Eating disorders are serious mental illnesses with potentially grave consequences. Children and teens will not accurately estimate the risk that an eating disorder poses to their health. As such, it is up to parents to see that their child is supported to recovery. The treatment approach most strongly supported by research evidence is family-based treatment, in which parents take responsibility for managing the eating disorder symptoms.
Seek to understand
Assure your commitment
Be clear and explicit
Because there is very little training about eating disorders in the medical curriculum, your family doctor or pediatrician may or may not have expertise in eating disorders. Parents are usually the first to notice changes in their children, so take confidence in your own knowledge of your child.
Ask for an appointment that will give you adequate time to discuss your concerns. Be specific with the doctor about the changes you have noticed and ask to speak with them alone and together with your child (the doctor may also want to speak with your child alone). Tell the doctor why you think an eating disorder may be developing and that you understand that early identification is critical to recovery.
If the doctor is familiar with eating disorders, they will take your concerns seriously and will check your child’s weight and height, and blood pressure and heart rate (lying and then standing). They might compare the current weight with earlier weights on a standard growth curve chart to see if your child is growing appropriately. They might ask your child about other issues like sleeping disturbances, stomach aches, friends, bullying, school work, self-harm, and so on.
If your doctor does none of these things, you can respectfully ask:
You can download NEDIC's Guide for Parents and Caregivers (PDF). A checklist (PDF) for discussions with your child's primary care provider is also available. You may also wish to review NEDIC's Tips for Choosing a Provider (PDF).
F.E.A.S.T. is an international non-profit organization of and for caregivers of loved ones suffering from eating disorders. Their mission is to support caregivers by providing information and mutual support, promoting evidence-based treatment, and advocating for research and education to reduce the suffering associated with eating disorders. You can learn more on their website.
Young adulthood is a unique phase in life, hallmarked by many transitions and a feeling of being ‘lost’ or ‘in-between.’ Young adults are no longer as reliant on family support and, at the same time, they’re not yet fully independent either! It is a time of amazing possibilities and growth, but this tension between support and independence while so much is changing can also make it a time of uncertainty and self-doubt.
Typically, young adulthood spans from ages 17 to 27 but it can start earlier or end later depending on each person’s unique experiences. The various transitions that tend to happen during this phase may include:
Systems of mental health care change based on chronological age from paediatric care (typically up to the age of 18) to adult care, and the changes can be dramatic. Some treatment programs are developing transition programs to ease the change between paediatric and adult models, but, for most, the transition between systems is sudden.
Paediatric systems often offer treatments that are family-based, where caregivers can support their child in treatment and can communicate directly with the treatment staff. Often, it is caregivers who are trained to provide meal support and coping strategies in times of distress. In adult models of care, treatments are individual or group based, and the young adult is responsible for accepting treatment and communicating directly with staff. Unless the young adult gives consent for treatment to involve their caregivers, it is fully their own responsibility.
This change in who is considered most responsible during treatment can be a hard transition for both the young adult and their family members, especially if the young adult is ambivalent about treatment or is still reliant on the support of caregivers.
It is common to experience a recurrence or worsening of mental health struggles during times of stress and change. Given that young adulthood is hallmarked by transitions (i.e. moving, going to a new school, career changes, dating, marriage, and financial strain), many young adults struggle.
It’s important to remember that caregivers are experiencing these transitions, too. It can be its own challenge to navigate the change of being very involved during paediatric treatment, to having very little say in adult models of care.
Along with the suggestions above, also try to practice helpful communication strategies that support collaboration, openness, and compassion. (See the handout with tips for being an effective talker and listener)
Supporting an adult child or someone who has had an eating disorder for a long time can be frustrating and exhausting. Challenges include the fact that they have full self-determination as an adult, and this means there are limits to what you can do, especially if they are financially independent and no longer living with you.
Continue encouraging them to seek help and offer to support them in ways that will be sustainable for yourself. This may mean sitting with the discomfort of knowing you can’t “fix” them, but that perhaps there is still space for you to work with them in ensuring there is a safety plan for immediate medical attention and for conversations around expectations of what is acceptable and what is not.
For example, it is unsustainable for your relationship if your loved one is constantly calling you in crisis, then dismissing your concerns and refusing to seek help once the crisis has passed, as this places an unfair burden on your shoulders. Setting boundaries is important, perhaps especially with someone you’ve been supporting for a long time. Read more about taking care of yourself as a support person here.
As a caregiver (i.e. parent, spouse, or partner of an individual affected by an eating disorder) you may already be familiar with the stages of change model and have years of experience supporting them. You may be familiar with many of the resources available. You also still deserve support. Take steps to care for your own well-being – connect with other caregivers in a similar situation through FEAST.