Anorexia Nervosa: Parents as Part of the Treatment Team

What is Anorexia Nervosa?

Anorexia Nervosa (anorexia or AN) is a biologically-based disorder that involves restricting one’s food intake, leading to significantly low body weight. Anorexia is accompanied by an intense fear of gaining weight and a distorted perception of one’s body.

Eating Disorders have high rates of suicide and the highest overall mortality rate of any psychiatric disorder.  Eating disorders don’t just affect the mind, but can cause severe medical complications. Individuals with anorexia face a constant, daily, fear of food. To most people, food is a staple that often elicits pleasant experiences and memories, but not for someone with anorexia – and likely not for their caregivers during recovery.

The Role of Parents and Caregivers in the Recovery Process

Parents and caregivers are an integral part of recovery and, as a result, are one of the most important members of the treatment team. They are often put in charge of all food choices, preparation, portioning, and serving. For many parents and caregivers, this can mean a constant battle to get food into their child; something that most parents no longer have to worry about (beyond food preparation) once a child can feed themselves. Given the severity of the illness, parents are charged with the overwhelming task of getting their child to eat – all while managing the rest of their lives.

Redefining Meal Time

Without food and proper nutrition, a child won’t recover well from anorexia, if at all. For parents and caregivers, the process of feeding their child doesn’t just mean providing a meal – it can mean all, or some, of the following:

  • Providing 6 meals a day, consistently
  • Following a meal plan consistently and enforcing structure at home
  • Having family meals
  • Having neutral conversations, particularly at meals, to ensure no discussion of food, body image, or exercise
  • Providing coaching and support during meals
  • Providing an overall healthy environment for recovery

It also means staying calm and helping a child manage intense fear of ingesting food. It means providing constant supervision to prevent a child from exercising or getting rid of food and easing into control of those things when the time is right. And, it means a lot of appointments, especially if your child needs a higher level of care.

Elements of a Positive Recovery

In the case of anorexia, food is medicine. Malnourished minds and bodies don’t think clearly, sleep well, or function well. Parental awareness of eating disorder symptoms such as persistent patterns of dieting/restriction, an unhealthy relationship with food, over-exercising, and significant emotional distress surrounding food, is key. Getting early, multidisciplinary treatment like therapy, psychiatry, dietary and medical monitoring is associated with a better chance of recovery, as well.

Eating disorders are influenced by both genetic and environmental factors. Parents are not to blame, but are a part of the solution. Parents and caregivers of adolescents with eating disorders must fight every day, and every meal, to make sure their child receives proper treatment and to ensure their child has their fair chance at recovery.

For more information on the levels of care and treatment provided by the Nationwide Children’s Eating Disorder Clinic, click here or listen to our PediaCast.

Kristen Armbrust, LISW-S
Kristen Armbrust is a licensed clinical social worker with experience working with children and families within Behavioral Health. Currently, she is the clinical lead supervisor of the Eating Disorder Program at Nationwide Children’s Hospital where she provides eating disorder treatment and clinical supervision to other clinicians. She also has experience working with adolescents with mood and anxiety disorders and is a clinician on the Dialectical Behavioral Therapy team. Her clinical interests include eating disorders and improving family-centered care.

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