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Mental health checklist for eating disorder recovery (free download)

Mental health checklist for eating disorder recovery

If your child has an eating disorder, recovery means more than simply gaining weight and/or stopping eating disorder behaviors; it means becoming mentally healthy. Eating disorders are frequently misunderstood, and people don’t always realize that mental health, not just eating disorder recovery, is the goal. 

That’s why I’ve put together a mental health checklist to help you set expectations and goals as your child recovers from their eating disorder. This mental health checklist is especially important if your child is returning to college or independent living after undergoing recovery in your home and/or a treatment facility.

Eating disorders are often layered on top of poor mental health and other mental disorders, so if parents don’t pay attention to mental health overall, they risk having a boomerang effect of having a child leave and return to treatment. While you can’t control their recovery, you can do your best to set your child up for success. Nobody wants your child to feel they are ready to return to independent living or go to college only to discover that they are not yet equipped to care for themselves, so the more you can help them build the skills they need to be mentally healthy, the better. A mental health checklist to be used during and after eating disorder recovery can help.

How to measure mental health

Mental health sometimes feels arbitrary. But in fact, we can measure mental health based on the behaviors that lead to and indicate mental health. It’s just like eating disorders. Except for medically-underweight anorexia, eating disorders don’t often have measurable physical symptoms. Instead, they are diagnosed based on the behaviors observed. 

For example, eating disorders are measured by how often a person eats, how much they eat, and how they feel about eating. Similarly, mental health can be measured by how well a person takes care of themselves and how they feel about themselves.

In addition to your child’s recovery process, they should be learning to take care of their physical health, which includes at a minimum: 

  • Getting adequate food and water
  • Moving their body appropriately
  • Getting enough sleep
  • Basic hygiene

Beyond basic physical healthcare, your child should also take care of their emotional health, which includes at a minimum: 

  • Connecting with others
  • Managing social media use
  • Practicing mindfulness
  • Getting outdoors
  • Asking for help
  • Taking breaks
  • Having self-compassion

Physical self-care after an eating disorder

Even if your child is cleared of an active eating disorder diagnosis, they are still at risk of mental illness. They will need to care for their bodies and minds intentionally for life. This is important for every person, but particularly for someone who has/had an eating disorder. Here are the basic physical care steps that your child should take to improve mental health. 

Getting adequate food and water

All bodies need enough food and water to function. And a lack of food and water has a significant impact on both mental and physical health. When someone has/had an eating disorder, it’s an indication that they may need to be more vigilant than others about caring for this most basic element of self-care. As your child transitions to living independently from you, they should demonstrate an ability to feed themselves adequate quantities of food every 3-4 hours and drink at least 6-8 glasses of water daily. 

Moving their body appropriately

Our bodies are made to move. Regular movement is essential to both physical and mental health. The tricky part is that many people who have eating disorders incorporate excessive exercise and/or are at risk of serious health complications if they exercise. However, as your child recovers from their eating disorder, they should work in regular movement to maintain health. This can be functional like having a walking commute to work or school, going for a short walk each day, doing a brief home exercise routine, or joining a gym or attending fitness classes. Your child should demonstrate an ability to move their body regularly, not too much and not too little.

Getting enough sleep

Getting enough sleep is a cornerstone of mental health. Your child needs 8-9 hours of sleep per night. People with eating disorders and other behavioral and mental health problems often experience sleep loss. Your child may have insomnia or struggle to settle down and get to sleep. While it’s easy to dismiss sleep as unimportant, it is as important as food, water, and movement to the human body and mental health. Sleep loss is no joke for anyone, but it is particularly risky for someone who has been diagnosed with a mental disorder like an eating disorder. Losing sleep is a major risk for someone with a history of mental disorders. Therefore, your child should demonstrate an ability to get adequate sleep each night and wake up at an appropriate hour in the morning. 

Basic hygiene

While basic hygiene may seem like a given, it can be a major struggle for someone with an eating disorder, anxiety, depression, or other mental disorder. On the one hand, if your child has OCD, they may lead towards overdoing hygiene. Some people will wash and clean themselves excessively. On the other hand, someone who is depressed or has ADHD may feel unable to clean themselves adequately. Either way, taking care of basic hygiene is essential to mental health. Like exercise, you’ll need to measure whether your child’s challenge is doing too much or too little and work from there. Set some basic expectations, like flossing and brushing teeth twice daily. Bathing can vary per person, but discuss the maximum number of days between showers and/or the maximum number of showers per day. Your child should demonstrate an ability to take care of their basic hygiene. 

Emotional self-care after an eating disorder

An eating disorder is a mental illness. This means that while physical symptoms and/or behaviors are used to diagnose an eating disorder, it is emotional and mental in nature. This means that your child needs to care for their emotional health. This is important for everyone, but particularly for someone who has/had an eating disorder. Here are the basic emotional self-care steps that your child should take to maintain their mental health. 

Connecting with others

Human connection is as important as food, water, sleep, and movement. It is a sign of mental health to reach out to other people. It doesn’t have to be lengthy or intense. Still, you should feel confident that your child has some human connection daily. It might be a phone call to a loved one, but it could also be as simple as going in person to get groceries or food and speaking to someone while getting it instead of ordering contactless delivery. 

Managing social media use

Social media can be a major impediment to mental health for numerous reasons. It is particularly dangerous for people who have/had eating disorders due to the algorithmic preference for very thin people who promote “healthy lifestyles” that include eating disorder behaviors and beliefs. While zero social media use might be ideal for mental health, it’s not realistic or necessary for most people. Your child should demonstrate that they can set limits on their usage. 

Practicing mindfulness

One of the symptoms of an eating disorder is a disconnection between the mind and the body. It’s as if the brain-body connection is severed. To recover and maintain mental health, your child needs to practice a mindful connection between the brain and body. Your child should have a daily mindfulness practice that actively connects the brain and body.

Getting outdoors

Studies have shown that being in nature, even for a few minutes daily, has numerous physical benefits, including less pain and lower diastolic blood pressure. It improves mood and reduces the risk of mental illness. Support your child in getting outdoors for at least a few minutes daily. They can combine this with either exercise or mindfulness, or both. They should take a few moments to feel the air in their lungs and look at the sky, a tree, or anything natural and not human-made.

Asking for help

There is a tendency when someone has a mental disorder like an eating disorder, anxiety, depression, etc., to self-isolate. They reach out less to people who care about them and say less about how they are feeling. You want to support your child in reaching out for help when they feel sad, scared, or angry. Nobody can take their feelings away, but sharing our feelings with other people is soothing and improves mental health. 

Taking breaks

The brain-body disconnection common in eating disorders often translates to ignoring signs of mental or physical fatigue. A mentally healthy person recognizes when they need a break and takes breaks to improve their health and performance. Help your child learn to take breaks when they are overwhelmed or having physical or mental symptoms of fatigue.

Having self-compassion

A mentally healthy person has compassion for themselves. They don’t beat themselves up when they make mistakes and don’t speak cruelly or dismissively to themselves. They know how to soothe themselves when things go wrong and treat themselves as they would a good friend. Help your child learn to speak to themself with self-compassion and love.

Giving your child a mental health checklist for eating disorder recovery

Discussing mental health with your child while they are still recovering from an eating disorder and preparing to leave your daily care will help them build mental health. You can create your own checklist or use the one I created. The checklist I created includes both daily actions and warning signs to keep in mind. You can provide this to your child and talk with them regularly about both elements: are they doing daily self-care, and are there any warning signs to address? This can help you communicate your concern for their mental health, even if your child isn’t living with you.

Ginny Jones is on a mission to empower parents to raise kids who are free from eating issues, body shame and eating disorders.

She’s the founder of and a Parent Coach who helps parents navigate disordered eating, eating disorder recovery, and other challenging emotional and behavioral issues.

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Helping a child recover from an eating disorder prepared me for parenting in a pandemic

by Oona Hanson

Some of the most poignant essays about parenting during the coronavirus have come from families who have already experienced a quarantine or the sustained care of an immunocompromised loved one.

I started thinking about how living through a child’s serious illness helped build my own family’s resilience and confidence as we prepare to weather this current storm. 

Having a child develop a life-threatening eating disorder and undergo a number of different treatment programs (all of which were traumatic in their own right) taught us so many skills that are applicable in this moment. I am deeply grateful for the painful lessons we learned.

1. Opting out of socializing is nothing new to us

During certain phases of the illness and treatment, we were house-bound. For nearly a year, eating in restaurants wasn’t an option because it would paralyze our sick child with fear. Staying home to monitor meals and physical activity became a new normal. At other times, we simply didn’t have the energy to see friends. Even though I’m extroverted by nature, I had a physical aversion to being in a group or making small talk. Self-isolating was the choice I had to make for my own self-care, even when it meant making sacrifices. Knowing I turned down the chance to cheer on my beloved Dodgers (from a private box!) reminds me I can survive without longed-for special outings and celebrations.

2. Panic-buying, hoarding, and rationing don’t ruffle us

The responses to seeing long lines or empty grocery store shelves make perfect sense when you consider how evolution has primed us to endure the threat of famine. A feeling of scarcity can trigger a variety of behaviors intended to boost the chances of survival for an individual or their family group. Understanding these biological reactions helps me withhold judgement of others and keeps my own anxiety from spiraling when I see certain supplies running low.

3. We aren’t afraid of meals and snacks that aren’t “fresh,” “perfectly balanced,” or what diet culture would deem “healthy”

We had to kick the diet mentality to the curb a long time ago, so we already follow this mantra: all foods fit. Comfort food is always welcome, and we know it’s normal to have particular, often nostalgic, cravings during times of uncertainty. Rather than worry about calories or micronutrients, we know we’re better off reducing our anxiety around nutrition and that neutralizing foods–not elevating or demonizing them–decreases their power over us. Our new approach to eating, more relaxed and peaceful, is actually healthier than ever. 

4. We learned how to menu-plan

I had long aspired to be someone who could plan ahead and shop for a week’s worth of groceries, but I never seemed to follow through–until I had to. During the nutritional rehabilitation phase of family-based treatment, we had to plan out three meals and three snacks a day–taking into account the need for variety, high energy content, and systematic exposure to “fear foods.” Meal-planning and shopping became like a puzzle that demanded focus, creativity, and flexibility–skills we are using regularly during this new normal of socially-distant, hit-or-miss grocery shopping.

5. We know it’s okay to mourn the little things

Although health and safety are always the top priority, we learned how important it is to grieve the loss of other parts of life–the cancellation of long-planned adventures, once-in-a-lifetime experiences, and what-would-have-been annual traditions. It’s important to let ourselves feel sad when our hopes and dreams–and even our ordinary expectations–are dashed.

6. Relaxing certain rules can be healing and joyful

At an intensive eating disorder treatment program, we were shown the power of meal-time distraction for patients learning to eat again–in the form of watching old episodes of “The Office.” It was hard at first to let go of our old “no-TV-at-dinner” rule (other than during baseball playoffs, that is!). It helped us see there are times for putting aside rigid rules when the game changes; different seasons of life call for different approaches–not to mention the fact that enjoying humor as a family can buoy you through some really stormy days.

7. We’ve learned how to discuss hard things

Talking openly about mental health is a skill we had to develop. It’s such a relief now to be able to check in with each other and be able to speak more matter-of-factly about painful feelings. Being open and direct about the tough stuff didn’t come naturally to us, but it got easier with practice.  

In our darkest days, it was hard to find hope, particularly as eating disorder recovery is seldom a linear process. Fear, especially of the unknown, can make it nearly impossible to function. But it doesn’t have to break you. 

I believe wholeheartedly in the possibility of post-traumatic growth. And I recognize it’s a great privilege to have access to the support and care you need to get through pain and loss in one piece.

All parents are struggling in one way or another right now. And I’m hopeful families will come through this experience even stronger, with deeper wells of gratitude, resilience, and wisdom. In the meantime, we need to go easy on ourselves and remember that this, too, shall pass.

In education for over twenty years, Oona Hanson works as a parent coach, supporting parents of teens and tweens. Passionate about helping kids develop a healthy relationship with food and their bodies, she runs the Facebook page “Parenting Without Diet Culture” and gives parent education workshops on body image resilience and eating disorder prevention. She holds a Master’s degree in Educational Psychology and a Master’s degree in English. Oona lives in Los Angeles with her husband and two children. You can follow her on TwitterInstagram, and Facebook: “Oona Hanson–Parent Coaching.” To learn more, visit

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What I want parents to know about eating disorder recovery, an interview with Kristie Amadio CEDC

We interviewed Kristie Amadio, Certified Eating Disorder Coach and Founder of Recovered Living. Kristie is recovered from an eating disorder and now coaches people who are in recovery and their families. She even lives with families 24-7 as they navigate recovery, making her an excellent resource for what really goes on during recovery and what parents need to know about the process.

1. What do you wish all parents knew about eating disorders?

That it’s not their fault. Every parent I’ve ever met feels this way but the truth is, the cause of eating disorders is a combination of genetics and environment.

I think parents look at the word ‘environment’ and blame themselves, but I’ve worked with many people in recovery who were teased at school, or read a magazine about weight loss and that triggered their eating disorder. Environment doesn’t necessarily mean ‘home environment,’ it means the world we live in. Right now, we live in a weight-centric society. It is impossible to protect against it but we can help shift it by taking a stand against body shaming and having an inclusive attitude towards food.

I also want parents to know that getting support for themselves is so important. It can be scary and overwhelming to help a child navigate recovery, and having someone who is dedicated to supporting your needs can really help.

Parenting for positive food and body

2. Are there any particular books or learning materials you recommend to parents who have kids who are in recovery?

Absolutely! Carolyn Costin has some excellent books on eating disorder recovery that are easy to read and super informative. Her book 8 Keys to Recovery from an Eating Disorder: Effective Strategies from Therapeutic Practice and Personal Experience is designed for people in recovery, but I often recommend parents/friends read it because it can help them gain a better understanding of the world of eating disorders.

The great thing about the digital age is there is a veritable wealth of information out there that help to create an understanding of the recovery process so parents don’t feel quite so in the dark. I encourage parents to read as much as they can about eating disorders, and also to reach out and find a support group if possible where it is safe for them to express their own feelings about the process.

One of the services I love providing is Support Space, which is a free online support group for family and friends of people with eating disorders. It runs for an hour each month and people attend from all over the world. I like the idea of it being a place where people can ask questions, work through difficult situations and get the support they need. An eating disorder doesn’t just affect one person in the family, it affects the whole family. Feel free to jump on the website and come along!

3. What do you think kids who live at home need most from their parents during recovery?

Everyone’s recovery is different, but in general, I think kids living at home need their parents to be their parents first and foremost. It is so easy for parents to fall into the role of therapist/dietitian/and food police – it is a hard line to walk. People living at home need a duality of things – they need boundaries but also grace, they need support but they also need to learn how to stand on their own. They need closeness and they need space. There isn’t a perfect way to parent someone in recovery – it’s going to be messy!

An eating disorder is a disordered relationship with food, a disordered relationship with the body, and a disordered relationship with the self. People consciously or unconsciously use their eating disorders to communicate in relationships but the rest of the world doesn’t speak that language! Part of the recovery process is learning new ways of being in relationships, using words rather than their eating disorder, and weaning themselves off the ‘safe’ relationship of their eating disorder and onto healthier but ultimately changeable relationships with other people.

This is why I think that kids need help articulating what they need from their parents as a very first step. Most kids don’t know, which can make it hard to parent them! Learning to articulate needs is something they need to learn from a therapist, a mentor, coach, etc. … or it could just come with time. Deep soul work isn’t an easy process, but slow change is sustainable change.

body image for girls ebook

4. What would you say to a parent who is feeling hopeless about their child’s recovery?

The first thing I want to say is, ‘I hear you.’ Eating disorders are scary and can have very very bleak looking prospects at times. I don’t want to bullshit anyone and say ‘it’s going to be OK,’ because I can’t guarantee that. What I can guarantee is that while there is life, there is hope.

Provided someone’s body is willing to continue sustaining life, there is a part of them, (even if it is a cellular part) that wants to live. That is the part I focus on. I always take the stance that just because an eating disorder is stubborn and persistent doesn’t mean it is impossible … it just means it is stubborn and persistent.

I think it is important to make a distinction between hope and attachment. Carolyn Costin says, ‘don’t be attached to the results.’ What this means is that recovery – whether they take the road to recovery or not – is the individual’s choice. No one chooses to develop an eating disorder but they can choose to recover. Sometimes I feel like 70% of my work with clients is going through the process of making that choice. I don’t know that everyone will choose it but I know that everyone can.

If someone doesn’t want recovery, I’m not going to force it on them. Some people want to live the rest of their life with their eating disorder because it feels safer or more comfortable than recovery. I feel sad about the life they are missing out on but I also respect their choice. I hold hope that they will choose differently in the future, but I’m not attached to what they choose – they have free will.

Here’s what I really want parents to know: I’ve seen too many miracles to give up, so I don’t give up, not on anyone. Ever.

To those parents who feel hopeless right now, please remember that while there is life there is hope. A huge part of recovery is getting to the point of being brave enough to want a different life, so being in a difficult spot could be a good thing – sometimes hitting rock bottom is what instigates change.

5. What do you think is the hardest part about living with someone who is in recovery?

So many things! Feeling shut out, feeling helpless, struggling to see your person in pain but knowing the pain is necessary to recover. I’ve had an eating disorder and I’ve lived with people with an eating disorder. Both are equally hard in different ways – I mean that. A family’s support role is JUST as hard as having the eating disorder itself.

My best advice is to keep the three tenants of recovery in mind:

  1. You can’t make your person want to recover
  2. You can’t do it for them
  3. You can set your boundaries about what you will and won’t tolerate

As much as it is important for your person to be communicating about what is going on for them, the same goes for you. No more walking on eggshells, no more ignoring the elephant in the room – an eating disorder thrives in secrecy and isolation but once it is brought to the table, it can’t survive in secret anymore.

Kristie Amadio is a Certified Eating Disorder Coach and Founder of Recovered Living. She is also a certified life coach and eating psychology coach. A former elite athlete, she worked as a counselor in both Australia and New Zealand before beginning Recovered Living as a solution to the gap between recovering in a treatment center and continuing recovery when back at home. She uses the same strength she required in her own recovery to guide and inspire others while her genuine compassion allows her to connect easily with clients.

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Can a person fully recover from an eating disorder?

Eating disorders are poorly understood, and there are many different perspectives on why they occur and exactly what is involved in their development and recovery. The quick answer, is YES. A person can fully recover from an eating disorder.

There are many theories pointing towards a combination of genetics, temperament, family, and social predictors. As of right now, all we can say is that these factors seem to combine in some people to result in an eating disorder.

For a long time, eating disorders were treated similarly to the addiction model for alcohol. This means they were seen as persistent and something that can never be healed, only managed. Some treatment providers still see eating disorders as lifetime afflictions.

For a very long time, eating disorders were treated as something that parents caused though a combination of inattention and neglect. Some treatment providers still see eating disorders as something that are directly related to parenting practices.

However, neither of these approaches is currently considered appropriate in the treatment of eating disorders today. There is a large population of people who have had eating disorders who now consider themselves fully recovered. There are also many signs pointing to the confluence of factors (genetic, temperament, family, and social) rather than a single-source cause of eating disorders.

Can eating disorders be cured?

Yes. Any person can identify as recovered from an eating disorder – it’s completely up to the individual to define recovery for themselves. Some people who identify as recovered experience relapses, others find they must commit to recovery every day, and others feel completely free of their disorder.

Many of us move from having eating disorders to what is technically considered disordered eating. Since one survey found that about 65% of the U.S. population meets the criteria for disordered eating, this is less dire than it seems. In fact, disordered eating, in our culture, is considered “normal.”

And there are people who continue living with their eating disorders. This is not a crime, but a choice made by people that is no different from choosing to live with (rather than fight) a powerful behavioral pattern such as gambling, shopping, sex, and, of course, substance abuse.

What is full recovery from an eating disorder?

Since eating disorders are complex psychosocial adaptations, there is no easy way to define recovery. Nor is it necessary to do so. Each individual is allowed to state whether they live as a recovered person regardless of how others perceive their recovery.

It’s important to know that eating disorder/disordered eating status has nothing to do with a person’s intelligence, strength, or worthiness.

However, there are some common themes that arise in the eating disorder recovery community regarding what “full recovery” looks like, and they include:

  • The ability to eat all foods (excluding medical allergies) without fear or shame.
  • The ability to feel neutral or positive about one’s body, regardless of its weight and shape.
  • Healthy coping strategies that allow us to process uncomfortable emotional states without causing harm to ourselves.
  • Not attempting to reduce or maintain weight in any way through restriction or purging.
  • Healthy interpersonal relationships that are fulfilling and meaningful.

There are many more signs of full recovery from an eating disorder, but these are the ones that arise most frequently in the community.

What is disordered eating?

Sixty-five percent of American women between the ages of 25 and 45 report having disordered eating behaviors, according to a 2008 survey by SELF Magazine in partnership with the University of North Carolina at Chapel Hill. Disordered eating is a natural side effect of intentional weight loss, in fact, the majority of diets are disordered eating. The symptoms of disordered eating include:

  • Desire to lose weight
  • Fear of gaining weight
  • Seeing food as good or bad, healthy or unhealthy
  • Feeling shame and guilt for eating “bad” or “too much” food
  • Eating in secret
  • Binge eating after a period of restriction
  • Restricting food for periods of time (including skipping meals when hungry and intermittent fasting for non-religious purposes)
  • Ignoring hunger cues based on established times for eating
  • Ignoring food cravings based on an established food plan
  • Using vomiting, laxatives, diuretics, and detoxes to reduce bloating, calories, and weight
  • Feeling compelled to exercise in order to achieve weight loss or maintain current weight

It’s important to know that a person who recovers from an eating disorder but continues to experience disordered eating is not a “recovery failure.” They are simply responding to strong societal cues and direct advice from healthcare providers, the government, media, loved ones, and even strangers.

Having disordered eating patterns in our current society can be considered adaptive based on the pervasive nature of diet culture.

Many of us who have recovered from an eating disorder and have the term “eating disorder” on our medical records will still receive weight loss recommendations from our healthcare providers despite the fact that such efforts are extremely risky for us. This situation exposes our society’s heavy weight bias and the challenges of maintaining full recovery in a fatphobic culture.

Nobody has to recover from an eating disorder

One thing we know for sure about eating disorders is that they require some form of personal motivation in order to recover. This doesn’t mean that loved ones cannot facilitate and support recovery efforts, but loved ones must also recognize that having an eating disorder, and choosing to recover, is a personal choice. Nobody can force a person to recover if they don’t want to.

Non-recovery or partial-recovery is not a failure. It is just the way that one person is dealing with their individual psychology and societal pressures. We must recognize that many people live in gray areas when it comes to food and body issues, and we must honor individual agency when it comes to recovery.

All people deserve respect, regardless of their eating disorder/disordered eating status.

Eating disorders are not a crime, and they are not the worst thing a person can do. This is not to dismiss the fatal nature of a very small subset of eating disorders, but rather to affirm that many of us live along a continuum of disordered eating, and we should have tremendous compassion, respect, and understanding for everyone on the spectrum.

What we have to do to recover from an eating disorder

Everyone recovers in their own way. Eating disorders are complex, and therefore recovery is complex, too. However, there are a number of trends among people who have recovered from an eating disorder, which include:

  • Healthy emotional hygiene practices – the ability to process uncomfortable emotions and manage anxiety.
  • Healthy self-worth – the perception of being inherently worthy. Believing that we have value regardless of our appearance or behaviors.
  • Healthy relationships with people – maintaining at least one healthy relationship that involves personal boundaries while sustaining deep connection and honoring each person’s individuality and worthiness.
  • Healthy relationship with food – recognizing that food is neither good nor bad, and the freedom to consume food without fear. Responding to hunger cues and food cravings with food rather than restriction. Recognizing that a person’s food consumption does not indicate that person’s worthiness.
  • Healthy relationship with the body – recognizing that the body’s appearance does not indicate a person’s value or worth.

When a person meets these criteria, they are operating from a higher level of self-worth and confidence than that of a person who is engaging in eating disorders and disordered eating. As we have stated, not everyone needs to recover to be worthy of our respect and compassion. We wish for everyone to achieve as much self-worth and peace within themselves as possible, regardless of their eating disorder/disordered eating status.

Why many of us become social justice warriors and fat positive activists

Because of the powerful societal pull to constantly shrink our bodies, full recovery requires significant effort, and many of us who identify as fully recovered are active in the anti-diet movement and work to overcome weight bias and stigma while promoting a Health at Every Size approach.

This is because we see the focus on maintaining low body weight as an unhealthy societal obsession rooted in sexist, patriarchal white supremacy. To understand these concepts, begin by learning about the social determinants of health, which have a far greater impact on human health than body weight. For many of us who have recovered, fat is a social justice and feminist issue.

Just as someone who has recovered from an alcohol addiction must navigate an alcohol-oriented society and sit through events and celebrations surrounded by alcohol while also being exposed to articles about the (nonexistent) health benefits of alcohol (based on biased studies funded by the alcohol industry), a person who has recovered from an eating disorder must sit through events and celebrations surrounded by weight loss advice, diet talk, healthism, fatphobia and food fear.

A person who has recovered from an eating disorder who lives in a larger body will likely be advised to lose weight “for health reasons” even though any efforts at intentional weight loss puts their entire recovery at risk. Aside from the risk of eating disorder relapse, repeated intentional weight loss has actually been shown to increase **not decrease** mortality rates (Journal of Community Health). Since almost everyone who has recovered from an eating disorder has intentionally lost weight at some point in their lives, their healthcare providers should actually be advising strongly **against** any future weight loss efforts. But, of course, most don’t.

If we pursue the alcohol analogy, recommending weight loss to someone who has recovered from an eating disorder is akin to recommending a glass of wine every night to someone who has recovered from an alcohol addiction. It doesn’t make any sense, but it happens every day for those of us who have recovered from eating disorders.

These situations and more inspire many of us to put the energy we once devoted to our eating disorders into social justice and fat positive movements.

Recovery looks different for each of us, and ideally, we find our own definition based on our individual criteria for health.

Ginny Jones is on a mission to empower parents to raise kids who are free from eating issues, body shame and eating disorders.

She’s the founder of and a Parent Coach who helps parents navigate disordered eating, eating disorder recovery, and other challenging emotional and behavioral issues.

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When your child relapses during eating disorder recovery

child relapses eating disorder

As she watches Fiona slip back into the eating disorder symptoms they fought so hard against, Melissa feels hopeless. “This is the second time Fiona has gotten into recovery only to slip back into her eating disorder,” she says. “I’m tired. We’re all so tired of battling this eating disorder, and I just want recovery to stick.”

Melissa’s frustration makes sense. An eating disorder affects everyone in the family, and the primary caregiver in particular often gets burned out while facing such a difficult disorder.

When a child relapses during eating disorder recovery it can feel like a failure. Everyone worked so hard to get into recovery, and it’s hard to see it just slip away. But it may help to remember that you are not going back to where you started. You have months of experience that you didn’t have when the eating disorder first started. 

When your child relapses, it’s not the same as the first time you saw the eating disorder. You are more educated and more able to respond this time around. But of course it’s hard. I know you have put so much work into your child’s recovery, and it would be so nice to feel the success of watching them walk away from the eating disorder for good. 

Eating disorder recovery and relapse

I know that a relapse can feel like a failure, but let’s try thinking of it as a process rather than an event. Think of math. Throughout their school career, your child will constantly face new, more challenging math problems. 

Some kids need tutoring or special help to adapt to each new module. As they become more confident with the concepts, they need less help. But then, like clockwork, they face something new and need more help again. This likely continues in a cycle throughout your child’s education. You don’t take this personally, but instead just keep a list of excellent tutors and learn to recognize the signals that your child needs help.

An eating disorder diagnosis feels really different than learning algebra. But recovery also requires learning new skills. And since our kids are constantly growing and facing new situations, these skills need to flex and expand over time. They are regularly going to deal with new “modules” of recovery. And sometimes we may need to ramp up the support to learn and adapt to the new conditions. 

This perspective may help you realize that what we call “relapse” is really just part of growth. It’s a sign that your child needs to flex and learn new skills. Just like you would call in a math tutor if you saw them struggling with a new math module, you may need to call in a recovery team to help them navigate a new life module. 

Building and adapting skills

Unlike math (for most of us), the skills learned during eating disorder recovery are easy to get on an intellectual level. But they are challenging to implement in life. Eating disorders are exquisitely responsive to stressors, and thus, with every new stressor encountered, skills are tested. 

It can be hard to incorporate recovery skills into everyday life. But relapse is not a failure – it’s a signal that help is needed to get to the next stage of recovery. 

Back to the math analogy, when your child is struggling to learn a new concept, you ramp up the help available. You may help organize study time, schedule additional meetings with tutors, and brainstorm ways to master the concepts.

When your child relapses into their eating disorder, you will also need to ramp up the help available. You may need to help organize meals, schedule additional meetings with therapists, and brainstorm ways to master the concepts.

It’s not always a huge crisis, and you will be more helpful if you think about ramping up support without ramping up your stress level.

Manage stress levels

I’m not being flippant here. I recognize that it’s entirely different when your child has an eating disorder than when they’re struggling with math. But it’s important for you to adjust your mindset so that you don’t get bogged down by the stress. 

Because your ability to manage relapses will make a difference. Likening relapse to learning new math concepts doesn’t mean I don’t understand how serious this is. I’m framing the problem in a way that empowers you. 

This is important because people who have eating disorders are finely attuned to other people’s stress levels. If parents are stressed, kids are stressed. And stress makes getting back into recovery harder.

I’m asking you to change your mindset so that you can be concerned and active, but not stressed and overwhelmed. Stress shuts us down. Concern allows us to think strategically about a problem and mobilize plans that will help (not hurt) forward progress.

What to do when your child relapses during eating disorder recovery

1. Take care of your needs 

It may seem as if you are supposed to drop everything in exchange for your child’s needs, but actually, it’s more important than ever that you find ways to take care of your needs. If your child relapses back to their eating disorder, you may need to schedule some therapy or coaching for yourself. You may need time alone, walking, reading, or meditating. You may need to get away with your best friend or spouse – for lunch, dinner, or even a weekend away. Your own self-care is just as important as the care you give your child because we can’t pour from an empty cup, and we can’t help our child if we are emotionally depleted.

2. Center yourself

Think of the math analogy. What would you do if this were any other type of challenge in your child’s life? Take away the stigma and automatic thoughts you have about your child’s future mental health, and center yourself on the knowledge that you do not have power over the eating disorder, but you do have the power to take action and ramp up support.

3. Scan the environment

Eating disorders are very sensitive to stress. Scan your child’s environment and calmly assess the stressors, new, old, and upcoming. Stressors are not always bad – sometimes they are positive and exciting. Starting a new job, making new friends, and going on a long-anticipated vacation can all be stressors. Even though they are positive in nature, they are still stressful. Help your child identify the stressors that may have contributed to relapse. None of us can live without stress, but during recovery we need to learn to anticipate, manage and process stress in healthy ways.

4. Gather the troops

People who have eating disorders tend to underestimate the serious nature of their disorders, which can lead them to deny help when offered. Parents can be incredibly helpful by finding ways to gather supportive resources even when children say they are fine. If your child lives at home, then ramp up therapy and provide extra support and resources for your child. If your child lives independently, then encourage them to schedule appointments and get help.

5. Reduce stressors

Consider what you can do to take stressors off your child’s plate. Family events, social events, and vacations may need to be put on hold if your child relapses into their eating disorder. If your sister is coming to stay for a week, you may need to change the plans. This doesn’t feel fair, but it may be necessary for your child’s recovery. It’s not that you need to stop life from happening, but when there are optional events on the calendar, you should consider your child’s health first and foremost.

When your child relapses into their eating disorder it is terrifying and overwhelming. The last thing I want you to do is feel ashamed for how hard this is. This is hard.

Melissa relaxed when she heard the math analogy. “I recognize that I’m so tightly wound up about this and that’s not helping,” she says. “Of course I get to be upset, but it’s not helping me move forward and feel better. So I’m going to work on my mindset.” 

I hope Melissa will also attend to the first step, which is to take very good care of herself. Eating disorder recovery is a marathon, not a sprint. So pacing herself is going to help a lot. 

Ginny Jones is on a mission to empower parents to raise kids who are free from eating issues, body shame and eating disorders.

She’s the founder of and a Parent Coach who helps parents navigate disordered eating, eating disorder recovery, and other challenging emotional and behavioral issues.