangerous is bulimia for a pregnant woman?

Jill Palmer Says...:

I'm not a medical professional so I don't know the medical risks with bulimia while pregnant. From a counseling prospective, I would be concerned about her coping skills. Life is only going to get more stressful when her body grows and goes through the pregnancy process. How is she going to cope with all of the changes to her body and the new stress coming her way? I would want her to learn new and healthier coping skills before she gets too far along the pregnancy so she can enjoy the process more. A new infant will bring joys, sleepless nights, and a lot of change which all require good coping skills. Counseling would help her get a handle on her bulimia before it does effect the pregnancy or her future parenting skills.

Question: I sometimes make myself throw up after a really big meal or whenever I feel like it. I don’t do it too often, probably no more than 5 or 6 times in a month. Because I don’t do it too often I want to know if I am at risk of becoming bulimic?

Jill Palmer Says...:

It appears that the purging gives you some sort of relief. So while purging 5 to 6 times a month isn't the worst thing, I wouldn't want purging to become a bigger coping skill in your life (bulimia). Maybe try to pay attention to what is going on with you emotionally when you have the desire to purge. You might be able to see a pattern which could enable you to make different choices for relief. 

I would also suggest that you think about seeking counseling to be proactive. I would start to deal with the root of the issue before it becomes bigger and potentially an eating disorder. Take care of yourself. You deserve it. There are plenty of coping skills to use on a daily basis. Purging doesn't have to become one of them. 

Sincerely, Jill Palmer, LPC