Episode 326: This week on the show I'm chatting with parent coach Oona Hanson. We talk about her child developing an eating disorder, the FBT model, and the many reasons that parents reach out to her for help.
Oona Hanson is a writer, educator, and parent coach who supports families navigating diet culture, including those who have a child in treatment for an eating disorder.
Oona holds a Master’s Degree in Educational Psychology and a Master’s Degree in English. A regular contributor to CNN, Oona has been featured widely, including on Good Morning America, The Washington Post, USA Today, US News & World Report, People, and Parents Magazine. She writes the Parenting Without Diet Culture newsletter and will publish her first book in 2026 with Cambridge University Press.
She is a mother of two and lives in Los Angeles.
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Chris Sandel: Hey! If you want access to the transcripts, the show notes, and the links talked about as part of this episode, you can head to www.seven-health.com/326.
Hey, everyone. Welcome back to another episode of Real Health Radio. I’m your host, Chris Sandel. I’m a nutritionist and a coach and an eating disorder expert, and I help people to fully recover.
Before we get on with today’s episode, I just want to mention that I’m currently taking on new clients. If you are living with an eating disorder and you want to reach a place of full recovery, then I would love to help. Even if the idea of full recovery seems like some kind of pipe dream or something that you feel is hard to connect to, I truly believe that everyone can reach a place of full recovery. And this is true whether an eating disorder has been going on for a year or multiple decades.
So if you want to reach a place of full recovery or you want support with recovery in any form, then please reach out. You can send an email to info@seven-health.com. Just put ‘coaching’ in the subject line, and then I can send over the details.
On with today’s show. Today it is a guest interview, and my guest on the show today is Oona Hanson. Oona is a writer, educator, and parent coach who supports families navigating diet culture, including those who have a child in treatment for an eating disorder. Oona holds a master’s degree in educational psychology and a master’s degree in English. A regular contributor to CNN, Oona has been featured widely, including on Good Morning America, the Washington Post, USA Today, US News & World Report, People, and Parents Magazine. She writes the Parenting Without Diet Culture newsletter and will publish her first book in 2026 with Cambridge University Press. She’s a mother of two and lives in Los Angeles.
I’ve been following Oona for maybe 6 to 9 months on Instagram, and I really love the content that she is putting out, and this is why she’s on the show. I go into this in more detail in the intro, so I won’t repeat myself here. As part of the episode, we talk about Oona’s relationship with food and how she got into being a parenting coach. We talk about her child developing an eating disorder and how they dealt with this, and connected to this, we talk about FBT or family-based treatment; we go through what this is, how it works, and the nuances around it.
We go through many of the areas that parents are reaching out to Oona about and talk about different specifics with different scenarios connected to these. We talk about body image, we talk about kids going off to college, going to the doctor’s office, self-esteem, eating disorders, eating disorders in teen boys, going into each of these different areas and looking at topics connected to them.
We also talk about the Common Sense Camp, which is a programme to help parents teach their kids essential life skills that Oona and her husband developed.
I know from what I’ve just shared here, a lot of the focus is on parents and parents helping kids with certain issues or struggles they’re dealing with, but even if you don’t have kids or you do have kids but it’s you that is struggling with these issues, I still think that this episode is going to be helpful. So see this advice through the lens of reparenting – the advice that is given to the child or given to the parent to give to the child is the same support that you can then show yourself.
So that is it for this intro. Let’s get on with the show. Here is my conversation with Oona Hanson.
Hey, Oona. Welcome to Real Health Radio. Thanks for joining me on the show today.
Oona Hanson: Thanks for having me.
Chris Sandel: I need to start and say how I became aware of your work. I have a group programme as part of the work that I do with eating disorders. I work with people one-on-one, but there’s always a group element as part of that, or at least that’s how it’s been over the last 18 months or so, and you are someone who is regularly posted about in our group. There’ll be links to either articles or to posts from your Instagram, and that was how I became aware of you. And then for whatever reason, the algorithm started serving up more of your stuff and I’ve always really enjoyed seeing what you’re posting out there, and that was why I wanted to get you to come on and be on this podcast, because I really love the messages that you’re putting out. There are lots of people who need a person like you to help them navigate this stuff. So thank you for doing what you do.
Oona Hanson: Thanks for sharing that. That means a lot. I’m an educator at heart, so knowing that I’m helping people learn new things, that makes my day.
Chris Sandel: Nice. What I want to do as part of this conversation – I really want to make it a practical one. As you said, you’re an educator. I know you’re helping parents, so I want to be able to talk about specific stuff that people are coming to you for and seeking advice or support on and what are some of the things you’re suggesting in those situations. But I also want to talk a little about you and your background and how you got into doing all of this.
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Just as a starter, for any of the listeners who don’t know who you are, do you want to give a bit of a background on who you are, what you do, what training you’ve done, that kind of thing?
Oona Hanson: Sounds good. My name is Oona Hanson, and I’m an educator, a writer, and a parent coach. I focus on helping families of kids of all ages navigate diet culture and eating disorders. As I said, I’m an educator at heart. My first career was as a high school English teacher, and I coached girls’ field hockey. Even then, I started to pick up on the fact that teenagers’ parents often needed a lot of support. When I would have phone calls or conferences with parents, I got the sense, even before I had my own kids, that parents want to get it right. They want to do their best for their kids, and they don’t always know how to get the support and information to know how to trust their instincts or when to seek help.
Fast forward, I had my own kids. I got really interested in learning about learning, so I went back and got a master’s degree in educational psychology, and I started doing parent education and even some teacher training and professional development.
Then I had a child develop an eating disorder, and very quickly people came out of the woodwork who had been struggling with this in their families, and I had no idea. But they knew I was someone they could trust to come to for help. So pretty quickly, I narrowed the focus of my parent education and parent coaching to focusing on things like eating disorders, body image, navigating the system of health care. Especially in the US – I know there’s controversy going on in the UK right now as well, but it’s pretty tricky to navigate here.
This is my passion. I see parents who are more thinking about prevention. Maybe they know that they struggled with these things, so I might see parents of younger kids who want to get ahead of it and want to break those intergenerational cycles. I also see families who are thinking, “I think something might be a little bit off; what’s my next step?” So I guide them in that. And then I work also with parents whose kids are in eating disorder treatment, and I specialise in families doing family-based treatment, also sometimes called Maudsley method. And then I write a lot about these topics, too.
Chris Sandel: Nice. When you retrained to be this educator before you’d had this situation with your child developing an eating disorder and that narrowed your scope, what were you helping parents with at that stage?
Oona Hanson: It was primarily things like communication between home and school, deciding about the next school – let’s say they’re transferring from elementary to middle school; how do they decide what’s best for their student? Should they get a therapist for their child? Navigating homework demands. Homework demands have gone up significantly. It hasn’t translated into better learning outcomes that we’ve been able at least to capture in the data. So navigating a lot of struggles around homework was a big part of what I was doing, and helping teachers understand how they could make some modifications to their homework to get the best out of their students and actually make it easier on them as well.
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Chris Sandel: Let’s go back a little further than this and talk about you. Obviously, you’re now in this area where you’re talking about and helping parents with children with eating disorders; I think your tagline is around how to do food without diet culture, or parenting without diet culture. So tell me about your history with all this. If we go back to you as a kid, what was food like growing up in your household?
Oona Hanson: In a lot of ways I was protected from – we didn’t know the term ‘diet culture’ then, but protected from a lot of that because I happened to be in a smaller body as a kid. I didn’t have parents who were dieting. But when I got to the adolescent years, definitely reading Seventeen Magazine, watching MTV, my friends and I were all very aware of what was considered ideal in terms of body size or appearance.
So I did struggle with some negative body image, definitely some disordered eating – although it was very normalised, so it didn’t seem disordered. It seemed like this is what you were supposed to do, if you follow what the teen magazines tell you to do to get ready for summer or whatever. So I definitely struggled with that.
I was an athlete, and I remember realising, even in high school, “Wow, if I’m following the rules of this magazine article about your bikini body, it’s really hard to run fast on the field hockey team.” So I was already picking up on this tension of ‘something isn’t quite right here’.
Then it really wasn’t something I thought too much about. It’s the water we’re swimming in, right? Diet culture. I wanted to protect my kids from having any of these struggles. I saw not just what I had gone through, but what friends had gone through. So I had what I thought was a foolproof plan to protect my kids from body image issues. I had the best-laid plans, but I really didn’t know a lot. I thought I knew a lot about eating disorders and body image and food, but I knew just enough to be dangerous, and I think that’s true for a lot of people.
I’m sure you’ve encountered this in your work, too; people have a false confidence about what they know about eating disorders because the headlines repeat these narratives, and it’s like “Oh, I understand what eating disorders are all about, or I know what they look like.” And that’s really where people can get into a lot of trouble.
Chris Sandel: When you say “I had this plan”, what was your plan how to deal with this? And we can look into what this turned into later on as a possibly better plan.
Oona Hanson: I thought, “Well, if I have a daughter and someone gives her a Barbie doll, I won’t let her play with Barbie dolls.” I thought, “As long as I never disparage my own body in front of my kids, they’re going to learn positive body image.” But I was still complimenting people on weight loss. I wasn’t disparaging my body or other people’s bodies, but I was complimenting weight loss. Things like that where I sort of understood certain things, but I didn’t really have the tools or the knowledge to have a bigger picture.
I also didn’t realise the way that diet culture – there’s this Trojan horse about health, that if you’re feeding your family in a healthy way or healthy foods, that’s going to be a really good thing – not realising the way that diet culture has co-opted these ideas around health and wellness. So I was really, even with the best of intentions, perpetuating certain ideas about good and bad foods, not realising how that is understood, especially from a child’s perspective.
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Chris Sandel: Tell us a little about what happened. How did it occur that your child then developed an eating disorder, and how did you deal with that?
Oona Hanson: What’s so heartbreaking to look back on is how long it was going on before we realised that this was an eating disorder. Again, that false confidence is what led to that. When you have a high-achieving, very conscientious child, you never can imagine that they’re not telling you the truth. Packing a lunch for school, sending breakfast for the bus ride to school, assuming that those are getting eaten. Child comes home from athletic practice, “Oh, they gave us food at practice, so I’m not really that hungry for dinner.” Okay, that sounds possible that a teen parent might bring food. That’s one example of how easy it is to get the wool pulled over your eyes. Not that the child is trying to manipulate you, but that the eating disorder is manipulating your child and getting the whole family to participate without you realising.
In our family’s case, it was anorexia, and I think in my mind, I thought someone with anorexia didn’t eat at all. And I didn’t realise the ways that undereating, a state of semi-starvation, is still very serious.
The other piece is you think of dramatic weight loss as a symptom, which it can be, but when you’re seeing your child every day, it’s not as dramatic. Things that are gradual are harder to pick up on.
And then ideas around health, around my child wanted to become vegan. There are a lot of vegans in our family; it was not something I had any concern about. But the narrowing and the eliminating of food options, again, under the guise of health – absolutely, an animal-loving, environmentally conscious child might want to reduce their intake of animal products, and at the same time, I didn’t know that that could be a risk factor, that a child could get into energy deficient really easily, or that having a lot of rules and restrictions around food as an adolescent can really take them down a pretty dangerous path, even if their intention was not to change their body or to lose weight.
One other thing I’ll add. I knew quite a bit about adolescent development; that was something I had really focused on in my graduate work and also as a teacher having worked with a lot of teenagers. I saw teen moodiness or irritability or isolation as just an expected part of the teen years. I think teenagers get a really bad rap in the sense of as a culture, people tell you as a parent, “Oh, just wait for the teen years. You’re gonna be in trouble.” There’s like a cultural smear campaign against adolescents. And actually, I think teenagers and adolescents are wonderful.
But I think those cultural messages led me to dismiss certain mood changes that really were a sign of ‘something isn’t right’, but I was thinking, “Oh, no, I’m going to let this ride. This is just the way it goes. Everyone warned me, this is what it’s going to be like.” All those things together really made it so that we didn’t see what was happening right in front of our eyes.
And part of why I love doing this work is that pretty much every parent I meet will say, “I wish I had caught this sooner”, and parents can have so much shame and self-blame and guilt around this. If it can happen in my home, it can happen anywhere. You only know what you know, and you can’t know what you don’t know. That’s, again, coming back to that education piece. I think the more parents are aware of these warning signs, the better off they’ll be in terms of catching things earlier, getting their kid the support they need.
Luckily, when we discovered that this was probably what was going on, we got my child help right away. It wasn’t necessarily a quick fix.
Chris Sandel: Never really is.
Oona Hanson: Right. I thought, “Okay, we are fortunate enough to have access to really well-respected professionals. They’re going to give us a plan and we’re going to hand it over to the pros.”
My child ended up having to go through a lot of different kinds of treatment, all the higher levels of care. Things weren’t getting better with more treatment. In many ways, new behaviours and symptoms were coming up, and a lot of things that happened in treatment were actually pretty harmful. Hearing the doctors say, “Don’t worry, we won’t let you get fat.” Hearing eating disorder professionals perpetuate the very fears that the eating disorder has, that was not helpful. And I’ve come to learn that it’s all too common for people to hear that in treatment.
We were really lucky, though; over the course of many months, we did get encouragement to try another option. Well, we had tried all the other options, so it was kind of a no-brainer at that point. That’s when we learned about family-based treatment, and that’s what helped save my kid’s life and I think really saved our family.
I know there’s no one-size-fits-all in eating disorder recovery. I also know that I do feel strongly that FBT can work for more families than we think it can. So that’s one of the things I like to share with families when they have questions or concerns. They’ve heard maybe horror stories about FBT going badly. I always say, bring me those questions. I want to hear what you’re hearing and what you’re worried about, and a lot of times I can allay those fears and help them find the right programme or provider that can really give them the personalised support that we got that saved my kid’s life.
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Chris Sandel: Awesome. I want to touch on a couple of things you said there, especially with eating disorders developing around the adolescence / teenage years and how difficult it can be for the parent. As you said, they’re going through this phase of individuation. They’re deciding who they are, and that could mean “Hey, I’m getting much more into sports”, and that’s a really healthy, good thing – and it can also be a really not healthy, good thing. And “Hey, I’m much more concerned about the planet and I want to do certain things”, whether that’s around climate or around animals or whatever, so yes, that can be a really helpful thing, and that can also not be a very helpful thing.
There can be, as you say, a lot of mood stuff, a lot of “Hey, I don’t want to speak to you.” There could be times where all through their younger years, you were seeing them either nude or semi-nude or with very little clothes on, and then they hit this point where “Actually, no, I don’t want you seeing me in that way.” So it becomes a lot more difficult to notice how certain changes occurred. And for different people, there can be the weight spurt first and then the height growth spurt, and it doesn’t always happen in this nice, neat way. So it can be very easy to think “Well, they’ve shot up a little bit, and maybe that’s what’s going on.”
I think there are plenty of reasons why this can be missed, or there can be things that are chalked up to just being normal and fine, and then it’s later on that you discover that’s not so. And we are all putting on performances in terms of how things are compared to what it’s really like. I think about myself as a teenager and what would’ve been presented versus what was going on inside. I have a seven-year-old son and he has high anxiety, and it’s only in more recent times that I’ve realised, I don’t think I know the half of it in terms of how intense and challenging that is for him. And even for him, when he’s not putting on his best self and I can see that he’s struggling, there’s an understanding of “I think this is a lot more challenging than I imagine.”
For all of these reasons, I can really understand how all this can get missed, and I have a huge amount of compassion. I mean, I work in this role and this would be my absolute nightmare, to have a child go through this – even with everything that I know about it. This is my job, this is what I help people with, but there’s that piece of “I can only do so much.” It really does come down to the individual, that there has to be this willingness to want to get better, at least to some degree, for this to actually start working.
I know part of where FBT can come into this is that there’s a lot more of the parents taking the lead of this, but there’s still no guarantees with this stuff.
Oona Hanson: Right, and I do think that motivation piece, especially for kids, is also what can hold kids back from recovery. The waiting for them to have the motivation when the illness might be – especially if they’re weight suppressed – preventing them from having motivation. That’s where a loving parent or a caregiver can be the bridge to motivation. You can draft off the parents’ motivation to start getting the child renourished.
Once their actual cognitive function is back online, then of course you’re handing over more and more of the responsibility and the motivation to the child. But I think that’s probably one of the most dangerous myths, that someone has to want to get better in order to get better.
I understand where that comes from, but when by definition the illness is preventing you maybe from recognising you’re ill, also physically preventing you from doing the things that are going to help you recover, that’s where having – and it doesn’t have to be a parent. I’ve worked with families of older kids, and it was their spouse or roommate or significant other who really helped them start to renourish themselves so that they could then take more ownership over their recovery.
To your point about adolescence and autonomy, I think a lot of parents get the message – and we were told this, too. We were told, “Don’t be the food police. You have to give your kid autonomy. This is how they’re going to develop the strength to recover and have ownership.” And that made sense to me, from everything I knew about adolescent development. The problem is, a child who’s under the control of an eating disorder doesn’t have autonomy. The eating disorder is what’s standing in the way of autonomy.
So if parents can step in and play this critical role in helping their child start to separate from the eating disorder first, then the child can work on separating from the parents. That order of operations is something that – once I learned about that, it was like this light bulb, like “Oh, this makes so much more sense.” And that was the game-changer.
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Chris Sandel: Let’s maybe take a step back, and for anyone listening who’s like, “What the hell is FBT? What are you people talking about?”, do you want to explain it a little bit so that we can bring people up to speed with this?
Oona Hanson: Yeah. FBT is family-based treatment. That can be the confusing term. I think people hear ‘family’ and think, “Oh, it’s the family that’s the problem.” Or you’ll hear people call it family-based therapy, and they think it’s family therapy. Like this family needs to work on some things.
So first let’s clear up some myths. Family-based treatment is a manualized treatment for eating disorders in adolescents. It’s actually statistically our best option for that age group in terms of recovery. It’s still not great; we can keep improving. It’s a low bar in eating disorder treatment, as you know, for what’s considered recovery rates or success rates.
But basically, family-based treatment comes from the Maudsley method, developed at the Maudsley Hospital in the UK, where families were part of helping renourish a child. The kids were coming back to life with more food and with that family support. It makes a lot of sense when you think about it in terms of, if we send kids away to treatment – which sometimes we have to do, and we did that in our family as well – if you’re not also giving the family information, skills, support, then the child’s coming back home and I guess they’re supposed to be able to do this all on their own. It just doesn’t make any sense, right?
Or when you think about a child having any other serious life-threatening illness, I can’t imagine taking them out of their home environment and not allowing the family to be part of that treatment. That’s why we have, in the US, Ronald McDonald House – housing for parents whose kids are in the hospital for something very serious, so they can be there.
But for some reason, with eating disorders, because we have all these myths and stereotypes about families causing eating disorders, there’s this idea like “If we take them out of this potentially problematic environment, they’re going to suddenly get well over here, without any of their support, their pets, their friends, their family. They’re just going to work with these professionals, get better, and then somehow come back into their normal life and carry on with their recovery.” When you think about it, it doesn’t really make sense.
I know I’m oversimplifying, and lots of residential programmes have stepped down to day programmes – IOP, PHP, or virtual support. So it’s not as harsh necessarily, but I’ve seen it be pretty harsh in terms of people getting kicked out – basically, “You’re done with treatment, you gained X number of pounds, your insurance isn’t going to pay, now it’s time to go back home.” No wonder people relapse or never get to a robust recovery.
Chris Sandel: Or they’re on a ward where it’s not just eating disorders, it’s other mental health issues, and it’s not just other kids who are 12 to 14 or 16; it’s with adults, and there’s a huge amount of trauma through going through that experience. Like “I was already scared before I was removed from my home and put in this place and I didn’t want to be here.” So yeah, there are lots of reasons why that can be a very traumatising experience.
Oona Hanson: Absolutely. And there are times where it’s absolutely life-saving. Yes, it’s going to be traumatic for your child to have to be in let’s say an inpatient hospital setting, and that may be what they need. If they’re so medically or psychologically fragile, that can be a really important step in helping get a child to recover.
And I apologise if you’re hearing the demolition next door. [laughs]
Chris Sandel: I’m hearing no demolition. It’s all good.
Oona Hanson: Okay, good. So family-based treatment is a manualized treatment, meaning a therapist can be trained to deliver this treatment over a set number of sessions, and there are assignments or goals for each session. The whole family attends these appointments, and then a lot of the work is happening at home. Parents are put in charge, at the beginning, of helping renourish their child and creating a recovery-supporting environment at home.
I often think of it as like you’re turning your home into a residential treatment centre for one child in your own home. Really getting the support to create that kind of structure and support for your child.
There are three phases to FBT. Parents are really in charge of the food and movement at the beginning. In phase 2, there’s gradual movement toward the child taking over more and more of the ownership. And then phase 3 is really about relapse prevention and addressing any of the other potentially co-occurring conditions. A child who has co-occurring OCD or depression or anxiety or bipolar disorder or any other issues that are going on, in that phase 3, the therapist is also focusing on those things.
And also just adolescent development. Especially kids who’ve been sick with an eating disorder often go on pause. There’s a little bit of a stalling out of their development, and there’s a lot of catch-up that can happen, and that’s also what can happen in that phase 3. The therapist can really support them to develop their social skills and their social and emotional regulation and communication and things like that.
That’s the overview. But more and more, people are finding that a more personalised approach – you don’t have to go by the book. The by the book version can work. It has worked. We have evidence that it works. I’ve even known families that didn’t have an FBT provider in their area, and they bought the manual, written for health care providers, and basically did it DIY on their own for their family, and that worked too. And there are some fabulous books out there written for parents about helping their child recover. So there are a lot more resources out there now.
Then a lot of treatment providers and treatment programmes are starting to build a more holistic support around FBT, because FBT is really hard. Essentially, you need a parent or guardian, in many cases in phase 1, to support every meal and snack.
Chris Sandel: You’re basically becoming the inpatient services, where you’re the one that is making everything, sitting there, making sure that food is consumed. Yeah, it’s a lot.
Oona Hanson: Yeah, and you’re monitoring for purging behaviours, exercise, all those kinds of things. You’re really having to stay attuned to your child’s mental state as well. A lot of parents have to learn how to assess for suicidal ideation. Again, as you said, just as if they were in a treatment facility.
It’s incredibly draining, so parents need a lot of support. Even though it’s not forever – it’s for this finite period of time, which again, I can’t give a number because everybody is different – but in many cases –
Chris Sandel: The finite amount of time can feel infinite.
Oona Hanson: Right. Because it can be months and months. What’s nice is that more and more, people are realising parents need support. The traditional FBT says you don’t need a dietitian, parents know how to feed their kid, so just the therapist, the parent or parents, and the child. And siblings are involved, too. That’s the other important thing about FBT; siblings are part of the conversation if it’s appropriate. I think when siblings are left out of these conversations, it’s even scarier, to not know what’s happening with their brother or sister. So FBT really helps bring the siblings into the mix.
The siblings are not in charge of doing the delivery of the treatment. I want to make that really clear. There are rare cases where adult siblings can be supported to provide some of that care, but in general, siblings are just to be part of the conversation and that they understand what the eating disorder is and why the family is taking this approach, and that they have a place to share their feelings and their fears and their worries.
Back to modern, more flexible FBT. A lot of families do benefit from working with a dietitian because in diet culture, if the family, unknowingly, if their way of eating and feeding their kids is maybe on the orthorexic part of the spectrum of eating, it can be really hard to renourish their child. So sometimes having a dietitian reassure parents that they can bring this, all foods fit, or at least bring in more variety, and that their fears about food, we can address those, that’s really going to help their child.
And then FBT in general, the child doesn’t have their own separate therapist, but some families find it’s really helpful for the child to have someone to talk to who’s not the therapist doing the FBT. Again, it has to be done well because, as you know, if people aren’t all on the same page, the eating disorder loves to split and make everyone question themselves and try to find who’s going to give them the answer that the eating disorder wants.
Chris Sandel: Yeah, and then for the kid, who is then hearing this ambiguity, that’s a nightmare. It gets latched onto and everything halts.
00:36:15
Chris Sandel: You said that there are more and more people who could use this and maybe more than people realise. When would this be something where you’d be wary or think maybe this isn’t the right approach?
Oona Hanson: A doctor that I worked with always said if there’s abuse in the home, that is almost always an indicator that FBT would not be appropriate, and I think that makes sense to everyone.
At the same time, I have talked to quite a few people who will say if maybe there’s a history of abuse, but if the family is getting support from a therapist as they’re working through – it could actually be very beneficial to a family that has had a history of problems. So that’s where it’s not family therapy, despite the name having ‘family’ and sometimes having the word ‘therapy’ in it, although I consistently call it family-based treatment – because the whole family is involved, this is an opportunity for a lot of interpersonal things to come out into the open and be talked about.
But I think there are a lot of myths about that it has to be an intact family with two parents. That’s just not true. Or that it has to be a family where one parent is staying at home. I’ve seen this work amazingly well where both parents are working or even with a single parent who’s working. I’ve seen people say you shouldn’t do FBT if let’s say there’s a sibling in the home that has some kind of special needs of their own. Again, the family will need a lot of support. I’ve also seen that college age, a young adult, is too old for FBT. In fact, there’s an adaptation of FBT called FBT-TAY, FBT for transition age youth. We know that this can work very well for that age group. And it does look a little different for a 24-year-old compared to a 14-year-old or younger.
But I think it really comes down to support and education. That’s why what I love doing is supporting parents who are doing this because it is really hard. You can believe this in your soul that this is going to work, you want to implement all of these strategies and skills to help your child recover. Without the support to take care of yourself, without some tips and scripts, even – having been an English teacher, I love words and I love helping parents find the words that help them support their child, help regulate their own nervous system.
Because the eating disorder can make it feel like you can never say anything right. So parents get really tongue-tied about “What do I say? How do I do this?” and then they explode with maybe anger or frustration or fear, which is completely understandable. But sometimes having some language to come back to can really be helpful. That’s something that I love working on with parents.
And that’s not something that’s in the manual, for instance. This is something that parents with lived experience can share with other parents and pass along, like, “Here’s what I learned the hard way. Let me help you learn an easier way.”
I’m sure you know Eva Musby. She’s a parent coach as well. She’s in the UK. She has fantastic free resources on her website, and her YouTube videos are phenomenal. These beautiful animated short videos that explain key concepts about helping a child recover from an eating disorder. They’re so user-friendly, and I can’t recommend her enough. And she has books and things as well, but there’s so many free resources out there as well. If you can, get her book. If you’re a parent listening and you think “I could use that help”, she’s a great resource.
Chris Sandel: Awesome. I’ll put that in the show notes and people can check it out. It’s a new name to me, so that’s great to hear.
One of the ones that comes up a lot – and I don’t actually know what the right solution is in this situation, and maybe you have some advice on this – but the ones where parents have said to me, “We did FBT, and if we had our time over, we wouldn’t” were with kids that were neurodivergent and typically had PDA, pathological demand avoidance. Which I absolutely hate as a term, but just means that there’s a lot of ‘no’ that comes up. And there’s a lot more to it than just there’s a lot of ‘no’ that comes up, but the parents being the one dictating “This is what you’re going to do”, they said it just absolutely did not work. It broke things and it made things so much worse.
As I said, I don’t know what the solution is, but I’ve heard that enough times to think maybe in that situation, that’s not the right approach.
Oona Hanson: I have worked with families doing FBT with neurodivergent children, and I think it has to be personalised. Again, it’s not the manualized, by the book version, but I think parents can be tremendous supports for their child. It has to be a provider who understands what the child’s experience is and helping the child express that to their parents. There’s no one-size-fits-all, but I do think having that family structure and support around the recovery is key.
One thing that comes to mind with that question, I think for some young people with ARFID, parents may think “This is a problem that is going to be fixed, and with a certain number of weeks or sessions, my child’s going to eat like the rest of the family.” With a lot of presentations of ARFID, when it’s really part of a sensory experience around food, their child may never eat exactly the same way as everyone else in the family. So really understanding what the expectations are and learning how to accept and stay attuned to their child, I think that can be done really well in a family-based treatment structure.
But I agree; it has to be personalised and individualised. And sometimes it may be a child hasn’t been diagnosed. People aren’t aware that the resistance is not coming from the eating disorder; it’s coming from some other factor. So yeah, that is really important. If something isn’t feeling right, this is where maybe asking the provider, “Is there someone else we could talk to? Is there some supervision we could get or some more support we could get? This feels like maybe this is not the eating disorder only as the barrier to eating”, let’s say.
Chris Sandel: Yeah, and in terms of remembering where this was the case, one, it wasn’t ARFID, it was anorexia. The difficulty wasn’t just that there’s certain sensations and textures. It was much more of the amount that was needed. And for them, they could identify this stuff goes back way before the eating disorder was there. It might not have been necessarily so much around food, but there’d been a lot of this difficulty getting the child to do anything unless the child was the one that really wanted to do that thing.
And that then can become very difficult when you bring in a severe mental disorder like an eating disorder, where so much of someone’s perspective and perceptions are shifted because of being in that state.
Oona Hanson: It is really tough. I’m so glad that there are more and more people thinking about these issues. It’s not just like “Send your child away for treatment or do this manualized treatment at home and that’s going to be the only option.” But it makes sense to me that parents who aren’t getting that kind of personalised support would think FBT was a disaster. If another kind of treatment is working better, I’m not going to say, “No, yank your kid out and do FBT.”
Chris Sandel: Sure. That’s my thing. I’m like, I don’t know a better solution; I just know for them, they were like, “This wasn’t great, and it was so hard.” But again, I think the alternatives would also have been creating lots of hardship and struggle. Just something I had noticed and I wondered if you’d had any insights.
00:45:28
As I said at the top, I want to go through some other issues that you’re commonly seeing in your practice or that people are coming to you with, and what is some of the advice that you have around this. I also should say that Ali, my wife, and I have gone to see people similar to you for lots of things since we’ve had our son, Ramsay, for various stuff in terms of how to best support him.
What’s been really interesting for us, and I’d love to hear for you how much this applies as well, is that some of this is around understanding and education and tips and stuff of what we can do, but so much of it has actually been around us, and me understanding how I am, and how my nervous system is, and how much I’m a mirror to him. And actually, so much of the work has been me doing my own stuff so that I come into this in a very different way, so that I have a different perspective on how I should be in this situation.
So much of it has been a lot of unlearning around “I get that that’s how I was parented, and maybe it worked, maybe it didn’t work so well, but I know in this situation it clearly isn’t working well, and I have these expectations, and these expectations are wrong based on what’s actually happening.” So a lot of the work has been around, for lack of a better word, cleaning up my own stuff. That’s the thing that’s had the biggest impact when I then return into being in dad mode.
I just want to get a sense from you, how much of your work is that type of stuff versus “Hey, I think in this situation, these are the two or three steps that you should be taking”?
Oona Hanson: It’s such a great question. The first thing that comes to my mind is when we’re talking about eating and body image, it’s really hard for parents to look at the way that they’re role modelling certain things. And because, as we talked about earlier, diet culture makes us think a lot of the things we’re doing to and for our bodies are for our health, we may not realise the way that it’s being perceived by our kids.
Whether it’s using a fitness tracker, whether it’s cutting out foods, whether it’s doing intermittent fasting or any other thing like that that a parent might think “I’m biohacking” or “I’m optimizing performance” or “My doctor said I’m pre-pre-pre-diabetic, so I should really change this up in my diet” – so it can be really hard for parents to recognise the things that might be worth being curious about.
I don’t blame – parents do not cause eating disorders. I feel very strongly about that. Although I know some people who’ve had eating disorders who very much blame their parents, and they have every right to do so; that’s their lived experience. From my perspective, I don’t find blaming parents useful or effective. I think parents already feel guilty if their child becomes ill with anything, but especially eating disorders because of these cultural narratives around dysfunctional families causing eating disorders or controlling mothers causing eating disorders. Fill in the blank.
I blame diet culture. I blame the way parents themselves were raised around food and body and the world that we live in.
It can be a cold, hard look in the mirror sometimes for parents around their own relationship with food and body, and especially – let’s say they’re helping their child renourish and their child is going to need a lot of energy-dense food. If Mom or Dad or other caregivers aren’t eating those foods too, that can make it harder for the child to recover. The child might need more than the parents do because they’re having to make up for that energy deficit, but that can be one of the wake-up calls for parents, to realise, “Oh, I’m afraid to eat this food that my kid is afraid to eat because of their eating disorder.” It can be that moment of empathy, too.
For some families, going bite for bite with their child for a while is life-saving. And I know many families that didn’t go bite for bite with their child, and that helped their child recover, too, because they were able to say, “I’m giving you what you need. My body doesn’t need this much, but your body does.” Again, there’s no one-size-fits-all. I’ve seen this work both ways, and I think some families might go bite for bite when they’re on the edge of medical stability and they’re going to do whatever it takes, and there are some families that go “I don’t need to do that anymore. I can actually make sure my child eats what they need.”
Because to stay in recovery, they’re probably going to have to eat more than their friends when they’re out on their own. They can’t decide what to eat based on what other people are eating. They have to always know to keep their eyes on their own plate. Or distract themselves from their plate with a screen. Again, all these things that we think of as rules about eating, when we’re helping someone recover from an eating disorder, if we can broaden our ideas about what’s going to be effective – I think having more tools in the toolbelt for a family is really helpful.
But the emotion regulation piece, that’s where some emotion coaching support can come in. Emotion-focused family therapy, EFFT, is something that I’ll often direct parents toward. Adele Lafrance’s work, she’s got a lot of free webinars.
Chris Sandel: I’ve had her on the podcast before. I’ll link to that one in the show notes.
Oona Hanson: That’s been really helpful for some families. I also help families sometimes trim down their scripts. For some people, the full EFFT process is exactly what they need. For some families, that can feel so overwhelming. So I work with families to provide maybe a condensed version. If that works, great. And I’ve seen that be really effective for some families.
Yeah, the emotion regulation piece is tough. A lot of times parents, because they’re so afraid, think that yelling at their kid is how they’re getting their emotions out, but they also think “If I just yell loud enough or I threaten enough, my child will eat.” That rarely works. That’s where I think having other tools helps parents regulate their own emotions and really helps their child eat. Adding stress to eating is not going to be effective, that’s one thing I can say for sure.
Chris Sandel: I should’ve probably clarified, the work that I’ve got is not around the eating piece with him. That part is fine. It’s more of other issues that we’ve been working on where it’s been much more helpful. So yeah, let me bring up my list here in terms of where I think would be useful.
00:53:24
If we start with body image – and maybe it’d be useful if we get specific with this – what would be a very common thing that comes up with a parent connected to body image? This could be around a teen, it could be around someone younger, saying, “Hey, we’re having this challenge with body image specifically”, what would be an example of that?
Oona Hanson: I think one of the most common is the beginning of puberty, when rapid weight gain is happening – which is essential for the child to develop into their adult body, but because our culture demonizes weight gain, especially rapid weight gain and especially weight gain without simultaneous height gain, this strikes fear in the hearts of parents, and even in a lot of paediatricians. Paediatricians know a lot about child development and the way those growth curves work, but because of the culture we’re in, we tend to overreact to rapid weight gain.
This is where suddenly a child’s clothes aren’t fitting, their body shape has changed, and it’s very tempting for parents to say a couple things. A kid will say, “I’m getting so fat”, and a common thing parents might say is, “Oh, you’re not fat, honey. You’re beautiful.” Compassion to all the parents who’ve said those lines, because I think they’ve been said millions of times because that’s something that we’ve been taught to say – I would guess most of your audience would already see some of the problems with this response.
If we say, “No, honey, you’re not fat. You’re beautiful”, you’re saying fat can’t be beautiful. You’re also diminishing – the child’s telling you something and you’re shutting down the conversation. They’re feeling something, they’re not sure what it is, and you’re shutting it down. You’re also coming back to prioritising physical appearance. So we’ve accidentally kind of tripled down on some of the things that diet culture teaches us.
I encourage parents, if you’ve done this before, it’s okay. You haven’t ruined things for your kids. We can always go back and talk to them – even if it’s been a couple of years since this conversation. If you want to, you can go back.
In those cases, I advise parents to really sit and listen to their kids. “Tell me more. What do you mean by that?” Really find out where the kid is coming from. Is it because their favourite pants or skirt don’t fit anymore? Trousers, sorry, for your audience. It could be pants too.
Actually, underpants that are too tight are such a body image trigger for kids, so I’m actually glad I said that because we sometimes forget that our kids need bigger size undergarments, and those elastic bands cutting in can really make their body something that they’re thinking about all day long while they’re fidgeting at school in their chair, and really they just needed to go up a few sizes in their undergarments.
But I think it’s really a conversation about letting the kid share their feelings, showing your curiosity, showing that you can handle this kind of conversation. I think for so many of us, body image is this thing we’re so terrified of talking about. We want to rush in, “No, no, no, it’s fine. You’re fine, honey. You’re beautiful.” Or “Oh, that’s your puberty pudge. You’re going to grow out of that really quick. Don’t worry.” Again, we’re saying the pudge is a problem but it’s temporary. First of all, you don’t know. They might stay that shape even as they grow. We don’t know. But we’re also reinforcing the fear that this is something undesirable or problematic.
I don’t know if I answered your question, but that’s a common one around the puberty. I do think it’s a great opportunity where parents can talk about “Yeah, bodies change. Sometimes body change can be uncomfortable at first.” Really validating that this can be hard, and maybe you do talk about anti-fatness or diet culture. Depending on your kid and what they’re interested in.
You can also talk about clothes are supposed to fit your body, not the other way around. “Hey, let’s donate your old clothes, or maybe it’s time to go shopping for some new clothes” and maybe even make it a positive thing. It’s a lesson they can take with them forever because, as we know, bodies continue to change.
This can be an area where, especially for parents who are entering middle age or maybe even in middle age, having their own hormonal changes and body changes, we get to be role models for this. We can really connect with our kids on some of this, like “Yeah, boy, in our culture, it’s really hard when your jeans don’t fit” and even be playful about it in a way, rather than it being this thing that “No, we can’t talk about this. It’s fine, don’t worry.”
Chris Sandel: I think also, as you said, by having a conversation, you can understand what this means more for them or where this is coming from. If you say “Don’t worry, it’s fine”, you may have missed an opportunity to hear about the fact that “I’m being bullied about this at school” and we could’ve then done something to have a conversation around that. Or as you said, this could be “I just needed to tell them we could get new clothes, and they were worried about asking for the fact that they need new clothes because money’s really tight right now, but we could’ve found a way to be able to do this as opposed to them just staying in these clothes.”
So we don’t want to make assumptions about what this means for them or why this is coming up. It’s better to be able to have that conversation. They are growing into young adults, so great, let’s start to have some of those more adult conversations around these kinds of things, because it’s going to be coming up more and more for them, whether they’re talking to you about it or not.
Oona Hanson: Exactly.
00:59:41
Chris Sandel: Is there another example on this one of body image? Is there another common struggle or area that comes up that people are reaching out to you about?
Oona Hanson: I think the transition to college is a big one, and the concepts or the myths about the so-called ‘freshman 15’. I don’t know if that’s a phrase – maybe it’s a bit different there.
Chris Sandel: It’s made its way over here, probably more through pop culture, movies, that kind of thing.
Oona Hanson: Right, so this fear of weight gain in college. Some kids will try to diet before they start college. Their parents might even make jokes about some of these things, not realising that actually, the transition to college is a really high-risk time for the development of eating disorders or relapse. Again, taking it as the beginning of a conversation. If a child says something like, “I’d better start doing X, Y or Z because I don’t want to gain the freshman 15”, that’s a moment to say, “Hey, what do you mean? Tell me more” and asking where they’re coming from. That can really guide your next steps in terms of where the conversation’s going to go next.
Chris Sandel: What would you then be advising in that situation? Is it just have a conversation and see where this goes? Or “these tend to be some of the sticking points and this is the thing that I’m advising them around, or this is where we have a conversation about what to do in the dining hall”? Are there any areas that come up a lot connected to this?
Oona Hanson: I think it comes up a lot especially for young women wanting to join a sorority. There is a lot of appearance pressure. Those parents I think should really, if they don’t feel equipped to have some of these conversations to support their daughter, getting some support around that. The reality is, yes, you are entering a system where you are being judged on your appearance. Let’s talk about that. What are some of the risks? How are you going to protect yourself if you’re starting to feel preoccupied with your appearance or if you don’t get accepted into the group that you want?
I think it’s a series of ongoing conversations, too. We used to have that idea of you have the talk about the birds and the bees with kids, and we now know, no, it’s actually thousands of little conversations about sex and development and things like that. And I think it’s true for these things as well.
I think the summer leading up to a child going off to college or living independently can be that great time to experiment. Can they feed themselves? Can they get their needs met without you having to micromanage their food? That’s where if you start to see a lot of restriction, that’s a different conversation. Maybe that’s where you do bring in a dietitian or someone to give a little bit more information and support. Like, let’s figure out how to make sure you know how to put together some meals on your own, and talk about what happens if you restrict. I think a lot of kids don’t realise the risk that they’re taking when they’re doing something like that because it’s so normalised in our culture.
01:03:09
Chris Sandel: For sure. What about in terms of eating disorders? I know we’ve obviously talked a lot about the FBT piece, but what are some of the other questions that people are reaching out to you about with this that we haven’t touched on so far?
Oona Hanson: A couple things. One is when other family members, especially grandparents, make comments about food. The other is when kids hear things at school or from their coach about food. We might have created this pretty nice home environment where people feel free around food, but we can’t keep our kids in this bubble, and they’re going to have these outside influences.
So having a child come home and say, “My coach said I need to cut out X, Y or Z before games” or “At school I had to do a food journal and then we had to make a better meal plan for ourselves” – this is where parents are not sure what to do. Like, “Do I march into the school? Do I call up the coach on the phone? Do I let my kid handle it?” Again, these are pretty nuanced. It depends on the age of the child, it depends on your relationship with that teacher or coach or grandparent.
But these are some of the tricky things to navigate. Especially if you have an older teen where you think, “They should be able to handle this.” Then again, this is an adult giving guidance to my child. If they’re in recovery from an eating disorder, I think that’s where if your child isn’t able to advocate for themselves, that’s really a place for parents to step in and say, “Hey, you need to understand that this kind of assignment or this kind of advice is not helpful and is actually harmful to my child. What more do you want to know? How can I help support you in learning about this?”
Chris Sandel: Nice. In those situations, are you really giving people scripts with that if they need it?
Oona Hanson: Yeah, sometimes. Just like our conversations with our kids, I think our conversations with other adults will go a lot better if we aren’t coming in with too much of a plan. Really being curious. I’ve had families find out, “Oh, the child was allowed to choose between the food journal assignment and something else, but they chose the food journal assignment.” Maybe that’s a different conversation. Or the coach says, “I didn’t say they couldn’t have whatever sports drink. I just said save the clear ones for me because I like that flavour better” or whatever. Sometimes there’s something that gets lost in the game of telephone.
So assuming positive intent, coming in with curiosity rather than marching in with a stack of articles about food restriction or eating disorders.
Now, I will say sometimes it’s helpful to write the long angry email but not send it. I think it can be very – to your point about parents learning their own emotion regulation skills, sometimes that can be a really effective exercise to do that first, and then send the email that just says, “Hey, I’d love to have a conversation about something. Can we meet in person or talk on the phone?”
Chris Sandel: I do a lot of that with clients as well, like “Let’s write this letter to your mum or the treatment centre or whatever it was. I want you to get out everything you need to get out. We’re not going to send the letter. If you want to send the letter at some point, you can, but the intention is I want you to have the ability to say all the things you wish you could say and we can go from there.”
Oona Hanson: Love it.
Chris Sandel: It’s a nice tool.
01:07:10
Another one would be going to the doctor’s office with your child. I can imagine there are a number of different scenarios that come up connected to this. What are some of the ones that parents are reaching out to you about? And what are some of the suggestions you have connected to this?
Oona Hanson: Parents are understandably terrified because we know that comments from a doctor are a very common seed that gets planted that can become an eating disorder later. “My doctor said, my doctor said.” So parents are nervous.
Especially in the States, we have this new American Academy of Pediatrics guideline around weight that reverses the earlier decision. The protocol was not to discuss weight with kids because of the risk of eating disorders and body image issues. The new recommendation is actually diets for kids as young as two, weight loss medications for kids as young as twelve. They’re testing it on six-year-olds now. And then bariatric surgery for kids thirteen and up.
Now, I don’t know many paediatricians who are taking these guidelines and aggressively applying them to every kid that comes in their door with a BMI over X, Y or Z. But it has changed the landscape for families, and I think for parents of kids in larger bodies, especially if parents are also in a larger body, this can just feel like walking through a minefield.
These guidelines do say that physicians need to get permission from the parent to talk about weight with the child. I don’t think that’s happening very often. That’s not the part of the guideline that people have focused on. There’s not a lot of money to be made by promoting that step of the process. But parents should know – for parents in the States; I don’t know all the details where you are, but the doctor is not supposed to launch into a discussion about weight.
The other piece, I think, is that not every parent feels they have the resources to push back against a doctor. And there’s so many ways that a marginalised identity can make this even harder. Let’s say English is not your first language, or you’re in a larger body, or you have your own health conditions and the doctor might be making subconscious judgments about you. There could be gender dynamics. There’s a power differential in that doctor’s office.
That’s where I do find prewritten scripts really helpful. It helps level the playing field a little bit. There are some wonderful resources out there written by eating disorder professionals, for instance. So if a parent is like “I need to bring in some backup when I make requests of the doctor”, you don’t have to do this from scratch, or you don’t have to reinvent the wheel.
Asking ahead of time, letting the doctor’s office know, “Please don’t discuss weight in front of my child; if you have any concerns, talk to me privately.” If the doctor or nurse forgets, because that happens, I think this is where parents can say, “Actually, can we talk about that separately? I’d rather not focus on that in this appointment.” And then you’re probably going to have to have a conversation with your child. “Did you notice when the nurse made a comment?”
This is where, again, while we might want to bubble-wrap our kids, it just doesn’t make sense because they’re going to encounter weight stigma and all these things in the real world. But knowing that we can talk to them about it, that we can help them build some skills around it, and that we’re not going to immediately jump to a restrictive diet or something for our child because of an offhand comment at an appointment.
I think putting something in the child’s chart – you can even ask that it be put into the chart, “Please do not discuss weight.” You can ask for the weight not to be shared with your child. And you might ask them. Sometimes if people learn their weight, numbers can be kind of tricky. We can get kind of fixated on it. “How would it feel to not know your weight?” Some kids, it’s more anxiety-provoking not to know. So again, there isn’t one-size-fits-all.
I’m personally not a fan of recommending that parents opt their kids out of weigh-ins in general. I know a lot of adults now are declining to be weighed at the doctor’s office, and this can be very empowering and you can end up having a great appointment with your doctor because you’re talking about your actual health concerns and not getting distracted by a number or BMI.
But for kids, because of all the things we’ve talked about, because kids can start losing weight without parents realising, I think having those weight checks not only at the well visit, but even if your child goes in for something else – the standard, at least here, the first thing they do is step on the scale – I actually think in general that can be a good thing, to be getting more data points on a child.
Now, if getting weighed at the doctor’s office is an incredibly traumatic experience because your child has been through a lot, if they’re in a larger body and they’ve been put on horrible weight loss programmes that were very damaging to them, that’s maybe a different conversation. You might say, “You don’t have to know the number.” Letting a child in a larger body know, “I still want to know, if you were losing weight, even by accident, that’s something that would be concerning to me. So I do want the doctor taking your weight.” Letting them know you’re more concerned about weight loss, even though the medical system is more worried about weight gain.
Those are the thoughts that come to my mind about the doctor’s office.
Chris Sandel: Nice. I think that’s really helpful. As you say, there are scripts online that people can find around this piece. It’s just really tricky because, as you say, there is this power differential with this. You also want someone to feel like “I can go to the doctor’s office.” The last thing you want is someone to not go and then later on, they find out they’ve got stage 4 cancer that if we’d got in earlier, we would’ve found this a lot earlier.
There’s lots of different examples connected to that, where it would’ve been really helpful for you to be having these regular check-ups to look for all of these different things. So you don’t want the pendulum to swing so far the other way that someone is avoiding this and doesn’t want to take any information that any doctor ever says seriously at all.
Maybe having that conversation with your child, like, “These are the areas where there’s a lot of expertise. This is an area where there’s unfortunately some real blind spots and there’s a lack of training and a lack of understanding in this area, and that’s why we’re doing things in this way, but I also want you to be able to go. You’ve noticed this thing, this lump, whatever, I really want you to go and get this thing checked out without the fear of ‘now I’m going to get a lecture about this other thing’.” That’s a really tricky thing because there will be times where that will happen with a doctor. And that shouldn’t be happening, but that’s what does occur. So I can understand why people are then put off from this.
I also had an experience today with a client, and she’d gone in – she’s an adult client – and done a blind weigh-in, saying, “I don’t want to know the number”, and then they sent her an email the next day, and the first thing on the top had her weight.
Oona Hanson: First thing, yeah.
Chris Sandel: First thing. And it’s now causing her a problem, and we’re trying to resolve the fact that she now knows this and all the thoughts that are coming up connected to it.
These kind of things really sadden me. She’s doing her absolute best to try and advocate for herself, going through this process, and was very explicit about “I don’t want to know this. This is why I’m doing it this way”, and then gets an email the next day basically not following through on what she’d asked.
I’m saying this just because I think some things like this happen more often than not, and there will be things that get messed up, and that’s really heartbreaking, frustrating. We then need to find ways of being able to navigate through that.
Oona Hanson: Yeah, I’ve definitely heard those stories as well. It’s tough.
Chris Sandel: Yeah, it really is.
01:16:33
Another one may be around low self-esteem. Is this something that comes up much in terms of people reaching out to you and asking for advice or suggestions connected to it?
Oona Hanson: Yeah, and I think it often connects to body image. This can go a couple different directions, but in our culture, we’ve been taught that if you’re not feeling great all the time, it must be something about you that’s wrong, and that you should go on a self-improvement project to fix it.
We do know that self-esteem issues can precipitate some disordered behaviours, or negative thoughts about appearance, but also someone who is bullied about their appearance or doesn’t feel at least neutral about their appearance can be more vulnerable to having this sense of low self-worth.
To me, this is where the power of creating a safe haven in your home, where all bodies are good bodies, body diversity is celebrated, we don’t disparate our bodies, we don’t disparate even the bodies of let’s say certain political figures that you disagree with – that’s just not something that your family does, that all bodies are accepted, celebrated, and we also can talk about these cultural pressures – I think especially with teenagers, understanding, “Wait a minute, who benefits if I feel bad about myself? Oh, this makeup company or this clothing brand or this workout programme” or whatever it is.
Going back to our earlier conversation about how teenagers can often get a bad reputation in our culture, when in fact teenagers are amazing, and they in general can have a really strong sense of justice and fairness, and they don’t want to be bamboozled. The idea of being tricked by someone into doing something often really angers them. I think this is where sometimes we can help kids see that when someone makes you feel bad about how you look or who you are, they’re profiting off of you. They’re creating this problem and they’re trying to sell you a solution.
That being said, I don’t think we want to skip over that connection and validation piece either. We want our kids to see themselves the way we see them. We think, “How can my kid have low self-esteem? They’re amazing. They’re the most wonderful creature that has ever existed.” But I think we often can do a disservice to our kids if we – it’s kind of like the “No, honey, you’re not that, you’re this.” If we can say, “Oh, you’re feeling really down about yourself. That’s a really awful feeling to have. Tell me more. What does this feel like? Where is this coming from? I want to hear. I’m curious.”
And if they don’t want to talk in that moment, say, “You pick a time when we could talk more about this. Maybe when we’re walking the dog tomorrow or we’ve driving home from school.” That’s that autonomy piece. It’s not always on the parent’s terms. Giving especially adolescents a chance to say, “Here’s how I want to do it” – maybe they want to text it to you. Maybe they want to leave you a voice note. Giving them that.
Technology can be our friend. We think of it as – it gets so demonized, like the phone is the source of all of our problems. And yes, it’s contributing to certain problems, but it’s also this tool that we can use for a lot of good things, too. I’ve even worked with families where when the kid is having a tough time, there was a certain emoji they picked that they’d text their parents. Rather than saying, “I’m feeling really low and I need help”, it was easier to text a picture of the unicorn on the phone to the parent, and that was a sign of “I need you.”
So I think the low self-esteem piece – and again, if it’s something where you think “This might be going beyond typical self-consciousness or there’s something more”, parents listening to their gut should know, maybe this is a sign of depression or anxiety. There could be something more going on here, and getting them evaluated. Is there more support we could be giving besides what the parent can provide with that validation and that connection and maybe a little bit of harnessing of that social justice or personal justice feeling about “Hey, wait a minute, these fat cats at Instagram are trying to make me feel bad about myself so I buy this product.”
Chris Sandel: For sure. I think also, as I’ve experienced as a parent, there was so much stuff that it’s like, “Oh, I’m past that” and then you have a kid and you’re like, “No, I’m definitely not past that” and it comes up. For a lot of parents, they’re dealing with stuff that teenagers are going through which is very much mirroring back to them stuff that they’re going through.
In your earlier comments about the “No, it’s fine, you’re not getting fat, you’re beautiful” type thing, there’s often some reckoning that parents have to do, either with the way that they are about themselves or the way that they were parented.
There’s definitely conversations that I’ll have with clients who are telling me about certain things that are going on with their kids, and for them, this is now an opportunity to be the parent that you wish you could’ve had. To be the one who is able to not say, “You’re worried about your weight, let me be the mum that takes you to Weightwatchers and helps you diet and that kind of thing”, but is the one that is really supportive with you and has these difficult conversations and is able to say, “These are ways that I really want to show you can support yourself” and all of that type of stuff where someone can start to recognise, “This is what I needed when I was younger, and I now get to do this for my teenager or my kid”, and that can also be very healing for that person.
But sometimes it takes some work to get there because you’re then knocking up against some open wounds in some of the cases.
Oona Hanson: Definitely. I think this is where it’s okay to ask for a do-over. In the moment, when you’re flooded with – you’re right back to being 12 or 13 years old yourself, and you don’t maybe give the most supportive response, I think coming back to our kids the next day or the next week and saying, “Hey, I’m so glad you told me about this thing you were worried about. Boy, I don’t think I gave you a lot of support in the moment because I think it took me right back in a time machine to my own teen years. But I’m an adult now and I’m your parent, and I really want to help you through this. Tell me more.”
So yeah, getting those do-overs, I think that’s really powerful. Parents I think are worried about showing vulnerability to their kids sometimes. And obviously we’re not dumping our emotional stuff on them and asking them to take care of us, but I think admitting when we’re wrong and when we make mistakes – again, especially with adolescents – that’s like gold. This sense of “Oh, my parent is really respecting me by admitting their mistakes” can really bring you a lot closer, even though parents might think we have to be presenting this strong, perfect exterior all the time when in fact, what our kids actually need is for us to be authentic and vulnerable and connect. And it’s not easy.
Chris Sandel: You’re then role modelling the real world for your kids. The amount of times I’ve had conversations and done the repair work, I think it comes up a lot. You’re then showing how to do conflict resolution. You’re showing how to reflect on my behaviours or my emotional state in that moment, and that actually, “Okay, I got caught up or swept up in that thing, and I’m really sorry with the way I spoke to you in that moment or the way I handled that. How was it for you? Tell me what your experience was like.” Again, you’re having these conversations.
I think you’re much better – and I’m not advocating like ‘intentionally mess up’, but it’s going to happen anyway – you’re much better being able to role model “Hey, I messed up and then I was able to quickly repair.” That is the thing that matters the most and makes the most impact. It’s not that “I had that time where I really raised my voice and you got scared.” It’s like, within half an hour or the next day, I sat down and I was like, “I really need to apologise about what happened last night.”
I feel like there’s a big shift now in parenting that I don’t think was something that happened a generation ago, being able to have more of these kinds of conversations with kids. And I think it’s really important to show that even as adults, we have troubles with emotion regulation in moments. I think for kids to be able to see that – because otherwise it feels like, “I’m the only one that goes through this.” It’s like, “No, I’m in my forties and I still struggle with these things from time to time. So it’s probably a little bit rich of me to expect you as a seven-year-old to not have that happen.” So being able to have conversations and really model that I think is super important.
Oona Hanson: Couldn’t agree more.
01:26:58
Chris Sandel: One of the other things – I can’t remember if you did an article on this or it was an Instagram post, but talking about eating disorders in teen boys. How much is this coming up with the people that you’re seeing or are reaching out to you? Talk more about this.
Oona Hanson: Yeah, I’ve been a part of quite a few articles on this topic. It’s a passion of mine because again, that education piece – I can’t tell you how many times I’ve met someone and they say, “What do you do?” and I tell them, and they say, “I’m so lucky I don’t have to worry about that. I only have boys.” And then I have to have the heartbreaking – “Actually, you do need to be aware of these things and know about these things because it’s one of the fastest growing groups of people getting diagnosed with eating disorders.”
A 2020 study showed that 1 in 7 males will have an eating disorder by age 40. Currently in treatment, 1 in 4 people in treatment are boys and men. I think many boys and men don’t get treatment, don’t get diagnoses. So I don’t think it’s really that 25% of people with eating disorders are male; I think we’re getting closer to 50/50, but we just don’t know.
I think what is important for parents to know is that boys can get all the same eating disorders as girls – yes, including anorexia. And boys can also develop a preoccupation with bulking up, being lean but also really muscular, which people have coined as ‘bigorexia’. Or sometimes it’s really just falling under a body dysmorphia diagnosis.
But I care less about, from my perspective, what diagnostic criteria necessarily it’s going to point to. If you see your son focusing on protein at the expense of other macronutrients, if your son is working out in a way that feels like it’s a little obsessive or compulsive or it’s joyless – a lot of parents are told, “If your son starts turning down social opportunities to go to the gym, that’s a red flag.” And certainly it is a red flag. I think there’s usually signs before that point.
Things like supplement powders and a lot of these things that are unregulated that can have pretty dangerous components in them or can even be a slippery slope to kids experimenting with anabolic steroids and things like that. Parents need to know terms like ‘bulking and cutting’, intermittent fasting, biohacking. The terms that their boys might use aren’t necessarily going to be – like the word ‘diet’ probably isn’t going to come up. But you might hear things about ‘performance’.
And dads should be really paying attention to this as well, because the way that diet and wellness culture now markets to men, it doesn’t sound like the way it’s necessarily marketed to women. A lot of it is about performance and vitality and longevity and these terms like biohacking that can really sound cool. Some of it is like, “Oh, my body is like a science experiment. This is so cool”, but not realising how that can really kick off disordered behaviours, and our sons – obviously, parents of any gender can influence kids of any gender. But especially for dads thinking about their sons, the way that they’re modelling what it means to be a man in the world and what body image means.
The other piece that’s so tricky is that boys often don’t talk to each other about body image the way girls might. You put a room of teenage girls together, or a group of adult women together, and unfortunately – or maybe it’s for better or for worse, I don’t know – there’s going to be talk about bodies and how they’re feeling about their bodies. Boys, again, in general, aren’t necessarily going to be talking as directly about these things. There might be jokes and teasing about bodies.
But this is where parents can let their sons know that this is a topic they can talk to them about. There’s a really nice book called Being You: The Body Image Book for Boys. I think I have that title correct. One of the authors is Dr Charlotte Markey, and she has two co-authors whose names escape me right now.
Chris Sandel: I’ll put it in the show notes.
Oona Hanson: Okay. Even giving your son a book like that, those sort of conversation starters – it doesn’t mean like, “Okay, I’m giving them a book, I’m done, I don’t have to talk about this.” But it can be a great conversation starter just to share a book like that that really talks to boys about – it’s not just about weight and shape. Boys can have all kinds of other body image – whether it’s having body hair or not having body hair, do they have a certain kind of jawline. The way that boys are getting appearance pressures now, it’s not like when we were kids. It has gone to a whole new level.
It’s not surprising that a recent study showed middle school boys, I think 75% of boys have body dissatisfaction. 75% of middle school boys. We’ve never seen numbers like that before, but thanks to social media, thanks to the way that wellness and diet culture has come for men and boys, it actually makes sense that they’re having some of these same appearance concerns that we used to only associate with girls.
Chris Sandel: For sure. I reflect upon myself with this in that when I was in high school, the joke was always it looked like I was in the wrong grade. There’s a photo of me – I can’t remember if it was Year 8 or Year 9 – and it looks like I’m the wrong grade because I’m just so much smaller than everyone else. I was very insecure about the fact that I was going through puberty a lot later than other kids and that I was in this smaller body.
But the one thing that was different than compared to now was I never got the message that I could change that thing. And that was possibly lucky in the household that I was in because I didn’t have a dad who was saying “Hey, let’s go to the gym and we’re going to put a load of muscle on you” or anything along those lines. It was very much “This is just how it is and I can’t do much about that.”
And there is something that is useful about that. I can be disappointed, but there’s something added when you’re like “But you can change this. You just need to go and get your protein or creatine powder. You need to do intermittent fasting or you need to do these things.” If those things were available to me and were in my consciousness, I don’t know what I would’ve done. It just wasn’t there when I was at that age. The internet was only just beginning when I was in high school, so we didn’t have all of these different things.
So I think there’s just a lot more that is put onto boys and men. I also think the way it’s talked about is very different. As you said, it’s about biohacking and longevity and maximising performance and efficiency. It’s very much the same kinds of people who are really into marketing are also then into all of these type of stuff, and you’ve got the Human Lab and Peter Attia and all of these people who are very much put up on this pedestal as “He goes to Stanford and he knows all this stuff and these are the doctors who know everything about everything.” We’re thinking about it in this very different way, like “No, no, no, that’s not dieting. This is about life extension.”
I think it can be much easier for that to get missed. When it’s a girl and she’s saying, “I’m going on a diet because I want to lose weight”, we’re calling a spade a spade, and we then have some red flags about “Maybe this is not a good thing.” But when someone’s talking about “I just really want to help my performance and my ability to focus and that’s going to get me into the better college or university that I want to go to”, it can be like, “Oh wow, I love that dedication. It’s great that you’re doing that.”
And I know it’s not so black and white and that men and boys are doing it this way and women and girls are doing it that way, but I do think the verbiage and the language that is used around the way that men and boys do food is very, very different. So I understand why it can so easily get missed.
But I’m with you; I think the statistics don’t tell us the real truth around this stuff and how common eating disorders really are. I think, one, there has always been a lot more going on in terms of this affecting males, and two, I also think it is rapidly increasing just because of all the new demands and pressures that are being placed upon men.
I saw something recently on Instagram – I finished school in ’99, so I think it was in 2000-2001 that Fight Club came out. Brad Pitt was then the epitome of what every guy of my generation thought was like, “That’s the perfect body.” Seeing something recently with people talking about that as being like “Oh, Brad Pitt’s tiny in that film” – just how much culture has moved on in terms of what is expected of young men in terms of their time in the gym and what their body should look like. In the last 20-odd years, that has shifted so greatly.
We have really shifted in our culture in terms of the expectations around what bodies for men should look like and what should be done to achieve that. Basically, we’ve created the same or similar rules that have been put on women, and we’ve seen how that’s worked out for the last handful of decades.
Oona Hanson: Exactly.
01:38:14
Chris Sandel: The other thing I wanted to ask about with you is – and I know this was something that you did, I think over the pandemic, the Common Sense Camp was this programme you developed. I don’t know a huge amount of detail about it; I saw this on your site and wanted to ask and find out more. So tell me about this.
Oona Hanson: Common Sense Camp as a phrase was sort of an inside joke in our family. Whenever our kids didn’t know how to do something we thought was a basic life skill, my husband and I, who grew up in an era where kids had a lot more independence and a lot more free time – we didn’t have the internet, so we just figured out a lot on our own. We’re Generation X, so all the associations you have with that of drinking out of the garden hose and being a latchkey kid, coming home from school to an empty house and making your own snack and putting your own laundry in and all that.
Our kids don’t live in that world. The world is different. So sometimes we would joke, “Oh my gosh, our kids need Common Sense Camp. They don’t know how to do this basic thing”, and we would teach them.
In 2020, when both of our kids would have gone to some summer programmes, we were thinking, “What are we going to do for the summer? How do we make summer feel different from the prior months when we were all stuck at home?” We said, “Hey, actually, let’s do Common Sense Camp. Let’s really do this.” So my husband and I planned out a series of lessons or topics – things like cooking, cleaning and laundry, car care, some handy skills around the house. We put together a little curriculum together. Again, this was 2020. There was a lot of time.
Chris Sandel: There was time. [laughs]
Oona Hanson: There was time. And I wrote an article explaining, “We’re going to run a Common Sense Camp this summer.” I thought it was kind of funny, and I shared it, and it sort of went viral. I had a little 15 minutes of fame. I was on Good Morning America talking about it. It was so surreal. But it was really fun, and we still come back to that. We’ll realise one of our kids is missing a certain life skill that they don’t teach in schools anymore, for the most part.
So I wrote up a little guidebook for parents who wanted to do their own version of it. It’s very DIY. Parents would email me, “Can I send my kids to your house to learn all this?” I’m like, I get it, but your kid needs to learn how to use your washer and dryer and your dishwasher and how to take care of the yard at your house. It’s going to be different from my house. So I wrote a little guide for parents, and a lot of people did it.
And I included even things like some social justice things. That was the summer of Black Lives Matter marches that one of our kids participated in. How to be a good ally, a good upstander in the face of injustice. We did first aid and CPR and things. Just a whole range of life skills. I think having that time was really nice.
Even today, parents still reach out and say, “Hey, do you still do this?” Most parents don’t have this kind of time anymore, but even over a spring break or a winter break, I’ve heard from so many families who say, “The kids are making one of the dinners over the holidays” or “My kids learned how to change the oil and now they’re going to go get their driver’s license.” It’s really fun to think about building that connection with our kids, passing on these skills.
And it’s building – going back to your questions about self-esteem and autonomy, kids learning these hands-on skills is really powerful. Especially the kitchen things. Back to the food piece, a lot of our nutrition education, in my opinion, we give kids a lot of nutrition facts, and also a lot of myths, but we don’t often give our kids the chance to learn about food and about cooking and about how to put a meal together, how to plan maybe a few days of meals ahead of time, how to go to the grocery store. Those are really important life skills if we want our kids to be able to nourish themselves, and also maybe even nourish their friends and people they love. Learning how to cook for people is really this great connector.
I think about the fact that the pandemic started five years ago, and in a lot of ways we still aren’t quite back – the rhythm of life hasn’t been quite the same, at least in my community. Food is one of those things that brings people together, and wanting my kids to know how to put a quick thing together so that their friends come over and they have something homemade – doesn’t have to be homemade, but even if it’s reheating a frozen thing from the grocery store, knowing how to put it on a platter and have their friends feel welcome, I think that’s a really powerful life skill.
Chris Sandel: Nice. Do you have this as a PDF or something that people can get from you?
Oona Hanson: Yes, I do. Again, it is very DIY. It’s not very prescriptive. It helps you make a plan for your family. And it was written in the earlier days of the pandemic, so some of it – I haven’t bothered to update it, so it’s a little bit of a time capsule. It’ll take you right back to 2020. [laughs] But yeah, I do still have that.
Chris Sandel: Cool. Just because as you were talking there, I know you said it was as a summer camp, but even if someone looked at this and thought, “We could do this over the course of a year. We’ve got that Saturday where we’re going to do that thing”, and just starting to think about “These would be really helpful things for them to learn.”
I was reflecting, as you were talking, on when I finished school, my mum said – I had finished school, my sister was still in school, my older brother was out of school, and she said, “Look, I’m not doing all the cooking anymore. Pick a night each week and you can do some cooking.” I can’t remember how much I protested or enjoyed or whatever at that moment, but I’m really glad that that happened, because that got me into learning how to cook, and then when I moved over to the UK, I started doing more cooking, and now at home I’m the predominant one that cooks, and I really enjoy that. It’s a skill that I have. I feel very comfortable in a kitchen. I can follow a recipe, but I can throw anything together.
That all came about because of this initial nudge of “Hey, we’re going to have you do some cooking once a week.” Again, I can’t remember how long that went on for, but it was enough to give me that spark and also that confidence of “Oh, I can make something without burning down the house” or “I can make more than just some toast.”
I still can’t change the oil in a car, so maybe I need something on that, but I think learning some of these skills – as you say, it’s not even just about the skill; it then feeds into someone’s confidence in terms of their self-esteem. It’s helpful outside of just the skill that someone is learning.
Oona Hanson: I love that.
01:46:23
Chris Sandel: The last thing I want to ask you – and I know this is probably quite a broad question to finish on, but I’d love to hear your thoughts on this. You talk a lot about teaching kids about healthy food, and I’ve read a number of articles of how this isn’t a great thing when it’s taught in school, and healthy foods curriculums can really backfire, especially for kids who are predisposed to develop eating disorders.
So, how would you recommend we talk to kids about healthy eating? Or maybe we even remove the word ‘healthy’. How do we help kids develop that relationship with food? What advice would you have in this arena?
Oona Hanson: Isn’t it a shame that the word ‘healthy’ has been co-opted by diet culture in a way that can actually make kids unhealthy? It drives me up the wall.
Chris Sandel: And as someone who has the word ‘health’ in their brand name, I feel the same way. [laughs]
Oona Hanson: It’s really tricky. We’re trying to expand what health means, and I think you said the word ‘relationship’ – what I invite parents and educators to think about is that we want our kids to have a healthy relationship with food. And when we label foods as healthy or unhealthy, that actually interferes with the healthy relationship with food.
I like starting from that common ground. We want our kids to have a healthy relationship with food. How do we do that? One thing is by no longer dividing food into a binary or even a hierarchy. A lot of schools teach ‘red light’, ‘yellow light’, ‘green light’ foods. Even Sesame Street teaches ‘sometimes foods’ and ‘anytime foods’. Which shocks me because Sesame Street is known – this was children’s programming built from the foundation of understanding child development, and words like ‘sometimes’ and ‘anytime’ are so abstract for our little concrete thinkers. How often is sometimes? To have kids questioning, “Am I eating this too often?” – they can get precocupid with food and questioning things.
It may not develop into an eating disorder, but we know that having these labels around food can really create a fraught relationship with food that can last someone’s whole life.
It’s funny; we used to say good and bad foods, and people were like, “Oh no, that’s really problematic. We’ll just say healthy and unhealthy.” But kids understood – kids are smart – this is the same binary. One is good and one is bad. So then we got ‘sometimes / anytime’ food. I’ve heard some families do ‘fun food’ and ‘fuel’, like fun versus fuel. I think people think, “If I just use gentler binary language, it’s going to be fine.” And maybe for some kids it is. I think some kids can take it or leave it, it’s not a big deal. But for a lot of kids I think it can be very confusing.
For anyone listening who thinks, “I want my kids to have a healthy relationship with food”, I think we want to take a step back and try to move away from labelling foods into categories.
Now, for some kids, understanding the different food groups can be a category that is a safer thing to think about, as long as we’re not saying, “Here are the good food groups and here are” – because the way protein is king right now and carbohydrates are still seen as the boogeyman is really creating a problem. So we want to be careful even when talking about food groups that we’re not saying “Here are the better ones.” Kids need all of the food groups.
Chris Sandel: Adults need all of the food groups as well.
Oona Hanson: Yes, they absolutely do. So I think the language we use around food really matters. I don’t think it’s the only thing. We talked about role modelling earlier. We can’t just talk about it; we have to be about it. And the language we use can shape our thoughts and behaviours and beliefs around food. So when we stop seeing food as ‘bad’ or ‘unhealthy’ or ‘red light food’, it can really change the dynamic and vibe in the house.
There are some trickier words, too, like for some people, ‘balance’ and ‘moderation’, those words work for them. For kids, I find those to be, again, these tricky, abstract terms that really can undermine that healthy relationship with food. I’m a fan of families offering a variety of foods and modelling enjoying a variety of foods without shame, guilt, compensatory behaviours. Kids don’t have to burn it off, adults don’t have to burn anything off or earn food through exercise. Those are the things that really help kids develop that healthy relationship with food.
Chris Sandel: Nice. One, as a parent, you really need to have a healthy relationship with food to be able to pass that on and model that because, as you say, you can say all the right things, but they’re also going to notice that “Hey, Mum or Dad isn’t eating this thing or that thing. They’re not having dinner most of the nights” or whatever. That can get picked up on. It’s just easy for things to start to seep out in terms of the messages that are being given if someone doesn’t have a healthy relationship with food.
And I know that can be difficult. I’ve worked with adults who are trying to work on that, so it’s not to shame anyone. It’s just more talking about it’s important to work on this stuff for you as well as for your kids.
I also think figuring out what works for your family, because I guess that’s definitely been one of the things that we’ve learnt through going through this experience. I have a very healthy relationship with food, and we’ve still had to navigate certain things. I was very much in favour of the whole Ellyn Satter division of responsibility; my responsibility is “I’m going to provide these things for you and your responsibility is you’re going to eat them, and we’re as a family all going to eat the same foods generally, but we’re going to put down some different options and see what works.”
The reality is that that doesn’t often work with us. There can be six nights a week where Ramsay is eating pasta because that’s just what has to work for him. So the whole division of responsibility piece and us all eating the same things doesn’t necessarily work with us. We then need to figure that out and be okay with that and work out, what does modelling a healthy relationship with food look like in this household?
I’m just saying this so that people don’t read a book like that and think, “Okay, now I’ve found it. I just need to implement this”, and then that doesn’t work and it feels like “I must be failing somewhere.” It’s understanding that different people have different needs, and we can model that healthy relationship with food in very different ways depending on that. And where someone gets to and what their thoughts on variety are is going to be different to what someone else’s thoughts on variety are. Just being okay with it not looking like the Instagrammable food photo with all the family sitting down to the exact same meal because that’s what I thought should be what’s happening.
Oona Hanson: So true.
01:54:43
Chris Sandel: Is there anything I haven’t asked that you would like to talk about before we wrap this up?
Oona Hanson: Just on your last comment, I was thinking, we know that even parents with eating disorders can raise kids who have a healthy relationship with food. So for folks who are listening who think “Oh gosh, I have to get all my stuff perfect before I can help my kids” – I don’t think that’s true. Depending on the age of your child, if it’s developmentally appropriate and you can share that you’re working on something, this is something you struggle with, I think having things out in the open can be really beneficial and less scary to kids than the unspoken.
And to your point about there isn’t always a one-size-fits-all, like the family feeding – yes the Ellyn Satter method can be very helpful, and for a neurotypical kid – and actually, a lot of research on parents with eating disorder, the division of responsibility model with support can be an effective and really helpful way to have a healthy, relaxed dinner table without parents feeling like they have to micromanage every bite. So we have some evidence that it can be quite helpful for some people.
But that more responsive or attuned feeding that it sounds like your family found its way to, that can be really powerful. And I think what’s beautiful about the Ellyn Satter piece is not micromanaging and not policing kids’ food and having structure. Predictable times where parents are providing food I think is really helpful.
To take us way back to the beginning, in family-based treatment, you’re not following – it would not be appropriate to follow Ellyn Satter’s division of responsibility for someone in the acute stages of an eating disorder. So I just want to make sure I hit that little footnote there.
Chris Sandel: For sure.
Oona Hanson: All of these things that we’ve talked about, like you said, every family has to figure out what works for them in that moment. Like you said, the Instagram images put so much pressure on parents to have these rainbow bento box lunches for their kids that they somehow eat all of. That pressure that parents feel, then the kids feel that pressure. We pass it on to them.
Pressure is one of the things that interferes with that healthy relationship with food, so if we can take the pressure off ourselves a little bit, that’s going to take the pressure off our kids, and we can have those more peaceful, even joyful, relaxed mealtimes that are nourishing beyond what we can capture on a nutrition label. That nourishment we get from eating together, even if we’re not eating the same things.
And some kids can’t eat at a table with parents. They might have to eat in a slightly different way. Every family is going to find what works for them. But approaching all this with that curiosity and exploration, like “If it’s not working, let’s try something else” I think can really help parents find what works for them.
Chris Sandel: Yeah, for sure. And it’s not that I have disavowed everything that Ellyn Satter has ever said. We use a lot of that, and as you say, the regularity piece is really important. It’s just being able to navigate your way through it. The word ‘curiosity’ is something that I’m a big advocate of. It’s how I want people to be doing recovery as well; let’s put on our experimentation hat and approach this from a place of curiosity as well. So yeah, I agree.
The same with the family feeding piece, and it was something we had to try out some different things and figure out what worked. And what’s working for us now might not be working for us at some point in the future, and we’ll reassess and figure out what the next plan is. But just being able to be flexible and curious with it I think is really important.
This has been wonderful. Where can people be finding out more about you if they want to connect more or want to read more of your stuff?
Oona Hanson: One place to go would be my website, which is www.oonahanson.com. I always say when in doubt, it’s an ‘O’. I post the most on Instagram of all the social media. I’m @oona_hanson. There’s an Oona Hanson on Instagram that’s a baby, so if you go to Instagram and you find a baby, that’s not me. [laughs]
And then I do have the Parenting Without Diet Culture newsletter on Substack, where I really try to give parents practical tips and scripts and strategies for navigating this crazy diet culture world that we’re in. I do also talk a little bit about eating disorders there as well, so if parents are navigating that, they’ll find some good resources on the newsletter too.
Chris Sandel: Perfect. I will put all those things in the show notes, and thanks so much for coming on, for your time. I really enjoyed this conversation.
Oona Hanson: Thanks for having me.
Chris Sandel: So that was the episode with Oona Hanson. I loved this conversation. I love what Oona is doing. If you resonated with this, then I suggest that you follow her on Instagram, you subscribe to her Substack, and if you are a parent that is needing this support, then please get in contact with her.
So, that is it for this week’s episode. As I mentioned at the top, I’m currently taking on new clients. If you want to reach a place of full recovery, then I would love to help. You can send an email to info@seven-health.com and just put ‘coaching’ in the subject line, and I can send over the details to you.
That is it for this week’s episode. I will catch you again next week. Until then, take care, and I will see you soon!
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