Some people believe that a woman with anorexia should not have children  —  “have” as in raise kids.

In other words, that it’s not ethically right for anorexic women to decide to rear kids, as they’d be subjecting them to the emotional turmoil and extreme anxiety that this eating disorder creates.

For this article I interviewed Linda Centeno, PhD, clinical psychologist, and assistant director of the Koch Center in NJ that specializes in eating disorder treatment.

“This is a very personal decision and I can only offer some points to consider (as to whether an anorexic woman should or should not start a family),” says Dr. Centeno.

First of all, Dr. Centeno says that a child has a greater risk of developing anorexia or another eating disorder if the mother has anorexia.

This increased risk is, in part, genetic, adds Dr. Centeno. However, environment is also a powerful variable.

Dr. Centeno explains, “An anorexic mother is also at risk of modeling disordered eating and body image.

“If a mother is constantly dieting and expressing dislike towards her body, the child receives the message that restrictive eating is normal and a healthy body weight is not.”

What if an anorexic woman truly wants to have children; what should she do?

“One reason why it is important to seek eating disorder treatment before having a child is because many mothers may impart unhealthy eating patterns onto their children,” says Dr. Centeno.

An anorexic who wants to have kids should consider how destructive these patterns can actually be, such as restricting their child’s food intake  —  when the child very much needs adequate calories for optimal growth.

Or, she may make her kids eat more than necessary. The anorexic mother may express disapproval of her children’s size, even if they aren’t overweight.

She may avoid eating in the presence of family members, even skipping out on important get-togethers to avoid food.

“A mother with anorexia might underfeed her child to make her thin, or, you overfeed her to show nurturing,” says Dr. Centeno.

“Power struggles over food and eating often affect families when a mother has an eating disorder.  Mothers need to set a good example for children with respect to weight and eating.”

If a woman with anorexia is wondering if she should or should not have children, she also has to consider another striking element: Kids need and crave their mother’s full attention.

“Individuals with anorexia spend much of their time internally focused on weight, food and body issues,” says Dr. Centeno.

“Even if a mother tries to hide her preoccupation with weight and food, her child will sense that she is not available in the way that the child needs.”

Children can be very perceptive and should not be underestimated, especially as they grow older.

“A child also needs to learn healthy ways of coping,” adds Dr. Centeno.”

Often, the anorexic individual relies chiefly on her eating disorder as a way to cope with life’s major as well as minor challenges, says Dr. Centeno.

Kids need to be shown non-food-related coping tactics for troublesome thoughts and feelings.

In summary, maybe the question shouldn’t be, “Is it wrong for anorexic women to have children,” but rather, “What should anorexic women who want children do to prepare for this new role in their life?”

Dr. Centeno works with adolescents and adults. In her private practice her specific clinical expertise also includes anxiety and panic disorder, depression, relationship issues and sexual abuse.