Episode 92: Susan Landers, M.D.
By Cameron Suorsa
February 1, 2022
0:00 / 22:39
Mothers of Misfits00:01

Welcome to the Mothers of Misfits podcast. Join me for conversations about how to advocate for our kids in a one size fits all world. Be sure to subscribe, so you never miss an episode!

Emily Melious00:17

Welcome back everybody. To another episode of Mothers of Misfits, we are always so glad you are here to join us for these awesome conversations about how to advocate for our kids in a one size fits all world. And our guest today knows a lot about kids, because she practiced neonatology, I was afraid I might mess that up. That's kind of a, uh, a tongue twister.

Susan Landers00:41

You got it!

Emily Melious00:41

Yeah. So you practiced that for 30 years, full time over 30 years. And at the same time you raised three children with your physician husband.

Susan Landers00:53

Yeah.

Emily Melious00:54

And then you've also, uh, reflecting on that experience, published a book about that challenging balance act of being a mom and a career person that so many of us know, uh, firsthand and your book is called So Many Babies: My Life Balancing a Busy Medical Career and Motherhood.

So thank you for coming on Susan.

Susan Landers01:15

You are so welcome. My pleasure. I've got lots of misfits to talk about.

Emily Melious01:19

Uuh, I love it, I love it. And even though you've spent your career helping, uh, the newborns we're actually going to talk...

Susan Landers01:29

Tiny ones!

Emily Melious01:30

Teeny tiny ones, uh, which I'm sure you could, you could tell lots of stories from that, but we're actually going to focus on a different age group, uh, and, and something, you also have expertise in and experience in and wealth of knowledge, which is teenage eating disorders.

Susan Landers01:46

Yes!

Emily Melious01:47

And you had said, you know, this is more relevant than ever as a topic. So I want to touch on that, but that's what we're going to, we're going to get into today. So.

Susan Landers01:57

Let's do it.

Emily Melious01:57

Yeah.

Why teenage eating disorders are more rampant than ever

So, so start with like, why. You said they're rampant, more now than ever. Why?

Susan Landers02:04

The wall street journal published an in-depth investigation into Instagram and the way the algorithm fed information to teenagers. And they, the reporters who did the investigation uncovered that on Instagram, and to some degree on TikTok... if a girl types in diet, or weight loss, or fitness, or thinness, she will get bombarded with videos, reels, posts, about fitness and weight loss. And there was a survey of preteen girls and teen girls in which 40% said Instagram made them feel worse about their bodies.

Now all the mothers out there know that we live in a culture in which thin is beautiful. Um, and that's just the way it is. Look at any magazine cover. Look at the, um, pictures, your kids are seeing on Instagram and TikTok. Most of the influencers are thin and fit and they like to brag about it.

Well, our teens, being locked down in the pandemic had only social media to deal with. And what they did, actually, this investigation showed is look at more and more videos on thinness, and weight loss, and fitness. And fitness is okay. But if you're 110 pound girl and you're exercising four hours a day, you're going to lose weight.

Um, so we have this recent investigation Emily. That says our teens are being bombarded with an algorithm that gives them a recurrent messages about being thin and losing weight. That's the environment in which Mothers are raising pre-teen and teen daughters right now.

Emily Melious04:08

Yeah and I'm going to be honest with you. So, uh, I've got boys, but I lived that. And as a mom hearing you talk, I'm, I'm, I'm feeling overwhelmed, right? Because what's the antidote? How do I, as one person, one voice in their life and then our significant others, so that's two, combat hundreds of thousands of voices that they're seeing out there on social media, that are saying the opposite.

Like, how do we even start fighting that fight?

Susan Landers04:39

Well, that's a good question. And I don't know that I have all the answers other than ask your daughters and sons to share with you what they're looking at. Um, but I can tell you some things to look for. I've posted about this on my Instagram post and in Facebook about early signs of eating disorders in children and pre-teens, and.

Emily Melious05:03

Ooo, and let me. I don't mean to interrupt you, but I'm going to stop you right there.

Is

When do eating disorders show up?

this is a pre-teen thing? Is this, is this, what, at what age does it typically start showing up?

Susan Landers05:12

I am sad to tell you the average age of onset is 12. So, so, so my 11 or 12 year old daughter, in the eighth grade, would be worried about something, and she would kind of push food around on her plate and she wouldn't interact at the dinner table and she would go upstairs and say, I have to study.

And she just wasn't herself. I thought she was eating enough. She didn't lose weight, her friendships were going okay. She was swimming every day. She was on a swim team, a club team. And, but I was worried about it because I could tell that when she was upset about something, she tended to not eat. The school year, went on, she got into a new click of friends.

She was real happy. She started eating more and everything was fine. So she never lost weight, but she wouldn't talk to us about it. Okay. So 8th grade goes fine. 9th grade, 10th grade, 11th, the big bad year. AP classes, SAT courses. Uh, she was captain of the swim team, team teaching. She came home from sleep-away summer camp.

And she said, mom, I really, she's like 115 pounds. Beautiful. Mama I'm fat. I really need to lose weight. And this is before Instagram. I said, well, you're not fat. You don't need to lose weight. She rolled her eyes and proceeded to eat special K cereal and raspberries for about a month. That's all she ate was cereal.

Um, she would pick it or food and kind of pretend to eat. She got more moody. She was quieter. She would, uh, hang out away from the family. She was definitely not eating. After about a month of this. That's about all I could take, I called her best friend's mother. And I said, what is going on with my daughter?

And she said, Well, Jenny, her best friend told me she's not eating at school and I know she's not eating at our house. So. Let me tell you she's not eating. I went, Oh man! I talked to my daughter, she said, I really just have indigested mom. She had these vague complaints of indigestion. She wasn't exercising more than normal.

So I took her to the pediatrician and the pediatrician said, oh, she probably just has some reflux. And she put her on antacid. And I said, but she's not eating. Like she used to, she really picking out her food and she's on this silly diet. And the pediatrician said, oh, don't worry about it. It's probably indigestion.

And so another month passed and I said, this is not indigestion. I dragged her to a nutritionist and a therapist. Luckily, she loved the nutritionist. She liked the therapist okay. By that time we knew she had anorexia. She had lost 10 or 15 pounds. I don't know how she was swimming. Cause she was so weak.

So she was 115. That means she was down to about a hundred pounds. So, um, the nutritionist helped her with refeeding and within six months she was back to normal. The therapist helped her talk about her feelings, helped us as a family. Talk about things that made us anxious, things that worried us. And gave us some techniques to try to get our teenager to open up. But she was a perfectionist, like B straight A student, taking all the AP classes.

And so a lot of it, we kind of heaped on her with our unreasonable expectations. A lot of us moms, especially career moms, want our children to be educated. We want them to have good grades. We want them to go to good colleges. They get those messages. And now on social media, they're getting the message. They should be thin and fit. And so a child that tends to internalize anxiety and not talk about it, what they do in anorexia is they control the only thing they think they can control, which is food. And then they keep doing all the things that they do to put out this perfectionistic, um, image. And so it is, uh, it's a neuro-biological disease. It's a mental illness. It is pretty common and anorexia and eating disorders are increasing right now in preteen and teen girls.

So any of your moms listening who have a perfectionistic, controlling daughter, high, strong, very sensitive, good student. Um, really likes to be in control, watch what they eat and watch what they're looking at on Insta, on social media. Talk to them about food. Talk to them about their bodies. Do you think your body is good, honey?

Do you think you're fit? Do you, do you think you look good? How do you look compared to your friends? What do you and your friends talk about? Cause they talk about a lot of stuff when we're not around.

Emily Melious10:54

Hm, absolutely. Well let me ah, I'm just going to interrupt you a minute. Cause you have said so many amazing things and I want to make sure we really highlight several of them.

Um, first off, kudos to you because everybody listening caught the fact that the pediatrician and how many times have we all been there? Where we're saying something is not right. And they say, oh no, it's fine. You're fine. And I'm sure they probably encounter it all the time where it really is fine, but you knew it was not fine.

And we say all the time on this podcast, you know your child the best. You are their best advocate and don't let someone cause you to think I'm just crazy. I don't know what I'm talking about. If you have that gut feeling, keep talking about it. Keep talking to people until you find the help that you need.

And I just really admire that you had, you lived that out because I can't imagine what would have happened if you had let that go longer. And then I also want to just highlight what I was hearing from you in terms of those early warning signs. So first off, you know, that awful, um, reality that this is a pre-teen thing.

And then it might be very related to their social media activity or exacerbated by that. And then you gave some of those other sort of character traits that might lead someone to be more inclined to have an eating disorder, particularly anorexia. But here are the signs I heard about, um, uh, first changing moods, changing patterns of eating.

So if that's not normal, um, also social, uh, disengagement. She was removing herself and then having these little ready-made excuses, uh, dismiss it or dismissals of what was going on. So those seem to me like, um, you know, if those puzzle pieces are happening in your world and one or more of those things, those are some of those warning signs.

And

How eating disorders affect girls more than boys

we've been talking about girls from the uninformed perspective that I have. I've always thought that this affected girls more than boys. Is that truely the case?

Susan Landers12:58

It does, it does. Recent studies have shown only 4% to 6% of boys are at risk for eating disorders. It's not zero. And so if you see these signs in your son, be concerned, especially a son that has the same characteristics that I described.

And maybe boys are a little tougher to get to talk about their feelings when they're preteens, too. I feel like you can kind of drag it out of preteen girls, but boys really do clam up. You're going to find out as your boys get older.

Emily Melious13:29

I know

Susan Landers13:30

They don't like to talk to mom.

Emily Melious13:31

They are real talkative now, but I know, I'm not going to be, I'm not going to be that person in their world for too much longer.

Susan Landers13:37

Another sign for moms to look at is excessive exercise. Now, if you're, if your child is binge-eating and a lot of the kids, apparently during the pandemic, they didn't have anything else to do to make them feel good. So they did some binge-eating while they were remote learning. If your child is using laxatives, if your child has marks on their teeth, if they're complaining of a sore throat, if they have muscle weakness, um, if they're losing weight, even though you see them bingeing on food, you might consider that they're inducing vomiting or that they're using laxatives.

Bulimia is less prevalent than anorexia, but it does occur in some kids. So the patterns are slightly different.

Emily Melious14:28

So for the parents that are listening and saying, wow, I, I think, I think this could be going on in my child's life. And, um, you know, we need to, we need to pursue this. I've watched TV specials and things in the past where they've highlighted a child who was confronted and uh, it, it got, it got bad. Um, there was tension, there was conflict they rebelled, or, uh, went deeper into the unhealthy behaviors. I'm sure every parent is scared of that possibility that we say something and we somehow make the situation worse. So what is our first step? Our first helpful step and maybe we have to create some tension to move through to better health.

I mean, not, you know, it might be some, some conflict that we need to move through to make sure they're going to be okay because by avoiding conflict, we might be enabling the situation, but what's that first, one step that families should take if they're concerned about their son or daughter,

Susan Landers15:30

The whole family has to be involved in therapy. It's a huge step. Eating disorders are family disorders, not just one child. Remember those high expectations, uh, running at a fast pace. Um, we're all fit. We're all thin. Thin is beautiful. Those sorts of notions. Live within families, not just within children, preteens and what they see on social media. So eating to cure an eating disorder, the child has to be treated not only with psychotherapy, but by a nutritionist.

And the family has to be involved. How do family dinners work? How much tension is there during breakfast? Is there any breakfast as a family? Is there any dinner as a family? How are feelings talked about in the family? Because eating disorders are a form of mental illness and some girls can starve themselves close to suicide.

Um, there is a wonderful website. Uh, eating disorder, NationalEatingDisorders.org Association it's something like that. They have checklists for parents, checklists, um, for both bulimia and anorexia and non-specified eating disorders. And I urge people to go there.

They have a hotline that's available, where if you're concerned about your daughter or your son, you can call someone and go talk to them free about what they, what you're seeing and they can tell you whether it's something to worry about.

Emily Melious17:25

We need to pursue this. I've watched TV specials and things in the past where they've highlighted a child who was confronted and Uh, it, it got, it got bad. Um, there was tension, there was conflict they rebelled, or, uh, went deeper into the unhealthy behaviors. I'm sure every parent is scared of that. Possibility that we say something and we somehow make the situation worse. So what is our first step, our first helpful step. And maybe we have to create some tension to move through to better health.

I mean, not, you know, it might be some, some conflict that we need to move through to make sure they're going to be okay because by avoiding conflict, we might be enabling the situation, but what's that first one step that families should take. If they're concerned about their son or daughter,

Susan Landers18:19

The whole family has to be involved in therapy.

It's a huge step. Eating disorders are family disorders, not just one child. Remember those high expectations, uh, running at a fast pace. Um, we're all fit. We're all thin. Thin is beautiful. Those sorts of notions. Live within families, not just within children, preteens and what they see on social media. So to cure an eating disorder, the child has to be treated not only with psychotherapy, but by a nutritionist.

And the family has to be involved. How do family dinners work? How much tension is there during breakfast? Is there any breakfast as a family? Is there any dinner as a family? How are feelings talked about in the family? Because eating disorders are a form of mental illness, and some girls can starve themselves close to suicide.

Um, there is a wonderful website. Uh, NationalEatingDisorders.org (Association), it's something like that. They have checklists for parents, checklists, for both bulimia and anorexia and non-specified eating disorders. And I urge people to go there.

They have a hotline that's available, where if you're concerned about your daughter or your son, you can call someone and go talk to them free about what you're seeing and they can tell you whether it's something to worry about. Then I don't have the exact website because it took me a little off guard with this topic, but I can get it to you. And you can put it in the show notes because there's a wonderful national eating disorders website, where the helpline is and great, great information for parents.

Emily Melious20:30

We would love to do that. We'll make sure we make that available to our listeners, not only in the episode page, but also in our Episode Insider's newsletter, which anybody signed up to receive those. We just give you more information, more resources. Um, the day that our episodes go live. So every Tuesday you get something in your inbox, that it connects you up with our guests and also these kinds of resources.

That has been so helpful today, Susan, that you're teaching me that it's a family problem. So it means it's a family solution and that's true for so many things, not just eating orders.

And I know we've just scratched the surface on this topic today, but I just have to say thank you for, opening our eyes to, how prevalent this is right now for giving us those clear warning signs so that we can take action and knowing that we're going to need to be a central part of that solution, be vulnerable ourselves, to make this work. And I just appreciate you also sharing from your personal life, I can't imagine what that's like to go through.

Uh, it's good to hear everybody's healthy and successful today, but thank you so much for sharing your story with us.

Susan Landers21:38

Oh, my pleasure. My pleasure. The way we all get better is we stick together and we share things that work.

Emily Melious21:45

Yeah, I'll just close us out on that, because I couldn't have said it better. We need to know the messages that are coming into our kiddos lives. And we got to block the bad ones because the damage is deep and widespread. Uh, and, and we got to parent today like we've never had to parent before.

Susan Landers22:02

If we can't block the bad messages, we have to counterbalance them and have good, honest conversations about, you know, what's really the definition of beauty. You don't have to be thin to be beautiful.

Emily Melious22:17

So perfectly said, well, thanks again, Susan. So glad to have you on.

Susan Landers22:22

Thank you.

Mothers of Misfits22:24

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