Dear Food Speak: I read that obese children are more at risk for eating disorders. How can I protect my 11-year-old daughter who's been struggling with obesity since she was 8?

SJ, Fairfield

Just knowing that your daughter could develop an eating disorder reduces her risk.

A report in the October edition of the medical journal "Pediatrics" raises awareness about how eating disorder symptoms among obese adolescents often go unrecognized and untreated by health-care practitioners. The report details two eating disorder cases that grew out of obese adolescents' efforts to lose significant weight. In both cases, health-care providers failed to consider an eating disorder despite concerns from parents about extreme dieting and excessive exercise as well as signs of malnutrition including fatigue, dehydration and decreased heart rate.

Hopefully the report alerts health-care providers to the fact that obesity and eating disorders are related medical problems. Like parents, health practitioners have a unique responsibility for early detection of eating disorder symptoms -- regardless of a person's weight. Research shows that early intervention for eating disorders provides the best chance for recovery.

To help your daughter prevent an eating disorder, provide her with the best tools for safe and effective weight control. Studies show what works best is a non-diet approach that emphasizes balanced nutrition, mindful eating, physical fitness, stress management and a positive self-image.

Educate your daughter to say no to dieting, a primary risk factor for eating disorders. Remember that a parent who diets (while telling her child not to) reinforces dieting as acceptable. Even if you don't diet, discourage your family from using unsound dietary practices like calorie counting or categorizing foods as good or bad since these often foster an adversarial relationship with food. Instead, focus on promoting the message that all foods can fit into a healthy diet. For more individualized nutrition, seek help from a registered dietitian who is experienced in treating both weight issues and disordered eating in adolescents.

Use caution when discussing your child's weight. Explain to your daughter that her health is the reason you're concerned about her weight. Communicate often about her feelings and ways she can empower herself against social pressures to be unrealistically thin. As you accompany your daughter on her journey toward a healthier weight, keep the topic of eating disorder prevention alive with advice from reputable sources like the national eating disorders association (

Courtney Sansonetti is a medical nutrition therapist and certified diabetes educator for Rehabilitation Associates Inc. Email questions to