Prevention Should Never Add Guilt to Grief

I recently read the words of a mother who lost her daughter to suicide after a long battle with an eating disorder. She wrote about how difficult the word prevention has become for her.

Her words stayed with me.

As someone whose work is deeply rooted in eating disorder prevention, I believe strongly in prevention. I believe in reaching girls earlier. I believe in addressing risk factors before they become deeply entrenched. I believe in teaching skills that strengthen self-compassion, emotional resilience, body image, and self-worth. And I believe that changing the environments and messages surrounding our children can make a meaningful difference.

But I also believe we need to be very careful about what we suggest when we use the word prevention.

Prevention Is Not a Promise

Prevention does not mean that every eating disorder can be prevented.

It does not mean that every suicide can be prevented.

And it certainly does not mean that when someone dies, someone else failed to prevent it.

Families can love fiercely, recognize that something is wrong, seek excellent treatment, advocate relentlessly, provide support, and fight alongside someone for years—and still experience an unimaginable loss.

That loss should never be met, even unintentionally, with the suggestion that perhaps something more could have been done.

There should never be guilt added to grief.

So What Do We Mean by Prevention?

Prevention means recognizing that there are factors that can increase risk and factors that can offer protection—and doing what we can to influence them.

We know that the messages children receive about their bodies matter. We know that weight stigma matters. We know that perfectionism, comparison, appearance pressures, emotional coping skills, self-compassion, media exposure, and the language surrounding food and bodies can matter.

If we can address some of these things earlier, we should.

If we can give a girl tools before she is struggling, we should.

If we can help parents and educators recognize harmful messages and create healthier environments, we should.

If we can identify concerns earlier and connect someone with appropriate help sooner, we should.

That is not a guarantee. It is prevention.

In fact, much of prevention is precisely about changing probabilities rather than promising outcomes. We take what research and experience have taught us and use it to give people the strongest protective foundation we can.

Prevention Looks Forward, Not Backward

Perhaps this is the distinction we need to make much more clearly.

Prevention asks:

What can we do now that may reduce risk going forward?

It should never ask:

What should someone have done differently so this wouldn't have happened?

Those questions may sound similar, but they carry profoundly different meanings.

One creates opportunities to do better with what we know.

The other can place an unbearable burden on someone already living with loss.

We can learn from tragedy without assigning responsibility for tragedy.

Holding Two Truths at Once

I don't think we have to choose between compassion for families who have experienced devastating loss and a strong commitment to prevention.

We can hold both.

We can say that prevention matters enormously and acknowledge that human beings and illnesses are complex and that we cannot control every outcome.

We can work tirelessly to reduce risk and recognize that the presence of tragedy does not prove the absence of prevention, treatment, love, or effort.

We can believe that early education can change trajectories without suggesting that every trajectory could have been changed.

For those of us doing prevention work, perhaps that is an important responsibility of its own.

We must continue asking what we can do earlier, what we can do better, and how we can give children and families more protection, more knowledge, more tools, and more support.

But we must also make sure that our language never turns prevention into blame.

Prevention should create possibility for the future. It should never create guilt about the past.