Parenting a Child with an Eating Disorder

Recognizing that your child has an eating disorder can be painful and scary, but confronting the disorder is the first step toward recovery. Here are some of the signs that your child may be struggling with an eating disorder.

Signs related to eating and exercise include developing unusual routines around eating, such as wanting to eat at the same time each day or use the same plate for each meal, eating alone, leaving the table early, cooking without eating what they made, weighing themselves frequently, wearing baggy clothes, and exercising compulsively.

Signs related to physical health include rapid weight loss or weight gain, exhaustion, dizziness, fainting, stomach problems, damaged teeth, thinning hair, and feeling cold.

Signs related to mental health include becoming fixated on weight or body image, feeling stressed, anxious, or shameful about eating, and struggling with low self-esteem, isolation, and depression.

Nothing can definitively prevent an eating disorder—those forces are sometimes out of a parent’s control. But cultivating a positive, accepting atmosphere around body image can help your child thrive.

Parents can do that by emphasizing that self-worth comes from personality, not appearance, and that people with all different body types can be strong and happy. Parents can avoid voicing regular concerns about their own body, weight or food choices (“I can’t believe I gained two pounds. I look horrible!”). They should also avoid commenting on their child’s weight or body.

Additionally, parents can strive to develop an open, communicative relationship so that if their child encounters challenges such as bullying or anxiety, parents can listen and address those challenges together in a healthy way.

Parents should not blame themselves for the development of a child’s eating disorder. While researchers do not yet know why some people develop eating disorders, we do know that such disorders have a strong biological component, and that social and environmental factors contribute to the picture.

What is in a parent’s control is the ability to model healthy eating behavior and a healthy mindset about body image. (Although there are plenty of parents who do this and whose children still develop a disorder). In the case that a disorder does emerge, parents play a pivotal role in their child’s treatment and recovery.

Children as young as 5-years can develop an eating disorder. In fact, research suggests that anorexia is emerging at a younger age and that the condition has increased among children between 8 and 12 years old over the past decade.

Still, the median age when anorexia and bulimia develop is 18 and the median age when binge-eating disorder develops is 21, according to the National Institute of Mental Health.

Before beginning the conversation, it can be helpful to research the condition thoroughly, as well as read accounts from those in recovery. This way parents can better understand and empathize with their child’s experience.

It’s valuable to recognize that children with an eating disorder may deny that they have a problem. This occurs for many reasons—children may struggle with shame and anxiety about the disorder, they may feel overwhelmed by the prospect of having to confront it, and younger children may not fully understand it themselves. Even if this is the case, it is important to begin discussing and confronting the disorder together.

Another line of thinking a child may have is "I'm not sick enough to get better," in which the child recognizes a problem but doesn't believe it's severe enough to merit solving. Perhaps they believe the benefits outweigh the costs, fear what they might lose, can't imagine a life without their particular relationship to food, or perceive recovery as self-indulgent. In response, parents can encourage small changes and provide perspective on what the child is missing in their current state of being.

Approach the topic by gently expressing that you are concerned for them. Be direct and specific about what you have observed. Then ask questions about their perception and experience, and listen attentively. Be open to exploring any topic that emerges, from being bullied at school to feeling intense anxiety.

Maintain a calm tone throughout the conversation, even if you are struggling internally, so that it feels less overwhelming for your child. Whether in the first conversation or a later one, discuss concrete steps to begin treatment.

Confronting a disorder and seeking treatment will likely require many conversations. In these talks, parents should be specific about the next step, such as finding a therapist or being evaluated by an eating disorder specialist.

Stay involved in a child’s treatment, such as by attending appointments. This can allow parents to support their child and provide insight or advocacy in the treatment setting. Don’t be discouraged if the first therapist or clinic doesn’t seem to work—finding an effective treatment plan may take time.

There may come a time when a parent has to draw a strong boundary. They may decide that seeking treatment is required for them to continue paying for a child’s phone or college, or even for a child to continue living in their home. Although this can be deeply distressing, it is for the child’s safety and sometimes becomes the final straw that forces them to address the disorder.

The guidance above applies to children who need help but are not in immediate danger. If you are urgently concerned for your child’s safety, go to the hospital or call 911.

Find a treatment center or an eating disorder specialist who takes your insurance in the Psychology Today Therapy Directory. Referrals from doctors or friends can also be helpful in this process.

Parents will want to research a clinic or therapist beforehand. It can be helpful to ask questions about credentials, experience, past patient outcomes, treatment strategies, how progress is measured, and insurance plans and payment options.

Recovery from an eating disorder is a continuous process, with twists and turns along the way. Parents should recognize that in addition to moving forward, children will probably also contend with setbacks or relapses.

Parents can encourage their child to stick to the treatment plan or meal schedule and continue developing coping skills. They can also remind the child of their larger life goals, such as returning to school if they took time off.

Supporting a child through an eating disorder takes time and energy, as it’s not an isolated incident but a continuous process. Therefore it’s important to set aside time to care of yourself, by finding ways to release stress and relate your own emotions to a loved one or a therapist. Maintaining central pillars of your own life is important, both for yourself and so that you can be there for your child.