Parenting and Eating Disorders

Cole Kazdin

8 min Read Cole Kazdin

Cole Kazdin

Parenting and Eating Disorders

How to talk to kids about food when your own relationship to it is fraught

Cole Kazdin

8 min Read

I’m delighted today to have a post by Cole Kazdin, the author of What’s Eating Us, about managing parenting amid the complications of diet culture and eating disorder recovery. Cole’s book really resonated with me — one of my parenting fears is passing on my messed-up 1980s food issues to my children. Reading about her journey, and now about how she thinks about parenting in these moments, is both calming and helpful. The timing strikes me as especially appropriate headed into the holiday season. Enjoy.—Emily


Recently on a preschool tour with my husband, the school’s director started talking about foods they forbid to be packed in kids’ lunches. “No judgments about what you serve at home!” She forced a laugh, attempting to lighten what was, indeed, judgment, as she continued. “While your kids are here, we don’t allow any processed foods — only protein, whole grains, and healthy fats.”

I scanned the small yard to see if any of the other parents might find this disturbing. We were sitting outside behind the school, crammed uncomfortably onto tiny, low wooden benches intended for toddlers. (Does this seat make me look fat? Yes.) As the director continued on about the evils of sugar, I signaled to my husband: grab your jacket, we’re leaving.

“No processed foods” sounded innocent enough, especially in Los Angeles, where I live, and where you can’t swing a stick without hitting an acai bowl.

But as a woman who’s struggled on and off for decades with an eating disorder, this was, to put it mildly, triggering. I’ve spent much of my life dieting, starving, and restricting foods. In recovery, one of my daily battles is internally disputing well-meaning but uninformed outside messages about health: that foods can be good or bad and that so-called bad ones (usually the fun ones — pizza, cake) should be avoided. Gently working these once-restricted foods back into one’s diet supports healing.

I’m also a journalist who has researched extensively on how eating disorders manifest and the harm they cause. Now that I’m a parent, I’m on high alert. Ideally, we want our kids to enjoy a variety of foods, including fruits and vegetables (key word: enjoy), but most of us can’t stay up late grinding our own millet. These days, everything is processed. Unsweetened applesauce doesn’t grow in the wild. Families have different access to different foods, and we feed our kids what we can. Food policing from schools — or anywhere — is a dangerous game, adjacent to the restrictive weight-loss messaging we all get every day. And it may put kids at a higher risk for developing an eating disorder later in life.

Eating disorders are complex illnesses that even experts in the field don’t fully understand, a tapestry of individual biology, genetics, family pressure, trauma, and a culture obsessed with thinness. Social media doesn’t help, but the epidemic predates TikTok. One of the greatest predictors of developing an eating disorder is a history of dieting, according to one of the largest studies on the subject. I want to do everything in my power to prevent my child from learning those potentially life-threatening habits.

Most of us are familiar with anorexia, bulimia, and binge-eating disorder, but there’s another category, “other specified feeding or eating disorders,” or OSFED — a catchall for folks who don’t neatly fit diagnostic criteria for the other disorders. For example, a diagnosis of anorexia requires low body weight. If a person is starving themself but not at a low weight, they’re not “officially” anorexic. OSFED can be as nebulous as it sounds, including symptoms like frequent dieting or eliminating an entire category of food. Most patients in community clinics diagnosed with eating disorders fall into the OSFED category, and people with OSFED are just as likely to die as a result of their eating disorder as people with anorexia or bulimia.

One of the greatest challenges for those of us who struggle with food and our bodies is the ambiguity of the problem: when does “watching what you eat” or “getting healthy!” become an eating disorder? I don’t know what that point is and, more importantly, neither does much of the scientific or medical community. The gaps in research and treatment are astonishing, and it’s why we, as parents, need to educate ourselves and intervene early on.

Eating disorders have among the highest mortality rates of any mental illness. Nearly 30 million people in the U.S. will have one in their lifetime. About a quarter of them will attempt suicide. During COVID, emergency room visits and inpatient admissions for eating disorders at pediatric hospitals skyrocketed, and those numbers, according to recent studies, have not returned to pre-pandemic levels. Every 52 minutes, someone dies as a direct result of an eating disorder.

There are effective evidence-based treatments (family-based treatment for kids and teens, and cognitive behavioral therapy for adults), but there’s no standard of care for eating disorders in the U.S. It’s really hard to get better. Treatment is expensive and not regulated. It’s part of the reason relapse rates are high, and for many who are fortunate to receive treatment, it may not “stick.”

It didn’t for me. I spent my teen years battling genetics that were not rigged for the dance career I so desperately wanted and then, years after that, just battling, period. I reached dangerously low weights while friends and coworkers gushed that I looked amazing. “What’s your secret?”

No one ever talked to me about eating disorders. I knew I had one, confirmed by late-night googling with a glass of wine (90 calories). I was in my 30s when I finally sought care, and thought I nailed recovery, only to spend years afterward relapsing again and again, wondering what I’d done wrong. I decided to investigate my recovery as a journalist instead of as a patient (which was getting me nowhere). Interviewing leading researchers and identifying the many obstacles to recovery, I gained a deeper understanding of the neurological underpinnings of the illness, as well as the uphill battle to heal in a world that so often uses health as a proxy for weight loss. I discovered new treatments and a surprising amount of hope.

I was relieved to hear “It’s a boy” when my son was born, thinking gender alone might shield him from all of this, but boys and men suffer too, though girls and women are twice as likely to. The highest risk for onset of an eating disorder is during adolescence, but eating disorders can start as young as age 5, and up to over 80 years old. It is never too early and never too late.

So what can we do? As parents, there’s so much we can’t control, but we can start the conversation and act as goalies for the outside messages our children hear. Categorizing foods as “good” or “bad” is the on-ramp to restriction, dieting, and bingeing. (Virginia Sole-Smith offers excellent tips on having these conversations.)

We can also examine our own relationship to food and our bodies. Anyone who’s yelled “shit” when they’ve stubbed their toe and then heard their child sing the word back on repeat knows that kids model everything we do. We can throw out the scale, not critique our own bodies (aloud, at least) or anyone else’s, and enjoy foods we may have once restricted (I’m looking at you, bread).

Finding ways to reduce stress — around eating and just in general — may be one of the most powerful changes we can make to improve health. Food restriction has been shown, in humans and mice, to prompt a stress response and raise cortisol levels.

As for the inevitable obesity question: A vast amount of scientific research tells us that all diets are equally ineffective, and we don’t yet have a complete picture of the long-term effects of the new semaglutide weight-loss drugs. Most people gain back lost weight anyway, and weight fluctuation itself is correlated with chronic illnesses like Type 2 diabetes. As one leading public health researcher told me, you can control your behaviors, but you can’t control your weight. Behavior changes, like adding exercise, can have positive impacts on health, whether weight drops or not.

Like so many women who have struggled with food and body image in their own lives, I desperately want a “do-over” in raising my child. And yet. At my son’s new school, everyone seems to be turning 3 at the same time, and the weekend birthday schedule is relentless. Last Saturday, we’re in a park, the neon-blue-frosted Elsa sheet cake comes out, and I feel my body tense. Be cool! I tell myself. You wrote a book on this! The singing stops and the birthday girl’s mom smiles, moving the knife across the cake, the universal sign for “this big?” and I stop her at the smallest corner — shit — I’m doing it! It’s three layers of chocolate and gooey white-and-blue, and my son lights up, taking the plate. I inhale a deep breath as we sit, and as if on cue, I hear the crackle of a speaker and there’s that song again (every girl’s birthday party!) blaring: “Let It Go.” So I do. I exhale. I ask my son how he likes his cake. He beams, opening his mouth to show me — his tongue is bright blue.

Chocolate covered ice cream popsicles are arranged on a green background.

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If you have a fever during pregnancy, you should take Tylenol, both because it will make you feel better and because of concerns about fever in pregnancy (although these are also overstated).

The evidence that suggests risks to Tylenol focuses largely on more extensive exposure — say, taking it for more than 28 days during pregnancy. There is no credible evidence, even correlational, to suggest that taking it occasionally for a fever or headache would be an issue.

People take Tylenol for a reason. For many people, the choice may be between debilitating weekly migraines and regular Tylenol usage. The impacts studies suggest are very small. In making this decision, we should weigh the real, known benefit against the suggestion of this possible risk. Perhaps not everyone will come out at the same place on this, but it is crucial we give people the tools to make the choice for themselves.

#emilyoster #parentdata #tylenol #pregnancy #pregnancytips

If you have a fever during pregnancy, you should take Tylenol, both because it will make you feel better and because of concerns about fever in pregnancy (although these are also overstated).

The evidence that suggests risks to Tylenol focuses largely on more extensive exposure — say, taking it for more than 28 days during pregnancy. There is no credible evidence, even correlational, to suggest that taking it occasionally for a fever or headache would be an issue.

People take Tylenol for a reason. For many people, the choice may be between debilitating weekly migraines and regular Tylenol usage. The impacts studies suggest are very small. In making this decision, we should weigh the real, known benefit against the suggestion of this possible risk. Perhaps not everyone will come out at the same place on this, but it is crucial we give people the tools to make the choice for themselves.

#emilyoster #parentdata #tylenol #pregnancy #pregnancytips
...

Parenting trends are like Cabbage Patch Kids: they’re usually only popular because a bunch of people are using them! Most of the time, these trends are not based on new scientific research, and even if they are, that new research doesn’t reflect all of what we’ve studied before.

In the future, before hopping onto the latest trend, check the data first. Unlike Cabbage Patch Kids, parenting trends can add a lot of unnecessary stress and challenges to your plate. What’s a recent trend that you’ve been wondering about?

#parentdata #emilyoster #parentingtips #parentingadvice #parentinghacks

Parenting trends are like Cabbage Patch Kids: they’re usually only popular because a bunch of people are using them! Most of the time, these trends are not based on new scientific research, and even if they are, that new research doesn’t reflect all of what we’ve studied before.

In the future, before hopping onto the latest trend, check the data first. Unlike Cabbage Patch Kids, parenting trends can add a lot of unnecessary stress and challenges to your plate. What’s a recent trend that you’ve been wondering about?

#parentdata #emilyoster #parentingtips #parentingadvice #parentinghacks
...

As of this week, 1 million copies of my books have been sold. This feels humbling and, frankly, unbelievable. I’m so thankful to those of you who’ve read and passed along your recommendations of the books.

When I wrote Expecting Better, I had no plan for all of this — I wrote that book because I felt compelled to write it, because it was the book I wanted to read. As I’ve come out with more books, and now ParentData, I am closer to seeing what I hope we can all create. That is: a world where everyone has access to reliable data, based on causal evidence, to make informed, confident decisions that work for their families.

I’m so grateful you’re all here as a part of this, and I want to thank you! If you’ve been waiting for the right moment to sign up for full access to ParentData, this is it. ⭐️ Comment “Link” for a DM with a discount code for 20% off of a new monthly or annual subscription to ParentData! 

Thank you again for being the best community of readers and internet-friends on the planet. I am so lucky to have you all here.

#parentdata #emilyoster #expectingbetter #cribsheet #familyfirm #parentingcommunity

As of this week, 1 million copies of my books have been sold. This feels humbling and, frankly, unbelievable. I’m so thankful to those of you who’ve read and passed along your recommendations of the books.

When I wrote Expecting Better, I had no plan for all of this — I wrote that book because I felt compelled to write it, because it was the book I wanted to read. As I’ve come out with more books, and now ParentData, I am closer to seeing what I hope we can all create. That is: a world where everyone has access to reliable data, based on causal evidence, to make informed, confident decisions that work for their families.

I’m so grateful you’re all here as a part of this, and I want to thank you! If you’ve been waiting for the right moment to sign up for full access to ParentData, this is it. ⭐️ Comment “Link” for a DM with a discount code for 20% off of a new monthly or annual subscription to ParentData!

Thank you again for being the best community of readers and internet-friends on the planet. I am so lucky to have you all here.

#parentdata #emilyoster #expectingbetter #cribsheet #familyfirm #parentingcommunity
...

Just eat your Cheerios and move on.

Just eat your Cheerios and move on. ...

The AAP’s guidelines recommend sleeping in the same room as your baby “ideally for the first six months.” However, the risk of SIDS is dramatically lower after four months, and the evidence in favor of the protective effect of room sharing is quite weak (both overall and even more so after four months). There is also growing evidence that infants who sleep in their own room by four months sleep better at four months, better at nine months, and even better at 30 months.

With this in mind, it’s worth asking why this recommendation continues at all — or at least why the AAP doesn’t push it back to four months. They say decreased arousals from sleep are linked to SIDS, which could mean that babies sleeping in their own room is risky. But this link is extremely indirect, and they do not show direct evidence to support it.

According to the data we have, parents should sleep in the same room as a baby for as long as it works for them! Sharing a room with a child may have negative impacts on both child and adult sleep. We should give families more help in navigating these trade-offs and making the decisions that work best for them.

#emilyoster #parentdata #roomsharing #sids #parentingguide

The AAP’s guidelines recommend sleeping in the same room as your baby “ideally for the first six months.” However, the risk of SIDS is dramatically lower after four months, and the evidence in favor of the protective effect of room sharing is quite weak (both overall and even more so after four months). There is also growing evidence that infants who sleep in their own room by four months sleep better at four months, better at nine months, and even better at 30 months.

With this in mind, it’s worth asking why this recommendation continues at all — or at least why the AAP doesn’t push it back to four months. They say decreased arousals from sleep are linked to SIDS, which could mean that babies sleeping in their own room is risky. But this link is extremely indirect, and they do not show direct evidence to support it.

According to the data we have, parents should sleep in the same room as a baby for as long as it works for them! Sharing a room with a child may have negative impacts on both child and adult sleep. We should give families more help in navigating these trade-offs and making the decisions that work best for them.

#emilyoster #parentdata #roomsharing #sids #parentingguide
...

It was an absolute pleasure to be featured on the @tamronhallshow! We talked about all things data-driven parenting and, in this clip, what I call the plague of secret parenting. To balance having a career and having a family, we can’t hide the fact that we’re parents. If mothers and fathers at the top can speak more openly about child-care obligations, it will help us all set a new precedent.

Watch the full segment at the link in my bio 🔗

#tamronhall #tamronhallshow #emilyoster #parentingsupport #workingparents

It was an absolute pleasure to be featured on the @tamronhallshow! We talked about all things data-driven parenting and, in this clip, what I call the plague of secret parenting. To balance having a career and having a family, we can’t hide the fact that we’re parents. If mothers and fathers at the top can speak more openly about child-care obligations, it will help us all set a new precedent.

Watch the full segment at the link in my bio 🔗

#tamronhall #tamronhallshow #emilyoster #parentingsupport #workingparents
...

Invisible labor. It’s the work — in our households especially — that has to happen but that no one sees. It’s making the doctor’s appointment, ensuring birthday cards are purchased, remembering the milk.

My guest on this episode, @everodsky, has come up with a solution here, or at least a way for us to recognize the problem and make our own solutions. I’ve wanted to speak with Eve for ages, since I read her book Fair Play. We had a great conversation about the division of household labor, one I think you’ll get a lot out of!

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#emilyoster #parentdata #parentdatapodcast #parentingpodcast #householdtips #fairplay #invisiblelabor

Invisible labor. It’s the work — in our households especially — that has to happen but that no one sees. It’s making the doctor’s appointment, ensuring birthday cards are purchased, remembering the milk.

My guest on this episode, @everodsky, has come up with a solution here, or at least a way for us to recognize the problem and make our own solutions. I’ve wanted to speak with Eve for ages, since I read her book Fair Play. We had a great conversation about the division of household labor, one I think you’ll get a lot out of!

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#emilyoster #parentdata #parentdatapodcast #parentingpodcast #householdtips #fairplay #invisiblelabor
...

Prenatal vitamins 💊 If there is any product that seems designed to prey on our fears, it’s this one. You’re newly pregnant and you want to do it right. Everyone agrees you need prenatal vitamins, so you get them. But do you want to be that person who just… buys the generic prenatal vitamins?

Good news: fancier vitamins are not better.  Folic acid is the most important prenatal ingredient. Iron (with vitamin C) and DHA are also nice to have. Other included ingredients have only weak or no evidence to support their use. (If you do not consume animal products, add B12, plus a few others depending on your diet.)

Vitamins are just vitamins. Any prenatal vitamin that contains these is enough. 

Comment “Link” for a DM to an article with everything you need to know about prenatal vitamins.

#emilyoster #parentdata #prenatalvitamins #pregnancydiet #pregnancytips

Prenatal vitamins 💊 If there is any product that seems designed to prey on our fears, it’s this one. You’re newly pregnant and you want to do it right. Everyone agrees you need prenatal vitamins, so you get them. But do you want to be that person who just… buys the generic prenatal vitamins?

Good news: fancier vitamins are not better. Folic acid is the most important prenatal ingredient. Iron (with vitamin C) and DHA are also nice to have. Other included ingredients have only weak or no evidence to support their use. (If you do not consume animal products, add B12, plus a few others depending on your diet.)

Vitamins are just vitamins. Any prenatal vitamin that contains these is enough.

Comment “Link” for a DM to an article with everything you need to know about prenatal vitamins.

#emilyoster #parentdata #prenatalvitamins #pregnancydiet #pregnancytips
...

When it comes to introducing your newborn to the world, timing matters. It’s a good idea to minimize germ exposure in the first 6-8 weeks; after that, it’s inevitable and, very likely, a good idea! This doesn’t mean you need to be trapped inside. The most significant exposure risks are from seeing other people at home — family, etc. These interactions are not infinitely risky, but they do pose more risk than a walk or a trip to the grocery store, since they involve closer interaction. Think simple and make sure everyone is washing their hands before holding the baby. 💛

#parentdata #emilyoster #newborncare #parentingadvice #parentingtips

When it comes to introducing your newborn to the world, timing matters. It’s a good idea to minimize germ exposure in the first 6-8 weeks; after that, it’s inevitable and, very likely, a good idea! This doesn’t mean you need to be trapped inside. The most significant exposure risks are from seeing other people at home — family, etc. These interactions are not infinitely risky, but they do pose more risk than a walk or a trip to the grocery store, since they involve closer interaction. Think simple and make sure everyone is washing their hands before holding the baby. 💛

#parentdata #emilyoster #newborncare #parentingadvice #parentingtips
...

The first edition of Hot Flash is out now! Comment “Link” for a DM to learn more about the late-reproductive stage.

There are times when we expect hormonal shifts. Our reproductive lives are bookended by puberty and menopause. We discuss those changes often because they are definitive and dramatic — a first period is something many of us remember clearly. But between ages 13 and 53, our hormones are changing in more subtle ways. During the late-reproductive stage (in your 40s), you can expect a lot of changes in your menstrual cycle, including the length and symptoms you experience throughout. It’s an important time in our lives that is often overlooked!

🔥 Hot Flash from ParentData is a weekly newsletter on navigating your health and hormones in the post-reproductive years. Written by Dr. Gillian Goddard, Hot Flash provides all of the information you need to have a productive, evidence-based conversation about hormonal health with your doctor.

#emilyoster #parentdata #hotflash #perimenopause #womenshealth

The first edition of Hot Flash is out now! Comment “Link” for a DM to learn more about the late-reproductive stage.

There are times when we expect hormonal shifts. Our reproductive lives are bookended by puberty and menopause. We discuss those changes often because they are definitive and dramatic — a first period is something many of us remember clearly. But between ages 13 and 53, our hormones are changing in more subtle ways. During the late-reproductive stage (in your 40s), you can expect a lot of changes in your menstrual cycle, including the length and symptoms you experience throughout. It’s an important time in our lives that is often overlooked!

🔥 Hot Flash from ParentData is a weekly newsletter on navigating your health and hormones in the post-reproductive years. Written by Dr. Gillian Goddard, Hot Flash provides all of the information you need to have a productive, evidence-based conversation about hormonal health with your doctor.

#emilyoster #parentdata #hotflash #perimenopause #womenshealth
...

There are plenty of reels telling you how to parent. Plenty of panic headlines saying that “studies show” what’s best for your kid. Even good data, from a trusted source, can send us into a spiral of comparison. But I want you to remember that no one knows your kid better than you. It’s important to absorb the research, but only you will know the approach that works best for you and your child. 💙

Now tell me in the comments: what’s a parenting move you’ve made recently that feels right to you?

#parentingcommunity #parentingsupport #parentingquotes #emilyoster #parentdata

There are plenty of reels telling you how to parent. Plenty of panic headlines saying that “studies show” what’s best for your kid. Even good data, from a trusted source, can send us into a spiral of comparison. But I want you to remember that no one knows your kid better than you. It’s important to absorb the research, but only you will know the approach that works best for you and your child. 💙

Now tell me in the comments: what’s a parenting move you’ve made recently that feels right to you?

#parentingcommunity #parentingsupport #parentingquotes #emilyoster #parentdata
...

Let’s talk about sex (after) baby! Today on the podcast, I was lucky enough to speak with @enagoski about her new book on sexual connection in long-term relationships. Especially after having kids, this is something many people struggle with. Emily tells us to stop worrying about what’s “normal” and focus on pleasure in its many forms.

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#parentdata #parentdatapodcast #emilyoster #emilynagoski #comeasyouare #cometogether #longtermrelationship #intimacy #relationships

Let’s talk about sex (after) baby! Today on the podcast, I was lucky enough to speak with @enagoski about her new book on sexual connection in long-term relationships. Especially after having kids, this is something many people struggle with. Emily tells us to stop worrying about what’s “normal” and focus on pleasure in its many forms.

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#parentdata #parentdatapodcast #emilyoster #emilynagoski #comeasyouare #cometogether #longtermrelationship #intimacy #relationships
...

Ever wondered if you can safely use leftover baby formula? 🍼 The CDC says to throw out unused formula immediately because of the risk of bacterial growth. However, research suggests that bacterial concentrations do not appreciably increase after 3, 12, or even 24 hours at refrigerator temperatures. Good news! This means there’s not a strong data-based reason to throw out formula right away if you store it in the fridge.

Comment “Link” for a DM to an article on another common formula question: should you throw away old formula powder?

#emilyoster #parentdata #babyformula #babyfeeding #parentingstruggles

Ever wondered if you can safely use leftover baby formula? 🍼 The CDC says to throw out unused formula immediately because of the risk of bacterial growth. However, research suggests that bacterial concentrations do not appreciably increase after 3, 12, or even 24 hours at refrigerator temperatures. Good news! This means there’s not a strong data-based reason to throw out formula right away if you store it in the fridge.

Comment “Link” for a DM to an article on another common formula question: should you throw away old formula powder?

#emilyoster #parentdata #babyformula #babyfeeding #parentingstruggles
...

What’s the most important piece of advice for new parents? Here’s one answer, but I want to hear from you! Share your suggestions in the comments ⬇️

#emilyoster #parentdata #parentingtips #parentingadvice #newparents #parentingcommunity

What’s the most important piece of advice for new parents? Here’s one answer, but I want to hear from you! Share your suggestions in the comments ⬇️

#emilyoster #parentdata #parentingtips #parentingadvice #newparents #parentingcommunity
...

What's in the bag of a Vagina Economist? 👀 Someone please tell me this looks familiar to you.

What`s in the bag of a Vagina Economist? 👀 Someone please tell me this looks familiar to you. ...