Teen eating broccoli
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According to the National Eating Disorders Association, as many as 11 million Americans suffer annually from eating disorders. That's why Evelyn Resh wants to make you aware of six warning signs to watch for when it comes to your teenage daughter's relationship with food.
The parents of teen girls have plenty to worry about: high school grades, college expenses, unsafe sex, drugs and alcohol—and whether they or their kids will even survive adolescence in the first place. The teen years are demanding on kids and on parents. And then, in addition to all these worries, throw in the risk of an eating disorder and you might as well push parents off a cliff before their daughters turn 12—just to spare them the years of angst! 

Bulimia, anorexia and obesity are serious health problems that often begin in adolescence and can affect girls throughout their lives. It's sad but true that these problems often become remitting relapsing conditions; in other words, problems that hang around forever, rearing their ugly heads repeatedly when life's stressors get overwhelming. While parents need to loosen the reins on girls as they pass through adolescence and give them increasing amounts of independence, this doesn't mean ignoring what they're doing; it means paying attention with a consistent and watchful eye from ever-increasing distances. 

Here are some things to watch for to determine whether something is going haywire with your kid's relationship with food and eating:

Her definition of a normal weight
When you talk to your daughter about what a normal weight would be for someone her size (and you should definitely have this conversation), if she disagrees with the numbers over and over again, you both have a problem. Girls who dispute what's considered normal for their height and frame—give or take 5 to 10 pounds—have traveled to another planet and have lost their grip on reality. If this is reemphasized by her LOVE of ultra-thin models or her rebuking of Queen Latifah as an example of plus-size and healthy, then you need to address it and not waste a moment getting help. 

What and how she eats
Skipping breakfast and lunch and having only small salads for dinner every night is not normal eating. Also, if she is obsessed with the calorie content of food, then your ears should perk up. Investigating calorie content is not one of life's details that teen girls with normal eating habits are thinking about. On the other hand, eating three large meals plus snacking reflects an indulgence with food that may be problematic in the opposite way.

4 other warning signs to watch for 
Teen with lollipop
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Her dental health
Make sure your daughter goes to the dentist every six months for preventative checkups. If she's frequently vomiting or starving herself, it will show up in her mouth. 

Her clothing choices
Look at the clothes she's wearing. Girls who conceal their bodies in clothes that are way too big or girls whose excess fat is spilling out beyond the slight "muffin top" need intervention. You can get meaningful clues by looking at what your daughter chooses to wear and how she looks in her clothes.

Her menstrual cycle
Do your best to track her menstrual cycle. I don't suggest putting it on the family event calendar. But, you could make a note in your personal calendar after you've casually and privately asked her about her period. If your daughter had started her period and then stops for three months or more, you should be concerned.

Her exercise habits
If your daughter has created a training schedule to match that of Lance Armstrong, she may be overexercising, which may be an additional manifestation of an eating disorder. 

The thought that your daughter might be starving herself, vomiting after meals or oblivious to her ever-increasing girth is terrifying. As a healthcare provider to teen girls and as a woman who has struggled with being overweight her entire life, I empathize. I know only too well from personal experience the feelings of both attachment and disdain for my favorite cookie. Neither adults nor kids need to be paragons of virtue when it comes to healthy eating and exercise. After all, no one is perfect. But keeping an eye on our developing teens and how their relationship to food and eating is taking shape is critically important.

Reflect on your own relationship with food, as this will influence your daughter. If you always complain about your weight or are beyond thrilled with new low-cal foods, then you too need some fine-tuning when it comes to your own eating habits. Unprocessed foods, lots of fruits and vegetables, whole grains, healthy fats, lean meats and fish or a sound vegetarian diet with portion control is the way to go for lifelong health. Adopt healthy habits of eating, and your chances of influencing your daughter to do the same will increase dramatically. Take advantage of being your daughter's best teacher when it comes to a healthy relationship with food.

Evelyn Resh is director of sexuality and relationships programming for Miraval Resorts in Tucson. She is a certified sexuality counselor and nurse-midwife and continues her practice in both fields in Tucson and Western Massachusetts. She has taken care of teens and women of all ages in OB-GYN and primary care settings for more than 20 years and specializes in working with women 25 and under. She is also the mother of a 19-year-old daughter. Evelyn speaks all over the nation on topics related to women's health and sexual satisfaction and is the author of the new book The Secret Lives of Teen Girls: What Your Mother Wouldn't Talk About but Your Daughter Needs to Know published by Hay House Publishers.

More from Evelyn Resh:
How to help your teenage daughter manage her weight
How to talk to your daughter about weight
What you should do if you love your teenage daughter but just can't stand her right now
The 4 most important things your daughter needs to know before she leaves for college


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