refuses treatment eating disorder

When your teenager refuses to get treatment for an eating disorder

If your teenager has an eating disorder but refuses treatment, you’re in a tough spot. No matter how much you want your teen to recover, they need treatment to do so.

Lots of parents waste a lot of energy and money trying to force their kids into recovery. It’s exhausting and often ineffective. So what can parents to when a teenager refuses treatment for an eating disorder? Here are some tips:

  1. Get help for yourself (you’ll need it!)
  2. Repair your relationship with your child
  3. Attend family therapy
  4. Support your child in getting into eating disorder treatment
  5. Get nutritional counseling
  6. Enjoy the family you have

Why teenagers refuse treatment for eating disorders

Teenagers are biologically driven to differentiate and individuate from their parents. This is the main reason why parenting a child from ages 10-20 can be especially tricky. It gets even harder when there’s an eating disorder.

Adolescent brains are working very hard to prune childhood neural connections. They are building powerful new adult connections that will stay with them for life. Adolescence can fundamentally change the way your child relates to you. They can be confounding to even the most grounded parents.

Eating disorders often begin during these important growth years. There are many reasons for this. The development of individual identity is, for most children, closely tied to their body. The mistaken belief that we are defined by our bodies is accelerated by diet culture. This promotes the lie that we can and should control our body size and shape.

It is also true that a child’s family may have inadvertently caused some misguided beliefs about the child’s body, emotional expression, and sense of self-worth. Parents are critical players in developing our children’s emotional health. To help them heal, we must recognize any mistakes we have made. Most of them were with the best intentions. But we still need to acknowledge them if we are to move forward in our relationship.

What parents should not do when a teenager refuses treatment for an eating disorder

It’s natural that parents feel defensive when a child is diagnosed with an eating disorder. But defensive actions will hurt our child rather than help them heal. An eating disorder can be a signal that the family dynamics need healing. If we dig our heels in and refuse to acknowledge our mistakes, we can create an anti-recovery environment.

It’s natural to want to argue when your teenager refuses treatment for an eating disorder. But you want to avoid turning your child’s eating disorder into a power struggle. Teenagers love to debate. 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.

When treatment begins

Of course, if your child is medically underweight, you must seek medical treatment immediately. Your teen may require hospitalization to achieve a minimum weight. Please know that once your child achieves the minimum weight, they will likely still be living with an eating disorder. The vast majority of people who have eating disorders are not medically underweight and may be “average,” “overweight” or “obese.”

As long as your child is not in imminent physical danger, treatment can and should begin at home. Parents are tremendously powerful in helping their children heal from an eating disorder. When your child is above their minimum weight, you can take the long road and trust that the following steps will make a huge impact on the likelihood of full recovery.

Here is what you can do to help your teenager refuses treatment for an eating disorder:

1. Get treatment for yourself

You may find this a strange recommendation. While your child is the one who has an eating disorder, you must seek support in how you parent them. Find a qualified therapist who works with parents of adolescents.

At this point, you don’t need an eating disorder specialist. But you should clarify that you are looking for a therapist who is familiar with Health at Every Size (HAES) and will not mistakenly discuss your child’s body as a problem.

There are always parenting skills you can work on to help you parent your child effectively right now. Your therapist will provide a sounding board. They will also help you learn some parenting techniques and approaches that will help your child recover.

2. Repair your relationship with your child

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 likely refuse treatment or perhaps attends treatment but do not fully participate.

While you may be dismissing your child’s volatile behavior as “normal” teenage behavior, when it is combined with eating disorder symptoms, it is not healthy. You must realize that the first emergency at hand is your relationship with your child.

Your child may say they do not have an eating disorder and call you ridiculous for thinking they do. They may abuse 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 improvement.

Many of us mistakenly believe that our teens want to be completely self-sufficient. But they desperately crave our caregiving, love, and unconditional acceptance.

Your child’s recovery is unlikely to truly begin until you repair your relationship with them. Your therapist 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.

3. Attend family therapy

Once you have made some progress on your relationship with your child, you should be able to convince them to join you for family therapy. Take your time setting this up, and get help from your therapist 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-teen relationships and, again, is HAES-informed.

Your child may refuse family therapy. This is because they will assume you’re attending family therapy to “fix” them. Help them understand that family therapy is about repairing the family dynamic. It will help you all relate to each other better.

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.

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 are likely going to learn some communication skills and work on expressing yourself authoritatively and compassionately while unconditionally accepting your child exactly as they are. Your child is hopefully going to remember that you are dedicated to supporting and loving them, and will eventually agree to see a therapist individually and begin eating disorder treatment.

4. Get your child into eating disorder treatment

Once you are in family therapy, you can work with your family therapist to discuss the eating disorder. Your family therapist can help you discuss your concerns about your child’s eating disorder. They can support you in getting your child to meet some potential therapists and begin treatment.

You should continue attending family therapy during your child’s eating disorder recovery. Hopefully, by now you can see that working on your family dynamics is making a positive impact on everyone. Your continued active pursuit of being a better parent will mean your child is more likely to succeed in their healing process.

Your child’s eating disorder treatment will vary, but keep it as close to home as possible. Sending your child away to attend inpatient treatment should be considered only in extreme cases.

READ: What I want parents to think about before sending their child to an Eating Disorder Treatment Center, by John Levitt, PhD

5. Get nutritional counseling

Once your child is in eating disorder treatment, you should seek support from a non-diet dietician who is HAES-informed. You need someone who follows the Ellyn Satter philosophy and feeding program. You are looking for someone who can help you put together a feeding structure for your family.

Depending on your child’s treatment program, they may be assigned a nutritionist. If that is the case, make sure you get to have meetings with their nutritionist. They can help you learn what you need to do at home to help your child’s recovery.

The focus is more on the approach you bring to food than the food itself. Your nutritionist may provide you with basic guidelines for nutritious meals. But you may be surprised that these meals are not as rigid or “healthy” as you were expecting. This is because a non-diet dietitian is looking for balance, pleasure, and satiety as much as nutritional value. For long-term health, the best diet is one that provides pleasure.

Find a non-diet dietitian who can consult with your family.

6. Enjoy your family

Your child’s eating disorder may feel like the worst thing to ever happen to you. But many parents who embrace the changes required in recovery improves the entire family. An eating disorder is not a life sentence for either you or your child.

Most people who have eating disorders can and do recover. Taking the steps outlined above, and embracing your potential to change and improve 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.


Ginny Jones is the editor of More-Love.org. She writes about parenting, body image, disordered eating, and eating disorders.


Disclaimer: This article is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this Website. If you think you may have a medical emergency, call your doctor, go to the emergency department, or call 911 immediately.

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