Nutrition Research Forgot About Dads

When his 18-year-old daughter Francine first started losing weight, in the fall of 2018, Kenneth initially thought it was a good thing. Francine had always been artistic but never particularly athletic, which puzzled her father. Kenneth, now 47, is a runner with dozens of half-marathons and even one ultramarathon under his belt.

When Francine started to express an interest in exercising and joining Kenneth’s wife, Tracy, for workouts, Kenneth and Tracy thought it was a positive sign. When Francine announced that she was vegan, they rolled with it.

Then Francine’s hair started to fall out.

It took more than a year of trying different therapists, while Francine got progressively worse, for Kenneth and Tracy to grasp just how sick their daughter was. (I’ve changed the family members’ names to protect their privacy.) Kenneth started to add up exactly what his daughter was eating in a day and realized it wasn’t nearly enough. He also suspected that Francine had learned some of her new eating habits—such as replacing breakfast with bulletproof coffee—from watching him.

Around the same time that Francine began struggling, Kenneth was following his own intense diet while on a quest to improve his running time. When Francine asked about his eating, he explained what he was doing and why. “I think I was probably malnourished myself, and in that place where you can’t help but obsess about food and talk about it constantly,” he says. Kenneth thought that he was modeling healthy eating and exercise habits to his daughter. “I just had no idea that the stuff she was asking me was really her disease asking,” he says.

For decades, researchers trying to understand the role of a child’s family in eating-disorder development looked almost exclusively to mothers. “The literature on fathers’ child feeding practices is scant,” observed the authors of a scientific-review paper on the topic published in 2014. They could find only 20 studies that included fathers in a meaningful way. “The research that has included fathers has focused on fathers who are part of a family in which the mother has an [eating disorder], rather than examining fathers’ unique contributions,” wrote two Yale researchers in their analysis for a 2016 study. More studies on parents and eating habits have been published since that 2014 review, but the gap between research on mothers and research on fathers remains wide.

Scientists and the public alike have long ignored the idea that a father might also struggle with dieting or disordered eating, despite the fact that, according to a 2008 estimate from the National Institute of Mental Health (NIMH), roughly 1 million American men live with eating disorders. Men aren’t supposed to obsess over their weight. Men—especially straight, cisgender, white, thin men—aren’t defined by their appearance to the same degree that women and other marginalized people tend to be. And that might explain why Americans talk much less about how fathers’ eating habits and beliefs around health and weight can influence their children than, say, the motivations of almond moms.

[Read: The harder, better, faster, stronger language of dieting]

One 2018 study of 658 parents by Yale researchers found that although nearly everyone (93 percent) demonstrated some sort of weight bias, fathers, as well as parents of any gender with the perceived privilege of “healthy weight,” were more likely than mothers to agree with negative statements such as “Severely obese children are unusually untidy” (findings on the differences between mothers’ and fathers’ food parenting vary). Other research concluded that fathers with more education and a higher family income were more likely than other fathers to endorse fat stereotypes. And kids absorb this stigma: Adolescents were more likely to diet and binge eat if their parents talked about weight, according to a 2013 survey published in JAMA Pediatrics of 2,793 kids.

Many experts say that the NIMH’s figure on the number of men living with eating disorders is likely an underestimate: Men don’t tend to disclose their disordered-eating behaviors, and health-care providers don’t think to screen men for symptoms. “Men tell me they don’t have a script for how to talk about diet culture,” Jaclyn Siegel, a social psychologist at San Diego State University, told me in 2020 when I was reporting a story on the coronavirus pandemic’s effects on men’s dieting habits. “But there’s also no script for men to express their own concerns or to seek help, because it isn’t seen as normative for men to develop eating disorders or body-image dissatisfaction.”

What happens instead is a normalization and even a glamorization of men’s relationship with food and exercise. This rests on a common cultural misconception that men not only don’t get eating disorders; they don’t get emotional about food or bodies, period. Many dads go on diets, but far fewer actually call it that. Instead, like Kenneth, dieting dads might get super into long-distance running, or CrossFit, or bodybuilding, or Ironman training. They may become passionate about vegetable gardening; Kenneth and his family used to run an organic farm, and he says his passion for farming led him to preach about “good” and “bad” foods. All of these pursuits can be motivated by an interest in health and wellness—even science, the environment, social justice. But they can also be motivated by a fear of becoming or being perceived as fat, reflecting a broader bias against heavy people. “I used to do a lot of banter about ‘Look at that person; she’s fat,’” Kenneth says. “Or I’d say to the kids, ‘Hey, don’t eat that pizza,’ or ‘Don’t eat too many desserts; that will make you fat.’”

Some research suggests that dads can affect their kids’ relationship with food as much as or perhaps even more than moms do. Findings vary, underscoring the need for more research, but in a 2014 study of more than 2,700 kids, girls whose fathers reported binge eating were 3.38 times more likely to report binge eating themselves, although there was no correlation with mothers’ eating. (The researchers found no relationship between boys’ binging and that of parents.) Even if they don’t actively model disordered-eating habits, fathers may withdraw from family meals altogether—something many men can do more easily than women because of societal gender norms around who prepares food.

The little research we have on how dads influence their kids’ relationship with food and their body suggests that dads might be slightly more prone than moms to engage in what researchers call “pressure-to-eat behaviors”—pushing children to eat (or not eat) certain foods in certain amounts. Kyle Ganson, a clinical social worker at the University of Toronto who studies eating disorders in boys and men, speculates that fathers’ pressures on sons may relate to a desire for them to perform athletically in specific ways. “If the dad is pushing the kid in a certain direction with sports, or if the dad is their coach and heavily influencing their exercise plans, that can lead to disordered eating,” he says.

[Read: Putting kids on diets won’t solve anything]

On the flip side, fathers of kids with eating disorders may resort to exerting pressure because they are confused by a child’s inability to comply. “Anecdotally, the phrase I often hear from male caregivers is ‘Why can’t they just eat?’ They may also be more likely to think their child needs to ‘grow up’ or ‘deal with it,’” Ganson says. “Female caregivers tend to be doing a lot of the emotional processing around the eating disorder, while fathers are much more driven by logistics: ‘How do we move to the next phase of treatment? When do we see results?’” And when progress isn’t evident—as it often isn’t in the circular recovery process of eating disorders—dads are more likely to disconnect. “This isn’t really my territory” is another comment Ganson and his colleagues often hear from dads.

This is not to say that men can’t engage emotionally with a sick child, or that managing treatment logistics isn’t valuable. But helping and connecting with a child in eating-disorder recovery requires dads to be vulnerable and humble, skills they aren’t always asked to employ or that haven’t been modeled for them. And the conditioning to push away feelings and move toward action mirrors the “No pain, no gain” messaging of much of male-diet culture.

Kenneth is now striving for acceptance as he and Tracy support Francine through her eating-disorder recovery. Soon after Kenneth’s realization of just how sick Francine had become, she was admitted to an inpatient recovery program for nine days. When she came home, Kenneth and Tracy began following a common eating-disorder-treatment protocol known as family-based treatment, where parents take full responsibility for feeding a child who can no longer hear hunger cues or make decisions around food, planning and preparing every single meal and snack and monitoring every bite.

There were many nights when Francine cried at the table. Tracy bore the brunt of making the food and talking Francine through the process of eating. “A lot of nights, I could see, she just could not eat unless Mom was there to support her,” Kenneth says. Those were the days he felt most helpless, just as the eating-disorder literature has so often painted fathers. But he began to look for ways to contribute, getting out board games for the family to play after dinner, when Francine had finished eating but still needed some help and distraction from the eating-disorder voice in her head.

Just being there—without judgment, without trying to fix it—made him reconsider what it meant to be Francine’s dad. “I still believe it’s my job to be the protector of my family,” Kenneth says, “but I’ve had to sort of rethink what that looks like.”

This article has been adapted from Virginia Sole-Smith’s forthcoming book, Fat Talk: Parenting in the Age of Diet Culture.