A Parent’s Guide to Navigating your Child’s Eating Disorder Treatment
If your child or adolescent has recently been diagnosed with an eating disorder, you might be really scared. You may be wondering what an eating disorder even is or what to expect about the upcoming weeks or months. Maybe you’re wondering what caused this disorder or if you or your partner are to blame. Stop and take a deep breath- you came to the right place. This post is designed as a parent’s guide to navigating their child’s eating disorder recovery. Throughout this post I will use the terms “child” and “teen” and “adolescent” interchangeably.
At a glance:
This article will cover:
What an eating disorder is
What causes eating disorders
The professionals on the treatment team
How seriously to take an eating disorder diagnosis
What to expect from treatment
How to best support your child throughout treatment
Let’s dive in!
What is an eating disorder?
In short, an eating disorder (ED) is an unhealthy relationship with food, exercise, or bodies that has manifested in dangerous, potentially life threatening behavior such as restriction, purging, bingeing, laxative abuse, or excessive exercise. For most eating disorders, the behavior stems from a desire to manipulate or change one’s body in order to fit society’s ideals. In some cases, the behavior stems from another mental health concern or trauma that influences one’s ability to eat an appropriate, nutritionally balanced diet.
Eating disorders affect every organ system, which makes them particularly sinister. You may have noticed biological or mental or emotional changes in your child. Common symptoms include losing one’s period, excessive coldness, heightened anxiety, obsession with food/recipes, irritability, hair loss or hair growth on the arms, bone density loss, and others. Often, the consequences of eating disorders cannot be seen on the outside, so someone may look healthy but actually be extremely ill. All eating disorders should be taken seriously and you cannot determine whether someone has an eating disorder just by looking at them.
Eating disorders are extremely manipulative, and may cause your child or teen to lie to you. It’s common for eating disorders to convince people to dispose of food or eat food in secret, privately weigh themselves or body-check, or exercise at odd hours of the day. Despite this deception, please try to remember that your child does not want to be dishonest; they have instead been overtaken by a very serious illness that will do anything to remain part of their life.
What causes eating disorders?
Eating disorders often emerge as a way to cope with something else. You can think of an eating disorder like a monster that came along and told your child, “Here is what we are going to do to cope. You need me.” Folks with eating disorders are often subconsciously attempting to manage troubling circumstances such as trauma or an otherwise volatile situation.
Genetics also plays a role, meaning that someone may be simply predisposed to development of this disease. Furthermore, heightened anxiety, depression, or other mental illnesses may contribute to the emergence of an eating disorder.
Therefore, it is unlikely that you, your parenting, or your family “caused” the eating disorder. The National Eating Disorder Alliance states very clearly in their Nine Truths about Eating Disorders that families do not cause EDs. While it is true that some family members should address their own relationships with food and bodies, families overall are an incredible ally to the treatment process. So if you’re worried that you may have may have contributed to this problem, fear not.
Who should we hire for our child’s treatment team?
First, let me take the time to discuss why a treatment team is crucial to the treatment process. Because of the complexity and the long term physical, emotional, and mental consequences of eating disorders, best practice is to have a registered dietitian, a medical professional, and a therapist on board. It is important to work as a team and be a united front in challenging the manipulation of eating disorders. It is also crucial that the providers communicate with one another about their concerns from their own professional lens.
A note about providers: Our society as a whole is woefully under trained and misinformed about the severity of eating disorders, therefore, it is crucial that you ask about your therapist, dietician, and medical provider’s training in the prevention and treatment of EDs. I have given more information about this in my post, “How to Choose the Right Eating Disorder Professional for You": tips to vet your providers and advocate for yourself.” I have also added small notes through this section about markers of competency in this field. In my personal opinion, if a provider’s website gives the impression that they primarily work with folks to help them lose weight, then they most likely lack the specified training to work with this illness. As I mentioned above, many eating disorder emerge from the desire to manipulate one’s body (often to become thinner) and a provider who is complicit in this will most likely lack the skillset required to beat the disorder.
Physician/Physician’s Assistant, Nurse Practitioner, Registered Nurse
The medical professional is a vital part of the treatment team as they offer insight as to the medical consequences caused by the illness. Your child’s primary care provider will want to run various tests, obtain blood work, and look into functioning of major organ systems. Importantly, they can provide information about your teen’s weight and give insight into whether they are dangerously malnourished or underweight. You will continue to visit your child’s medical professional for weight checks throughout the treatment process. A trained medical professional will offer the opportunity to do a blind weigh, which means the patient turns around on the scale or the number is obscured from view using paper or a card. Most professionals agree that the teen does not need to know his or her own weight during the treatment process, as knowing the exact number will often be triggering and thus counterproductive to the treatment process.
Registered Dietitian
Dietitians have a unique knowledge base about adequate nutrition needed for a client to have a well-balanced, sufficient diet. The dietitian provides valuable insight about meals, snacks, and nutritional values of foods so to offset the nutritional consequences of the illness. Your child will ideally meet with a dietitian regularly to discuss rebuilding a diet to ensure adequate sustenance, preparing for a stressful day by packing snacks, or disrupting binge eating patterns. They may also develop a meal plan for your child to follow, depending on the diagnosis and severity of the disease.
At higher levels of care settings, dietitians play a role in meal support, meaning that they actually eat with the patients to reteach what normal eating should be like. They may also give cards to each patient with exchange lists to help them rebuild a balanced diet with sufficient nutrition. You can read my post about the different levels of care here.
Mental Health Therapist or Counselor
The eating disorder counselor (or therapist) helps the client first identify that the eating disorder emerged as a coping skill and then teaches the person how to replace it with healthier coping skills. Like the dietitian and physician, the mental health provider should be able to challenge harmful ideals about thinness and weight loss.
In a practical sense, the therapist meets with the client for regular (usually weekly or biweekly) talk therapy to help challenge harmful beliefs and restore healthier thinking patterns about food and bodies. The therapy session can be a valuable opportunity for your child to simply discuss how he/she is feeling and what is worrying or upsetting. We may talk about what pressures at school or in their peer group contributed to poor body image. I like to incorporate writing exercises into my work with teens.
Therapists have a responsibility to treat our clients with non-judgment, which means that regardless what happens, I am on your child’s side. Like the medical provider or dietitian, it is my role to guide them with confidence that we can beat this illness.
I emphasize somatic experience in my work with clients, which means that I help clients tune into their body sensations using mindfulness and notice what messages the body sends. I also help clients understand that their body holds incredible wisdom and works exceptionally hard to keep us alive. Click here to read a detailed post about my therapeutic approach.
How seriously should we take this diagnosis?
Let’s pretend for a moment that you just found out your teen has a tumor and will need to begin chemotherapy and radiation in order to remove the disease. How might you react to this diagnosis? What changes to your daily routine might you make to allow time for treatment? I imagine that your world would halt temporarily as you regroup and determine what steps to take. You or your partner may take time off work or your child may take a leave-of-absence from school to make time for treatment/recovery. In my opinion, parents should treat an ED diagnosis with the severity they would a cancer diagnosis.
One of the biggest hurdles to treatment, from what I have seen, is the temptation not to fit eating disorder treatment into the teen’s hectic daily lifestyle. Most adolescents these days are involved in myriad activities such as sports, clubs, committees, music classes, art classes, and other extracurricular activities. As a parent who manages the household, I can understand how it may be daunting to consider squeezing in weekly appointments. Nevertheless, during eating disorder treatment, the treatment should be the priority. Eating disorders are simply too life-threatening not to take seriously.
Although I am equating eating disorders as an illness to cancer, I also want to encourage you that eating disorders are absolutely treatable with appropriate interventions. A patient who helps their child find the right providers and adhere to treatment expectations should have a hopeful outlook.
What should we expect from treatment?
You should expect weekly appointments and meetings with your child’s provider. As I mentioned above, this process can be time consuming, but it is also vital for your child’s health and recovery.
You should also expect some pushback from your child, especially if treatment involves them following a meal plan that significantly increases their daily caloric intake. Because the eating disorder has come in and convinced your child that they need to lose weight, following a meal plan will seem like the most frightening, worst thing they could possibly do. I often tell clients and their parents: “your eating disorder will hate me and that is OK. There may be part of you that never wants to step foot into another session, and that’s OK.” Over time and as treatment progresses, the eating disorder voice will often get “quieter” so to speak and the child’s healthy self will re-emerge.
If your providers follow Family Based Therapy, you may be expected to prepare all your child’s food and enforce them eating the meals you prepare. Research shows that parents and family members are invaluable assets in the recovery process. You can read more about Family Based Therapy (FBT) or the Maudsley Method here.
How do I best support my child/teen?
In a practical sense, you can support your child by encouraging them to attend sessions, follow their designated meal plan (if applicable), and do readings/writing assignments assigned by providers.
You may also want to consider the language you use in your home about bodies and size. Do you frequently talk about losing weight or “good” and “bad” foods? What conversations take place about people you encounter in larger bodies? Click here to read my post, a Parent’s Guide to Supporting Healthy Body Image in the Home.
Finally, I recommend that you keep a close eye on your child’s behavior. Are they exercising late at night or early in the morning? Are they eating their lunch at school? Expect your teen to be dishonest with you. Nevertheless, your child needs you to notice and lovingly acknowledge their eating/exercise patterns.
Your child also needs you to encourage them by reminding them why they are in treatment. Teens have a tendency to minimize the severity of eating disorders, so you may have to frequently reiterate the seriousness of this problem. You may have the unfortunate role of dragging your child to a doctor’s appointment or session when they would rather do anything else with their time. I promise you that this process is worth it, as you may be saving your child from a lifetime of eating disorder struggle and instead helping them rediscover a healthy relationship with their bodies. Always feel free to ask your providers questions about this process. We want to help!!
I am an eating disorder and trauma counselor in Winston Salem, NC and would be happy to schedule an appointment with you, answer any questions, or help you find the right treatment option. Contact me at taylor@nourishedandknowncounseling.com.