My Child Has an Eating Disorder. Now What?
When a child is diagnosed with an eating disorder, there can be so many emotions, fears and questions that come along with it. An eating disorder is not like other types of illness that can be treated with medicine; there is no immediate fix. The solution takes time, education, perseverance, support, and patience. As a parent, this can be confusing and frustrating. You may feel a sense of helplessness and loss of control. While you are responsible for your child, it is your child’s responsibility to choose recovery. Your job is to create an environment that is supportive and informative so that your child may begin to take ownership of their health and recovery.
Here are some things to remember when supporting your child with an eating disorder:
Your child is not their eating disorder.
Eating disorders are complex. Although it is a piece of them, your child is not their eating disorder.
It can be helpful to think of it as an uninvited guest that can influence your child’s attitude, choices, and can cause manipulative behavior.
Differentiating the eating disorder voice and your child’s voice can be really tricky and oftentimes frustrating, however can be important in providing the opportunity to create safe environment for your child and challenge the eating disorder behaviors.
Compassion for yourself and your child are extremely important
Offer yourself and your child compassion. Blame, shame and guilt are feelings that your child or yourself may already be feeling with this diagnosis and will not provide a safe environment for healing. Instead of labeling the unhealthy behaviors as “bad behaviors” that warrant punishment, try framing them as symptoms of the eating disorder that exhibit the pain they are experiencing.
Cultivating Trust
Your child is likely experiencing a lot of shame and guilt tied to their behaviors. Cultivating trust will be important for them to receive support and for you to provide it. Let your child know they are able to tell you if they are fearful about eating, if they have been eating in secret, or when they have purged. Even though you may not fully understand, let them know that you are trying to understand and that you want to support them. Allowing them a space to speak the truth takes power away from the eating disorder.
the eating disorder can be sneaky
Things to look out for during meal times that may indicate an ED behavior:
- Spending long amounts of time in the kitchen getting their meal together (and not eating)
- Going to the bathroom during or after meal times
- Dropping food/crumbs on the floor
- Eating really slowly
- Cutting food into small pieces
- Drinking excessive fluids before or during the meal
- Wearing large clothing or clothing with pockets to the table
- Covering up their plate with a napkin
- Missing food from the cabinets or hidden wrappers in their room
- Avoiding eating in public or in front of others
- Excessive chewing
- Body checking
If you are noticing these behaviors, take a look at some helpful redirections.
“but My child is just eating super healthy”
Did you know that being overly concerned with eating healthy can actually be an eating disorder? This is another way this disease is sneaky. It could lead to orthorexia, a term that literally means fixation on righteous eating. According to NEDA, “Orthorexia starts out as an innocent attempt to eat more healthfully, but orthorexics become fixated on food quality and purity. They become consumed with what and how much to eat, and how to deal with slip-ups.” Read more about orthorexia here.
Helping yourself will also help your child
Helping a loved one with an eating disorder can be exhausting both emotionally and physically. The best way you can help your child in their eating disorder is also to help yourself. This may look like getting together with friends, taking a nightly solo walk, asking for help from your co-parent, talking with a counselor.
Supporting your child with an eating disorder can be challenging. Healing takes time and will have ups and downs. Keeping these things in mind can help guide creating the safe environment for your child to work towards a lasting recovery.
seek help from professionals
You do not have to tackle this alone, nor should you. Seeking help from professionals is vital as they need to asses the medical and psychological stability of your child. They can also help you assess the severity of the eating disorder and determine the correct level of care.
Levels of care include outpatient, intensive outpatient, partial hospitalization, residential, and inpatient hospitalization. Factors that are assessed to determine the correct level of care include
- medical status
- suicidality
- weight as percentage of healthy body weight
- motivation to recover
- co-occuring disorders
- structure needed for eating/gaining weight
- ability to control compulsive exercise
- purging behavior
- environmental stress
- geographic availability of treatment program
Outpatient treatment
The Tasty Balance is considered an outpatient level. If your child is appropriate for the outpatient level it’s important to create a team you trust. The gold standard would be to have an eating disorder informed physician, therapist, dietitian, and psychiatrist if medication is needed.
To be cleared for outpatient the patient must be medically stable, generally above 85% of ideal body weight, have fair to good motivation, be fairly self sufficient in completing meals and snacks, can manage compulsive exercise, can show an improvement in purging and no electrolyte abnormalities, and able to have adequate emotional support and structure from support system/family.
there is hope if your child has an eating disorder
This might be the most important point of all. There is hope. It’s important to know that treatment works best when delivered early. According to the National Eating Disorders Association, “If left untreated, eating disorders tend to become more severe and less receptive to treatment.”
Don’t be surprised if you approach your child with your concerns they may deny it and push you away. It’s important to trust your gut and intervene before the eating disorder has a chance to develop further.
