When pop psychology and parent blame go viral
Eating disorder myths harm kids and families
It’s really hard to write about eating disorders. But I’m going to do it anyway.
Will everything I say resonate with everyone? No. Will some people accuse me of making excuses for abusive parents? Probably.
But I felt compelled to write something after a psychologist with 8.5 million Instagram followers (I used to be one of them) asserted that most eating disorders aren’t actually disorders at all but rather coping mechanisms for a traumatic childhood.
While many celebrated seeing their own painful experiences put into words, parents and eating disorder professionals responded with concern and even outrage.
I’m not trying to “cancel” an influencer. She didn’t even invent this idea—in fact, assuming parents are at fault is one of the oldest (mis)conceptions about eating disorders.
Of course, if someone traces the development of their eating disorder to their childhood environment, they have every right to do so. Everyone with an eating disorder is entitled to conceptualize their illness in a way that makes sense to them and supports their healing.
I don’t doubt any individual’s story.1
But we need room for all kinds of stories.
Stereotypes about who gets eating disorders or what “really” causes them leaves too many people out of the narrative—and out of treatment.
Dominant beliefs about the causes of eating disorders influence research investments, access to diagnoses, treatment approaches, prevention efforts, and the average person’s basic understanding of these illnesses.
I get why people see eating disorders as having a function stemming from childhood. And while this concept rings true for some, it’s problematic for a professional with a massive platform to suggest this framework applies to most people with eating disorders.2
Saying most eating disorders are caused by dysfunctional families does a lot of unintended harm.
Because parent blame has been a dominant cultural narrative about eating disorders, it’s no surprise that moms and dads already question and blame themselves when their child becomes ill. Did I say something wrong? What could I have done differently? Why didn’t I recognize the issue sooner?
And then parents tend to fear the suspicion and judgement they may face. What are people going to think of me? Will the doctor be psychoanalyzing me? How can I present myself as calm and capable when I haven’t slept in weeks because I’m afraid my child could die?
Parental guilt and fear of judgment can themselves be barriers to treatment. When parents are bogged down in self-blame and shame, it’s that much more difficult to be an effective advocate for their child’s wellbeing. Accessing quality care is hard enough as it is. If you are pre-judged as the “prime suspect,” imagine how much more challenging it is to find the right support in a timely fashion.
It’s not just parents who are right to be concerned about the platforming of old stereotypes about bad childhoods causing eating disorders.
James Downs, an activist and educator, responded to this one-size-fits-most message on social media:
“Sooooo… there is a post going around from a prominent social media psychologist which makes some pretty wild, outdated, poorly-researched & family-blaming claims about the cause of ‘most eating disorders.’ I guess my version is not so eye catching”:
And that word “dangerously” isn’t hyperbole. Delays in care can lead to unnecessary suffering, longterm complications, and even death.
The problem comes when people are told they first have to excavate their past to find answers and insight before they can begin to take any other steps toward recovery. Many people firmly believe they—or their children—can’t start to regulate their eating until they have discovered and addressed the true underlying “root cause” beneath their symptoms.
Others may simply not seek treatment at all because their experience doesn’t fit the stereotype. Folks who feel they came from a “happy home” may doubt they could even be that sick, let alone be deserving of treatment.3
For kids with eating disorders, a focus on individual therapy without simultaneous nutrition support can be especially risky. Without attention to renourishment, kids are getting sicker and sicker during a time when they should be growing and developing—hence the motto of some treatment programs for adolescents: “save the brain, save the bones.”
Parent blame takes our eyes of the ball when it comes to prioritizing nutritional rehabilitation. Parent blame risks ignoring potential physiological factors. And parent blame often takes a treatment option off the table: Family-Based Treatment (aka “FBT”—also sometimes referred to as the “Maudsley Method” in the UK).
Family-Based Treatment isn’t a fit for every family, of course. But the research suggests it’s the best option we have for adolescents with eating disorders. And with the right support and beyond-the-manual individualized care, many more families can succeed with this approach than we previously thought. Gatekeeping this treatment and reserving it for “special families” means fewer young people will get well.
Parent blame disempowers the very people who may be in the best position to support a child’s longterm recovery.
It’s been an uphill battle against old stereotypes that took hold long before social media and pop psychology. For decades, eating disorders—like many other diagnoses—were automatically blamed on parents, particularly mothers.
And the focus wasn’t initially on maternal dieting or attitudes toward food or bodies—for which moms are often blamed today—but on their general mothering style, such as being seen as cold and distant or, conversely, overly anxious and too involved in their child’s life.
Clinicians who observed mothers bringing in children for treatment for anorexia noticed the women were incredibly anxious and seemed to be pushing food on their child. Can you guess what the experts concluded?
Eureka! Worried, controlling mothers are causing their kids to have eating disorders!
Hmm, why would a parent whose child was in a health crisis seem anxious? Why on earth would a caregiver be desperate to get their starving child to eat?
Talk about confusing correlation with causation. But that’s exactly the erroneous interpretation that dominated for decades and that, as you see, still persists today despite plenty of evidence to the contrary.4
And here’s the thing: even if it were clear that parents or siblings have played a role in triggering or maintaining someone’s eating disorder, wouldn’t we want them to learn and change?
One of the most powerful aspects of Family-Based Treatment is that the whole family gets to learn about eating disorders and, with the right support, develop their own emotion regulation and communication skills so they can better support their loved one through recovery.
With the families I’ve worked with over the years, I’ve never met parents who didn’t grow in some way, such as recognizing unhelpful patterns learned from their own childhoods, becoming aware of weight stigma, and understanding how to meet their child’s needs better while also taking care of themselves.
Families I know who’ve done FBT express feeling stronger and closer than ever before, even though the early stages of treatment may have initially increased conflict in the home. This hard-won growth and connectedness gave their child an even greater chance at a robust recovery and protection from relapse.
Imagine if these parents had been written off as “the source of the problem” and told to stay out of it. Where would those kids and their families be now?
I know I haven’t addressed every possible nuance about these issues. If your particular situation isn’t represented here, please remember I am not denying your experience. Yes, I’ve heard horror stories about FBT that went badly.
I cut thousands of words from this piece in order to make it more accessible and to focus on a few points most relevant to parents. I know what I’ve written here isn’t perfect, but I hope it’s done some good.
In case you missed it
I wrote an opinion piece for CNN about how body-shaming even a notorious body-shamer does collateral damage, especially to the boys and men in our lives. I got a lot of hate mail for this piece, so it definitely touched a nerve!
Move over, thigh gap. There’s a new body-shaming trend on social media. If you don’t know what “big back” is or how teens are using the term, check out this Fortune magazine piece, which includes some of my thoughts on how parents can talk to their kids.
Good luck to those who are already navigating the transition to a new academic year. If you need some guidance for handling the inevitable diet culture kids will encounter at school, this piece might be helpful:
And if you need more personalized support, I’m available for private consultations. Simply complete a contact form, and you’ll hear back from me shortly.
I recently co-authored a paper on the value of lived experience in the eating disorder field: Duvall, A., & Hanson, O. (2024). Peer Support and Beyond: The Role of Lived Experience in a New Era of Eating Disorder Treatment. FOCUS The Journal of Lifelong Learning in Psychiatry, 22(3), 333–338. https://doi.org/10.1176/appi.focus.20240002
Of course, eating disorders, like other mental illnesses, can affect people who have survived trauma, whether a specific horrific incident or the slow burn of growing up surrounded by emotional dysfunction, abuse, addiction, prejudice, racism, poverty, oppression, or all of the above. And eating disorders, like other mental illnesses, can also affect people who faced none of these challenges and instead had the privilege of a relatively warm, safe, and stable childhood. Also true: having an eating disorder can itself be a traumatic experience. Everyone deserves trauma-informed care.
Not recognizing the severity of one’s eating disorder is a common symptom, especially with anorexia. This is another way the viral social media post can put people’s health at risk: downplaying the severity of these illnesses (saying they aren’t disorders but simply coping mechanisms) can fuel someone’s dangerously disordered thinking or behaviors.
If you’re wondering, there is very little research on dads—a perfect example of the ways stereotypes end up limiting research progress.
What you wrote is perfect !!
My husband and I have spent the last two years navigating FBT with our daughter. It’s not for the faint of heart, but here we are—still standing. We’ve come a long way, but we know there’s still a long road ahead. Every day, we focus on feeding her, reading, learning, growing, and trying our best to provide her with a teenage life worth living. Yet, self-imposed guilt is always lurking, trying to distract us. We ask ourselves, “Why didn’t we see this sooner? What were we doing wrong? How could we let this happen?”
We’ve been told many times that it’s not our fault, and intellectually, we know that’s true. But that guilt still tries to creep in and get in our way. Thank you for the reminder that we’re doing our best, and that’s enough.
I remember that prolific post and its utter simplistic nature. It certainly wasn’t based in our experience and that view does exactly the harm you point out - it moves the immediate focus from the most critical issue - re-nourishment and weight gain. The goal should be to support parents in saving their children’s lives by working with them to refeed their children as the first priority, educating them (because there is nothing about eating disorder thinking that “make sense” to anyone who doesn’t have one), and teaching them all kinds of coping and supportive skills (such as DBT and EFFT) to work in conjunction with FBT.