Whether your child is 11 years-old or 17 years-old, watching as she sits at the dinner table and refuses to eat what used to be her favorite foods, hearing him throwing up in the bathroom after meals, witnessing as he or she transforms from a robust thriving young person into an increasingly empty shell … these are some of the scariest things that can happen for a parent. The dread. The fear. The panic. Oh no, it’s happening.
I think my child might have an eating disorder.
If you are worried that your child might have an eating disorder, here are the six most important steps to take as you decide whether to seek treatment for your child and enter into the process of recovery.
- Know the signs.
Sometimes the signs of an eating disorder are obvious. If you know your child is forcing herself or himself to vomit after eating or if he or she is completely refusing to eat, then there is clearly a problem. But other times, the eating disordered behaviors are hidden from you by your child or seem like “normal” adolescent or young adult behaviors.
Even a healthy body size or evidence that your female child still has her period or normal routine blood work and physical exams are not reliable ways to judge if there is an eating disorder. Many people with eating disorders are never clinically underweight, many continue to get regular periods and the physical destruction from the eating disorder can take many years to show up in lab results.
So how can you tell? What you should look for is increased restrictive behaviors with food, anxiety around eating and rigidity with eating and exercise. Is your child eating fewer and fewer foods? Are there seemingly more and more rules around eating like no sugar or no meat? Is he or she becoming increasingly rigid and compulsive about exercise? Does he or she seem secretive about eating? Is your child finding reasons to avoid eating with the family even if you make plans to include his or her friend(s)? Is your child weighing herself or himself every day or more than once a day?
If so, it is worth taking your child to get full assessment from a professional.
- Take swift and comprehensive action.
Once your child is diagnosed with an eating disorder, the best approach is to take strong action. Recovery rates are best when there is early intervention and an opportunity for the young person to stop all exercise and rapidly restore any deficit in nourishment. Parents are often reluctant to do this because their child says it’s not such a big deal and/or is so intensely resistant to treatment that the parents fear getting into a control battle with their child and making things worse.
However, almost everyone who suffers with an eating disorder will resist treatment and deny the severity of the disorder — the resistance to change and the inability to reflect accurately on the seriousness is actually part of the illness. It is therefore up to the parents to make the decision about treatment based on the reality of the situation and the benefit of early aggressive action.
- Find treatment that is up-to-date and based on science.
There has been an amazing amount of research and new ways of understanding eating disorders over the past fifteen years. Unfortunately, much of this information has not yet integrated into mainstream culture or even into the way professionals treat eating disorders. If your medical doctor, therapist or nutritionist is unable to explain how their treatment is based in current science about the brain and eating disorders, find a different practitioner.
If no one suggests or encourages Family Based Treatment, an effective and evidence-based treatment for eating disorders, find different practitioners.
- Do not blame yourself.
Eating disorders are largely genetic. They are not caused by controlling mothers or absentee fathers. If you are the biological parent, you could possibly blame yourself for handing down genes, but that isn’t quite your fault either. The direct cause of an eating disorder is a diet. In a person with the genetic predisposition for an eating disorder, that diet will trigger the illness.
- Do not blame your child.
Once the eating disorder is triggered, your child’s brain will begin to direct them, as if their survival depended on it, to avoid and restrict food. Food becomes as terrifying and anxiety-inducing as a plate of giant tarantulas would be to a person phobic of spiders.
They are not choosing to have this disorder. They are not being vain, or stubborn, or silly, or shallow or ungrateful. They have been hijacked by an illness that has changed the way their brain deals with food and eating. The illness also changes how exercise affects your child; exercise becomes something that reinforces the brain’s restrictive pattern with food.
So your child can’t just change. They need a huge amount of help and even then they will likely struggle for a long time. That is the nature of this illness.
- Get support for yourself.
Your child needs you to be as strong and psychologically healthy as possible through this process — a process that can be long, complicated and emotionally harrowing. Seeking support for yourself will allow you to develop self-compassion and acceptance for the limits of your power to help. It will allow you to have space to process your own feelings.
If you are the biological parent, it can allow you to explore and work on your own relationship with food in case it is part of your genetic makeup as well. It can help you to connect with other parents and feel less alone. And, it will allow you to better understand the recovery process and to be clear about what is best for your child at each step of the way.
- Be willing to change your paradigm about eating, body size and health.
Supporting your child through recovery and then supporting them to stay healthy and not relapse will often involve a shift in how you think about eating, body size and health. Our culture is saturated with messages about controlling our eating, controlling our body size and exercising. For your child, none of these is healthy. Yes, that will feel shocking at first. It will feel like trying to accept that up isn’t up and down isn’t down.
It will likely take time to make this shift. But your child’s life and health depends in part on your willingness to support them to never restrict foods for any reason (except for a true allergy) even for “health,” to never try to control their body size, even if they are bigger than average, and to recognize that exercise is a risky endeavor for them.
You will also need to reframe the way you think about binging because for your child, while purging is a problem and every effort must be made to block your child’s access to a way to purge, binging simply means that their body is desperate for nourishment. They might binge regularly for an extended period of time before their body is in balance again.
Your child is already going up against the continual barrage of diet advertising, how to change your body advertising and articles about the dangers of not exercising and not controlling your body size. You can help your child immensely by being on their side and supporting them against the tide of the mainstream diet mentality.
Words fail to adequately describe what it is like to have a child struggling with an illness. But there is help and there is hope. So, take a deep breath. And start the process.
Refusing to eat photo available from Shutterstock