Highlighting: “How Can I Help My Daughter? A Mother’s Guide to Nurturing Her Daughter’s Best Self,” by Marcy Forta, EdD MBA. Mosaica Press Hardcover. 2024. 184 pages. ISBN-10: 1961602407.

Despite advances in all fields of medicine, eating disorders and their root causes in mental health remain relatively unknown. The disease of eating disorders spreads without wide knowledge and can lead to untreatable long-term health issues and even death. “How Can I Help My Daughter?: A Mother’s Guide to Nurturing Her Daughter’s Best Self,” the new book by Marcy Forta, EdD MBA, should be required reading for all.

While the title notes mothers and daughters, the book’s audience should include fathers, grandparents, teachers, neighbors, family members, friends and anyone concerned about this disease. Caught early enough, eating disorders seldom have long-term impact on an individual. The problem is that the symptoms are often overlooked and/or ignored—and are not restricted to adolescent or teen girls. Males, adult women and young children are all at risk, and the disease is not confined to emaciated individuals. People who appear to be at normal body weight may suffer from malnutrition and have major threats to their kidneys, liver and other organs.

With 9-12% of all people being diagnosed with an eating disorder (up more than 60% since COVID), one death every 52 minutes attributed to eating disorders, and being the number two cause of death for adolescents—it is important that more is learned about the causes, triggers, signs and symptoms of eating disorders.

The book describes the various aspects and triggers of eating disorders while addressing the social, cultural, emotional, genetic and educational forces that can obscure the proper relationship with food and nourishment. Using vignettes and stories to illustrate some amazing statistics, the book covers: building a positive body image; cultivating a healthy relationship with food; countering weight stigma; developing self-compassion; and identifying and preventing eating disorders.

Interestingly, the Jewish community has a much higher incidence (more than double) of eating disorders than the non-Jewish community—a statistic that includes Orthodox as well as non-Orthodox communities. Even without the influences of social media in the ultra-Orthodox communities, there is a high incidence of the illness. Forta says that one of the most positive things parents can do for their families is to model appropriate behaviors. “Children see when their mothers only eat a small salad when serving multiple main and side dishes to the rest of the family. Behaviors that are seen send more of a message than words that are said.” The emotional aspects of eating disorders can’t be overcome by telling someone to just get over it and eat something. “The root cause of the emotion needs to be addressed before the eating disorder can be cured.”

Sadly, only a small portion of medical providers have spent any significant amount of time learning about eating disorders. With early identification being so critical, delays in diagnosis can lead to more severe, and potentially harmful, outcomes. Forta relates how a mother brought her daughter to the pediatrician several times with concerns about her child’s eating, and was dismissed each time. Eventually the child’s blood work revealed severe abnormalities that required in-patient hospitalizations. Forta believes that parents know their children better than anyone else, and they should serve as staunch advocates for them. If the parent feels something is wrong they should not rest until all avenues are explored. Parents, teachers and others should watch for changes in behavior (eating and otherwise), particularly during stressful periods, such as the start of a new school year, death or divorce in the family, or moving to a new city.

Some people are concerned that revelation of an eating disorder and an associated mental anomaly could cause problems with shidduchim or yeshiva admission for other family members, and are willing to overlook the health of the affected person for the sake of the rest of the family. One man is quoted as telling friends and family that his wife was unable to get pregnant because she had cancer. It was more socially acceptable to say the word “cancer” than describe the actual reason for her inability to conceive.

The book also covers the related problem of disordered eating, which includes the elimination of certain food groups entirely or increased numbers of rituals involved in eating. Forta reassures us that it is fine for a person to dislike a certain kind of food or food group, as long as they generally eat a variety of other foods. If a person only eats foods from a narrow group or performs rituals, such as cutting the food into very tiny pieces, for example, they may have an eating disorder.

Eating disorders are one way that a person can feel “in control” of an otherwise chaotic life. While there are genetic predispositions, there are other events that can cause a child to experience an eating disorder. Forta notes that a parent should not blame themselves if one of their children needs help. If the other children are fine, there was some specific issue happening with that one child. The family should work together to show support and help the affected child feel better about themselves as they work to overcome their disorder.

Some cases are so severe that even years afterwards, some former sufferers are given permission by prominent rebbeim to eat on Yom Kippur to avoid triggering a relapse that could require hospitalization or even result in death. The goal is to find other ways for the person to feel they have control. The best practice is prevention of eating disorders, but if someone has one, early diagnosis is key.

Forta is the founder and director of Atzmi, whose goal is to support the mental health of our adolescent girls through programs that improve their self-compassion and body image, reduce the focus on outward appearances, and give them tools to support their mental health. The goal is to help each girl find and appreciate her unique self as well as empirically prevent eating disorders. Atzmi also provides workshops for parents and educators. Forta works in eating disorder prevention, awareness and education and also provides support and guidance for loved ones of family members struggling with eating disorders.

Forta found that the most difficult part of the book was sharing her own personal story and her continued recovery from an eating disorder. With this publication she hopes to help our children become their best selves. In addition to the book, she has put together a mother/daughter companion guide with worksheets, exercises and conversations to begin the road to communication on the right track. More information is available at https://www.atzmi.org/

Find “How Can I Help My Daughter?” on Amazon, the Mosaica Press website or your local Jewish book store.