When your child refuses to get treatment for an eating disorder

Lots of parents get understandably frustrated with a child who resists or refuses eating disorder treatment. Sadly, trying to force your child can spark a dangerous power struggle. It’s tempting to invest a lot of energy and money trying to force kids into recovery. But it’s expensive, exhausting, and often ineffective. So what can parents do when a child refuses treatment for an eating disorder?

Why people refuse treatment for eating disorders

Let’s start with why people refuse treatment. First, many people who have eating disorders don’t think it’s a serious problem. In fact, part of the disorder is a distorted view of what “healthy” is. Therefore, it can be hard for them to actually see that what they are doing is a problem.

Next, eating disorders are coping mechanisms that your child has discovered make them feel better. Even though they seem terrible to you, eating disorder behaviors are serving a purpose in your child’s life, and they may not be able to tolerate living without them right now.

Finally, you may not have done a very good job of approaching your child about their eating disorder in the past. This is really common. Few parents have knowledge of eating disorders, let alone know how to handle them. Your past approach may be making it hard for your child to talk to you about their eating disorder or accept treatment or help from you.

I’m not saying this from a point of blame. I know you have done your best. But if you want to influence your child’s recovery, then we have to look at things as realistically as possible.

Here are five things parents can do when a child refuses treatment for their eating disorder:

1. Don’t engage in debates or power plays

Try not to turn recovery into a battle of wills, a debate, or a power play. Try to focus your energy on the things you can control (e.g. your beliefs and behavior), rather than the things you can’t (e.g. your child’s will).

It’s natural to want to debate the value of treatment when your child refuses treatment for an eating disorder. But you want to avoid turning your child’s eating disorder into a power struggle. The more they defend and protect their eating disorder, the harder it will be to get them into treatment. Avoid turning eating disorder treatment into a power struggle at all costs.

This doesn’t mean you can’t do anything (see below!) But it does mean that digging your heels in, making ultimatums, and otherwise trying to control your child’s willingness to get treatment will usually backfire.

It makes sense if you feel a strong urge to force your child into treatment. And the fact is that sometimes, if your child is a minor, you may need to and be able to do so. But in most cases, things will go better if you can encourage your child to enter treatment willingly. This is not easy. But an eating disorder can be a signal that the family dynamics need healing. And that’s usually where parents can begin if a child refuses treatment for their eating disorder.

2. Get help for yourself

You may find this strange, but you will be amazed by how much more you can accomplish when you get professional support for how you parent through your child’s eating disorder. Remember that we can’t change other people, but changing our own beliefs and behavior will often get things moving in the right direction.

While your child is the one who has an eating disorder, you can make a significant impact on their recovery. This is because parents and families are often part of the eating disorder formation and maintenance. Find a qualified therapist or coach who works with parents. Parents can also work with a dietitian who can help you with food and weight beliefs and meal behaviors. Ideally, seek someone who practices from a non-diet perspective and extensive training in eating disorders specifically.

In therapy/coaching, you can learn interventions that you are 100% responsible for. Your child does not need to agree to these interventions as they are all about what you do, not about controlling what they do. These include Family Based Treatment (FBT) and Supportive Parenting for Anxious Childhood Emotions (SPACE). You can also work on your beliefs, assumptions, and parenting skills. You’ll also get someone who has compassion for your experience. Parenting through an eating disorder is not easy, and you deserve support.

3. Repair your relationship with your child

Surprisingly, relationships are built not in the good times, but when someone takes action to repair mistakes. And every parent makes mistakes. When we repair the parent-child relationship, our relationship will strengthen and we’re more likely to have a positive impact. This doesn’t mean that it’s your fault, but it does mean that you can make a difference.

You have probably been experiencing increasing arguments, slammed doors, and cold shoulders from your child for months. It’s likely that your child denies they have an eating disorder. They may completely refuse treatment or attend treatment but do not fully participate.

While you may be dismissing your child’s volatile behavior as “normal” teenage or young adult behavior, when it is combined with eating disorder symptoms, it is not healthy. In addition to your child’s health, your lifetime relationship with them is at risk.

Your child may say they do not have an eating disorder and call you ridiculous for thinking they do. They may yell at you and tell you that it’s all your fault they have an eating disorder. These statements may make you want to pull away, but they are actually a sign that your relationship needs repair.

Many of us mistakenly believe that our kids want to be completely self-sufficient. But they desperately crave their parents’ caregiving, love, and unconditional acceptance. Even the most well-intentioned parents make mistakes that need to be repaired. In fact, rupture and repair is how relationships grow and become strong.

Your child’s recovery will be supported if you repair your relationship with them. Your therapist or coach should be able to help you get this process started. Once you have made some changes to the way you are parenting, you should gain your child’s confidence and be able to take the next step: family therapy.

4. Attend family therapy

An eating disorder exists in an individual, but it’s also often a symptom of family dynamics. It can help to expand your view of the problem. Rather than focusing all your effort on your child’s behavior as the issue, seek support in working together to improve attachment, communication and safety in your family as a whole.

This is where family therapy comes in. Once you have made some progress on your relationship with your child, you should be able to ask them to join you for family therapy. You can do this even if your child is still refusing treatment for the eating disorder. Take your time setting this up, and get help from your therapist or coach to optimize your chances of success.

Interview different therapists to find someone who will help, not hurt the process. You are looking for someone who has experience with parent-child relationships and is aligned with you on healing the relationship and encouraging your child to explore the option of eating disorder treatment.

Your child may refuse family therapy. They will likely assume you’re attending family therapy to “fix” them. Help them understand that family therapy is about repairing your family dynamic. Make sure you believe it will help all of you. It will.

If your child believes the family therapy is because they are a bad child, they will refuse to go. If the child believes the family therapy is meant to “fix” their eating disorder, they will refuse to go. So be very clear that family therapy is about healing your family dynamics.

The purpose of family therapy is for you to build a stronger connection with your child, to gain some parenting skills, and to help them express themselves fully to you in a safe space. You will learn some communication skills and work on expressing yourself authoritatively and compassionately while unconditionally accepting your child exactly as they are.

5. Enjoy your child

Your child’s eating disorder may feel like the worst thing to ever happen to you. You may think that enjoying time with your child while they refuse to get eating disorder treatment is enabling the eating disorder. But eating disorders are complex, and they take time and patience to treat. Ultimatums rarely help and can be harmful.

It’s OK, even advisable, to enjoy time with your child. Don’t treat them as if they are only their eating disorder. They are still your child, and they still need you to love them and accept them. In fact, loving and accepting them while making improvements to your parenting practices may be the best way to encourage your child into eating disorder treatment.

Most people who have eating disorders can and do recover. Taking the steps outlined above, embracing your potential to change, and improving your parenting techniques will help make that happen. The happy side effect of all of these steps is that your family will become more bonded and stronger in every way. And hopefully, your improved relationship will help your child accept support and seek eating disorder treatment.

See Our Eating Disorder Treatment Guide For Parents

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