Parenting a child who has an eating disorder is not easy. Eating disorders are complex illnesses that must be treated comprehensively to truly result in lifelong healing vs. just managing behaviors and consistent recurrences. The majority of eating disorders begin during adolescence while the child is still living at home with parents, which means that we are on the front-lines of recognizing there is a problem and paying for treatment and care.
Here are three key elements of this process that you need to know:
1. Adolescence sucks
It is important to understand, and truly connect with, how difficult it is to be an adolescent today. Maybe you had a pretty good adolescence, but chances are that even if you did, you still struggled at times. Maybe you have forgotten about the really hard year in the midst of good ones. Or maybe the last two years of high school were so great that you don’t think about the terror of the middle school years. Chances are good that if you look closely, you will uncover your own challenges during adolescence.
During adolescence, our emotions are all over the place. We are also biologically driven to separate from the people who we love and trust most – our own parents. This leads to seemingly ridiculous power struggles that really matter to adolescents who are trying to find themselves as independent people.
Then you add on the elements of today’s society, which include increasing pressure for school performance, extracurricular activities, getting into the right college, looking good, feeling happy, and, of course, social media, and adolescence has become downright terrible. Sure, some of it is fun, and our kids enjoy themselves some of the time but never forget that the 10 years between 10-20 are rife with stress and anxiety, both of which are heavy contributors to eating disorders.
2. Eating disorder behavior is “normal”
When you think of an eating disorder, you probably think of a severely malnourished and underweight person. This is the extreme end of anorexia, but it represents a small minority of eating disorders. The majority of eating disorders do not lead to hospitalization or require a feeding tube, but that does not make them serious. Sub-clinical anorexia, in which a person is chronically limiting food intake (also called dieting) but is not clinically underweight, is more common than its dramatic sister.
Much more common than anorexia are bulimia and binge eating disorder. They are similar in that they both involve binge eating. In the extreme cases, the binges become compulsive numbing behavior. In milder cases, a binge comes on under stress such as when studying for a test or when hanging out with friends and food is a way to reduce social anxiety. The purge of bulimia may include self-induced vomiting or laxative use, but it may also present in the form of exercising to “work off” the binge or restricting food the next day to compensate.
Most of the milder forms of eating disorder behaviors probably sound familiar to you. In fact, you may use some of them yourself. In this environment, our children who are susceptible to eating disorders believe that their behavior is normal – and even a necessary part of living in the world.
The normalization of these behaviors also means that a child may recover from an eating disorder in a technical sense only to adopt the socially acceptable, normalized disordered behaviors that still impact life. It is important that eating disorder treatment takes place over a long enough time that the child internalizes that what appears normal in our society is not, in fact, normal or healthy.
Mental health care is expensive
When you have a child who is clearly struggling with eating and body image issues, you are right to be concerned and to seek care as quickly as possible. The challenge is that finding care can be surprisingly difficult. Going through your insurance provider may be very challenging. Your provider may limit eating disorder treatment only to extreme “medical” cases, and even then, care may only extend through a minimum of weight restoration, which falls far short of full eating disorder recovery.
Even though insurance companies are technically required to cover mental health, it’s common for claims to be denied or held up. It’s also common for the best therapists to no accept insurance patients because they frequently don’t get paid by the insurance company. Insurance companies may only pay for medication, and not therapy. Even in cases in which your insurance covers therapy, it may not cover the level of therapist who is truly qualified to treat your child.
There is a good chance that you will need to pay out of pocket to provide your child with comprehensive eating disorder care, which typically requires a team of an experienced nutritionist and therapist over a period of months to years. This can get very expensive, very quickly. In many cases, even if you choose to pay out of pocket for your child’s care, the best therapists may not have openings or may not be physically nearby your location. This adds to the burden of care, further complicating recovery.
If you are currently struggling to find care for your child who has an eating disorder, please check out the National Eating Disorders Association website, which provides a phone number and email contact information so that you can find the resources you need.