Bridget and Tom are struggling to figure out how to support their child Lex without enabling her. “We’ve tried punishment, rewards, and boundaries,” says Bridget. “But nothing seems to be working. The eating disorder isn’t budging. In fact it’s getting worse, and we’re getting so burned out. What can we do?”

I get it. When parents are using punishments and rewards, they’re trying to motivate a child to recover. But while punishment and rewards are commonly-used parenting techniques, they tend to fail with an eating disorder for various reasons. Many parents try to establish boundaries instead, but because they misunderstand what boundaries are (and what they are not!), this can backfire, too. 

The only way to motivate someone to recover from an eating disorder is to build their autonomy and identity, and punishments and rewards directly interfere with that. Meanwhile, boundaries are how parents can make sure they aren’t enabling or accommodating eating disorder behaviors. But not all boundaries are the same and understanding what does and doesn’t work makes all the difference.

Emotional Regulation Worksheets

Give your child the best tools to grow more confident, calm and resilient so they can feel better, fast!

• Self-Esteem
• Self-Regulation
• Mindfulness
• Calming strategies

Learn More

Using punishment to deter eating disorder behaviors

A large portion of parenting advice has historically been based on punishing the behavior we don’t want our child to do. Since punishment feels pretty harsh to most of us, modern parents prefer the word “consequences.” Whether you call it punishment or consequence, the idea is something like this: if you don’t get off your phone, I’ll take it away for a week. Using punishments to teach a child makes perfect sense intuitively. After all, if you do something and receive negative feedback for it, shouldn’t that mean you won’t do it again? 

But unfortunately we know with certainty that as much as this approach makes intuitive sense, it is not actually effective parenting. Punishment is strongly associated with defiance, opposition, rebellion, and giving up. 

Punishment does not motivate kids to do the things we want them to do. Instead, it teaches them to avoid getting caught doing it. That’s why punishment can backfire when it comes to an eating disorder. The last thing we want is for a child to take their eating disorder underground where it becomes invisible. If we can’t see the eating disorder behaviors, we have almost no hope of motivating a child to change their behavior. 

There are a few limited situations in which you might use consequences/punishment for eating disorder behavior, but I would be very, very careful about this. Punishing a child for using a coping behavior (even one that is dangerous) is misguided at best, harmful at worst. And keep in mind that negative words, criticism, and judgment are just as punishing as physical consequences.

Using rewards to incentivize eating disorder recovery behaviors

The opposite of punishing negative behavior is rewarding positive behavior. This approach to parenting is also well-established. The idea is that rather than focusing on what you want your child to stop doing (e.g. restricting, binge eating, purging), you focus on what you want them to start doing (e.g. eating regular meals, going to therapy, etc.). And instead of punishing the behavior you want to stop, you reward the behavior you want to start. This is how most animal training works: when my dog sits, I give him a treat. 

This makes sense, and there is some good evidence for focusing on rewards rather than punishments. However, it can have unfortunate consequences in eating disorder treatment and recovery. Because while rewarding behavior makes intuitive sense, in humans it tends to reduce intrinsic motivation, or the desire to make behavior change for oneself vs. for external reasons. 

When parents reward a child for doing something, they can accidentally reduce their child’s intrinsic motivation to keep doing it. Getting a reward for taking positive action can, unfortunately, reduce a person’s perceived autonomy, or the idea that they are doing the action for themselves vs. someone else or exclusively to gain a reward.

This doesn’t mean you can’t ever reward your child for taking positive steps towards recovery. You just want to make sure you’re keeping in mind that their autonomous drive can be negatively impacted by doing so. To motivate recovery, you want to reinforce their sense of independence and agency at all times. Just like punishment, when your child has an eating disorder you must use rewards intentionally and with forethought.

Setting boundaries when your child has an eating disorder

The difference between punishment, rewards, and boundaries is mainly about who is taking action. When you punish or reward your child for an action they took, it’s about their behavior. When you set a boundary, it’s about your own behavior. 

For example, you may be in a situation in which your child is often yelling at you, which upsets you. You could either punish a child who yells at you or reward a child who speaks calmly. But this keeps the focus entirely on their behavior. On the other hand, boundaries mean that you tell your child during a calm moment that you don’t like being yelled at and are going to change the way you respond when it happens. Then when you are being yelled at, you tell them that you don’t like being yelled at. If they continue, you tell them that you don’t like being yelled at and are going to walk away. Finally, you follow through and consistently act on your boundary every time you are yelled at.

The focus is all about you. “I don’t like being yelled at” is very different from “stop yelling at me.” And “I’m going to walk away” is very different from “Why do you always yell at me? You’re so mean!” A boundary does not ask your child to change anything, do anything, or feel anything. It doesn’t make the child responsible for how you feel. It focuses entirely on what you like, dislike, and will do for yourself.

Focus on boundaries

This is the area you want to focus on most when your child has an eating disorder. Because short of force-feeding a child, which is rarely but indeed sometimes medically necessary, you can’t really control eating behavior. And even if you do, in the process you might damage your child’s sense of agency and their intrinsic motivation to recover. 

However, you can decide what you will do when your child refuses to eat, binge eats, or purges. How will you respond? What boundaries will you set about your own behavior? How will you make sure you aren’t enabling or accommodating the eating disorder? And to be clear, your boundaries should not feel like punishments or rewards. They should be clearly explained in advance and carried through without judgment or criticism. 

Clear boundaries about parental behavior is how parents can be supportive without enabling the eating disorder. It’s a tricky balance, but it’s possible. 

Checking in with Bridget and Tom

Bridget and Tom have agreed that punishments and rewards are not working to help Lex. And while they tried boundaries, they see now that their boundaries have actually been another form of punishment and reward. “I didn’t really see the difference between focusing on our behavior vs. focusing on what Lex is doing,” says Bridget. “In hindsight, I can see that our boundaries didn’t work because we were still trying to control her. Controlling myself, I’ve discovered, is actually even harder!”

I get it! When you switch the focus from changing your child to changing yourself, you realize how hard it is to build new patterns of behavior. Families all have patterns that unconsciously drive and support our behavior. Parenting a child with an eating disorder is about both supporting the child in getting treatment and also changing any parental behaviors that may be accommodating the eating disorder.

Bridget and Tom are working hard to disrupt their unconscious patterns and intentionally build parent-focused boundaries. “I’m already seeing a difference in how our household operates,” says Bridget. “And there are a lot of ways I can see we’ve been accommodating the eating disorder. Lex has resisted most of the changes we’ve made, but I’ve been surprised to notice that she ultimately accepts our boundaries. I think she feels more secure with our boundaries in place. I’m noticing small but important changes in her behavior now that we’re focusing on what we’re doing.”

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Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders. She’s the founder of More-Love.org and a Parent Coach who helps parents navigate their kid’s eating disorder recovery. Ginny has been researching, writing about, and supporting parents who have kids with eating disorders since 2016. She incorporates the principles of neurobiology and attachment parenting with a non-diet, Health At Every Size® approach to health and recovery.

For privacy, names and identifying details have been changed in this article.

See Our Guide To Parenting A Child With An Eating Disorder

Parental attachment impacts eating disorder recovery, and luckily there is a lot you can do to improve it. I’ll outline the steps to improve your parent-child attachment, but first let’s review attachment theory. Attachment theory is a well-established and deeply-researched psychological concept. All children develop an attachment style with their parents. There are two main styles of attachment: secure and insecure.

We all wish that everyone had a secure attachment, but it’s actually not as common as you might think. Just over half of the population (~56%) have secure attachment. A child who is securely attached feels they can rely on their caregiver to meet their needs. When the child is emotionally dysregulated, they seek their caregiver’s attention and are soothed by their caregiver.

There are three types of insecure attachment styles: 

• Anxious-ambivalent attachment (~20% of people): a child who is anxious-ambivalent feels insecure about their caregiver. When emotionally dysregulated, they will seek attention and soothing by doing things like whining, yelling, crying, and being rude. However, the caregiver is typically unable to soothe the child.
• Anxious-avoidant attachment (~23% of people): a child who has anxious-avoidant attachment does not seek their caregiver out when they are upset. When the child is emotionally dysregulated, they tend to go inward and avoid the caregiver and brush off any attempts to draw them out of their shell.
• Disorganized attachment (~1% of people): a child who has disorganized attachment does not rely on their caregiver for any reliable care. When the child is emotionally dysregulated, they may exhibit ambivalent or avoidant attachment patterns, but it is inconsistent, and they are rarely (if ever) soothed by their caregiver.

Parent Scripts For Eating Disorder Recovery

Scripts to help you figure out what to say to help your child with an eating disorder. Use these scripts:

• At the dinner table when behavior is getting out of control
• When you need to set boundaries – fast!
• After something happened so you can calmly review the triggers and events

Learn More

What is the risk of insecure parental attachment?

Children are dependent on their parents for emotional support, comfort and availability, especially during stressful situations, transitions, and change. Securely attached children learn that their parents are available, understanding, and responsive to their emotional and physical needs. As a result of this caregiving, they will feel competent and valuable as people. This core belief usually lasts for life and leads to better mental and physical health.

That’s great for them! But the other half of humans are insecurely attached to their parents and often feel incompetent and unlovable. They struggle to build secure emotional bonds with others. This is because the way we attach to our parents shapes how we attach to others. Parental attachment becomes the blueprint of how worthy we feel of love and what we believe we deserve from partners and friends in the future. Keep reading though, because we can build more secure attachment with our kids!

Attachment theory and eating disorders

The majority of people treated for eating disorders report they have insecure attachment with their parents. Insecure attachment is nobody’s fault. Notably, researchers recognize that parents who have insecurely attached children likely had insecure attachment with their own parents and also have a history of unresolved trauma that impairs their ability to securely attach with their child. It’s not your fault if your child is insecurely attached!

Studies have found that children with insecure parental attachment have:

• Poor self-concept, self-esteem, and self-worth
• Low identity differentiation
• Poor emotional regulation
• Dissatisfied with body and self
• Fear of gaining weight
• Impaired recognition of hunger and satiety
• Higher rates of perfectionism
• Unhealthy coping mechanisms
• Difficulty getting along with others and feeling connected
• Anxiety
• Depression
• Dissociation
• Substance dependency

All of these are also linked with eating disorders, which is likely the reason many people with eating disorders also have insecure parental attachment. That said, not everyone with insecure parental attachment develops an eating disorder, and not everyone with an eating disorder has insecure parental attachment. Eating disorders always involve a complicated web of causes, and cannot be attributed to a single cause. 

What can parents do to build a secure attachment?

Luckily, parents can improve their parent-child attachment. It takes effort and you may need professional support. But working on this may be the most efficient way to help your child recover from an eating disorder. Attachment can’t be forced, but parents have a lot of leverage when it comes to improving attachment. Because at the end of the day, children want a secure attachment. Even full-grown adult children still look up to their parents and crave their love and affection.  

1. Change your mindset

If your child is insecurely attached to you, there’s a good chance there’s a lot of anxiety, opposition, and defiance in your household. Maybe there’s yelling and arguing. Or perhaps your child just stonewalls you, retreating behind their bedroom door and refusing to interact. These behaviors are hurtful to parents, and it’s easy to feel hopeless and think there is nothing you can do to make things better. But these are just symptoms of the attachment relationship. Things can improve! The first step is to adopt two key mindsets. 

First, the growth mindset says that you can learn and grow. You are never stuck, and things are never hopeless. While it may not be easy, you have the power to change your own behavior. And what we know about children (even adult ones) is that when parents change, kids change. That’s just how we’re wired.

Second, you need a mindset of unconditional positive regard for your child. This can be hard if your child has been beastly towards you. But it is essential that you assume your child is doing their very best and means well. If you can’t find a way to adopt this mindset, please seek support from a therapist or coach. It’s an indication that you likely have unresolved trauma and/or insecure attachment with your parents. You’ll need to resolve that in order to build a secure relationship with your child.

2. Learn how to co-regulate

Your kid’s emotional regulation system is wired in direct response to how you co-regulate with them. Our kids automatically co-regulate with us, so it’s not a matter of starting to do it, but rather being intentional about how you do it. Your ability to stay emotionally regulated, calm and present when your child is upset is how your child learns to regulate their nervous system. Emotional regulation is an essential part of eating disorder treatment, so working on this with your child is taking direct action that will make a difference in their recovery. 

When you improve your own ability to self-regulate, you will improve your child’s ability to self-regulate (check out this course for help). This is easier said than done, but you can learn self-regulation techniques. And when you do this, you’ll naturally co-regulate your child’s emotions. Then everyone can calm down and feel better!

This is a practice that takes time. Mindfulness, therapy, and coaching all help to build your emotional regulation skills. You can also get specialized help in learning how to co-regulate with your child when they are feeling anxious and upset during eating disorder recovery.

3. Do things together

Find ways to be physically in the same room as your child. I know this can seem impossible, but it is a requirement of building a more secure attachment. Unless you don’t live together, find ways to be together every day. A great way to do this is family meals, which are an essential part of eating disorder treatment.

Next, find ways to connect with your child over shared interests. It’s OK if it seems like you have absolutely nothing in common right now. You can develop new interests or reframe your kids’ interests so that they become more compelling for you.

Start by picking something your child cares about. For example, if your child is passionate about a sport, you could ask them to tell you about it. Let them be the authority and show you their passion and excitement. Resist the urge to be an expert. Give them the floor! Admire your child’s knowledge, passion, and ability to teach you about something that matters to them. This will help them feel valuable and worthy of your love and attention.

If things go well, plan outings to watch the sport live. Or just plan dates to watch it at home together on TV. The main point is that you are going to show up and participate in your child’s interests. Over time, you will gradually build your connection and attachment.

4. Validate feelings

When kids are upset, most of us want to quickly soothe them. We say things like:

• You’re OK!
• Don’t cry!
• But you liked it last week!
• Stop that right now!
• I can’t believe you would say that to me!

These responses make sense, but it leads kids to shut down their emotional expressions. It can feel invalidating, and we may even be accused of gaslighting. This breaks trust and damages attachment.

To build parental attachment with your child who has an eating disorder, you need to be responsive, not reactive to their emotional bids for connection. When your child reaches out to you with any form of emotional communication, rather than shutting them down or trying to make the feelings go away, acknowledge their feelings.

Let their feelings exist without trying to change them. Work on understanding the breadth and depth of the feelings. Talk about the experience. Don’t give advice right now. Listen more than you speak. Just stay in the moment, with the feelings in real-time. Trust that your child will get through these feelings safely.

One important note: validating feelings means you don’t argue with or try to convince your child to feel something other than what they are feeling.

Your child’s big feelings, even horrible ones, should not be repressed, but felt in the safety of your love and acceptance. Once you accept and even welcome your child’s feelings, they will begin to trust that you can handle them. This will build your parental attachment, support eating disorder recovery and make parenting a lot easier for you.

Parenting a child who has an eating disorder isn’t easy, but you’re the right person for the job! You can help by practicing these techniques and building a more secure attachment.

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Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders. She’s the founder of More-Love.org and a Parent Coach who helps parents navigate their kid’s eating disorder recovery. Ginny has been researching, writing about, and supporting parents who have kids with eating disorders since 2016. She incorporates the principles of neurobiology and attachment parenting with a non-diet, Health At Every Size® approach to health and recovery.

See Our Guide To Parenting A Child With An Eating Disorder

Cara was feeling anything but happy when she called me. “It just feels like no matter what we do, everything is hard and dark,” she said. “I feel like this eating disorder has sucked the joy out of my family, and I want it back!” I get it. An eating disorder can put a damper on even the happiest families. But the good news is that regardless of what challenges they face, happy families share some common habits. And Cara’s family can pursue happiness even as they face an eating disorder. Here are the habits parents can work on to build a happy family during eating disorder recovery:

Connection

Happy families have deep and meaningful connections with each other and as an integrated group. There is a strong sense of belonging and identity. Each member of a happy family feels as if they are a part of something important and special. There is a lot of warmth and goodwill, a sense of well-being and mutual respect and regard. Happy families feel as if each person matters and that the family as a whole matters, too. 

If your child has an eating disorder: seek ways to build belonging by creating opportunities and rituals to do things together. Make family togetherness times a non-negotiable part of being in the family, and strive to make them pleasant and uplifting. Parents set the tone! The eating disorder doesn’t have to take center stage all the time. Instead, find ways to center your family’s strengths and enjoy each other.

Emotional Regulation Worksheets

Give your child the best tools to grow more confident, calm and resilient so they can feel better, fast!

• Self-Esteem
• Self-Regulation
• Mindfulness
• Calming strategies

Learn More

Differentiation

While happy families are deeply connected, they also value individual differentiation and individuation. This means that each individual is respected and accepted for their unique individuality. Every person is an autonomous being with their own beliefs, thoughts, and actions. And each person takes responsibility for their own emotions and identity. Therefore, nobody is triangulating or putting another member into an ill-fitting role in order to feel better about themselves. 

If your child has an eating disorder: very often we want to change the person with an eating disorder’s beliefs, thoughts, and behaviors. However, we must first seek to understand who they are and why the eating disorder showed up. What purpose is it serving for your child? Honor your child’s differentiation and autonomy as an individual who has their own hopes and dreams. Work with them to build a sense of personal identity that is neither trapped in the family system or their eating disorder behaviors. 

Authenticity

Happy families value authentic communication. They are not deceiving or lying to each other regularly because they don’t feel as if they need to lie in order to get along and be accepted as a member of the family. There are no big family secrets that are swept under the rug and never discussed. People aren’t walking on eggshells or ignoring the elephant in the room. Family members don’t pretend that big blowups, tantrums, and problems haven’t happened. They acknowledge them with honesty and humility. Feelings are accepted and validated without guilt, shame, or blame.

If your child has an eating disorder: it’s very possible that you are afraid to talk about things because your child becomes explosive and has big feelings. Maybe when you talk about eating with your child, they throw a tantrum. Learn how to respond to tantrums and emotions without either exploding or collapsing. Show your child that you can tolerate their big, authentic feelings by maintaining your own emotional regulation. Authentic communication requires that your child trusts that you can handle what they say. Doing this takes practice, so get some help recognizing your patterns and learning some new skills.

Security

A happy family offers security to everyone in it. There is a strong belief that each person is loved regardless of what they do or don’t do. There is no physical, verbal, or emotional violence. Parents provide a safe and secure base, including regular family meals as well as expectations and boundaries about eating, chores, bedtime, and acceptable family behavior. Kids can trust that what parents say is well-intentioned and has unconditional love at its core. Parents take responsibility for when things go wrong and repair emotional mismatch, arguments, and other relational ruptures intentionally and with skill. 

If your child has an eating disorder: create a sense of order and structure in the household. If meals have been casual or chaotic, establish regular family meals. Set clear expectations about what you expect your kids to do and hold your boundaries unapologetically while validating kids’ feelings about your boundaries. Hold yourself to the highest standards and avoid physical, verbal, or emotional outbursts or stonewalling. However, if your child gets violent, learn to respond to their outbursts effectively to maintain security for the whole family. Follow up with your child when things go wrong and repair the relationship. 

Fairness

Happy families know that not everything is equal, but it is fair. Rules and expectations are clearly and non-judgmentally communicated without drama, shame, or fear. They are consistently applied across the family system, not unevenly. Kids don’t wonder what they need to do to be “good” in the family, nor do they feel as if they are “bad” when they make mistakes. Consequences are given strategically, not reactively or out of anger. They are reasonable and fit the mistake. There is not a sense of shame or blame when things go wrong, just an acknowledgement of what is fair moving forward. 

If your child has an eating disorder: sometimes the person with an eating disorder is treated too gently and the other siblings feel things are unfair. Maintain expectations and chores throughout eating disorder recovery. Alternatively, sometimes the person with the eating disorder feels as if they have to do all the recovery work and nobody else in the family is working on themselves. If your child is going to therapy, it’s a good idea (and fair!) if you, the parent, gets therapy or coaching. Family therapy is also a great way to show fairness. An eating disorder is never about just one person. It’s also an interpersonal event that integrates into the family and thus requires a family-wide response.

Flexibility

A happy family realizes that circumstances change all the time. Jobs are lost, breakups happen, kids may announce a gender or sexuality you didn’t see coming. Happy families are able to learn and grow into new situations all the time because they don’t expect happiness to be a steady state of affairs. Relationships change, identities change, and each family member is able to roll with the punches of change. A happy family has a growth mindset, recognizing that life is meant to be experienced, and they are capable of being flexible no matter what happens.

If your child has an eating disorder: many people with eating disorders are stuck in a rigid and perfectionistic mindset. Rather than telling them to relax, start practicing and modeling a growth mindset in your family. Talk about mistakes and try new things. When you make mistakes, talk about them from a perspective of growth and learning (not self-recrimination). Sometimes you can make mistakes on purpose just so you can model this behavior. If you struggle with perfectionism yourself, get some therapy or coaching to expand your own flexibility. 

Your family can be happy even with an eating disorder

Parenting a child with an eating disorder doesn’t have to mean everyone is sad and anxious all the time. Sure, the eating disorder is a condition that you’re going to work on together, but it doesn’t have to define your family. With these habits, you can bring happiness to your family even as you navigate eating disorder recovery. And doing so will benefit everyone. 

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Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders. She’s the founder of More-Love.org and a Parent Coach who helps parents navigate their kid’s eating disorder recovery. Ginny has been researching, writing about, and supporting parents who have kids with eating disorders since 2016. She incorporates the principles of neurobiology and attachment parenting with a non-diet, Health At Every Size® approach to health and recovery.

See Our Guide To Parenting A Child With An Eating Disorder

We are often afraid to talk about how parents may enable an eating disorder. One reason is because we unconsciously believe that if a parent is “enabling,” they are therefore at fault or responsible for the eating disorder. So I need to start by clearly stating that parents are not responsible for a child’s eating disorder, and, by the way, the person who has the eating disorder isn’t at fault either.

✴️ As a parent myself, I prefer the less-fraught word “accommodating” to “enabling.” But since you are more likely to have heard and understand the word enabling, that’s the word I’ll use in this article.

Parent Scripts For Eating Disorder Recovery

Scripts to help you figure out what to say to help your child with an eating disorder. Use these scripts:

• At the dinner table when behavior is getting out of control
• When you need to set boundaries – fast!
• After something happened so you can calmly review the triggers and events

Learn More

Are you enabling?

OK, so we know that parents are not at fault for eating disorders, and now you want to know whether you are enabling your child’s eating disorder. And the short answer is that yes, you probably are. But remember, this isn’t because you’re bad! It’s because eating disorders cause a lot of distress for your child, and enabling is just a way that parents try to reduce distress. Enabling has a nasty reputation, but it’s really just a natural thing parents do to help their kids avoid distress. 

Let’s say your child is afraid of getting in an elevator because a man is inside yelling into his cell phone while loosely holding onto two big, growling dogs. Your child is afraid, and you understand, so you turn around and walk up a short flight of stairs to get to your destination. No problem. It makes sense, and it was easy to do. 

But let’s just imagine that after you do that one time, your child says they don’t want to go in any elevators, even if there isn’t a yelling man with growling dogs inside. Whenever you encounter an elevator with your child, they want to take the stairs. And you find it irritating (and tiring!), but you also see how scared your child gets when faced with an elevator and you don’t want to make them feel scared, so you avoid the elevator.

Anxiety escalation

Soon your child starts to sweat and shake even thinking about an elevator. So when you enter a building, you don’t even walk towards the elevator shaft. No matter how many flights there are to climb, you find the stairwell and trudge up the stairs with your child. After all, you don’t want your child to be upset. Sometimes you try to convince them that it’s safe, but nothing seems to work. In fact, getting on an elevator with your child now feels impossible. You cannot imagine them doing it. You keep taking the stairs with them.

The first experience with the man and the dogs in the elevator was a reasonable decision to protect your child from a scary situation. But continuing to avoid elevators, while it makes perfect sense and feels like the most loving, kind thing to do, is enabling your child’s anxiety. 

Tolerating distress

Enabling always starts as a reasonable accommodation. I’ve never met a parent who didn’t enable with all the best intentions. And remember, the intention is to avoid the child’s distress. But unfortunately, we know for a fact that when parents accommodate anxiety, it gets worse and more debilitating. 

In fact, the only way to overcome anxiety is to learn to get through the distress it brings. That doesn’t mean you should put your child in a dangerous situation with growling dogs. But it does mean that when doing something that is very safe, like going on an elevator without a yelling man and growling dogs, you must help your child tolerate their anxiety and use the elevator even though they feel anxious about it. The longer you enable your child to avoid the elevator, the harder it will be for them to overcome their fear and learn to tolerate an activity that is perfectly safe and reasonable.

The difference sounds like this: 

Enabling: “it’s scary, so we’ll avoid it.”

Supporting: “I’ll help you do this while you feel scared.”

Enabling an eating disorder

Let’s switch to an eating example now. Say your child came home from school one day realizing that eggs could turn into baby chicks, and they declare that they are disgusted by eggs, and the thought of eating them makes them gag. You figure that makes sense, and you don’t want your child to be upset, so you agree to change their breakfast from scrambled eggs to oatmeal – no big deal. 

But a few weeks later, your child says that eating any animal is disgusting, and they are now a vegan. Since your family is omnivorous and you enjoy cooking family meals, this is a big deal. In fact, family dinner is the only time you all sit down together, and you really enjoy eating together. Since the other family members aren’t vegan, you now have to cook two separate meals, which you don’t enjoy. But your child seems really upset about the animal thing, and you don’t want them to be upset, so you do it. 

Escalating anxiety

A few weeks later, your child says they don’t want to eat “junk food” anymore. This means you must figure out how to feed them a virtually sugar-free, fat-free, vegan menu. It’s a tremendous amount of work, but when you suggest they eat some french fries, something they enjoyed just a few months ago, they have a panic attack. They accuse you of not being sensitive to their needs and making them anxious. So you learn a new way to cook and start walking on eggshells when it comes to food.

Now you notice your child is losing weight and getting increasingly anxious. You also see them looking in the mirror and pinching their skin. They start to talk about not getting fat and worry that they’ve eaten too much. Restaurants are out of the question, and parties have become tense and strenuous. They rarely join the family for dinner anymore. You suspect they have an eating disorder, but you’re afraid to bring it up because talking about food has become impossible.

This is just one type of eating disorder + enabling presentation (there are many varieties!). And at every stage, the parent responds in the best way possible. This is not bad parenting! All of the steps they took are loving and well-meaning. They are doing their best. And they are also enabling the eating disorder. 

Parent Scripts For Eating Disorder Recovery

Scripts to help you figure out what to say to help your child with an eating disorder. Use these scripts:

• At the dinner table when behavior is getting out of control
• When you need to set boundaries – fast!
• After something happened so you can calmly review the triggers and events

Learn More

Wonderful, loving families

Almost every family dealing with an eating disorder has some form of enabling pattern. I hope I’ve made it explicitly clear that this is not because these families are bad. In fact, it’s the opposite. These are wonderful, loving families. But once you know you have an eating disorder in the family, you also have to recognize that it’s not just the person with the eating disorder who needs to recover.

Your child will need to get treatment for their eating disorder. This will require them to eat differently and think differently about food, eating, and their body. Meanwhile, you’ll need to start noticing how enabling patterns show up in your family and with your child’s unique eating disorder and begin changing the enabling patterns. Learning to stop enabling an eating disorder is extremely hard but also has a tremendous impact on recovery. 

I hope you see that none of this is parent-blaming. The parents with the most empathy are the ones who usually get into enabling patterns. You are not bad for enabling any more than your child is bad for having an eating disorder. But if you’re committed to your child’s recovery, then recovering from your enabling patterns is the key to making a difference.

Recovering from enabling

To recover from enabling patterns, parents need to: 

1. Recognize when and how you enable eating disorder behaviors
2. Change your enabling patterns
3. Tolerate your child’s distress with empathy and strength
4. Repeat, recommit, and practice daily

Like recovery from an eating disorder, ending your enabling patterns is really hard but also profoundly worthwhile. It will require tremendous fortitude and strength, but the payoff is enormous. Parenting a child with an eating disorder isn’t easy – please give yourself a lot of self-compassion!

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Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders. She’s the founder of More-Love.org and a Parent Coach who helps parents navigate their kid’s eating disorder recovery. Ginny has been researching, writing about, and supporting parents who have kids with eating disorders since 2016. She incorporates the principles of neurobiology and attachment parenting with a non-diet, Health At Every Size® approach to health and recovery.

See Our Guide To Parenting A Child With An Eating Disorder

Rachel is beside herself. “I know I need to wait for her to be motivated to recover, and I can’t do it for her, but this is excruciating!” Rachel had been watching her daughter Brooke struggle for over 12 months, and despite expert treatment for her eating disorder, there is little improvement. “This is impacting every aspect of our lives,” says Rachel. “I feel like a complete failure, but it doesn’t seem like there’s anything I can do to help.” 

Rachel is not alone. So many parents feel helpless when their children have an eating disorder. It is true that your child needs to embrace eating disorder recovery for themselves. But there are also many things you can do to motivate their recovery from an eating disorder. 

The good news is that motivation is an interpersonal experience. In other words, you can motivate recovery from an eating disorder, and unfortunately you can also have a demotivating impact on your child.

In this article I’ll review the principles of motivational interviewing, a well-known, scientifically validated method of behavior change. It’s supported by over 200 randomized controlled trials across a range of target populations and behaviors including substance use disorders, health-promotion behaviors, medical adherence, and mental health issues. And the good news is that it outperforms other common methods of treating a broad range of behavioral problems and diseases.

What is motivational interviewing?

Motivational interviewing is a way to support change by building intrinsic motivation. It is widely recognized as far more effective than what most people do, which is to educate and advise someone when we want them to change. With motivational interviewing, you stop trying to directly change your child’s behavior and start building their inherent motivation to change. It is effective because the greatest changes come from within.

Motivational interviewing is also helpful because it allows you to have more realistic expectations of yourself and your child. Many people misunderstand motivation and don’t realize that it is interpersonal. That is, while motivation is an internal experience, it is heavily influenced by the outside environment. Your words and behaviors can either increase or decrease motivation.

And the good news is that parents who use motivational interviewing are more likely to succeed at increasing their child’s motivation. They’re also less likely to become frustrated by their child’s resistance to change and relapses. This leads to significantly lower levels of parental burnout, which can negatively impact recovery.

How not to motivate someone

Most attempts to motivate other people to do things fail. But this doesn’t mean people can’t be motivated. It just means the traditional approach doesn’t work. The traditional way that people try to motivate others is: 

• Tell them what to do
• Explain why they should do it
• Give them health information and statistics
• Attempt to persuade them
• Negotiate with them
• Confront them
• Beg them

Unfortunately, these traditional approaches have a predictable effect on the person you are trying to motivate. Most likely, when you try traditional approaches to motivating your child to recover from their eating disorder they will feel: 

• Angry
• Agitated
• Oppositional
• Defensive
• Helpless
• Overwhelmed
• Ashamed
• Trapped
• Disengaged
• Dissociated

How to help your child recover from an eating disorder with motivational interviewing

You can have a tremendous impact on your child’s motivation to recover from their eating disorder if you use motivational interviewing techniques. First, you need to be clear about the fact that eating disorders are not educable disorders. In other words, all the education in the world will not motivate your child to recover. That doesn’t mean you can’t provide education. But it does mean that you should not mistake education for motivation. They are entirely different things. 

Second, it doesn’t work to bully, convince, or beg a person to change. While some people will temporarily stop their eating disorder behaviors with this approach, it does not lead to lasting change because it is inherently not motivating. 

Third, keep the focus on you. That’s right. You want to motivate your child to recover from an eating disorder, but the only person you can actually control is you. So make sure you’re keeping your attention on what you are doing. It’s all too easy to focus on what your child is doing. Instead, think about your impact on your child. 

So what should you be doing? Motivational interviewing is more motivating than giving advice and education. It’s also something active that you can practice and work on while your child recovers from their eating disorder.

Motivational interviewing: the RULE acronym

Here are 4 principles of motivational interviewing. They spell the acronym “RULE.”

R: RESIST telling them what to do

Avoid telling, directing, or convincing your child about the right path to good health. Use a collaborative process to motivate them. If you try to control your child you will shut down intrinsic motivation. Your child must maintain a sense of agency, the belief that they are in charge of their own body and life, in order to recover. This means parents need to focus on collaboration rather than coercion. Think in terms of dancing, not wrestling. You can still absolutely ask and expect your child to do things they don’t want to do, but don’t mistake that for motivation.

U: UNDERSTAND their motivation 

Your child needs to feel as if you understand how difficult it is to change and that you can tolerate their distress while they face this difficult change. Seek to understand their values, needs, abilities, motivations and potential barriers to changing their behavior. Try to understand what your child is communicating with their behavior. Don’t rely only on words, or you will miss important feedback. Behavior is a sign of emotional and physiological distress. Understanding is essential to this process because compassion, empathy, and understanding are essential to motivating someone to change.

L: LISTEN with empathy

Show them that you care about who they are and what they think and say. Here are three ways to do this: 

1. Ask open ended questions. Closed questions elicit a yes or no answer and will restrict the flow of the conversation. Open-ended questions allow them to tell their story and expand themselves. Examples of open-ended questions are “What do you think of …” and “How shall we …”
2. Use affirmation and validation. Show your child you understand their point of view by validating what they have said. Highlight their key skills, strengths, goals, and competence. Examples of affirmation and validation are “I can understand …” and “I get it …” and “It makes sense that …”
3. Reflective listening and mirroring. Listen carefully and repeat back or rephrase in slightly different words. This creates a sense of safety. This is much more effective than asking questions. You can say things like “What I’m hearing is …” or “You’re having a hard time with …” or “It feels as though …” or “It sounds like …” or “It seems as if what you’re telling me is …” or “What I’m hear you saying is …” or “I get the sense that …”

E: EMPOWER them

Work with your child to build agency and self-esteem by recognizing progress and strengths. Nobody can possibly be motivated if they feel disempowered, and yet this is so often what well-meaning parents and experts do when they give traditional forms of “motivation” like advice and information. Instead, build the sensation that they are capable of change and growth. Help them feel OK about who they are and what they are dealing with. And talk about their success now and in the past. Use a Growth Mindset to empower the sense that they can recover from their eating disorder. 

Expect resistance and relapse

One part of motivational interviewing is to expect resistance and relapse and not be thrown off by it. Resistance and relapse are part of every recovery journey. So if parents become upset and dysregulated when it happens, that can be demotivating to your child. 

Common signs of resistance are:

• Excuses
• Hostile
• Pessimistic
• Reluctant to change
• Argumentative
• Challenging
• Discounting progress or potential
• Interrupting

Expect these to show up, and respond as if you are not surprised. Instead, maintain your own emotional regulation and confidence that while this is hard, your child can do hard things. Have faith in your child’s ability to overcome resistance by themselves with your unwavering support. 

Likewise, parents should expect relapse into eating disorder behaviors that you thought were behind you. Relapse is not a sign of failure, but a part of progress. You are not going back to the beginning, you are already on your way. Stay confident and strong in your belief that your child can handle this. The goal is not to avoid relapse, but to manage it effectively. 

On the road to recovery

Rachel already feels better. “I felt so helpless before, but now I can see ways that I have been unmotivating,” she says. “I totally fell into the habit of educating and advising. But I can see how that’s not motivating her or making her feel good. In fact, it’s probably making her feel less powerful over this eating disorder.” 

With this attitude, Rachel is well on her way to improving her ability to motivate Brooke into recovery from her eating disorder. Parenting a child with an eating disorder isn’t easy, but Rachel’s doing great!

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Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders. She’s the founder of More-Love.org and a Parent Coach who helps parents navigate their kid’s eating disorder recovery. Ginny has been researching, writing about, and supporting parents who have kids with eating disorders since 2016. She incorporates the principles of neurobiology and attachment parenting with a non-diet, Health At Every Size® approach to health and recovery.

For privacy, names and identifying details have been changed in this article.

See Our Guide To Parenting A Child With An Eating Disorder