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Four reasons why eating disorders are so hard to treat in adolescents

Treating anyone with an eating disorder is complex, but when an eating disorder strikes your teenager, it can be even more challenging based on the following factors:

1. There are numerous psychiatric and medical comorbidities in someone with an eating disorder. Since many of these conditions may not have been previously identified in a teen, diagnosis and treatment is more challenging. It is very common for a teen who has an eating disorder to also have depression, anxiety, Post Traumatic Stress Disorder (PTSD), and Obsessive Compulsive Disorder (OCD). Read more

2. There is very little evidence-based research on the topic of eating disorder treatment, especially among adolescents. It’s extremely hard to gather hard science on psychological problems. Eating disorder research has largely been limited to therapists making observations of treatment modalities among specific groups, but it has (thus far) been virtually impossible to gain funding for the type of research that would provide the hard data we need to make conclusions about causality and treatment.

3. Eating disorders are complex mental illnesses, and often require a multi-disciplinary team working together. Finding the right team, and working together with them can be a challenge. A team may include your child’s therapist, a therapist for you as a parent, a parenting coach, a nutritionist/dietician, and more. Each member of your team needs to be a fit for your child and for you – they also need to have respect for each other in order to collaborate for best outcomes. Therapy is extremely personal, and even a qualified  therapist may not be a great fit for your individual child. Also, eating disorder specialists can be hard to find. Then there is the expense if you are paying out of pocket, and the stress of going through insurance, which is notoriously reticent to pay for mental health services, especially in a complex and highly stigmatized area like eating disorders.

4. Many adolescents with eating disorders resist treatment and are in denial about the severity of their illness. Adolescents, by design, are in a period of life in which rebellion and resistance are key. They are built to resist, and so when we are desperately trying to help them, they will often push back. Parents are critical elements of treatment, but they are specifically targeted during adolescence as people to be resisted and defied. Adolescents typically lack trust in authority, but trust must be built in order to change behavior. Adolescents also believe their thoughts – that is, if they think something, they believe it must be true. For an adolescent who has an eating disorder, thoughts conspire to justify the eating disorder behavior and protect it from being taken away. This results in powerful denial that there is a problem to be solved. If your child doesn’t believe there is a problem, it is extremely hard to treat the eating disorder.

The good news, however, is that eating disorders can be treated, and full recovery can and does occur. The earlier we intervene, and the more comprehensively we treat an eating disorder, the better our child’s chances are of full recovery. An eating disorder does not have to be a life sentence, and parents are uniquely situated to help their children heal and go on to have a full life.

The important thing to know is that recovery is rarely linear, and teens often require significant attention from parents and caregivers as they heal. There will be good days, and bad days, and this will take time, energy and money. But it is possible.

Remember that you are not to blame for your child’s eating disorder, but you are uniquely positioned to help your child heal. Just do the best that you can, given everything else on your plate. Gather your forces, and strengthen your connections. You can do this!

Ginny Jones is on a mission to empower parents to raise kids who are free from eating issues, body shame and eating disorders.

She’s the founder of and a Parent Coach who helps parents navigate disordered eating, eating disorder recovery, and other challenging emotional and behavioral issues.

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