A Parent’s Role in Eating Disorder Recovery

Let’s talk more about why your role as a parent is so important through your child’s full recovery from an eating disorder. I recently published a blog post, where I tell you more about HOW you can support your child through recovery, but today, I want to dive in on the WHY! 

Please note that this post is geared more towards anorexia, bulimia, binge eating and OSFED, however, generally speaking, this is relevant for all parents and caregivers who have a child with an eating disorder. 

This blog post is intended to provide information only. It is not a substitute for ED care – if you need support don’t hesitate to contact us.

 

 

First, it’s not your fault. 

I want to start off by setting the stage and telling you – Yes you, reading this. – it’s NOT your fault. It is NEVER the parent’s fault nor the child’s fault. Eating disorders are never something we purposefully want for ourselves or our loved ones… 

An eating disorder is a severe mental illness with severe physical repercussions. It can develop as a result of numerous factors and the multi-dimensional nature of eating disorders is what makes them so complex. 

There is never just 1 factor that leads to an ED

 

The best part as a parent is that you have the ability to support your child through this difficult time and be one of the main pillars throughout their recovery because recovery IS possible. 

 

You can support your loved one through the Family-Based Therapy Approach (FBT): 

Family-based therapy is an approach that empowers parents and caregivers to disrupt harmful behaviours that maintain the eating disorder. It focuses on the family as a key player in supporting the child in overcoming their eating disorder (NEDIC, 2022). 

There are 3 phases to the FBT approach (NEDIC, 2022):

• Phase 1: parents are supported to re-establish a ‘normal’ eating routine for the family. They take over the who/what/where/when of eating, while interrupting ED behaviours (such as purging and overexercising)
• Phase 2: eating is carefully handed back to the child in a gradual and controlled way
• Phase 3: work through the underlying issues of the ED and help them establish non-disordered-eating patterns. 

Research has shown that FBT is associated with improvements in ED symptoms as well as the individual and family’s self-esteem and quality of life (Baudinet, Eisler, Dawson, Simic & Schmidt, 2021). 

This is often the first line of treatment for youth with anorexia nervosa, bulimia and OSFED. Studies have shown that parental involvement in treatment can increase adherence to treatment, from 15% in adolescents to an average of 50% in adults (Halami, Agras, Crow, Mitchell, Wilson & Bryson, 2005). There is still a need for research on FBT and EDs on a larger scale, however, in multiple small studies, the results are consistent in demonstrating the benefit of the FBT approach to ED treatment.  

 

EATING DISORDER RECOVERY PROGRAM

We have developed a virtual, eating disorder recovery program to increase accessibility to recovery from the comfort of your own home.

This program includes:

• Individualized session with a dietitian or psychotherapist (weekly)
• Group sessions (weekly)
• Meal support (weekly)
• Parent, Caregiver, Partner support group (weekly)
• Care coordination

Want to learn more about? Find more information on our website: http://www.thebalancedpractice.com/edprogram

 

Why are parents vital to their child’s ED recovery? 

As the parent or caregiver, you know your child best. You are their consistent and constant source of support to meet their fundamental needs. Your role goes above and beyond nourishing them – you are there to hold them and guide them through this journey. 

The truth is, the eating disorder is not exactly the most trustworthy person in this dynamic. The ED is very good at telling your loved one all the reasons why the ED should stay, and why they should avoid recovery. As the parent in these circumstances, it may be necessary to take full ownership of your child’s care to create space between your child and the ED. At home, you have control over the environment. You are a role model as you help set routines and schedules – this is where your role as a caregiver comes into effect to help your child recover.

Studies have shown better independence in feeding when caregivers engaged in “parent-led renourishment” (Accurso, Sim, Muhlheim & Lebow, 2019). Because of the nature of the ED, it can be really hard for your child to step away on their own, and that’s okay. Help is okay, especially when the ED is really loud and scary. 

When the ED is very strong, it can often be the dominant personality during your interactions with your child. Your child’s behaviours may be more aggressive, which can be normal as the ED progresses and malnourishment develops. During these times, it can be difficult to assert your role as the parent, as your child may grow attached to their eating disorder. 

Remember that the resistance to change and the resistance to receive help is part of the eating disorder. The ED does not want to go away, and it will try many things to stay. Just because they may be resistant to help, it doesn’t mean they are deliberately being difficult.

 

> Many parents will ask themselves: 

Am I forcing my child into something? What do I do if my child doesn’t want to recover? 

 

As their parent, all you want is for your child to be safe, happy and well. It’s hard to see them fight through the eating disorder, but it’s even harder to see their illness progress. To counter these questions, I invite you to ask yourself:

 

> If your child had a life-threatening illness and needed to get needles, but they are super afraid of needles, how would you support them through it? 

 

They are not alone, you are here waiting for them

I like to illustrate the ED and the parents’ role like an intense coach and a maze! 

 

Picture this: 

The eating disorder is the coach who is working with your child to achieve “their goals” i.e the ED goals. At times, the child questions what the coach is suggesting and they consider leaving the office to explore other options/rooms in the building.

 

HOWEVER, once your child leaves the office, they find themselves in the hallway of a huge building! They don’t know whether to turn right, or left, or straight, or take the stairs, etc. 

They tell themselves – “How the heck am I going to get out of here?!?! I can’t do this myself!! It’s easier if I stay in the office. My coach was right, I can’t do this alone”

Your role as the parent is to reassure your child that when they step out of the office, you are there waiting for them. You and the other providers involved have a map to guide you out of the building. 

They are not alone on this journey, and you will always be there for them. 

 

It all starts with the 4Cs 

This is a technique used during meal support, but they are 4 characteristics to keep in mind, any time you are interacting with your child and supporting them through their eating disorder. 

CALM: your loved one will pick up on your anxiety which will make them more anxious

CONSISTENT: Stick with what you have decided and don’t negotiate. This gives more room for the eating disorder to take control.  

CONFIDENT: the more confident you are, the more reassured your child is. 

COMPASSIONATE: Understand and acknowledge that they are doing something that is terrifying for them. You are there to support them through it. 

Using the 4Cs, you are bringing your child from a place of “fight, flight or freeze” to a content, safe and resourceful state. They will begin to trust you and not the ED voice (Musby, 2014). 

 

Your role in prevention! 

ED Prevention:

Remember that there are maaaaany reasons why someone develops an eating disorder. However,  we know that there are some protective factors that can help in preventing the development of an ED or even prevent the worsening of an ED. 

• • Examine your own beliefs around food and bodies: what you believe about food and bodies can translate to how your child feels. Be mindful of the types of comments you say about food and bodies, such as:
    • “I should stop eating this or else I’ll gain weight”
    • “Urgh I hate my stomach, I’ll never look good in a swimsuit”
    • “That person shouldn’t be wearing something like that”
    • “We all need to go on a diet starting Monday because we are like sh*t all weekend”
  • Allow your child to determine when they are hungry and full: don’t shame your child for wanting a second portion, regardless of their body size. Foster the mindset that they can trust their bodies to nourish them as much as they need to. 
  • Talk about different body types: acknowledge and teach your child that bodies come in all shapes and sizes and that’s okay. Diversity your language and the types of bodies you show your child (e.g. books, social media, drawings, etc.).  
  • Social Media Literacy: teaching your child how to filter the information they consume on social media and become resilient to the harmful messages can prevent them from being internalized. You can develop this skill by monitoring the type of media they consume, and asking questions about media consumption to encourage them to see what isn’t being portrayed in the media.
  • And many more! 

Relapse prevention: 

Once your child has recovered, you will continue to support them to maintain their health and stability, and prevent a relapse! 

• Be attentive to their needs: 

• • • Know the red flags
    • Stay engaged if you notice things are sliding and address them as soon as possible. 
    • Find a time when you are both calm and ready to ask your child what they would like you to do to help them come back or stay on the path of recovery
  • Be consistent: 
    • Maintain the routine and continue with ongoing support as needed 

• • Act Fast:
    • If you notice your child is falling back into ED behaviors contact their treatment team as soon as possible. Don’t wait for it to be “bad enough” as this sends the wrong message to your child and we don’t want to wait for it to get worse.  

 

Conclusion

Your role as the parent is soooo important throughout your child’s recovery, and you are absolutely capable of taking care of child and providing them with what they need to get through this! 

Trust in your abilities as their parent and don’t hesitate to reach out for support! We are here to help you and guide you through this process. 

Check out Kelty Eating Disorders for awesome parent resources!:

• Full Guide for Parents: https://keltyeatingdisorders.ca/wp-content/uploads/2016/09/BCMH026_EatingDisorder_FullGuide_v6-Web.pdf
• Podcast Episode: https://keltymentalhealth.ca/podcast/eating-disorders-how-parents-can-play-active-role-recovery

 

EATING DISORDER RECOVERY PROGRAM

Recovering from an eating disorder is not easy, however it IS possible. We have developed a virtual, outpatient eating disorder program to increase accessibility to recovery from the comfort of your own home.

This program includes:

• Individualized session with a dietitian or psychotherapist (weekly)
• Group sessions (weekly)
• Meal support (weekly)
• Parent, Caregiver, Partner support group (weekly)
• Care coordination

Want to learn more about? Find more information on our website: http://www.thebalancedpractice.com/edprogram

 

Need support?👇

The Balanced Practice is a team of health care providers specialized in eating disorder outpatient treatment, disordered eating and intuitive eating. Our mission is to help folks heal their relationship with food and their bodies so they can live happily outside of diet culture!

We strive to provide evidence-based counselling to support you, or your loved one, in achieving full recovery. Schedule a connection call now.

Written By Joelle Ciccarelli, RD

Revised by Marie-Pier Pitre-D’Iorio, RD, B.Sc.Psychology
Founder of  The Balanced Practice

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References

Accurso, E., Sim, L., Muhlheim, L., Lebow, J. (2019). Parents know best: Caregiver perspectives on eating disorder recovery. International journal of eating disorders, 53, p.1252-1260. 

Baudinet, J., Eisler, I., Dawson, L., Simic, M. & Schmidt, U. (2021). Multi-family therapy for eating disorders: A systematic scoping review of the quantitative and qualitative findings. International journal of eating disorders, 54(12), p. 2095-2120. Doi: https://doi-org.proxy.bib.uottawa.ca/10.1002/eat.23616 

Halmi CA, Agras WS, Crow SJ, Mitchell J, Wilson GT, Bryson S. Predictors of treatment acceptance and completion in anorexia nervosa: Implications for future study designs. Arch Gen Psychiatry 2005;62:776–781. 

National Eating Disorder Information Center. (2022). https://nedic.ca/eating-disorders-treatment/ 

Musby, E. (2014). Anorexia and other eating disorders: how to help your child eat well and be well. 

The Renfrew Centre. (2022). 

https://renfrewcenter.com/eating-disorder-prevention-tips-for-parents/