What do you reply to, “Am I fat?” when your child has an eating disorder?

With anorexia and similar eating disorders, you've probably had your child wailing , 'Am I fat?', 'Will you make me fat?' Grabbing at their skin as though they want to tear off a slice of their tummy. They have anorexia, their body image is distorted, they're fighting mals or 'fattening' food, they're terrified of getting gaining weight. So what do you say?

There are lots of possible replies you may give to those 'Am I fat?' questions. I believe that for pragmatic reasons, you may give different replies at different stages of your child's recovery journey.

A pragmatic approach to those 'fat' questions

In an ideal world, at any stage of your teen's disorder you could just say: 'There's nothing wrong with being fat'. And they'd go, 'Oh, wow, you're so right! Well I guess I'll have some more pasta carbonara, because the truth is I'm really hungry.'

I wish…

You need a well-functioning, non-anxious brain, and many hours of study, of listening to non-diet dieticians, of tuning in to fat-activists, to understand how the health messages we've absorbed around body fat are mostly wrong, and harmful. To appreciate quite how weight-biased, fatphobic our society is (think of 'fatphobic' like you think of 'homophobic' or 'transphobic'). To recognise thin-privilege.

One thing that's not going to change in a hurry is the discrimination and alienation that a person has to endure if they're fat. Your child has seen it. Like all phobias, there's a grain of truth that in their malnourished brain, has been amplified into a massive fear. They believe the only way to fit into their peer group, the only way to be a loveable, worthwhile human being, is to be (very) thin.

You'll know how while your child has an eating disorder, logic doesn't work. Nor does nuance.

That's why I don't think it's realistic to expect your malnourished, terrified, weight-phobic child to be chill with any body shape — not yet.

So what CAN you reply to those incessant 'fat' questions?

Because those 'Am I fat?' questions are so pervasive, and there's so much at stake when a meal isn't working, I've devoted many audios with suggestions in my Bitesize collection. And lots of pages in my book (Chapter 14 for what to say, Chapter 11 for prevention for your other children).

Here's a quick one:

'I'm sorry, it looks like this is really freaking you out. You know it's not useful to talk about it, right? So, let's do something to change the mood. Shall we plant some seeds?'

As always, use what works and leave the rest.

Podcast 'Mommy, am I fat?'

A while back I was on a podcast titled 'Mommy, am I fat?', exploring possible replies. My focus was on children and teens with anorexia, while the hosts were thinking more of children in general — which makes it interesting.

It's a great podcast series for parents wanting to promote a great attitude to body, food and exercise in any child. The Full Bloom Project was hosted at the time by two certified FBT therapists: Zoë Bisbing and Leslie Bloch. Zoë went on to produce some more very relevant resources on bodypositivehome.substack.com.

On the question of prevention

There's a bit that's missing in the podcast, where I question the prevention angle. I wouldn't like to create unrealistic expectations — that you can prevent anorexia by taking care of the way you talk about bodies and food. Plenty of us have raised our kids with a lot of care around that, and they still got anorexia. The Body Project, a well-validated body acceptance program in schools (which uses 'body dissonance' as mentioned in the podcast), has not shown a preventive effect on anorexia.

Still, there can only be benefits from us becoming even more aware of how we talk about body shape, given the toxic environment we live in. I point you to some great resources in How to overcome weight bias and fat phobia.

Nutrition makes the fear of fat go down

Your responses to the 'Will you make me fat?' questions will evolve as your child gets nourished and makes up for lost weight. Paradoxically, the fear of weight tends to recede as weight increases.

So the most pragmatic response to 'Am I fat?' questions could be… whatever helps this meal work.

More:

• Your child is likely to ask about the weight recovery target weight. More from me on Weight-restoration: why and how much weight gain? You'll see there how on the whole, we don't know what they'll need until they get there. So a quick piece of advice is not to get caught up in numbers.
• Lots more on speaking with compassion (and dealing with the inability of the stressed brain to take in logic) in my book and my Bitesize audios.
• My post How to overcome weight bias and fat phobia offers resources that we all need to educate ourselves.