In her new memoir, De La Garza, who herself suffered from anorexia from childhood, recounts the indicators that she dismissed during Lovato’s teen years.
“One day Dallas [Lovato’s older sister, 29] came running into the dining room looking alarmed. ‘Demi is visiting some really weird websites about anorexia and bulimia,’ ” De La Garza writes. “I sighed. ‘She probably got on them by mistake.’ I’m horrified when I look back. Sometimes we so desperately want to believe the best about our children that we ignore the obvious.”
Lovato eventually checked into rehab twice for substance abuse and bulimia, and is now “learning to love” her body again. But for parents and guardians, spotting an eating disorder can be extremely difficult, Dr. Dena Cabrera, certified eating disorder specialist and executive clinical director for Rosewood Centers for Eating Disorders, tells PEOPLE.
“It’s very confusing for mothers,” Dr. Cabrera, who has not treated Lovato, says. “I’ve heard time and time again that they don’t know what to do. Eating disorders are a disorder of secrecy and shame, especially for a celebrity.”
She recommends keeping an eye out for signs like an interest in dieting, excuses about eating and concerns about body image. And take note if children or teens end up on sites about anorexia and bulimia.
“Part of looking at some of those pro-anorexia and bulimia sites is that they’re caught in this world where they need validation and inspiration, because they feel so out of control with their body and their weight, and there’s social pressure,” Dr. Cabrera says. “For parents, it’s important to keep an eye on that and talk to their child about body image and pressures of school and society, and try to connect with them any way they can.”
And even if you don’t suspect that your child has an eating disorder, there are preventive steps that parents can take to promote a healthy body image.
“Be aware of stress and anxiety, and implement ways to avoid it,” Dr. Cabrera says. “Ensure that they have social connections and aren’t isolated, and provide them with balanced meals — ideally eaten together — to foster a healthy relationship with food.”
If your child is struggling, start by getting them help, Dr. Cabrera says.
“An eating disorder is a version of mental illness, and there’s a lot of concern, not just nutritionally but psychologically. They feel trapped in their thoughts, they can get obsessive, and it can really lead to lower self-esteem,” she says. “The first step is to get professional help and address it in a loving, compassionate way and not to attack them. Say that you want to get them help. Showing that there’s love and concern, and that you want to get them help before it keeps going on and on before they’re entrenched in it.”