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How to use punishment, rewards, and boundaries for an eating disorder

How to use punishment, rewards, and boundaries for an eating disorder

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

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.”

Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders. She’s the founder of 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

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Parental attachment and eating disorder recovery

Parental attachment and eating disorder recovery

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

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.

Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders. She’s the founder of 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

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Habits of a happy family with an eating disorder

Habits of a happy family 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:


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


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. 


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.


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. 


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.


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. 

Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders. She’s the founder of 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

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My child is too young to have an eating disorder

My child is too young to have an eating disorder

Colleen called me in tears because her daughter Raleigh is eight years old and Colleen says “She’s too young to have an eating disorder! I can’t believe it.” I totally understand. It’s hard to believe that young kids can have an eating disorder, but in fact disordered eating can start even younger. Eating and feeding disturbances affect about 19.8% of kids ages 11-17, but some treatment programs for eating disorders start as young as age 5.  

1. Assess the behaviors

The first thing you want to do is assess your child’s eating disorder behaviors. Most people jump to conclusions about which eating disorder their child has, but it helps to review various eating disorder behaviors and consider whether they are involved in your child’s condition. 

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


Most eating disorders begin with restriction. There are three main reasons why kids restrict food: 

  • Highly sensitive to taste, texture, and other sensory feedback and/or how their body feels when they eat, for example, fullness, hunger, and nausea can be uncomfortable and lead to restriction. This sensitivity makes eating more stressful than it is for a less-sensitive child. 
  • Negative food-based experiences. If your child has experienced a recent stomach flu including nausea, vomiting, and diarrhea, or constipation, they may have developed an aversion to eating for fear their symptoms will return. 
  • Weight-loss goals. One of the biggest culprits of eating disorders is weight stigma and a fear of getting fat. 42% of 1st-3rd grade girls want to be thinner, and 81% of 10-year-old children are afraid of being fat. This can lead your child to restrict their food in an attempt to lose weight.  

Binge eating

When a body is restricted, it tends to crave food. Binge eating is often a response to a sense of being restricted. There are three main drivers of binge eating: 

  • Child-led food restriction. When a child restricts their food for any of the reasons listed above, they will become fixated on food and are likely to binge eat. 
  • Parent-led food restriction. When a parent restricts the type and quantity of food available to a child, particularly sweets and carbs, the child is more likely to binge eat. 
  • Chaotic eating. If a child does not eat regularly and enough food throughout the day they are more likely to binge eat when food is available.


There are two main reasons kids purge: 

  • Stomach discomfort. If a child binge eats, they may feel uncomfortable and over-full. This may lead them to induce vomiting in order to feel better. 
  • Fear of weight gain. If a child is afraid of gaining weight, they may induce vomiting in an attempt to rid themselves of food ingested during a binge eating episode. 

Kids may also over-exercise. Typically girls will attempt to get smaller (look like a Barbie™), but boys may try to gain muscle mass (look like a superhero). They may also use body checking as a compulsive behavior. This includes looking at their body, measuring and pinching their body, and asking parents for feedback and reassurance about their body’s appearance. 

2. Assess the circumstances

Once you have an idea of which eating disorder behaviors are active and why they are there, consider any circumstances that may be contributing to the eating disorder.

Autism, ADHD

Undiagnosed and under-managed autism and ADHD can result in eating disorder behaviors. Kids who have autism and ADHD tend to be highly sensitive to their five senses as well as their internal sensations like digestion. If your child has been diagnosed with either or both, you should evaluate their treatment and symptoms and get those under control as best you can. If you have ever suspected your child might have autism or ADHD, consider getting an evaluation. There is a lot of stigma about both of these disorders, but they can be managed, and doing so can transform a child’s life. Keep in mind that females are probably just as likely to have autism and ADHD but are much less likely to be tested or diagnosed.

Anxiety, PTSD, OCD

When a child has anxiety, PTSD, or OCD, they are much more likely to have eating disorder symptoms. If your child has been diagnosed, then please check with their therapist and/or psychiatrist to ensure they are being adequately treated for these conditions. If your child has not been diagnosed but you suspect they may have a diagnosable disorder, you can get them evaluated. Not addressing these underlying factors means the eating disorder symptoms will be harder to manage.

Life events

Eating disorder behaviors are much more likely to occur when there are stressful life events. These include divorce and remarriage, job loss, financial problems, moving, changing schools, body changes like early puberty, and a major accident or natural disaster. If your family has been going through transitions or having a hard time, that doesn’t mean it’s your fault that your child has an eating disorder, but it is likely a sign that your child needs support in managing the experience.  


If your child is being bullied about their weight, they are much more likely to attempt to lose weight. Both weight-based bullying and intentional weight loss are major risk factors for eating disorders. Weight-based bullying is very common. Unfortunately, it happens in schools, sports teams, and very often at home. Even gentle teasing by parents, siblings, and extended family members about weight can have serious consequences since we live in a deeply fatphobic culture. Consider this carefully in case you need to make some changes in your own behavior when it comes to weight. Most of us are unaware of weight stigma and how it shapes our behavior. Your child’s eating disorder is a great time to start understanding the dangers of weight stigma.

3. Find treatment

Regardless of the specific behavior and conditions, your child needs treatment for their eating disorder. There are three types of treatment to consider. 

Child-based treatment

Your child will need treatment from a team, most likely including a therapist, registered dietitian, pediatrician, and possibly a psychiatrist. These professionals can work with your child to monitor their health and determine the appropriate treatment. 

Parent-based treatment

Parent-based treatment is highly effective for childhood mental disorders. Parents are never the cause of an eating disorder, and yet parental behavior and beliefs can create an environment in which eating disorders either thrive or your child recovers. Working with an eating-disorder-trained therapist, RD, or coach can help you put a plan in place for improving your child’s home environment to optimize recovery.

Family-Based Treatment

An effective treatment for eating disorders is Family Based Treatment (FBT). This is when the parents take full responsibility for weight restoration and feeding their child. You can do FBT with the help of a specially-trained therapist. You can also work with an FBT-informed RD or coach who can guide you in a less formal approach.

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

4. Make some changes

Regardless of how you approach treatment, there are three essential steps you should take at home to support eating disorder recovery:

Structure feeding

It’s best if parents provide a structured feeding environment. Many families don’t eat together and it’s hard to manage everyone’s schedules. However, when parents are in charge of feeding their kids, kids do better across almost all measurements of health, including eating disorders. Learn about the Ellyn Satter method of feeding kids and get the support you need to make this happen.

Reduce household stress

All families face stressful events, but when families are chronically stressed it impacts everyone’s health. Seek guidance and advice from a therapist or coach who can help you reduce household stress levels. While you can’t change circumstances like divorce and financial strain, you can change the experience of feeling stressed by learning and teaching your child emotional regulation skills.

Respond to food and body anxiety

Most eating disorder behaviors are a response to anxiety. Learn to recognize your child’s signs of anxiety and respond effectively. Most parents either ignore or try to overcome anxiety with reassurance, but neither of these responses actually reduces childhood anxiety, and they may even make it worse. Learn about the SPACE method of responding to kids’ anxiety more effectively.

Having a young child with an eating disorder is not what Colleen thought she would be facing, but she took it one step at a time, and Raleigh is already making progress in her recovery. “I’m so happy to see glimpses of my happy little girl again,” says Colleen.

Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders. She’s the founder of 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 For Parenting a Young Child With An Eating Disorder

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Am I enabling my child’s eating disorder?

Am I enabling my child’s 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

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

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!

Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders. She’s the founder of 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

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How to motivate recovery from an eating disorder

How to motivate recovery from 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
motivate child recover from eating disorder

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 …”


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!

Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders. She’s the founder of 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

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Coach your child to eating disorder recovery

How to coach your child into eating disorder recovery

Ian and Melissa were stunned to find out that Jake, their son, had an eating disorder. “We didn’t see it coming at all,” says Ian. “I thought he was really applying himself to his fitness and sport, but now I can see that his behavior became more and more disordered over time.”

Ian is a high school coach, and while he doesn’t coach at Jake’s school, there’s still a lot of overlap. “I’ve been coaching Jake since he was born, practically,” he says. “I love taking him out to throw the ball and practice his swing. We’ve been playing baseball his whole life. And now he can’t play until he gets better. I don’t know what to do with him anymore.”

Melissa agrees. “It’s like our whole life revolved around baseball – Ian’s and Jake’s, and now we’ve had to change everything,” she says. “Jake can’t play, and Ian doesn’t know how to connect with Jake without talking about baseball. It’s created a double problem. There’s the eating disorder, but then there’s also the loss of this connection they had.”

I get it. Making the transition from feeling as if everything is on track to dealing with an eating disorder is a major shift. But the good news is that Ian’s background as a coach can be really helpful in eating disorder recovery. While they’re taking a break from baseball, he can use his coaching skills to connect and support Jake through recovery.

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

Here are six skills Ian can use to coach Jake through recovery from his eating disorder.

1. Know your role 

A coach has played the game and honed their skills over years of practice. But the best coaches aren’t always the best players. Because being a coach is very different from being a player. The key difference is that a coach recognizes and honors their players’ autonomy, knowledge, and strengths. 

A coach can’t get on the field and play the game. Instead they help their players do it. A coach’s responsibility is to guide, not to control. They provide support, insight, and knowledge, but never lose sight of the fact that the person they are coaching is responsible for making his or her own decisions. 

This is a great model for parenting through an eating disorder. Just like a coach, Ian can’t do recovery for Jake. But he can support Jake nonetheless. And his support will be invaluable to Jake’s recovery. Knowing his role will help him embrace what he can do to help.

2. Know the game 

A great coach knows the game inside and out. Just because you don’t currently know everything about eating disorders doesn’t mean you can’t be a great coach. But it does mean it’s time to learn. Learn about eating disorders, then, learn about your child’s own unique form of disordered eating and over-exercise. No two eating disorders are the same. 

Get to know more about your child’s co-occurring and underlying problems, such as anxiety, depression or ADHD, ASD, OCD, PTSD, etc. Learn about what is going on by reading, talking to others, and researching everything you can to help you better understand your child’s mental health.

Ian feels out of his element with eating disorders, but that doesn’t mean he can’t become an expert on Jake and his eating disorder. He can apply the same time and passion that he’s dedicated to baseball to this.

3. Ask questions

A good coach asks a lot of thoughtful questions and provides few answers. Coaches know that a great question can open up new ideas and opportunities for a player. When coaches have all the answers, the player doesn’t “own” their own game. But when a coach asks the right questions, the player takes responsibility for their performance and plays better as a result.

When working with your child, ask questions that allow your child to find out more about him or herself. Talking through problems without having your offer advice and guidance (unless expressly requested), will help your child find their own solution. When someone finds their own solution, they are more engaged in the outcome. 

Also ask questions of your child’s treatment team, not just at the beginning, but constantly. Never be afraid to ask about progress and the system the therapist is following towards recovery.

4. Listen carefully

Coaches must listen carefully and reflect back what they are hearing. During this process, the coach allows the other person to work out what they are really trying to say or do. A coach is both authoritative and humble. Coaches know their stuff and aren’t afraid to show it, but they also honor each player’s autonomy and empower them by treating them with respect.

Be humble enough to recognize that you do not know your child’s thoughts based on the simple fact that you are their parent. In fact, there is a very good chance that the fact you are a parent is making it impossible for you to guess at what your child is going through. 

When you learn to listen actively and supportively without judgment or opinion, your teenager will surprise you with how much they have to say. This is not easy, but it makes a huge impact.

5. Be organized

A coach comes to the table with an idea of what they want to accomplish with each player. Coaches know the skills their players need to succeed and are experts at recognizing who needs to work on what. Structuring practices so that everyone works on the skills they need requires organization and planning.

Talk to your child’s treatment team and find out what skills they are currently working in therapy. Ask for ways to reinforce that skill at home, and then work as a family towards that goal. 

Talk to your child about their own goals during recovery. What are some important milestones that you can help them work towards? Not all of the goals have to be about the eating disorder – life goals are just as, if not more important during recovery. Being a great coach through eating disorder recovery is a combination of organization and inspiration.

6. Leave your ego at the door

A coach must put the outcome – success or failure – in the hands of the player. A coach cannot get out on the field or force someone to achieve great results. Because great results must come from the player. 

Your child will only fully recover if they can find a way to be self-motivated. Coaches help players tap into inherent motivation by leaving their egos at the door. Coaches must disengage their success from that of the person they are coaching. Your child is not a reflection of you. Your child is a human being who needs to find his or her own way in the world.

Great coaches are not born, nor are they made overnight. The best coaches spend decades learning how to achieve the six points above. They learn through trial and error, research and deep reflection. 

Ian and Melissa don’t have decades to work with. But they have a lot going for them as loving, caring parents. And they can coach Jake through eating disorder recovery by attending to these six coaching concepts. Since we’re talking about their kid, for whom they’re willing to move mountains, I know they can do a lot to help. Parenting a child with an eating disorder isn’t easy, but they’re doing a great job!

Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders. She’s the founder of 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

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Childhood eating disorders: rates, risks, and treatment

Childhood eating disorders: rates, risks, and treatment

Childhood eating disorders have become a major concern, and parents are understandably panicked when their child needs to be hospitalized and begin treatment for these life-threatening mental disorders. Anorexia is now the third most common chronic illness among adolescents. Eating and feeding disturbances affect about 19.8% of kids ages 11-17 and often begin earlier.

We are facing increased rates of childhood eating disorders. Hospitalization rates for eating disorders doubled in 2020 compared to the prior two years. For comparison, previous studies showed that eating disorder related hospitalizations increased by 18% from 1999 to 2005. And hospital stays for eating disorders now last about 50% longer than before, suggesting more severe eating disorders. Meanwhile, there was no difference in outpatient visits or hospitalizations for other mental health conditions. This suggests that eating disorders are unique in their increase.

If you are facing childhood eating disorders, you’re not alone. Here’s some information about childhood eating disorders to help you navigate this tricky chapter of your life.

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

Types of eating disorders in childhood

Binge eating disorder: the most common type of eating disorder. It involves periods of restriction followed by periods of binge eating. Most people only look for the binge eating part. But it’s important to look carefully for the restriction that often precedes it, as it is an essential part of the cycle and should be addressed during treatment.

Bulimia nervosa: the second-most common type of eating disorder. Bulimia nervosa involves periods of restriction followed by binge eating and purging. Purging behaviors may include vomiting, laxatives, overexercise, and other attempts to expel calories consumed. As with binge eating disorder, there is a danger in only worrying about the binge-purge cycle without attending to the restrictive cycle.

Anorexia nervosa: the deadliest eating disorder. Anorexia nervosa involves periods of restriction. This may involve cutting out entire food groups like sugars, carbs, meats, and fats. It often involves skipping meals and eating tiny meals, extreme food rules, and fears that worsen over time. Most assume anorexia has a physical look (emaciation). However, someone can meet all the criteria for anorexia, including physical symptoms like low heart rate, and not meet the minimum BMI criteria.

Avoidant/restrictive food intake disorder (ARFID): the earliest-onset childhood eating disorder. ARFID involves a lack of interest in eating, extremely picky eating, and food avoidance due to reasons other than weight loss. A major indicator is a constantly-shrinking list of safe foods and increasingly limited food flexibility.

What are common eating disorder risk factors?

Weight orientation: Most people who have eating disorders have a weight preoccupation. Our society is weight-focused, so this is a risk factor for almost every child. Children who have parents who worry about their kids’ weight are at higher risk of eating disorders.

Chaotic and/or rigid eating: People with eating disorders may be very chaotic in their eating habits, which means not eating regular meals, sneaking food, and eating larger or smaller quantities than would be considered normal. They may also have rigid rules dictating which food is acceptable and cut out foods.

Dieting: Teens who diet are up to 18x more likely to develop an eating disorder, and the most common precursor to an eating disorder is starting a new diet or “healthy lifestyle.”

Body image: Kids who are worried about their body image are more likely to develop an eating disorder.

Over-exercise: A sudden increase in exercise, including rigid exercise schedules and a need to constantly move to burn calories is a risk factor and a symptom of eating disorders.

Family history: Having another family member with an eating disorder is a risk factor for eating disorders. Additionally, family member mental illness, including anxiety, depression, and substance use disorders, can indicate a genetic predisposition to eating disorders.

High anxiety: Children with high anxiety, poor distress tolerance, and low emotional regulation are at higher risk of eating disorders.

ADHD/ASD: There is a strong correlation between ADHD and ASD and eating disorders.

LGBTQ+: Children who identify themselves as or suspect they may be LGBTQ+ are at higher risk of eating disorders.

Health conditions: Health conditions requiring dietary control like diabetes, cystic fibrosis, inflammatory bowel disease, and celiac disease put a child at higher risk of eating disorders. 

Vegetarianism: People who are vegetarian are more likely to have eating disorders.

Certain sports: some sports have been highly associated with eating disorders, including swimming, gymnastics, and running. 

What parents should do about childhood eating disorders

It’s understandable if the list of risk factors is alarming to you. Young children are at risk of eating disorders, and they are not rare. However, prevention is possible, eating disorders are not a life sentence, and effective treatments are available. The earlier they are caught, the greater chance of recovery. 

If you want to prevent eating disorders: 

Not all eating disorders are preventable. However, many are. Given the massive increase in eating disorders over a short period, we cannot blame eating disorders on genetics alone. Therefore, here are the things parents can do to prevent eating disorders in their homes.

  1. Don’t diet or control your weight.
  2. Don’t focus on weight as a standard of health, and teach children that low weight is not a requirement for health, success, beauty, etc. 
  3. Don’t allow dangerous behaviors like cutting out food groups (e.g., carbs, grains, meat, sugar, etc.), dieting, skipping meals, over-exercising, and spending excessive time in the bathroom, particularly after eating. Talk about these behaviors and set limits to secure your child’s safety. Don’t worry that talking about things will make it worse. Address problematic behaviors quickly and consistently.
  4. Practice emotional literacy and emotional regulation. Eating disorder behaviors help people cope with their emotional states, so training your child to have good emotional regulation is a major protective factor. 
  5. Have at least one family meal per day. Family meals are protective against eating disorders.

If you suspect an early eating disorder: 

  1. Take your child for a physical exam and check weight, heart rate, and other vital signs. This is not the only way to find early eating disorders, but it is an essential step. 
  2. Seek individual therapy and/or family therapy to discuss disordered eating and treat other mental health conditions like anxiety, ADHD, ASD, etc.
  3. Do not allow dietary changes like low-carb or vegetarianism or new, intense exercise programs. 
  4. Work on family connection and belonging. Positive family dynamics always improve mental health, so create more opportunities to strengthen your relationships.

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

If your child has been diagnosed with an eating disorder: 

  1. Get treatment for your child as soon as an eating disorder is diagnosed. This may include hospitalization, residential treatment, or outpatient programs. Your child should see a doctor, therapist, nutritionist, and possibly a psychiatrist, especially if there are other psychological conditions like anxiety, depression, ADHD, ASD, etc.
  2. Get support and education for yourself. Find a coach, therapist, or support group to help you learn about eating disorders. You’ll need to change your behavior to create a pro-recovery household. You may also need to implement feeding programs like Family Based Therapy (FBT). It is very hard to do these things without guidance and support. You want to make sure that you are making significant changes alongside your child. 
  3. Increase emotional validation. A child facing a mental health crisis needs increased emotional validation. You are not validating the behaviors, but you are validating their feelings. Get some support and guidance for increasing your skills in this area. 
  4. Have clear and consistent boundaries. A major issue for parents facing a child’s mental health condition is that it’s very hard to set and hold clear boundaries. This is because the child is so distressed that it can feel cruel to hold them to expectations. However, boundaries are an essential part of recovery. Your child needs to know that you are strong enough to hold boundaries even when they are in distress. Also, you need boundaries for the sake of your own mental health. It will help nobody if you exhaust yourself in attempting to help your child. Parental burnout is a major risk factor for ongoing mental health problems, so your own care must also be a priority.

Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders. She’s the founder of 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 For Parenting a Young Child With An Eating Disorder

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Parental burnout and eating disorders

Parental burnout and eating disorders

If your child has an eating disorder, then there’s a good chance you’re dealing with parental burnout. This describes a parent who is mentally and physically depleted. This depletion can lead you to feel like you are failing at parenting, and, unfortunately, parental burnout is associated with worse behavior from kids. This creates an unfortunate loop of the parent being burned out, the kids behaving badly, and the parent getting even more burned out, and on and on. 

There are many reasons to address parental burnout when there’s an eating disorder, but the three most important reasons are: 

  1. Parents who have burnout deserve care and support – they are no less important than their kids.
  2. Parents who are burned out are less able to support their child through recovery.
  3. Kids whose parents are burned out sense there is a problem and may act out more, making things even harder.

An eating disorder is a major family crisis, and a depleted parent will be less effective at getting through to the other side. But burnout is not your fault. It’s a failure in the systems that should be supporting you. I’m so sorry this is happening. I hate that we don’t have better systems of care so that you don’t have to be burned out. But this is where things stand today: if you have a child with an eating disorder, you are probably burned out.

So I’ll give you some ideas for what you can do to help yourself recover from parental burnout. But first, let’s get started with more about what parental burnout is and its impact on family life. I’m afraid that if you don’t fully understand the consequences of burnout you won’t get the care you need to succeed.

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

What is parental burnout?

Feeling stressed while parenting is normal and expected. But parental burnout goes beyond expected levels of fatigue and means that you are exhausted and overwhelmed. When you are burned out, you struggle to function. 

When you become burned out, your ability to respond to both everyday and high-level stressors is reduced. Parents who are burned out feel physically and emotionally unable to connect with their kids, which can, unfortunately, lead to even more struggles with parenting. 

A 2021 study conducted by researchers at Ohio State University found that parental burnout has reached dangerously high levels since the Covid-19 pandemic began, particularly for working parents. The study found that: 

  • 66% of parents report feeling burned out
  • Women are more likely to feel burned out than men
  • Parental burnout is increased in households with 2-3 children, plateaued with 4-5 children, and increased again with 6 or more children
  • 77% of parents who had a child with ADHD and 73% of parents who had a child with anxiety reported parental burnout
  • 72% of parents who were concerned that their child could have an undiagnosed mental health condition reported burnout

Basically, burnout is common and responsive to how many kids you have and whether your kids have mental disorders.

What is the impact of parental burnout on kids?

Parental burnout can make it feel impossible to drag yourself through the day and you may feel like a failure in every aspect of your life. I’m so sorry about that. Unfortunately, parental burnout also impacts kids, which typically means they get even harder to manage than before. This can feel like an impossible situation, but don’t worry: I’m going to give you some solutions soon! 

Parental burnout is strongly correlated with depression, anxiety, and increased alcohol and substance use in the parent. Parents who are burned out are more likely to insult, scream at, criticize, and spank kids. All of these factors have significant negative impacts on kids’ behavior. In other words, when parents do these things, kids get even harder to handle, leading to even more burnout. It’s a vicious cycle.

Kids whose parents are burned out are more likely to exhibit attention issues, internalizing behaviors, and externalizing behaviors. Here’s what this looks like:  

Attention behaviors:

  • Fidgety, unable to sit still
  • Daydreams or zones out too much
  • Has trouble concentrating
  • Is easily distracted

Internalizing behaviors:

  • Feels sad or unhappy
  • Is down on themselves
  • Worries a lot
  • Feels hopeless
  • Seems to be having less fun

Externalizing behaviors

  • Refuses to share and may take things that don’t belong to them
  • Does not understand other people’s feelings
  • Fights with other children
  • Blames others for their troubles
  • Teases others

Source: Journal of Pediatric Psychology

And while I don’t have direct data linking parental burnout to eating disorder behaviors, you probably recognize some of the above symptoms in your child. They are all signs of distress, and while there can be a lot of reasons that kids are distressed, having a parent who is burned out is a major stressor for any child.

parental burnout workbook

Why is burnout common when parenting kids with an eating disorder?

It’s probably pretty obvious why parents who have a child with an eating disorder are at high risk of parental burnout. The constant stress of having a child with a major mental disorder is exhausting, and it can feel as if you have no options. The healthcare system does an inadequate job of helping parents who have kids with eating disorders cope. In fact, many times there is no support for parents or the advice is ignorant and even harmful. It’s rough. I’m so sorry. 

Based on the data available, we know that 72% of parents who worry their child has an undiagnosed mental health condition, 77% of parents who have a child with ADHD, and 73% of parents who have a child with anxiety report they are suffering from burnout. I think it’s safe to say that at the bare minimum 72% of parents who have kids with eating disorders have burnout, though I would guess it’s even higher based on my experience. 

And it’s no wonder. Our healthcare system is not structured to adequately and comprehensively care for people who have eating disorders and their families.

Recipe for parental burnout with an eating disorder

Burnout was initially recognized in the workplace. Here’s the recipe for burnout when you’re facing an eating disorder:

  • Lack of control: having a child with an eating disorder means you feel you are unable to influence their health, and you may lack the resources you need to parent effectively.

  • Unclear job expectations: you are likely unclear about the degree of authority you have or what your child who has an eating disorder, their treatment team, your other children, your spouse, and others expect from you. It’s unlikely you feel comfortable while parenting, which is stressful.

  • Dysfunctional dynamics: you may feel bullied by the eating disorder, micromanaged by your child’s anxiety, criticized by your other children, and undermined by your partner or spouse. This contributes to parenting stress.

  • Extreme activity: parenting with an eating disorder is typically chaotic. The constant demands placed on you, combined with the fear and anxiety about your child’s disorder demand intense energy in order for you to remain focused on the task at hand, which can lead to fatigue.

  • Lack of social support: most parents who have a child with an eating disorder feel isolated and unable to talk about what they are dealing with when talking to friends and family members. This lack of support leads to more stress.

  • Imbalance: parenting a child with a mental health condition takes up so much time and effort that it seems impossible to invest energy in your own needs and pursue activities that fill you up. As a result, you can easily feel depleted. 

How do you know if you have parental burnout when dealing with an eating disorder?

Many times you can sense that you are burned out. It’s completely fine to self-diagnose yourself. In general, be on the lookout for these symptoms of burnout: 

  • Irritability
  • Fatigue
  • Changes in sleep and/or appetite
  • Mood swings
  • Feeling like a failure
  • The sense that you are underwater
  • Complete overwhelm

What sets parental burnout apart from regular stress is that it negatively impacts daily functioning. Basically, you are less productive and effective and struggle to accomplish tasks that used to feel manageable.

What can you do if you are burned out from parenting a child with an eating disorder?

I know you have a lot going on with your child’s eating disorder. And while you need to continue the work of helping your child recover, you also need to care for yourself. As you know, when parents are burned out, kids do worse, not better. So if your lifestyle right now is leading you to burnout, then it’s essential that you get the support you need and deserve to feel better. Recovering from burnout takes effort, which is cruel since the primary symptom of burnout is the lack of energy to do anything. But you need to invest in yourself to recover from burnout. The consequences of not recovering are serious, so please reach out for help! 

Recovering from burnout is not unlike recovering from an eating disorder. It is essential to your health and wellness, and when you are burned out, everyone suffers. So this is not optional or selfish. You need to recover from burnout to operate effectively as a parent. Here are some ideas: 

1. Do less

It’s time to “Marie Kondo” your life. You probably have a lot on your plate right now. And there are a lot of things that were previously enjoyable and wonderful that may not be bringing you joy right now. Look at your life critically and decide what you can stop doing. This is urgent. Can you stop driving the kids to school? Maybe your child can unload the dishwasher so you can stop doing it. Can your neighbor walk your dog? List as many things as possible that you can stop doing, and stop doing them immediately. This can be temporary for as long as you’re dealing with the eating disorder, but don’t skimp on this step, as it is essential! You cannot reduce burnout if you don’t reduce what’s on your plate.

2. Non-negotiable self-care

No matter how busy you are, you have to prioritize non-negotiable self-care. Seriously. You don’t have the option of not taking care of yourself, because taking care of yourself is essential to taking care of your child who has an eating disorder. Sleep at least 7 hours per night. Move your body for at least 10 minutes per day. Drink 6-8 glasses of water. Feed yourself at least every 3-4 hours. And, most importantly, connect physically and/or emotionally with someone for 10 minutes per day. This could be asking your partner to cuddle with you on the couch (just make sure you aren’t doing anything else like scrolling through your phone). It could be calling a friend to talk about a TV plot line or crying about how hard your day was. If you can’t fit these essential self-care steps into your life, then go back to step 1 and figure out what you need to stop doing.

3. Take breaks

Even a 5-10 minute break a few times per day will help. During these mini-breaks, listen to your body. What feels right? Consider staring into space, guided meditation, stretching, drinking a cold glass of water or a hot cup of tea, walking around the block, or maybe dancing to Rage Against the Machine or the Mama Mia soundtrack. Do whatever feels good to you at the moment – make sure it is something that only benefits you! It doesn’t count as a break if you’re doing it for someone else.

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

4. Give yourself more love

Most of us are really mean to ourselves, and it often gets worse when we are burned out. We would never speak to our friends the way we criticize and berate ourselves. Start talking to yourself as if you are your best friend. Be kind, thoughtful, and understanding when things aren’t working out for you. Practice self-compassion. Research shows that people who practice self-compassion perform at much higher levels than those who do not. But even if there were no productivity benefits, being nice to yourself is the right thing to do!

5. Talk about it

Stay connected to family and friends, and pick at least one person to whom you can talk about the eating disorder. Shame thrives in secrecy, so bring it out of the shadows and talk about your experience with the eating disorder. It can be tricky to figure out the boundaries here, but a good rule of thumb is that you get to tell your story of the eating disorder, but not your child’s story of the eating disorder (because that’s theirs). It may be helpful to tell your friend in advance whether you’re looking for advice or just a compassionate ear. Hint: most of the time you’ll just want them to listen.

6. Ask for help

I know it’s hard, but you need to expand your help networks. Ask for help with meals, childcare, driving, and everything else you are struggling to fit into your day. Reach out to family and friends, neighbors, and online communities. We are social creatures, and we’re not supposed to handle life alone. Think of how good it feels when a good friend asks you for help, and remember that when we ask for help our friends usually feel honored and will help if they can. When you’re burned out you tend to get tunnel vision, and you believe that you have to personally do everything. This is a cognitive distortion. Reach out and get the help your community can give you.

7. Get professional support

Dealing with an eating disorder is not a small undertaking. Most of our care systems focus almost entirely on the person who has the eating disorder, but that leaves parents in the dark and they become prime candidates for burnout. Find a coach or therapist who can work with you to help you understand the eating disorder, your role, and how you can help your child recover. You don’t have to (and you shouldn’t) do this alone!

If you are suffering from parental burnout while your child has an eating disorder, it makes perfect sense. Please get the support and resources you need to start feeling better!

parental burnout workbook

Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders. She’s the founder of 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

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How to handle the Fourth of July with an eating disorder

How to handle the Fourth of July with an eating disorder

Jamie is worried. Her 13-year-old daughter Kayley has an eating disorder, and their annual family reunion for the Fourth of July is around the corner. This event is typically a highlight of their year. Filled with family and friends, four generations, and lots and lots of food. 

“I just can’t imagine how we are possibly going to do this holiday with Kayley’s eating disorder,” says Jamie. “How are we going to feed her, and what will I do when my mom inevitably comments on Kayley’s weight? It’s going to be a disaster if I can’t figure out how to handle this.” 

Jamie is not alone. Lots of parents have to decide whether to attend Fourth of July events and, if they do, how to make it as safe and fun as possible for everyone.

Check with your treatment team

The first thing to do is check with your child’s treatment team. Of course this event is a big deal for you and your family. But an eating disorder occurs on a huge spectrum from manageable to medically dangerous. Depending on where your child is on that spectrum right now, you may need to make the difficult choice to skip this year’s reunion. 

I know this is devastating, and I’m sure you would rather not. But please keep in mind that if your child is medically compromised by their eating disorder, then you are essentially in a similar position as someone who has a child who is in chemotherapy and is immuno compromised. While technically they can go to a family reunion, their doctor may suggest skipping it this year to maintain optimum conditions for recovery. 

If this is the case for you, I’m sorry. But an eating disorder doesn’t have to be forever, so hopefully this is a one-year change of plans with long-term benefits. 

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

Plan for feeding and eating 

Depending on your child’s eating disorder and stage of recovery, you may expect them to maintain a rigid meal plan, or you may agree to be more flexible during the event. Either way can work for a medically stable person who has an eating disorder, but make sure the decision is made up front and not in response to the conditions at hand. 

You’ve been to this event before so you know approximately what will happen. Is eating typically chaotic and random? Or is it formal and pre-planned? Given this information, plan how you will maintain your child’s need to eat regular, full meals every day. If you can fit in with the way your family operates every Fourth of July, that’s great! It would be wonderful if your child can join everyone else in eating. If not, maybe you can work in a few stable meals between group activities. Or you can plan to feed your child completely separately. 

You have a lot of choices. Don’t let them take you by surprise once the event is underway. Make them in advance and then stick to the plan when you’re there.

Check with your child

Next you need to talk to your child about the event. I wouldn’t put the decision of whether to go or not in your child’s hands. I know this is tempting, and our cultural norm is to empower kids to make their own decisions. But in this case, giving your child the power to decide whether your family will attend a reunion is too much pressure, especially if they have an eating disorder, which means anxiety is high. 

Instead, approach your child thoughtfully with the fact that you will go to the reunion this year, and then set your expectations in terms of the feeding and eating plan that you established. While you do want your child’s engagement in planning for the event, they should not feel they bear the responsiblity of keeping their care on-track. That should be yours to handle.

Also talk about how stress can trigger anxiety and eating disorder behaviors and have a plan in place for dealing with that. Mainly, you want to give your child permission to have feelings and be uncomfortable sometimes. It’s going to happen, so don’t turn something natural into a shameful event. Instead, set up expectations for how your child will recognize and respond to their feelings of anxiety and urges to engage in eating disorder behavior. 

This is not a one-and-done conversation. It is multiple conversations that should take place before and during the event.

Identify the “problem” family members

Every family has its combination of easy-going and more problematic family members. Take some time to think through who will be there and any potential disasters. For example, is your uncle Harry a known dieter who loves to share how many calories he’s restricting himself to and then names how many calories are on everyone else’s plate? Is your sister Jenny doing Whole 30 or Intermittent Fasting? Does Grandma tend to talk about people gaining and losing weight?

Make a list of the family members who may say things that will negatively impact your child’s eating disorder recovery and consider how to handle them.

Depending on your relationship with them, here is what I recommend: 

  1. Make a quick phone call or send a text telling them that your family is dealing with some body image issues and you hope they understand that it would be best if they didn’t mention dieting, weight loss, or weight gain. You do not have to tell them about the eating disorder unless you want to. A boundary does not require full disclosure or understanding to be valid or effective. 
  2. If they are offended by this, then you know to steer clear (and steer your child clear) of them during the reunion. It’s OK to prioritize your child’s health over being around people who refuse to respect your boundaries and requests.
  3. If they say “no problem,” then stay near your child and monitor conversations. Most people don’t even realize they are talking about dieting and weight loss when they do it because it’s such an integral part of their socialization. But just because no harm is intended does not mean it’s OK. You can change the subject, ask them to stop, or simply leave the conversation. 
  4. Talk to your child regularly throughout the event to find out if anyone has said anything upsetting. If they have, you don’t have to storm off and make a big deal about it. It’s in the past. But you can talk to your child about what happened and help them process it. Most of the time we don’t have to force other people to change in order to help our child feel better.

Stick to your plan

One thing that often happens at family reunions is that we get distracted by activities, people, and the chaos of being together. This is a lovely part of seeing people we know and love. But you do need a bit of extra dillgence this year to account for the eating disorder. 

For example, you may be tempted to relax the meal plan because it’s too complicated or feels too disruptive. Or maybe someone questions your decisions or makes you feel bad about doing things differently this year. But if you’ve committed to a meal plan before the event, avoid changing it due to circumstances. While flexibility is wonderful, it should not be applied to feeding when there’s an eating disorder.

Similarly, you may wish you could ignore relatives who say things that trigger your child’s eating disorder because you just want to relax and have a good time. That makes a lot of sense, but your child needs to know you’re paying attention and keeping them in mind even when it’s inconvenient. 

The basic advice for handling a big event like a Fourth of July party during an eating disorder is to make a plan, talk about the plan, and stick to the plan. Don’t avoid doing this even (especially) when it’s hard. Your strong efforts this year will pay off for years to come.

Jamie’s 4th of July

Jamie thought carefully about her family reunion in light of the eating disorder. Kayley’s care team said it was safe for her to go away for the four-day weekend, and Jamie planned out the meal structure and talked to a few problematic relatives. It was stressful for Jamie to talk to her mom especially. 

“I know how much she loves Kayley, and the last thing I want to do is make her feel bad,” says Jamie. “But I knew it was important, not just this year, but forever. Now that we’ve faced an eating disorder, things have to change. We can’t act like nothing has happened, and I can’t let diet and weight talk seep into our lives again. Of course people are going to do what they’re going to do, but I can at least set expectations.” 

And while Jamie’s mom assured her that she would not say anything, in the chaos of the reunion a few things did slip out. But Jamie gently redirected the conversations and it was actually helpful, she said. “My mom has never heard of the body positive movement, and she really hasn’t thought about how toxic it is to talk about other people’s weight. I feel like this gave us a good opportunity to talk about that. She was surprisingly open and curious, which was really helpful.” Holidays with an eating disorder can be tough, but Jamie’s doing a great job!

Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders. She’s the founder of 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 Parent’s Guide To Holidays With An Eating Disorder

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Sending your child to summer camp with an eating disorder

Sending your child to summer camp with an eating disorder

Summer camp is a great opportunity for your child who has/had an eating disorder to feel a sense of belonging, community, and independence. And since these things are essential to mental health, summer camp can be a great prescription for moving forward and embracing recovery. Here are six things to consider if you’re thinking about sending your child with an eating disorder to summer camp.

1. Medical stuff first

Before your child can go to camp, they need to be cleared medically and psychologically. This doesn’t necessarily mean they need to be 100% free of their eating disorder, but they should, at a minimum, not be medically underweight or have active complications like low heart rate, blood pressure, etc. 

Talk to your child’s doctor, therapist, and dietitian and get their opinion. Will the challenge of summer camp be a positive experience, or is it too risky? It’s really helpful for kids who have eating disorders to be with peers and to feel connection and belonging, and summer camp is a great place for that. It’s also a great place to try their healthy coping skills and stretch their independence. So be sure to ask your providers to consider the benefits as they make their recommendation.

Now, check your gut: do you think your child is stable? This is an intuitive choice you need to make, so read the rest of this article and then spend some time sitting with your options. 

Finally, consider which duration is best for your child. This may not be the year for a month-long camp, but perhaps a week or two weeks would work. Consider the duration based on your intuition of how stable your child’s recovery is right now.

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

2. Monitoring for trouble

Ideally your child should be stable enough in their recovery and you have chosen a duration that makes sense based on where they are in recovery. Those are important considerations, since I suggest you avoid making too many special accommodations during their time at camp. 

You may ask the camp nurse to weigh your child mid-way through a 2-week camp session if you believe that is necessary. You may also ask the camp staff if they can monitor whether multiple meals are skipped and alert you to that. 

But if you are asking for a lot more than that to accommodate your child’s eating disorder, it may be a sign that this is not the right year to do summer camp. The camp cannot step in and take the place of yourself or your child’s treatment team. If your child needs more support for their eating disorder, then it may not be the right time for summer camp.

3. Sending special food and other accommodations

Summer camps are structured and have a lot of rules. Those rules are there for a reason. In some ways, they are there to make the camp counselors’ jobs easier. But in a lot of ways those rules mirror social expectations and norms. Rules are a natural and essential part of belonging to a group.

If you find yourself making special requests for your child because of their anxiety and eating disorder, then pause. Look out for your desire to accommodate your child and consider if it’s serving recovery or maintaining the disorder.

I suggest that as much as possible you set the expectation that your child is a normal camper. They should eat the same food, have the same sleeping arrangements, do the same activities, and have the same communication standards as other campers. That, after all, is the point of camp. They are all in the same place at the same time, living under the same rules and expectations. That’s how camps build a sense of belonging. And belonging is exactly what your child needs to embrace recovery.

Avoid sending them to camp with a special diet or sewing a secret cell phone into their pillowcase for emergencies. The point of camp is that every camper is the same – that’s the beauty of it, and that’s where your child will gain the benefit of belonging and community. If you treat them differently, they will not get those benefits.

Finally, do not make an agreement in advance that you will pick them up early if they get uncomfortable. You need to set the expectation that they will stay the whole time. Don’t send them if you don’t believe they can make it. An anxious child will naturally feel anxious at camp sometimes. They will naturally reach for an “out” if it’s there and ask you to come and get them. Make sure you haven’t set up the expectation that they should call you to remove them from camp at the first hint of discomfort. Getting through discomfort is one of the benefits of summer camp.

4. Dealing with their worry

The most important thing about summer camp is to expect your child to be worried. Your child will feel worried and anxious about leaving home, about being in a different environment, and about meeting other people. Help them understand that worry is a normal part of trying new things, but that we don’t let worry make important decisions for us. The goal is for them to feel worried and do it anyway. That’s a key skill to emotional regulation and mental health, so don’t miss the opportunity to talk to them about it.

Don’t try to answer every question, instead, help them learn to tolerate the uncertainty of doing something different. Think of this as an emotional training camp. They will learn to handle worry, and they’ll probably have a great time while doing it.

Finally, avoid automatically jumping in to solve problems that are your child’s problems to solve. For example, if they are worried about making friends, don’t tell them how to make friends. They know how to make friends! They are just worried. And it’s OK to be worried. Help them feel their worry and solve their own problems rather than jumping in to solve their problems for them. That’s not the path to independence or emotional health.

5. Dealing with your worry

You are going to be worried. Your child is going to summer camp and they have/had an eating disorder. Expect your worry to show up, and deal with it with other adults, not your child. Look for your own anxiety and seek support from people you trust. 

If you tend to get worried, then be careful about the daily photo dumps that often come from camps. These photo dumps can send parents into a tailspin of worry. Desperately trying to find your child in the crowd and then carefully evaluating their facial expression and those on the faces around them can ruin your whole day. Review the photos (if you care to) when your child gets home. I’m certain you picked a safe camp. You don’t need to monitor your child’s safety through photographs!

Finally, be open to everything being fine. You will have worry, and your child will have worry, but that doesn’t mean they won’t have a great time at summer camp. They may surprise you … I hope they surprise you! Let them!

6. Communicating while they’re there

The camp should have clear rules about communication between campers and parents. Like all camp rules, these are structured on purpose to build belonging among the campers as well as independence for your camper. If you violate these rules, you risk the greatest benefits of going to camp. 

First, don’t call the camp every day to check on your child. They will call you if there’s a problem!

Next, don’t set up special communication with your child. Remember that the rules and norms are there for a reason, and you should follow them. I’m a big fan of camps that have a zero cell phone policy and don’t have campers call home mid-week. Let your child find the freedom, joy, and uncertainty of not reaching for their phone every 5 minutes to check in.

Finally, don’t panic if your child tells you they don’t like something. It’s normal not to like stuff! If your child complains about something, wait at least 24 hours before trying to resolve a possible problem. Wait as long as you can. Unless the camp calls you, then it’s probably fine. We’re talking about one week, not months. Each day at camp is different, and a miserable camper on Day 1 could easily be a happy camper on Day 3. Hang in there and trust the process.

The goal of camp

The goal of summer camp is to help your child build belonging and connection with peers as well as personal autonomy and independence, all of which will support eating disorder recovery. You want them to navigate the world as a healthy child who can tolerate being a little uncomfortable, grumpy, unshowered, and sunburned sometimes. That’s normal life! Camp doesn’t have to be perfect to be great!

That said, if everything I’ve said has made you very nervous, then maybe wait this year out and try again next year when you’re both feeling more stable. Parenting a child with an eating disorder is never simple, so use your best judgment.

Interesting article: Now Is the Time to Reboot Summer Camp

Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders. She’s the founder of 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

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Eating disorders in children: symptoms, evaluations & treatments

Eating disorders in children: symptoms, evaluations & treatments

Eating disorders are a serious problem, and young children are not immune to their symptoms and complications. About 9% of the U.S. population, or 28.8 million Americans, will have an eating disorder in their lifetime, and most begin in childhood or adolescence. The number of children with eating disorders has increased significantly since 2000. One study found that hospital admissions among adolescents with eating disorders more than doubled during the first year of the COVID-19 pandemic. Furthermore, eating disorders and their symptoms now occur in more children under 12 than before.

There are many reasons why an eating disorder arises in childhood. First, there are hereditable and genetic components to eating disorder development. But that genetic predisposition does not explain the massive rise in eating disorders in recent decades since our genes don’t change that quickly. 

Environmental factors play a significant role in eating disorder development. One of the biggest culprits is weight stigma. About 42% of 1st-3rd grade girls want to be thinner, and 81% of 10-year-old children are afraid of being fat. This societal fear of weight gain shapes a child’s psychology around eating and growth and can easily disrupt a healthy relationship with food and the body.

Then there are psychological and family influences. For example, stress and anxiety are frequently associated with eating disorder onset, meaning a major disruption like COVID-19 naturally increased rates of eating disorders, which can become a powerful coping mechanism. How parents and families respond to eating disorder behaviors can influence treatment outcomes.

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

What are the common symptoms of eating disorders in children?

Children with eating disorders have many symptoms. Most people think that an eating disorder has a “look.” But only 6% of people diagnosed with an eating disorder are medically “underweight.” Most eating disorders are not physically obvious, and the behaviors may easily fly under the radar since we live in a culture in which dieting and food restriction are considered normal.

Here are some signs that a child has an eating disorder

  • A sudden interest in calories, ingredients, fat content, carbs, and other nutritional data
  • Eating too fast or too slow
  • A shrinking list of things they will eat
  • Worrying about “getting fat”
  • Showing fear when eating or thinking about eating
  • Secret eating or lying about eating
  • Significant weight changes that cannot be explained by natural growth
  • Over-exercise
  • Frequently checking body weight and appearance
  • Mood disruptions and mood swings 
  • Skipping meals
  • Significant changes in clothing, makeup, and appearance
  • Friendship disruptions and losses
  • A negative change in school performance
  • Behavior that is either more aggressive or withdrawn than before

Quiz: does my child have an eating disorder?

Eating disorder symptoms in kids

Eating disorders in a young child can be hard to spot, particularly since there can be a lot of weight fluctuations through various growth stages.

This is why weight is only rarely a useful measurement of an eating disorder. Paying attention to your child’s relationship with food, weight, and exercise will give you the best indication of whether your child is struggling with disordered eating or an eating disorder. 

Early and comprehensive intervention is best, so don’t hesitate to consult with an eating disorder-trained registered dietitian if you are concerned.

Except in extreme cases in which weight is clearly below the standard weight trends on a BMI chart, weight can be an imperfect measure of an eating disorder. Parents should pay attention to other symptoms, including the child’s relationship with food, their weight and appearance, and how much they are exercising. 

Relationship with food: 

  • Has your child suddenly cut out meals, certain foods, or entire food categories? For example, are they skipping breakfast and lunch, no longer eating ice cream, which they loved before, becoming a vegetarian, or cutting out carbs? 
  • Does your child seem uncomfortable with food? Are they playing with their food at the table, avoiding eating it? Or are they eating very quickly and don’t appear to be savoring their food like they used to? Have they stopped eating with your family, preferring to eat alone?
  • Has your son started using dietary supplements and protein shakes? Sometimes parents miss this sign of eating disorders in boys, who may be interested in becoming both leaner and more muscular.

Weight and body image: 

  • Has your child suddenly started weighing themselves regularly? Do they seem obsessed with the number on the scale? You might not know this if the scale is in the bathroom. Get rid of all scales in your home and see what happens.
  • Does your child check their body in the mirror more than before? Are they pinching their flesh questioningly or disgustedly?
  • Has your child started asking you repetitive questions about their weight and appearance?
  • Is your child wearing very baggy, loose clothing to hide their shape? 

Relationship with exercise:

  • Has your child recently joined a sport like cross country running or other sports where participants tend to be very lean?
  • Is your child exercising daily when they used to exercise little or not at all?
  • If you go on vacation, is your child insistent that they must be able to exercise while you are away? 
  • Is your child exercising constantly, always wanting to be moving? Do they exercise secretly in their room?

Eating disorders in children: medical testing and diagnosis

A physical exam may include measuring weight and height and checking vital signs. Typically this includes: 

  • Heart rate
  • Blood pressure
  • Temperature
  • Heart and lung function

A doctor may also check skin, nails, and teeth for problems and conduct a general physical exam. Lab tests may be used to further evaluate health, including: 

  • Complete blood count (CBC)
  • Electrolytes
  • Protein
  • Liver, kidney, and thyroid function
  • Urinalysis

X-rays may be done to check bone density, assess for fractures or broken bones, and check for pneumonia or heart problems. Occasionally an electrocardiogram will look for heart irregularities.

Keep in mind that while Anorexia Nervosa does have a weight limit to aid diagnosis, the majority of eating disorders will not include low weight, medical complications, or any measurable physical signs. A doctor’s visit in which everything looks normal does not mean your child does not have an eating disorder. Eating disorders and their symptoms in children are a delicate subject that you want to approach thoughtfully and assertively.

Very few doctors have formal training in eating disorders. This means that while they can be useful in identifying and monitoring physical complications, they can rarely help with the behavioral symptoms of an eating disorder. If your child has medical complications as a result of their eating disorder then it’s best to find a physician who is a Certified Eating Disorder Specialist (CEDS) or is getting consultation from someone who is. 

One of the best professionals for eating disorder diagnosis and treatment is a registered dietitian who has the CEDS certification and/or formal training in eating disorders. They are trained and qualified to identify and treat the nutritional symptoms of an eating disorder and can typically direct you to other healthcare providers who can help.

Binge-type eating disorder symptoms 

Statistically, the most common eating disorder symptom is binge eating. This includes repeatedly eating a large quantity of food in a short period. Most people who binge eat report an altered state in which they feel numb or unaware of what they are doing. It is also important to know that most people who binge eat go through cycles of restriction first. If binge eating is part of your child’s diagnosis, make sure their treatment addresses food restriction first. Without changing the patterns of restriction, it’s unlikely that treatment for binge eating will be successful.

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

Restrictive-type eating disorder symptoms

Most eating disorders involve some form of restriction. This means your child intentionally avoids eating even when they are hungry or even starving. Most people who restrict feel strong and powerful when they overcome the physical sensation of hunger and skip a meal or eat less than they would have before the eating disorder. However, ARFID (Avoidant Restrictive Food Intake Disorder) is an eating disorder in which the person is not restricting for weight loss purposes but rather eats less due to sensory complications with food, eating, and digestion.

Purge-type eating disorder symptoms

Bulimia features purge behaviors, but all eating disorders may involve some form of purging. Common forms of purging include vomiting and laxative use. Most people who purge begin doing it to rid their bodies of food that they believe is “too much.” They believe they will gain weight if they don’t purge. However, over time, purging can become a powerful form of self-soothing, and it isn’t necessarily tied to weight loss. 

Exercise-based eating disorder symptoms

Many eating disorders involve some form of over-exercise. Most people begin a new exercise program to slim down and eliminate calories consumed. They believe that if they exercise enough every day, they will avoid weight gain and lose weight. Often exercise becomes compulsive, and it will be hard for your child to stop doing it for any reason. Some people with eating disorders will exercise in their bedrooms and in secret to achieve the fitness goals they have set for themselves.

Body image eating disorder symptoms

Most people who have eating disorders (except for ARFID) feel bad about their bodies. They believe their bodies don’t appear healthy or good and pursue weight loss and exercise programs to try and shape their body into what they believe they should look like. In girls, this typically means weight loss. In boys, it may look similar or involve a desire to be both lean and muscular.

Combined type symptoms

Most eating disorders evolve in children, so you often see a combination of symptoms. Bulimia is the most multi-faceted eating disorder, as it features all symptoms (though not always exercise). But even a person who has typical anorexia may sometimes binge eat or purge. During diagnosis, your child’s most pressing symptoms will be evaluated to develop the best label for treatment and insurance reimbursement.

Eating disorders in children: how a diagnosis is made

People who can diagnose an eating disorder include: 

  • Medical doctor
  • Registered dietitian
  • Psychotherapist 
  • Psychiatrist

It is best to find a professional who has received formal training in eating disorder diagnosis and treatment. Look for a Certified Eating Disorder Specialist (CEDS). One of the easiest and best ways to get a diagnosis for an eating disorder is by a Registered Dietitian who has the CEDS credential. They are more common and easier to access than a physician with that credential.

Eating disorders in children: how treatment is prescribed

Treatment is prescribed based on the diagnosis, specific behaviors observed, and the severity of the health outcomes. Depending on the situation, your child may be recommended to one of the following treatment options: 

  • Hospitalization 
  • Residential treatment
  • Intensive outpatient treatment
  • Personal treatment team: doctor, RD, therapist, and psychiatrist if needed

I strongly recommend finding professionals who explicitly embrace a non-diet, Health at Every Size® (HAES®) approach. In my experience, weight-neutral care, in which the provider is not using weight as the most important indicator of health, is essential to full eating disorder recovery.

See our directory of HAES®-aligned providers

In almost all cases, parental and family engagement will vastly improve treatment outcomes. There is strong evidence for Family Based Treatment (FBT) when weight gain is necessary. Family therapy and parent coaching are very helpful in supporting parents who want to optimize their child’s chance of full recovery.

Eating disorder or disordered eating?

Many parents will wonder if their child truly has an eating disorder or disordered eating. This typically doesn’t happen with classic cases of anorexia which include weight criteria. All other eating disorders do not have weight criteria and therefore leave more room for debate. 

I encourage you not to worry about the exact diagnosis. Many people who have disordered eating will move on to a full-blown eating disorder, and even if they don’t, they can live their lives with a sub-clinical but severely life-limiting problem. 

The bottom line is that if your child’s eating behaviors, relationship with food, feelings about weight and their body, and the way they exercise are disordered, then you want to treat those problems quickly and assertively.

Full recovery and a healthy, full life are possible for your child.

Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders. She’s the founder of 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 For Parenting a Young Child With An Eating Disorder

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The risks of accommodating an eating disorder

The risks of accommodating an eating disorder

Rachel was at the end of her rope. After years of trying to help her daughter Lily claw her way out of anorexia, it simply wasn’t getting any better.

Sure, there was COVID to blame. The pandemic made Lily even more socially isolated, and online treatment didn’t seem to be as effective. But overall, Rachel knew that Lily’s problem pre-dated the pandemic. And she was worried that it would extend way beyond the pandemic if something didn’t change fast. 

“The truth is that I’m completely burned out,” says Rachel. “This is my last hope. If this doesn’t work, I really don’t know what I’ll do or how I’ll keep this up. Something’s got to give.” 

Rachel has decided to try a treatment program called SPACE that focuses on changing her own behavior rather than trying to change Lily’s behavior.

“It’s just been a brick wall to try and convince Lily to recover,” says Rachel. “I know I’m not supposed to say this, but she just isn’t choosing recovery. She’s not taking any steps on her own to get better.”

Rachel is struggling under the caregiving burden. “When she was younger, she was a bit more self-sufficient, and being at school motivated her,” says Rachel. “But now she’s done with school, and she’s doing almost nothing. She lives with me, and I try to feed her six times per day like I’m supposed to. She’s nowhere close to feeding herself, and I can’t see her being able to get a job or move out.”

Rachel, like so many parents and caregivers, is terrified for her daughter. She’s also frustrated and fed up. Her diligent, valiant work feels like a drop in the bucket. The eating disorder is powerful, and she’s losing hope.

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

What is accommodation?

When someone is afraid of something, they naturally want to avoid it. 

Parental accommodation is a way that parents make it easier for their children to avoid doing the things that scare them. 

If your child screams when they see a spider, you whisk it away quickly and then soothe your child, trying to calm them down as soon as possible. This accommodation makes perfect sense.

But the next day, your child asks you to check under their bed for spiders before going to sleep. This, too, makes sense to you. You accommodate their wishes – it’s not a big deal! 

But the next day, your child asks you to check that their windows are locked tightly and check under the bed, scan the walls, and peer into the darkest corners of the closet with a flashlight to ensure there are no spiders. 

The accommodation snowball effect

You can see where this is going. Your child’s fear of spiders makes sense. But their avoidance of possibly encountering a spider ever again is becoming a problem. Even though you sense it’s wrong, you can’t imagine not accommodating them because they get so upset just thinking about spiders. It seems faster and easier to do what they ask than to convince them to go to sleep without it.

Sometimes you try to talk your child out of it. You prepare deeply-researched and highly-rational arguments to persuade them that spiders aren’t scary or dangerous. Sometimes you lose your temper and yell that you aren’t their personal spider valet and you won’t do this tomorrow night … this is the last time! 

But, of course, the next night, your child cries and seems so terrified that you give in one more time and look in all the nooks and crannies. Later they come into your room at midnight, wake you up, and beg you to check again.

You’re half asleep, and it seems like less trouble to just look than to try and convince your child there are no spiders, so you grudgingly get up, stomping your feet and huffing as you walk to their room and look in all the corners for spiders. 

You’re feeling angry, but you can’t see a way out of accommodating your child’s avoidance of possibly seeing a spider. You feel trapped and frustrated, stuck in a web.

How does accommodating impact eating disorders?

I started with a spider story because it feels less charged than an eating disorder. Eating disorders are complex, multi-layered mental disorders. Also, parents are not responsible for either their child’s fear of spiders or their eating disorder. It typically doesn’t work that way.

But parents may be responsible for accommodating their child’s anxiety-driven eating disorder behaviors.

Parental accommodation is called a “maintaining factor” in eating disorders. This means that it is not the cause of an eating disorder. But accommodation can make it easier for an eating disorder to dig its heels in and stick around for the long haul.

Eating disorder accommodation examples

There are many ways parents accidentally accommodate eating disorder behaviors. Let’s break down how accommodating can sneak into some of the common eating disorder recovery goals:  

  • Goal: have the child eat regular, healthy meals.
  • Accommodation: the child cries and yells at the dinner table. The parent becomes so distressed that they excuse the child before the meal is finished.
  • Goal: cut down on ingredient checking and calorie counting
  • Accommodation: the child refuses to eat until they know exactly how many calories are in the yogurt. It just seems easier and faster to tell them.
  • Goal: have the child eat various foods, not a limited menu of “safe food.”
  • Accommodation: when serving meals, the parent doesn’t offer new foods. They know their child will throw a fit or simply refuse to eat. Sometimes they try to add something new to the plate, but it goes so badly that they rarely do this.
  • Goal: have the child eat comfortably with other people.
  • Accommodation: the child becomes so upset about the idea of multiple people at the dinner table that the parents feed the child separately. Or they excuse the child from family meals because they are so distressed.
  • Goal: for the child to accept their body and not worry about its appearance.
  • Accommodation: when the child asks if they look bad, the parent freezes and ignores the question. Then, when the child doesn’t stop, the parent says in a falsely cheerful voice, “you’re just being silly – of course you’re beautiful!”
  • Goal: the child attends scheduled meetings with professionals.
  • Accommodation: the child insists that the therapist is useless. The nutritionist makes them eat unhealthy food, and the doctor is fatphobic and clueless. The parent spends hours every week convincing the child to attend just one more meeting. They use bribes and rewards, which work only some of the time.

All of these parental responses make perfect sense. If you do these things, you are not bad! Occasional accommodations make sense. But it can be a problem if parents repeat the same accommodation at every meal and/or the list of accommodations keeps growing. We want to stop accommodating eating disorder behavior even though it’s really, really uncomfortable for both the parent and the child. 

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

How can parents stop accommodating?

Parents can stop accommodating eating disorder behaviors, but it takes some careful thought, a solid strategy, and practice. It’s not a good idea to remove all your accommodations at once. A strategic, steady approach is best. 

First, you need to understand how you are accommodating the eating disorder behaviors and why you are accommodating. You will naturally think you are accommodating to avoid your child’s distress. But you are also accommodating to avoid your distress about your child’s distress. Make sense?

When your child yells and screams or slams their door in your face, you feel upset. You worry that your child will never get better. Of course you do!

This is what drives the accommodation. You want to avoid your child’s upsetting outburst, so you do whatever you can to avoid it. 

Start with you

Understanding your own worry is the first step to addressing and ending accommodation. Because ending accommodation is all about what you do. How your child responds must be relatively unimportant and not change your approach. 

You will take unilateral action to remove your accommodation lovingly and compassionately. And your child is going to be distressed. Both of you will be able to handle this distress. But you may need some support to prepare and get through it.

Next, you will pick a specific accommodation and make a detailed plan to stop doing it. You’ll tell your child what you’re going to do, why you’re doing it, and when you’ll begin doing it. 

Finally, you’ll follow through. You’ll stay steady even in the face of your child’s worry and anguish. This will be hard, but you know that continuing the accommodation, while possibly easier in the short term, will not help in the long term.

You’ll stay dedicated and single-minded in your commitment not to accommodate eating disorder behaviors anymore. Over time, your child will learn your boundaries. Your child will feel less anxious. You’ll interrupt the anxious cycle of an eating disorder and invite recovery to take root.

Rachel and Lily

Rachel was terrified of ending even her most minor accommodations. For example, she told Lily what was in her smoothie every day. This was happening even though it was exactly the same every day.

She made a plan and told Lily that she would not answer smoothie ingredient questions anymore. Lily asked a few times on the first day, and Rachel was near tears but held her boundary lovingly. 

The next day, Lily asked ten times and started to cry when Rachel held her compassionate boundary. She refused to drink her smoothie. Rachel worried that she was making a mistake or doing it wrong.

But on the third day, Lily asked Rachel once, then, shockingly, drank her smoothie. 


“I nearly fell out of my chair,” says Rachel. “I couldn’t believe it didn’t keep getting worse.”

Lily asked about the smoothie ingredients every few days throughout the next few weeks. And if it was an especially stressful day, she asked several times in a row. But Rachel was confident that not reviewing the ingredients was the right thing to do to help Lily recover, so she held her boundary lovingly and firmly.

Over time, Rachel removed more and more accommodations. Some were easier than others, but she could see the benefits. Mealtimes were less stressful for Rachel, which meant she could better support Lily through the stress of eating. 

“I feel more hopeful today than I’ve felt in five years,” says Rachel. “This is the biggest improvement I’ve seen in a long time. I feel like I’m really getting the hang of not accommodating her eating disorder behaviors. I’m focusing on controlling myself rather than trying to control her.” Parenting a child with an eating disorder is challenging, and Rachel is doing a great job!

Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders. She’s the founder of 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

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How to stop nagging and negotiating with your kid who has an eating disorder

Get your kid with an eating disorder to eat without nagging and negotiating

If your kid has an eating disorder, then there’s a good chance you are constantly nagging and negotiating with them to eat. How many reminders have you given your child this week? A certain level of reminding is to be expected. But if it feels constant and never-ending, then it’s probably time to make a change. This is because of two things: 

  1. Constantly reminding your child to do things is exhausting, especially when you’ve already explained why it’s important a thousand times. Reminding your kid to do something as essential as eating is a huge burden on you that will lead to burnout.
  1. When you nag and negotiate with your child to eat, you are essentially “owning” their food and eating, meaning they are not taking responsibility for their own nourishment and recovery. While this helps for short-term problems, it’s ineffective for long-term issues.

Maybe you lean more towards negotiation: “Eat just one more bite and then you can be finished.” Or “If you eat this, you don’t have to eat that.” 

Or perhaps you find yourself nagging: “Did you remember to eat?” “Please remember to eat!” Or “You have to eat fat and carbs!”

Either way, if you feel as if you’re in an endless loop of negotiation and nagging, it doesn’t mean you’re not trying hard enough. It’s just a sign your current system isn’t working.

Changing exactly how you ask your child to do something might help a little bit in the short term, but often the issue is a lot more complicated and relates to how eating disorders work and how our best intentions can sometimes get in the way of recovery.

If you find yourself exhausted by the constant nagging and reminding, here are some ideas to get you and your child to a different level.

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

SPACE treatment for eating disorders

The SPACE treatment stands for Supportive Parenting for Anxious Childhood Emotions. It’s a research-backed program to help parents stop accommodating or enabling eating disorder behaviors and start making it really uncomfortable for them.

I’ve adapted SPACE for eating disorders (BED, EDNOS, bulimia, anorexia, and ARFID) because of two things. First, anxiety drives most eating disorder behaviors. People who have eating disorders are often genetically predisposed to be highly-reactive, and therefore more sensitive to anxiety. Food restriction, rejection, and rituals are powerful coping mechanisms for anxiety and distress. Second, parental accommodation, which includes nagging and negotiating, has been identified as a maintaining factor in eating disorders. It has been associated with greater symptom severity and caregiver burden. SPACE addresses both your child’s anxiety and parental accommodation.

Beyond getting your child into treatment and feeding them regularly, eliminating parental accommodation is one of the most powerful actions you can take to stop the eating disorder. The best part is that removing parental accommodation does not require the child to be engaged or motivated to change. It’s entirely up to you.

In this article, I’ll take a look at some ways parents can use the SPACE approach to stop accommodating eating disorder behaviors.

1. See nagging for what it is 

When there’s an eating disorder you probably have spent time nagging and negotiating about food and eating. Over time, this is exhausting for parents and can actually make kids more (not less) resistant to eating.

Most parents who nag and negotiate believe that if they just say the right thing a switch will go off in their kids’ heads and they’ll start to eat. These parents are trying valiantly to convince their children that eating is good and healthy and that the kid should do it. 

But if you have any experience with this, then you know that it rarely works.

Nagging and negotiating about eating and food are a sign that your system is not working. You’re tired, and your kid isn’t changing. It’s not that you aren’t trying hard enough. Or that you haven’t said the right thing yet. It’s that you’re using the wrong approach.    

In SPACE for eating Disorders treatment, we work on stopping the endless loop of nagging and negotiating. Parents learn to create clear interpersonal boundaries and attend to the underlying drivers and beneath-the-surface communication that’s going on every time you and your kid start to butt heads.

2. Make what’s unseen, seen

An eating disorder loves the shadows. All it really wants is to be able to exist and flourish without a lot of talk or disruption. It believes that it’s got things under control and that your involvement is threatening and unnecessary. But the last thing you want to do is adhere to an eating disorder’s demands for secrecy. In fact, you want to do the opposite: bring disordered behaviors into the light and talk about them openly.

Of course, it’s very important to not be critical or threatening toward the eating disorder. There’s a huge difference between criticism and observation, and they are mortal enemies. You want to be respectful of the eating disorder while calmly observing what’s going on. 

“Oh, it seems like you’re feeling upset about eating right now. I get that it’s hard, but I’m 100% confident you can do this.” 

That’s very different from “Stop trying to hide food under your napkin! I can see what you’re doing!”

The former is supportive. The latter is threatening.

In SPACE for Eating Disorders treatment, we work on isolating a single behavior and figuring out exactly how parents will respond differently when it shows up. Then we write a letter to the child calmly and compassionately explaining the behavior and how the parents will respond from now on. This is an essential step in overcoming the eating disorder’s demands for secrecy and privacy.

3. Don’t wait for them to get on board

One of the hardest things about having a child with an eating disorder is the persistent belief that the child must be “on board” in order for them to recover. And of course, your child will need to own recovery for themself. You can’t do that for them.

But that doesn’t mean you have to wait for your kid to get on board in order for you to make changes. You can start making changes today that will impact your child’s likelihood of considering and ultimately embracing recovery. 

Without parental changes, it’s much less likely that the child will even consider eating disorder recovery. Because as hard as it is to have an eating disorder, the idea of living without one is so terrifying that most people remain stuck in the loop of eating disorder behaviors. 

In SPACE for Eating Disorders treatment, parents make unilateral changes in their behavior. This means we determine the ways in which you are accommodating the eating disorder and you learn how to stop doing that. These changes are about your motivation and commitment. They do not require your child to change; only you. 

5. Don’t just say it, show it

Nagging and negotiation are all about what you say. But eating disorder behavior works on a much deeper level. In fact, anxiety-driven behavior barely responds to language. It’s a deep, animalistic instinct. It responds to action. 

This is why nagging and negotiating rarely change the course of an eating disorder. The drivers of the eating disorder are much deeper and more primitive than language. And the eating disorder actually enjoys pushing back against nagging and negotiating because it’s a great distraction from what’s really going on.

In SPACE for Eating Disorders treatment, parents learn to show how they want their child to behave rather than ask for compliance. This means parents stop talking so much and instead show calm, compassionate confidence even in the most violent emotional storm. 

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

6. Practice, not perfect

One of the biggest impediments to lasting change is when we think it’s an event instead of a process. Eating disorder recovery is not a single-day event. It’s something that your child will need to practice in some form for the rest of their life.

Many parents feel some success if they need to nag and negotiate a bit less. They may think the eating disorder is in remission. But then something happens and it looks like their child is suddenly right back to where they were before. This should not be a surprise. Remember that eating disorder behaviors are a response to stress, so every time there is a stressor, you can probably count on the eating disorder showing up again in some way. 

In SPACE for Eating Disorders, parents learn to anticipate kids’ behavioral cycles and respond consistently and calmly no matter what’s coming up. This means parents have learned not just a script or a single response, but an entirely new system for responding to eating disorder behaviors. 

Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders. She’s the founder of 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 Eating Disorder Treatment Guide For Parents

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Talking to your child with an eating disorder without yelling & screaming

Talking to your child with an eating disorder without yelling & screaming

Many parents who have kids with an eating disorder tiptoe around difficult conversations because so many of them turn into screaming or yelling matches. 

Parents who are facing an eating disorder naturally want to create a healing environment and try to avoid screaming and yelling. But an unfortunate side effect is that parents often feel they are constantly walking on eggshells. They avoid difficult conversations because they are afraid of triggering eating disorder behaviors. This makes perfect sense. But when we avoid difficult conversations we almost always make the situation worse, not better

Because avoiding hard conversations separates us from the people we love. Also, avoiding tough conversations makes screaming and yelling more likely (not less) because complaints and disagreements get pent up and then inevitably erupt in unhelpful ways. This is a very common pattern that we frequently see in families with eating disorders.

The solution to avoiding yelling and screaming during eating disorder recovery is not to avoid difficult conversations, but to have difficult conversations more often, in a better way.

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

The cycle of repression 

If you’re like most parents, then your child does stuff that drives you crazy, and you want to avoid yelling and screaming. So you find yourself avoiding conversations. 

Here’s how it typically goes. You feel angry and you want them to stop whatever they’re doing or start doing something else. But you hold your tongue because you don’t want to risk triggering the eating disorder. 

Everything feels so charged, and your child seems too fragile. So instead of talking about it you may raise your eyebrows or make a big huffing sound, but you don’t actually address the negative behavior.

The next day, your child does it again … or does something else that drives you crazy. Again, you hold your tongue, but you start having angry conversations with them in your head. 

They are so irresponsible! They are so selfish! Just because they have an eating disorder doesn’t mean they get to treat you this way!

And then it happens again.They do something irritating and you repress your irritation to “keep the peace.”  

The pressure builds

Your anger is growing, but you feel you can’t express it. You repress your feelings. But inside you’re boiling. You blame your child for the fact that you can’t express yourself openly and honestly. You call your friend and tell her your child is “driving you crazy.” You say things like “the truth is that I’m afraid of my own kid. They’re like a ticking time bomb. I live in fear.”

And it’s true. You are living in fear. And you are getting angrier and angrier.

Every time your kid does something you don’t like, the pressure builds inside of you. Your eyebrow raises, snarky comments, and unpleasantness spread like a virus through your house. Everyone feels it. And you blame your child for the nastiness because you’re repressing your feelings to protect their feelings. To keep them safe from their eating disorder and avoid yelling and screaming.

This is a very unhealthy place to be in a relationship. You are repressing your feelings in an effort to protect your child’s feelings. But the impact is that your child feels worse, you feel worse, and everyone feels worse. Because feelings can’t be repressed forever. They inevitably leak out or, sometimes, explode into yelling and screaming. 

The good news is that there’s a very good solution to this problem. You just need to start having difficult conversations more frequently. And you need to learn how to have better difficult conversations.

How to have difficult conversations

Difficult conversations take time, energy, and a lot of practice. When you first begin this practice, you may be exhausted by how often you need to have difficult conversations. And they may be very, very difficult. They may include yelling and screaming – the very thing you’re trying to avoid. You may worry that it’s not working, and you may slip back into avoiding difficult conversations.

But when you commit yourself to having difficult conversations frequently, you will notice a steady improvement over time. Soon, difficult conversations will be much less difficult for everyone. There will be less yelling and screaming. With practice and the right strategy, difficult conversations get much, much easier.

With practice you will reach a place in which you are respectful and honest about what you want and need. And your child will feel respected because you are not avoiding hard conversations to protect their feelings. Parents who commit to the practice of having difficult conversations can transform their relationship with their children.

Here’s how to handle difficult conversations: 

1. Identify how you feel

What do you notice inside of yourself? Sure, you may think your child is the problem, but look deeper. It’s OK to start at the point of blaming your child for your feelings, but don’t stay there. You need to keep digging. Identify what you are feeling, and claim your own feelings.

Feelings of anger and rage towards our children usually indicate that we are feeling insecure about something. Anger and rage frequently disguise feelings like fear, nervousness, disgust, discomfort, guilt, and shame. 

These are all serious and valid feelings that you can claim as your own. Your child may be the person who is triggering your feelings, but they are never responsible for your feelings. Your feelings are always are yours to handle.

Until you claim your own feelings, you risk blaming your child for how you feel, and that’s typically when difficult conversations go awry.

2. Make a simple and direct statement 

Often when we start a difficult conversation we overcomplicate things. We believe we have to get the other person to see things our way and agree with us. But this is not a useful way to begin a difficult conversation because the other person immediately feels manipulated and controlled. This is where yelling and screaming often begin.

Another mistake we make is criticizing or blaming the person for their behavior rather than making a direct request for what we want.

Start the conversation by making soft eye contact, using a gentle tone of voice, relaxed body language and voice, and make your intent crystal clear. Some examples: 

Old version: You never take the trash out, and I always have to ask you. It’s so disrespectful! I don’t understand why we have to go over this again and again. You say you’re going to do it and then you don’t, and it feels like you just don’t care about me or this family that has given you so much.

New version: I’d like you to take the trash out by 8 p.m. each night without me asking.

Old version: Partying won’t get you anywhere in life. Aren’t you interested in doing better? What even happens at those parties anyway? I bet there’s drinking, and you know that’s not OK with us! I mean, come on! I bet Sarah’s parents won’t even be there! And doesn’t her brother use drugs?

New version: I get it that you want to go to the party. But I’m not OK with you going.

When we claim our own feelings and make the conversation about what we want, not about their character or bad manners, we get off to a much better start.

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

3. Listen

If you have already had this conversation in your head ten thousand times, you are going to need to work really hard not to assume your child’s answer. It’s critical to stop talking and really listen to their answers.

Hold this statement in your mind: I am a parent who loves my kid, and listening is loving. 

It’s true: a person who feels listened to feels respected and loved. They are much more likely to do what we’re asking when they feel heard, understood, and loved.

Sometimes yelling and screaming is for a good reason: the person doing the yelling and screaming is literally trying to make you hear them. You can bring the volume down by listening before it hits high volumes.

Listen with the intent to understand, not respond. And be careful not to respond with something about them, like “you always/never do this.” Remember to claim your own feelings in this situation rather than blaming your child for how you feel.

Be willing and confident to dive as deeply as you need to in order to uncover what’s really going on for your child. Don’t assume you already know why they’re doing the irritating thing. All negative behavior comes from some unmet emotional need. They are rarely intentional or designed to hurt us. When parents seek to identify and address the emotional need, kids’ negative behaviors typically recede and get much easier to handle.

4. Prepare to repeat yourself 

As the conversation progresses, simply share again how you would like things to be. Don’t try to convince them of your perspective. But do look for common ground, and build on areas of agreement. Then pause and listen.

Listening more than you speak is almost always the best advice when having a difficult conversation with your child. If you’re asking them to do something they don’t want to do, then just say what it is and then listen. Then say it again and listen some more. Keep it simple and direct.

You may have to say the thing you want many times. The key is to know that this is part of parenting. It doesn’t mean your child is bad or you are bad. It just means you’re two different people. You’re asking them to do something and they don’t want to. That’s OK. Ask again!

It’s deceptively simple. You don’t have to try and convince them or get them to agree with you. Your goal is to communicate your wishes clearly and directly and make your child feel respected and heard in the process. 

Your child does not need to agree with or like your boundaries in order for you to set them! 

More conversations, less yelling & screaming

The important takeaway here is that to avoid yelling and screaming when there’s an eating disorder we don’t want to avoid difficult conversations. Instead, we want to have more difficult conversations and do them better. Parenting a child with an eating disorder is hard – you’re doing great!

Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders. She’s the founder of 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