Eating Disorders Parent Support Guide As difficult as it is for you as a parent to watch your child suffer, it is even more challenging for your child to admit to having a problem and then seeking help and recovery from an eating disorder. Your role in this process includes providing support and love. The acknowledgement, hard work and recovery fall on your child and her/his health care team. My Child has an Eating Disorder, what is that? Eating disorders are not really about food and weight. Eating disorders are symptoms of something deeper going on inside a person. The most common eating disorders are anorexia, bulimia, and binge eating disorder. An individual may be diagnosed with one or more or a combination of these or other types of eating disorders. Beyond the physically obvious symptoms or complications of eating disorders are the emotions and behaviors that lead to the possible life-threatening consequences of this disease. ALL eating disorders require professional help from experiences eating disorder specialists. Anorexia Nervosa is characterized by self-starvation and excessive weight loss. Refusal to maintain weight Intense fear of weight gain or being fat Feeling fat despite dramatic weight loss Loss of menstrual periods for 3 consecutive months Extreme concern weigh body weight and shape Bulimia Nervosa is characterized by a secretive cycle of binge eating followed by purging through vomiting, laxative abuse, diuretics, excessive exercise or fasting. Excessive exercising Repeated episodes of bingeing and purging Feeling out of control during a binge Purging after a binge through self-induced vomiting, laxatives, diet pills, diuretics and fasting Frequent dieting Extreme concern with body weigh and size 1
Binge Eating Disorder is characterized by periods of uncontrolled, impulsive or continuous eating beyond the point of feeling comfortably full. Repeated episodes of bingeing without purging Feeling out of control during a binge and eating beyond the point of comfortable fullness Possible sporadic fasting or dieting Feelings of shame or self-hatred after a binge Anxiety, depression, loneliness Variation in body weight from mild to normal weight to milk, moderate or severe overweight or obesity What causes an eating disorder? Eating disorders stem from the body and mind. Many factors contribute to the development of an eating disorder. Possible Factors: Psychological issues Compulsive dieting Society s pressure to be unrealistically thin Low-self esteem Obsessive drive for perfection Depression Anxiety Mental, physical, and/or sexual abuse Obsessive Compulsive Disorder Alcohol/drug abuse problems Personality type Heredity Biochemical make-up Family background A common analogy used to define the cause of an eating disorder: Genetics makes the gun, family and social environment load it and unbearable emotional experiences fire it. 2
What treatment will look like. There are several different approaches to the treatment of eating disorders depending on the physical and mental health of the individual. Effective treatment should use a multidisciplinary team consisting of up to 5 members: a medical doctor, a therapist, a psychiatrist, a family therapist and a registered dietitian. Each team member plays an integral role in the recovery process: Medical Doctor performs an initial assessment, diagnoses the eating disorder, monitors medical condition, provides necessary medical treatment, monitors lab values. It is important to find a medical doctor who truly understands eating disorders. Therapist is the core of the recovery process as the team expert about the psychological and behavioral aspects of an eating disorder. The therapist identifies and helps the patient with the core issues which contribute to the eating disorder. Find a therapist who specializes in eating disorders. Psychiatrist a physician who can prescribe medications which often times is helpful during and after recovery from an eating disorder. Sometimes the psychiatrist will also do counseling along with subscribing medications. It is also important to find a psychiatrist who truly understands eating disorders. Family Therapist works with the entire family to help with your child s eating disorder and change habits or patterns that impact the eating disorder. The family therapist can also be your child s primary therapist. Registered Dietitian provides support and information for the patients trying to restore weight and normalize eating behaviors, educates the patient about sound nutrition, provides medical nutrition therapy, assists with meal planning, and monitors the weight. The dietitian helps patients learn a normal relationship with food and their body. 3
Types of Treatment Outpatient Treatment Outpatient treatment is typically the first approach to treating an eating disorder if the patient is not with severe medical complications. A treatment team is put together including some or all of the following: medical doctor, therapist, psychiatrist, family therapist and registered dietitian. The patient will most likely attend multiple appointment each week with the different providers. Intensive Outpatient Treatment Intensive outpatient treatment is an intensive form of treatment consisting of frequent visits with the therapist, family therapist, medical doctor, and might be attending support groups. The patient will often spend 5 or more hours per week in treatment. Residential/Inpatient or Partial Hospitalization A patient enters residential treatment immediately if they are diagnosed as medically unstable by their doctor, or, if outpatient treatment is not successful (lack of progress will be determined by the team). The length of treatment depends on each patient. Residential treatment is generally a minimum of 30-45 days, however, every treatment facility is different. Residential treatment includes a treatment team similar to outpatient treatment. Residential treatment facilities remove the patient from their environment allowing them to focus on themselves and recovery without external distractions. Residential treatment facilities include Center for Change, Renfrew, and Eating Recovery Center just to name a few. Recovery from an eating disorder Recovery is a process and setbacks and relapses often occur. Prepare for the hiccups during the road to recovery and create a support system for you as the parent. Disengage from your child s eating disorder Eating disorder recovery is a long and rocky process. It is important that you disengage from your child s eating disorder while continuing to provide unconditional support and love. The process of disengaging requires you to avoid/give up on threatening, pleading, cajoling, bargaining, bribing, and power struggles revolving around the eating disorder. All these engaging behaviors assume that your child can quit having an eating disorder and stop behaviors if she chooses. 4
What is a parent to do to support their child? Avoid fat talk o Fat talk is your child obsessive preoccupation with her own body weight and shape. o Do not acknowledge fat talk! It is a trap. Tell your child that you are not going answer these questions because they are a no-win situation. Examples of fat talk include: Do I look fat? Does this dress make me look fat? Have I gained weight? Are my thighs too big? Avoid conflicts o Instead express your concern and fear I am concerned about your because you refuse to eat. It makes me afraid to hear your vomiting. Avoid giving simple solutions o If you d just eat, then everything will be fine. o All you need to eat is a cheeseburger. Finding Support for Yourself and Loved Ones *This is a challenging time for you and your child. It might be helpful for you as the parent to seek assistance and support from a professional* Recommended Books: Eating Disorder for Dummies by Susan Schulherr Surviving an Eating Disorder: Strategies for Family and Friends by M. Siegel, J. Brisman, & M. Weinshel Talking about Anorexia by M. Monro Perfect Illusion: Eating Disorders and the Family by L Hutton, E. Cerna, and M. Hornbacher Eating Disorders (Talking Points) by J. Bryan Conquering Eating Disorders: How Family Communication Heals by S. Cooper, and P. Norton Helpful Websites: www.nationaleatingdisorders.org National Eating Disorder Association www.something-fishy.org Something Fishy www.nlm.nih.gov/medlineplus/eatingdisorders.html Medline Plus www.bulimia.com www.nimh.nih.gov/health/publications/eating-disorders/complete-index.shtml National Institutes of Mental Health 5