I just finished reading Brave Girl Eating by Harriet Brown, and I can’t stop thinking about it. This was such a powerful tale of how one family stood toe-to-toe with their daughter’s eating disorder, and how hard it was.
What was so encouraging, though, was that they figured it out. They came up with ways that worked for them to handle the many many challenges – from getting in 3000+ calories per day, to managing meltdowns and anger outbursts, to going to therapy and doctor’s visits, to having to keep adjusting the target weight range up due to growth spurts along the way, to navigating school and social challenges, and even relapse. It’s no small feat.
I’m acutely aware of how hard this is on families, and also what a key role they play. We need to do a better job educating parents, empowering them, and supporting them along the way.
In the book, Brown highlights the treatment approach they used – FBT (Family Based Treatment), which puts parents behind the steering wheel of managing their child’s eating until the child is back to health. When you think about it, it makes total sense. If the child had any other illness the parents would be in charge of administering the medicine, changing the bandages, or whatever other treatment was required.
It’s a balancing act though. Because kids, especially teenagers, are perpetually wanting more independence from their parents, not less. And in that first phase of treatment, we are arguably treating the child like a toddler when it comes to food. So of course the person with the eating disorder isn’t going to like this – on multiple levels – their independence and autonomy, as well as the eating disorder itself will be screaming in their ear not to eat the food or trust their parents.
Yet, I have seen time and time again, deep inside the child often feels safe knowing that their parents are in charge and aren’t going to let them die from this illness. That they are being taken care of, even if they don’t like it.
Here are just a few of the things families can do to help their child recover:
- First and foremost, schedule regular appointments with your “consultants” – the team of professionals who will guide you along the way. You will need their expertise about eating disorders to combine with your expertise about your child in order for this to work. This ideally should include: medical doctor, therapist, dietitian, and possibly a psychiatrist.
- Parents can be in charge of the food (the extent to which will depend on the age of the child and the recommendations from the treatment team). Being in charge of the food includes planning meals and snacks, grocery shopping, cooking, and sitting down to eat with your child and monitor the child’s eating.
- Get creative about distractions you can use outside of eating times. You don’t want your child isolating or dwelling on how awful it is to eat all that food. Siblings are great for this – they can watch a show, play games, go outside, etc.
- Extended family members can help by offering to supervise meals or snacks while parents take some time to themselves. They can also prepare meals ahead or help with grocery shopping or other errands to make life easier.
- Work closely with your child’s school to let them know what’s going on and make arrangements for the child to leave for appointments, take mental health days, potentially a safe space to eat privately, access to the school counselor, and feedback from teachers about what they are noticing about the child’s behavior.
This list could go on and on, but it’s a good start. I know families often feel scared, helpless and confused. So having some guidance and tangible things to do is often helpful.
It’s also important that family members, especially parents, are getting their own emotional support. It’s common for the parents of my clients to see their own therapist, and for them to attend a parent support group. Luckily, there’s a great one here in Kansas City (email me for the info!). If there isn’t one in your area, you could ask your treatment team to help you start one. They may even be willing to host it at their offices.
Above all, remember that full recovery absolutely IS possible. There is always hope, no matter how long you or your child has struggled, and no matter how bad things may seem right now. It can be done – don’t give up.