How To Help A Child Or Teen Who Has An Eating Disorder

Parents of children and teens who have eating disorders often need assurance they are doing the right thing. Here are 12 frequently asked questions and answers for parents helping their children recover from an eating disorder.

1. Do parents cause eating disorders?

Parents may pass down genes that play a small role in some eating disorders, but neither good parenting nor bad parenting is solely responsible for any eating disorder.

2. Yes, but did I cause my child's eating disorder in some way?

No. You didn't.

There was a time that parents were told that they were responsible for their child's anorexia or bulimia. But no matter what you have heard about Sigmund Freud's theory of eating disorders or Dr Phil's theory of eating disorders, parents do not cause eating disorders. Eating disorders are now known to be treatable brain disorders. Parents may assume that because they were in charge of their child's eating, they must have done something wrong. But there's no evidence for that point of view. Eating disorders start for many different reasons and neither the parents nor the child with the eating disorder are to blame.

3. Which eating disorder is the most dangerous?

It is important for caregivers to understand that any eating disorder is potentially deadly. The so-called "eating disorders not otherwise classified" (EDNOS), because they don't get adequate treatment, are more frequently deadly than the better-known conditions such as anorexia, bulimia, and binge-eating disorder.

4. Could my son or daughter need treatment? My doctor says to wait, it may just be a stage.

Early intervention is always best in eating disorders, especially when the symptoms are vague, as with EDNOS. Make a list of symptoms you observe in your son or daughter and make sure your doctor reads it.

5. Is treatment for a child or teen different from treatment for adults?

Children and teens are more likely to be helped by family therapy. Adults tend to have already fixed blame on their parents and therapy sessions can make family relationships worse, rather than better. But with children and teens it is possible just to give the family an assignment of prepare healthy, delicious meals. Families with younger members who have eating disorders aren't as inclined to dwell on painful psychological issues because the parents still control their child's livelihood.

6. What is the recommended treatment for a child who has anorexia?

In the US, you are likely to be referred for "Family-Based Treatment". In the UK, Canada, Australia, or New Zealand, the equivalent level of care is probably going to be called "anorexia nervosa-focused family therapy". This therapy should empower you to feed your child at home. If the program doesn't have home feeding of your child as an objective, then you probably should seek another therapist.

Older teens may respond to Cognitive Behavioral Therapy (CBT), which is the first line of treatment for adults who have eating disorders. But even for older teens, the starting point is usually family therapy.

7. Will my child end up admitted to the hospital?

With early intervention, hospitalization is less and less common. In the US there are also day treatment. Sometimes eating disorders are so complex that they require a long hospital stay. If this happens, it is important that parents use the time to learn the skills they need to keep their child on track for continuing progress once he or she is discharged.

8. My child already has a job (or 'My child is already in college'.). Is it too late to do family-based therapy?

Family-based therapy is not unusual for and gets good results for young people as old as 25. Beyond that point, either the parents have problems will have difficulty being treated as another adult or the children will have trouble deferring to their parents.

9. Does my child or teen need to 'develop insight' into the 'underlying causes' of their condition?

"Insight" as an objective of treatment is more common with psychotherapists who do not specialize in eating disorders. Psychotherapists who specialize in treating anorexia, bulimia, binge-eating disorder, EDNOS, and other eating disorders usually focus on changing behaviors rather than achieving insight into how they came about, especially with their youngest patients.

10. I think my child has PTSD. Isn't treating PTSD enough to get rid of an eating disorder?

It's always a good idea to get treatment for post-traumatic stress disorder, but eating disorders are not caused by PTSD. Treatment for both conditions will probably prove necessary.

11. Should I encourage my child who has anorexia to eat 'til they are full if I can?

12. My child is back to normal weight. What do I do now?

Congratulations! But your work isn't over. It can take up to a year after achieving normal weight in the process of recovery to reestablish normal appetite and eating habits. Bone and heart issues have to be watched indefinitely. Emotional trauma can cause a relapse. Eating disorders never completely go away. But you may be able to enjoy a very long period of remission.