By Julia Kannard*, CPC, DBH (Program Director Adolescent Residential Services, Eden Center for Eating Disorders)
Many people who are struggling with eating disorders feel like their lives are out of control. But “It’s usually not about the food,” as we say in the ED field. A child struggling with an eating disorder may present physical health concerns, such as purging, binging, etc.; however, there are almost always co-occurring mental health concerns that drive many eating disorders, including depression, anxiety, and PTSD.1 From a parent’s perspective, you’re on the outside looking in at your child’s struggles and probably thinking “why won’t they just eat” or “my child says they’re eating but I can see them wasting away before my eyes” or “I want to say something but I’m afraid of how my child will respond.” All parties involved are struggling with how the ED affects aspects of their lives: parents trying to understand their child’s experiences and how to help, and a child’s misperceptions about current control.2
While recent research indicates that there is a genetic component that increases a person’s vulnerability to developing an eating disorder, the co-occurring mental health issues need to be addressed, too. Comprehensive ED treatment looks at the entirety of issues together: physical & emotional health, genetic predispositions, and environmental influences.3 It is hard to expect a treatment facility to adequately help your child heal from an eating disorder if they are not equipped to provide such complete treatment. There are different interventions to consider when searching for the most appropriate treatment for your child. Family Based Therapy (FBT) has been proven to be an “effective intervention and is considered by some to be the treatment of choice for adolescents with AN who are medically stable and fit for outpatient treatment.”4 If your child does not seem to be an appropriate candidate for FBT, then residential ED treatment may be considered.
As a parent, one of the most terrifying experiences you’ll face is when your child enters a residential setting. Countless parents have shared similar concerns with me: their child is removed from home and school, and placed somewhere new where their child will have limited access to friends, family, and other identified supports. As a parent you go from having your child around 24/7 to having limited contact, concerned how they’re doing in the course of treatment, and to the fundamental issue: CHANGE IS JUST PLAIN SCARY. As the child entering a residential treatment, this can be an equally scary experience: I’m away from my home and my family—in a new place with unfamiliar people, I don’t know if I want recovery, treatment is scary.
As scary or out of control residential treatment may seem, consider these points:
At first, people often utilize ED as a way to manage some aspects of their lives that are causing pain and struggle. The ED serves a function and a purpose for persons who feel like they are in control of their eating disorder and its presence in their lives. However, many people experience a loss of control as their ED progresses and end up feeling like it now controls them. They end up sitting on the sidelines and watching their own life pass them by.
Residential treatment means that 24/7 structure and support is in place, which can seem contradictory to taking back control of one’s livelihood. But what if the person entering treatment chooses to harness control by making some treatment choices, e.g., “What will I have for snacks? Maybe I can use a strategy that I learned in group to soothe myself instead of engaging in self-harming behaviors?”
When your child enters residential ED treatment, trusting that strangers will make informed and compassionate decisions - just as you would if your child were home - can be a difficult adjustment. You may not be with your child 24/7, but that doesn’t mean that you should be in the dark about what is happening with your child throughout the week. Talk about your family’s needs and what will help you be in the loop about your child’s treatment and progress.
As a parent, you are the expert in your child, and the treatment team is the expert in eating disorders. I coined this as “the joining of the experts” to wrap around your child. Use those parent spidey senses to help inform the treatment team on what you’ve observed in the progression of your child’s eating disorder, and to help us learn more about who your child is so we can best support both your child and family.
Ultimately the goal of residential treatment is to equip you and your child with the skills and tools needed to maintain progress as your child continues treatment at home once they leave. Please allow us the time to help you with what you need to feel confident and competent as you take responsibility for implementing that structure and support that is helping your child’s fight against the eating disorder.
I know that the prospect of residential treatment is scary. The thought of an eating disorder further digging its claws into your child is far scarier. Help is out there for both you and your child. I invite you to explore the options that give children the best chance at regaining control and being an active participant in their own lives, rather than still sitting on the sidelines because of a parasitic ED.
*Dr. Kannard has worked extensively with clients struggling with eating disorders, substance use, and general mental health concerns. She has a BA in Psychology, MA in Clinical Mental Health Counseling, and DBH in Behavioral Health.
1. National Institutes of Mental Health. Eating Disorders: About More Than Food. 2021. From https://www.nimh.nih.gov/health/publications/eating-disorders
2. National Eating Disorders Association. Eating Disorder Myths. 2021. From https://www.nationaleatingdisorders.org/toolkit/parent-toolkit/eating-disorder-myths
3. Himmerich, H. et al. Genetic risk factors for eating disorders: an update and insights into pathophysiology. 2019. From https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378634/
4. Rienecke, R. D. Family-based treatment of eating disorders in adolescents: current insights. 2017. From https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5459462/