One of the myths surrounding eating disorders is that they are a “white kid’s problem.” The truth is that body angst and unhealthy eating practices beleaguer people of all races and ethnicities. There are increasing data that body dissatisfaction is equally common among Asian American, Hispanic, and Caucasian women and somewhat less common among African American women. The latter group is less inclined to idolize thinness or to restrict food intake, even with the weight gain that accompanies puberty. The difference in body satisfaction between African American and Caucasian women seems greatest for those in their 20s, disappearing at around age 40.

Fitting in,  being one’s own person,  making and keeping friends-these everyday trials and tribulations of adolescence are hard enough. But when changes such as moving to a new home or entering a new school occur, even the most resilient young person can feel off-kilter. Immigrant families face these stressors on a mammoth scale as they encounter values, norms, and even a language that may be very different from their own. For a young person to enter a classroom worlds away from her former one and see a host of unfamiliar faces requires enormous courage and fortitude. Longing for acceptance by her new schoolmates, she may adopt their codes of behavior; for example, she might dress like them, listen to the music they enjoy, read their favorite magazines, view their preferred TV shows and movies, and use their popular expressions as well as their instant messaging vocabulary. If they diet, she may too.

As a parent, you may feel ambivalent about whether (and to what degree) to adopt the culture of your new land or adhere to tradition.

Perhaps you grapple with decisions regarding which set of norms (the old, the new, or some combination) to encourage in your children. Then there is the question of what to do if your child insists on dieting or on other peer- and media-driven aspects of society that are unlikely to be in her best interest. Torn between two cultures, a person might turn to disordered eating behaviors as an attempt to escape inner conflicts. Yet one doesn’t have to be an immigrant or the child of an immigrant to face these challenges; the need for acceptance combined with the pressures of mainstream culture can lead to turmoil for many young people and contribute to the development of disordered eating.

Teaching Your Child About Teasing and Bullies
Although not all demographic groups ascribe to the same body ideal, weight bias is a problem in our society. Many individuals erroneously associate a large body size with laziness, ineptitude, emotional insecurity, friendlessness, and an unsatisfying dead-end job. In contrast, thinness conjures up images of perfection, high achievement, loving relationships, initiative, and leadership. Teasing about body weight can have a negative effect on how a child or teen feels about herself and may play a role in her development of abnormal eating patterns. Girls who reach puberty earlier than their peers may be particularly vulnerable to cruel body comments. Yet they are not the only ones who are teased. Many girls recall the overwhelming hurt or anger they felt when they were called names related to the size or shape of their bodies. Cultural mandates for slenderness can be so demanding that individuals sometimes consider themselves or others overweight when, by objective standards, that is not the case.

Do you remember incidents from your own childhood when you made or received unkind body comments? Perhaps you will want to share some of those memories with your child; by doing so, you can lead in to a discussion about her peer relationships, including any body-teasing incidents she has experienced. It is not unusual for someone who is obese or who has obese parents to develop an eating disorder, making it all the more necessary to impress on young people the importance of respecting all body sizes and shapes, including their own. We suggest building an ongoing dialogue with your child about her interactions with peers, conveying that you are receptive to hearing not only about the good times but also about the bad. When she describes her day, try to tune in to the feelings behind what she says (or doesn’t say).
Is she feeling comfortable and safe in her friendships?

If your child reveals that she has been teased, listen closely as she tells you what happened and accept her report of the incident as the truth. Your understanding can make a huge difference in how she perceives herself and copes with the teasing. You will want to offer statements such as “I’m sorry those girls were mean to you. It sounds like you had a hard afternoon,” or “I imagine you felt very alone and helpless,” or “It’s understandable you feel angry after being called those names.”

She will need a strategy for disarming bullies, and you can help her devise one by asking her to recall approaches that worked successfully for her friends who have been teased. Once your child has hatched a plan that sounds promising, try to boost her confidence with some role-playing. One of you can act the part of the bully while the other puts the new strategy into action, then switch roles. Learning to be assertive doesn’t happen all at once, so you need to give your child ongoing emotional support while allowing her some space to process what you have taught her. With each step she takes toward freedom from a bully, your praise (for her initiatives as well as for her courage) will mean the world to her.

For the most part, it is not helpful to call the teaser’s parents. If your child’s safety is at risk or if the bullying escalates, you should contact her school. Does she have positive friendships to help counter the negative impact of the teasing? Is she involved in enjoyable hobbies or after-school programs that are outside the bully’s reign of influence? Such activities can give your child the opportunity to make new friends in a safe environment and learn that she is not too this or too that simply because a bully said she is.

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David B. Herzog, M.D., Debra L. Franko, Ph.D., Pat Cable, RN

David B. Herzog, M.D., is the Harvard Medical School Endowed Professor of psychiatry in the field of eating disorders at Massachusetts General Hospital and the director of the Harris Center at Massachusetts General Hospital.
Debra L. Franko, Ph.D., is a professor in the Department of Counseling and Applied Educational Psychology at Northeastern University and the associate director of the Harris Center at Massachusetts General Hospital
Pat Cable, RN, is the director of publications at the Harris Center.