Having a loved one with an ED is heartbreaking and challenging on multiple levels.  It can be exhausting and frustrating.  Here are some tips:

Be Calm:

-Stay out of arguments and negotiations with the ED.  Trying to convince your loved one that she is not fat or that it is ok to eat a particular food is futile.  It only serves as a distraction from the underlying issues and fuels the ED.  Instead of fighting about the person's ED thoughts or behaviors, calmly disengage from those conversations without getting worked up. 

-Your loved one needs you to be level-headed.  She isn't always thinking clearly.  A symptom of the ED is minimization and denial of the severity.  Stay calm.  Stick with the treatment plan.  If unsure what to do, ask her treatment team to guide you.  

Be Consistent:

-The ED will look for loopholes and opportunities.  The minute you show inconsistency or bargain the ED will pounce.  It's like giving in to a kid in a toy store after you already said no.  He figures out that if he screams loud and long enough you will give in.

-Maintain a united front as a family, especially as parents.  If you disagree about how to handle something related to the ED, have that conversation in private.  It is also essential that you are on the same page as her treatment team.  She needs to be getting a consistent message from everybody involved.  Inconsistency creates confusion, chaos and delays the recovery process.

Be Compassionate:

-Above all, remain compassionate.  Your loved one did not choose this terrible illness.  She is sick, and she is suffering.  The ED thoughts and behaviors are symptoms of the illness.  The more intense the symptoms, the stronger the illness, and the more intensive the treatment that is needed.  Be empathetic to her situation.  Think about a time that you were sick – what did you need from others?  How would it have felt if your loved ones expressed anger at you for being ill?

-Underneath the ED behaviors is someone suffering emotionally.  Have compassion for the suffering.  

-Treatment and recovery can take years.  That's a long time.  It is exhausting.  Have compassion for the journey and work involved. 

-Compassion is not the same thing as complacency.  Sometimes the most compassionate thing to do is to set boundaries, even if it upsets your loved one.  For example, your loved one may adamantly oppose inpatient treatment, but if her team says that is what she needs then the compassionate thing to do is get her the life-saving treatment that's recommended.  Think of it this way – if your 3 year old wanted to play in the middle of a busy street you'd say no, even if she threw a fit.  The compassionate thing to do is prevent your child from getting hit by a car.  The ED is like the car that will run your child over.  

-This illness is hard on you too.  Do your own self-care.  Get your own therapy.  Whatever you need to do to stay strong.  Have compassion for yourself.  If you find yourself with "compassion fatigue" (yes, it's an actual phenomenon) this indicates you need to increase your own self-care.  Remember the oxygen mask analogy?  When you're on an airplane they tell you that in case of emergency put on your own oxygen mask before saving others.  If you are too depleted you won't have the stamina to fight the illness.

Recovery from an ED is a marathon not a sprint.  Pace yourself accordingly.  Put your energy into the things that are productive.  Avoid wasting energy on things that don't matter or are counterproductive.  Recharge your own batteries regularly.