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DIEt vs HEALth

By Katie Maki aka mamabear

One of the most frustrating things for me as a parent of a child who has had an eating disorder is our society’s (and let’s face it the entire world’s) obsession with the term and concept of what is “healthy”. The word “healthy” for those of us in the eating disorder realm has become synonymous with what is actually not “healthy” and quite the opposite for our loved ones. And we all know that an eating disorder loves to use that word “heathy” to manipulate us into thinking that we are the problem.

What is “healthy”?

 Before I even go into this I need to make it clear that BMI is outdated and a ridiculous way to assess health in general. Having said that, if you ask a lot of eating disorder professionals they will still deem your child at a “healthy weight” based on an arbitrary BMI of 18/19 or base it on an “average” growth curve for gender and age. I personally, after nearly 13 years since my daughter was diagnosed with Anorexia at age ten, have never talked with a single parent who felt that their child was able to recover at that low of a BMI. My own child was still  consumed by her eating disorder at that weight. The expert by experience caregivers seem to have a general consensus that a BMI of at least the low to mid 20s is when we saw our true children start to emerge from the grips of the eating disorder. Of course that number needs to be even higher for those who started their descent at a higher weight. A “healthy” weight for our kids is one based on their own individual growth curve that takes into account the period of malnourishment, lost growth to make up for, and cushion needed for future growth for age.

Another place in eating disorder treatment where we see the word “healthy” used incorrectly is related to the high fat and calorie dense foods that are necessary for refeeding and lasting recovery. It is frustrating and enraging to be told by a dietitian, physician, or therapist that you should not be feeding such high fats and should be giving more fruits and vegetables. This is unfortunately a common theme experienced by many caregivers. Being told by a professional that they worry about things like cholesterol and “too much” weight gain causing problems is absolutely not supported by any research. The vast majority of issues related to refeeding will self correct in time. Again, what is “healthy” for a person recovering from an eating disorder is vastly different than for the general population. My child needed 6000 calories daily from ages 11-14 to grow 9 inches, go through full puberty, and over double her weight from diagnosis. We went through a gallon of heavy cream a week, gallons of Haagen-Dazs, and many pounds of butter etc. Fat phobia still runs rampant, even in the eating disorder treatment world.

“She/he looks healthy”.

How many of us have heard this statement from others when our child is still incredibly mentally ill with an eating disorder? We expert by experience caregivers know that it is not just weight, but also state that matters. I had a friend once who seemed annoyed with me when I was crying about what was going on with my daughter about a year into the process. She could not wrap her head around the fact that my daughter “looked great” but that we were still fully supervising all meals and snacks, sleeping with her, and not allowing exercise. She actually said to me, “She looks great. Maybe you have a problem not letting go now.” Suffice it to say we did not speak for three years. We do not have the energy while fighting for our loved ones’ lives to constantly educate and battle those unwilling to truly listen and educate themselves.

For our daughter it will never be “healthy” for her to run, go to a gym, or lose weight in any capacity. She herself says this now well into recovery many years later. She knows what her own personal boundaries are to stay “healthy” for her. She knows that for her to stay well she needs to do physical activities that she sees as fun and non competitive within herself or with others.

For our loved ones dieting is often (but not always) what begins the restriction that leads to a negative energy balance that triggers an eating disorder to take over in the first place. For our loved ones dieting literally can and does lead to death. This is why whenever I now use the word “diet” in anything I write I type it as “DIEt “ vs “HEALth”. Because our loved ones as well as our families cannot truly heal from an eating disorder if we as a collective (Eating Disorder treatment providers and caregivers) do not co-opt these words for what they mean in our reality  and use them as a form of empowerment to fight against this metabolic/psychiatric illness that wants to take our family member.


  1. Jennifer

    Excellent! Yes!!! Our kid was a mess at the lowest ‘healthy” bmi and our pediatrician literally scratched her head and said.. “it is supposed to mean he’s healthy, but he’s really not ok” …..which we ALL knew!!! Great article.. thank you!

  2. Bob

    Great article mamabear,
    After reading the Minnesota starvation experiment years ago, I’ve been convinced because of the obsession “to be thin”… like you said “to be healthy” (not the same) has caused major health issues with children and even adults. I’m pretty sure anybody between the ages 45 and 65 in America has been there done some kind of diet. I’m going to list a couple sites/authors that come across in the years of studying obesity myth and the BMI myth thanks for the site. Grace2u bob…..I’m a married [45 years] old grandfather of 66 with 3 daughters and 4 grandchildren

  3. Das

    Your insights into the limitations of BMI and the nuanced needs of individuals recovering from eating disorders are incredibly valuable. It’s clear that a personalized approach, based on individual growth curves and specific recovery needs, is essential for true healing. The emphasis on calorie-dense, mental health acknowledges for refeeding is a critical point often misunderstood, even by professionals. It’s distressing to hear how misinformation and fat phobia persist in treatment settings, undermining the recovery process. The distinction between physical appearance and mental health is crucial; true recovery encompasses both. Your experience highlights the need for greater education and empathy among caregivers and professionals alike. Thank you for sharing your journey and advocating for a more informed and compassionate approach to eating disorder recovery.

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