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Clinical hypnotherapy for eating disorder recovery

3 Ways Clinical Hypnotherapy Can Help in Eating Disorder Recovery

by Bonnie Killip, Master Clinical & Medical Hypnotherapist 

Have you ever wondered if hypnotherapy can help with eating disorder recovery? If traditional eating disorder recovery is not progressing, it may be worthwhile considering hypnotherapy as a treatment option.

As a Dietitian and clinical and medical hypnotherapist, often my consults start with addressing people’s questions, concerns, and often skepticism around what hypnosis is. Let’s start by clearing up the common misconceptions. 

Hypnotherapy is not a trick nor is it mind control and it is also much more than meditation or relaxation.

Full disclosure: I’ve been one of the skeptics 

Until a few years ago hypnosis was not a part of my life. It wasn’t even on my radar. A no-nonsense biomedical scientist, I was only interested in evidence and randomized controlled trials (RCTs). 

I did not believe in using personal stories or anecdotal evidence. I believed in nothing that lacked piles of peer-reviewed literature and meta-analyses. 

In fact, if I’d even heard the word hypnosis, I’d have most likely tuned it out. Now, I cannot imagine my life without what hypnosis has brought and continues to bring to my world both personally and professionally. Actually, I can, but I’d rather not!

After 15 years of living with anorexia nervosa, clinical hypnotherapy not only saved my life – it gave me a life. 

And that’s no longer the most interesting part of my story. Because I now work daily with others who have fallen out of touch with their inner guidance. These people are in positions where all else has failed and they’ve all but resigned themselves to their eating disorders. To live a life of attempting to maintain pseudo-physical health while never being entirely well. 

Hypnotherapy for eating disorder recovery

I now have the daily privilege of facilitating people of all ages and life circumstances. I work with all types, from anxious and confused 10-year-olds to perfectionist and overachieving 16-year-olds, to successful 65 year CEOs and 87-year-olds. All of them want to begin the part of their lives where they are finally free to be themselves. 

I have both personally experienced and seen first-hand how hypnotherapy can help with eating disorder recovery.

Clinical and medical hypnotherapy offers a direct means by which we can bring about change in an area a person could not change through education, willpower, threats, or motivation alone. The profoundness of what this means in terms of someone’s day-to-day experience of life is high. Because information and knowledge is only part of the picture. It is not until we can put this into practice that we can experience the true benefits. 

Clinical and medical hypnotherapy is an effective eating disorder treatment because it:

  1. Treats the non-logical brain. Eating disorders are non-logical, so it can help to treat them on that level.
  2. Rewires neural pathways. Eating disorders can create rigid neural pathways that need to be loosened in order to recover.
  3. Feel good now. Recovery typically feels like chaos, so any method of feeling good during the process helps.

How does hypnotherapy work for an eating disorder?

Hypnotherapy is individually tailored to each person. It can be a powerful way to change beliefs and disruptive behaviors. The focus is on building the skills people need to function at their best versus rehashing past trauma or searching for a cause.

In hypnotherapy, a person is empowered to work on an unconscious and conscious level to change beliefs and behaviors that are interfering with their life. For example, if a person is afraid of food, we would work on decreasing the fear response both subconsciously and consciously. By experiencing the fear and moving through it in the safety of hypnotherapy, the person acquires confidence and fear patterns are reduced or eliminated over time. 

This works because the brain cannot tell the difference between an imagined scenario and a scenario that is taking place in the physical world. While it could take months of careful psychotherapy to get a person to face a fear food at the dinner table, we can face the imagined fear food in hypnotherapy rather quickly.

If a person is struggling with binge eating and/or purging behaviors, we could explore the unconscious fears underlying those behaviors. We would practice facing them in a safe, secure environment. 

The actual practice of hypnotherapy may include: 

  • Trance induction (direct or indirect)
  • Suggestion
  • Metaphor
  • Conversational hypnosis
  • Neurolinguistic programming

Hypnotherapy is specifically outcome-focused. We precisely target exactly what it is a person wants to change and then go about bringing about that change.  

Here is some more detailed information about the benefits of hypnotherapy:

1. Treating the non-logical brain

An eating disorder is not a logical problem.

Ask anyone with an eating disorder if they are choosing to feel those feelings or do those behaviours. I can guarantee they’re not. There are powerful emotions driving them to not eat, to binge, to over-exercise or whatever it is for them.

If the eating disorder was something you could fix through logic, information and understanding you’d have done so.

Clinical hypnotherapy offers a means by which we can re-establish rapport with the unconscious mind. In more science-y terms, we work with our autonomic nervous system. The goal is to restore back to what your body has known how to do all along before the outside world made you question the innate wisdom of your body. 

We’ve all had the experience of being children, and as children, we had no problem connecting to our bodies’ messages. And we have no problem communicating this. As a baby, we don’t think “I’m hungry but I can see mum is tired and busy at the moment, so I’ll just wait”. Nope, we scream and yell until we get that need met! 

Reconnecting with our bodies

If we want to be a successful adult, we have to at some point move on and meet those fundamental human needs for ourselves. If we do not, we become disconnected from the signals our body is sending. The body may even stop sending signals. Because, after all, “what is the point of telling her to eat if she will not do it, anyway?”

When we get out of the way, our body is free to do what it has evolved to do. It will steer us towards health naturally and without our micromanagement. You don’t have to think about when and how quickly you want your heart to beat or your lungs to breathe, do you? There are things your unconscious knows how to do much better and with much more ease than your conscious mind. 

2. Rewiring neural pathways

Hypnosis offers a direct means of altering neural networks and neural rewiring.  

When it comes down to it, this is the crux of eating disorder recovery, and it’s why hypnotherapy can help. 

At some point, recovery becomes recovered. And recovered is an entirely fresh way of not just behaving but also, crucially, of thinking and feeling.

The behaviors of an eating disorder often begin as a coping strategy. They are compensation or an attempt to meet a need (to be healthy, good, more confident, or better liked. But with time it turns from conscious choices into unconscious patterns. Hence why it is a disorder. Because the thoughts, feelings, and behaviors are no longer under the conscious volition of the person. 

The eating disorder then persists at an unconscious or habit level because neurons that fire together wire together. 

In recovery we change the structure, not just the function, of the mind. And there are many ways in which we can do this. Exposure therapy and cognitive behavioral therapy are the most well-known treatments. But hypnosis often offers a means of changing the structure more quickly and safely than either of these. 

Bypassing the habits of an eating disorder

Hypnotherapy bypasses the need for the involvement of the conscious mind. It goes right to where the issue is being maintained: the unconscious mind. The eating disorder thrives not in our prefrontal cortex but in our lower brain areas such as the amygdala. 

When I was sick I’d been told by so many therapists and doctors that my brain had changed because of the illness. That I’d been sick so long it most likely wasn’t possible that I could ever fix the damage or recover. What I know now is that the very fact that my mind changed to accommodate the illness meant it was more than possible for it to change back. It could even improve and rewire in all the ways it needed to to be not just free of the illness, but healthier than ever before.

 I just needed the means by which to do this. It turned out clinical hypnotherapy helped me recover from my eating disorder. 

3. Feel good now

Take a moment to answer this question:

If your child could feel great or good about eating, would they have a problem eating?   

The answer is always a resounding yes. And this is why recovery can be so hard for loved ones to understand. It may be hard to imagine, but choosing recovery from an eating disorder is choosing chaos and pain. 

To everyone outside of the disorder, recovery is short-term chaos with long-term rewards. But the person in the disorder doesn’t feel like the chaos will ever end. It feels like you are choosing indeterminate chaos and pain with no guarantee that it will have been worth it. 

The resistance to the chaos and pain is why recovery can go on and on and on for many people. I know this was my experience until I did eventually find the help that could help. And a lot of this has to do with the fact that it never feels good. If there are no wins, we lose heart, back down, and find ourselves back in old behaviors.  

How motivated, inspired, and excited are you to jump into shark-infested water just because someone tells you the island on the other side is incredible? Not much, I imagine. And that’s what it feels like for someone with an eating disorder. Eating feels unsafe, and we are asking them to do it 6 times a day as though it is nothing. Therefore, the way to truly help someone is not by focusing on all that is wrong. Instead, we must increasingly allow them to experience wins that show how recovery is worth it.

Achieve a relaxed, calm state

In hypnosis, we experience eating in a relaxed and calm state. We support the circumstances and situations which in their everyday eating disorder state of consciousness produce extreme anxiety and panic. This teaches the nervous system that they can get through these things safely and feel less panic when eating.

The power of hypnosis is that our minds produce exactly the same response whether we are in a dangerous situation in real life or we imagine being in a dangerous situation on the inside of our minds. Take a moment to imagine biting into a juicy lemon to get a sense of what I mean here. If you really imagine it, you will salivate and maybe make a scrunched-up face.    


Take-home message

We don’t know all there is to know about the intricacies of eating disorders. But we know enough to know that education, shame, and blame do not heal. 

We know that eating disorders are on the rise. And even our gold-standard treatments often fail those who seek to recover. 

If you’ve tried one eating disorder treatment path and it hasn’t worked, it may be time to expand and experiment with other options. Keep in mind that clinical hypnotherapy is an option. It’s a viable tool that I believe will only become more widely used as we improve our understanding of the human mind and what truly drives our behaviors. 

Thanks, Mom!

I could never capture in words just how thankful I am that my mum looked outside the box of what was offered to us for years and years and booked me into that first hypnotherapy session. 

Kids are great hypnotic subjects because they enter a hypnotic trance easily. They go farther and get a lot done when they get to be the creators of their destiny. I truly believe that building rapport with our unconscious mind is one of the greatest determining factors in how far we go in life. To re-establish this at a young age if it is lost or teetering on the verge of being swamped from ever-increasing messages from the outside world over what to eat, how to look, think, feel, and do, is inconceivably valuable.

Clinical hypnotherapy with a licensed professional offers a safe and controlled environment in which your child or yourself can try out fresh ways of being, something we often don’t otherwise get in the day-to-day rush of life.   

Eating disorders are complex, but please do not let complexity lead to undertreatment.

Bonnie Killip Fuelling Success

Bonnie Killip is an Accredited Practising Dietitian (APD), Master Clinical and Medical Hypnotherapist, and Master Neurolinguistic Programming Practitioner. She offers practical and usable nutrition education for those in recovery from eating issues. As a clinical and medical hypnotherapist, she can help kids reconnect with their inner guidance and develop the internal skills and resources to set them up for a life of emotional regulation, self-love, resilience, and happiness. Website: Fuelling Success

See Our Eating Disorder Treatment Guide For Parents

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Find a therapist for your child with an eating disorder

therapist child eating disorder

If your child is facing an eating disorder, you need a therapist, and it’s easy to feel overwhelmed. Your child’s pediatrician may help you get an initial diagnosis. They can point you in the direction of therapists and/or treatment programs. But it’s still up to you, the parent, to make the right choice for your child.

First, consider how you will approach finding a therapist for your child. To do this, gather your insurance details. Next, find out how many sessions are included, what is your deductible, what therapists are included in your policy?

Opening questions

Before interviewing a therapist for your child with an eating disorder, consider getting the following details up-front:

  • Where is the therapist’s office? Is it reasonable for you to get your child there at least once per week?
  • How many times per week does the therapist want to see your child? What time slots do they have available? Will this schedule be feasible for you?
  • Will there be a co-pay or are you paying out of pocket? If so, can you afford this therapist?

We recommend identifying at least three different therapists to interview for your child. To find these therapists, you may have to call around from the list your insurance provider gave you. And be prepared for therapists who are not currently taking new clients, who don’t have time slots that work for you, or who do not work with children who have eating disorders. This can be frustrating work, so be prepared.

Once you begin interviewing therapists, stay organized! Keep detailed notes of the therapist’s name, rate/co-pay, recommended treatment plan, and any thoughts and details you get out of your interview. You will think you’ll be able to remember which therapist you like without notes. But it’s really much better if you document your interaction. Also, if the therapist you choose ends up not being a good fit after a few months’ treatment, you may want to revisit your notes.

Here are seven steps to help you find a great therapist for your child who has a mental health condition:

1. Check their credentials

There are many types of therapists, so it’s important to start by understanding what the different credentials mean. There are two main types of licensed therapists: Licensed Clinical Social Worker (LCSW) and Licensed Marriage and Family Therapist (LMFT). Both have a master’s-level degree and at least to years of supervised clinical practice. Both are qualified to assess, diagnose, and treat the full range of mental and emotional disorders in the Diagnostic and Statistical Manual through the use of psychotherapy. The difference between these two licenses is blurry. Therefore, it’s best to ask your prospective therapist why they pursued their particular license.

Your child’s therapist should have a certification to work with eating disorders. Alternatively, they should be in the process of getting one, and/or be under clinical supervision from someone who is certified. Your child can technically be treated for their eating disorder by a general therapist, but it is not recommended d.

You may encounter professionals who are in pursuit of their licenses, which means they can charge less. The trade-off is less experience. Be very clear about their level of training and understanding. This is particularly important as it relates to your child’s current health status.

2. Ask them questions

The single best thing you can do is ask a lot of questions. Choosing a therapist is not like choosing a car to buy. In other words, it’s not just about lining up cost and features and selecting based on rational criteria. Therapy is a relationship, not a transaction so it’s important for you to understand your therapist’s motivations, approach, and philosophy.

One of the best ways to evaluate how your child’s therapist will treat your child is to evaluate how they treat you when you ask questions. If they seem disturbed, bothered, or put out by your questions, that may be a sign of impatience. On the other hand, if they treat you with compassion and respect, while still maintaining professional boundaries, you can make an educated guess that they will treat your child in the same way.

3. Talk about expectations

It is perfectly reasonable for parents to ask a prospective therapist about what can be expected from the therapy process. There’s a good chance that the therapist’s answers will be somewhat vague since every therapeutic intervention is unique in its own way. Nonetheless, you should feel reassured that your child’s therapist has expectations for recovery and will follow a path that they believe will achieve certain milestones along the way.

4. Find out how you’ll be involved

The old model of childhood therapy was to keep the parents at a distance. The concept was that if a child was in therapy then their parents had done enough damage and needed to stay away so the child can heal. This hurtful approach is not recommended anymore since parents can be an essential component of healing from and managing an eating disorder.

Your child’s therapist should be able to give you an idea of how often they will communicate with you and whether there will be any family sessions incorporated into the treatment plan. You should also find out how the therapist wants you to communicate with them if you observe any dangerous or concerning behavior at home.

5. Ask for a treatment plan

It doesn’t need to be typed up as a proposal, but your child’s therapist should be able to communicate with you what their treatment plan is based on your child’s condition. The treatment plan is designed to guide your child towards reaching recovery goals. It will also help your child’s therapist measure progress and make treatment adjustments along the way. A therapy treatment plan is not a rigid model, but it is a map to help the therapist, child, and parent all get on the same page about treatment.

6. Listen to your gut

Remember that therapy is a relationship, not a transaction, so one of the most important things, when you select a therapist for your child, is to listen to your gut. If you have an uneasy feeling or are unsure whether the therapist is a good fit for your child and your family, it’s OK to keep asking questions and interview some other professionals to test the waters.

It’s also OK if you engage a therapist and disengage later due to a lack of fit. Remember that the therapist’s work is likely going to disrupt some established patterns for you and your whole family, so when you’re evaluating a therapist, it can help to look closely at whether you really don’t like the therapist or if it’s just that you and your child are uncomfortable with the necessary changes that take place during eating disorder treatment.

7. Listen to your child

Your child is the one who is working with the therapist the most, so it’s important to listen to your child. Of course, some children are very resistant to therapy in the first place, so you have to listen very carefully to try and tease apart their resistance to recovery vs. their resistance to the therapist.

If your child is complaining about the therapist, that’s not always a sign that there’s a poor fit, but it’s definitely worth letting the therapist know what’s happening at home, and what the child is saying about therapy.

A child may seem engaged during therapy and be making progress, but then they speak poorly of the therapist to others. This is tricky, but don’t shy away from having open-ended conversations with your child about their experience with therapy and the therapist so you can help guide them towards health and healing.

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 eating disorder recovery.

See Our Eating Disorder Treatment Guide For Parents

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Get answers to your questions about eating disorder treatment

We held a Q&A webinar with eating disorder therapist John Levitt, Ph.D. on May 5, 2019. Here are some important questions he answered for us.

1. Do you have any advice about FBT for eating disorders?

Answer recap: FBT (family therapy) is one of the evidence-based therapies available for eating disorders. It’s effective for a certain group of patients. Its primary outcome is to cause weight gain.

2. Should I send my child to residential treatment for an eating disorder?

Answer recap: The purpose of a program is to stabilize and refeed to manage the critical side effects of an eating disorder. I’m concerned about sending a child away from their family and recommend asking: how is the family involved, and how does the family sustain recovery when they return home? Often a local treatment program can achieve the same goals.

3. What should I do if my child is in treatment for an eating disorder and the behaviors aren’t stopping?

Answer recap: If your child is in a treatment center and their behaviors aren’t stopping, it’s important to understand why that is. Ask questions, and understand the goals and treatment plan.

4. Parents are doing their best, why isn’t child recovering from their eating disorder?

Answer recap: Your child not recovering doesn’t mean you’re doing anything wrong. Most people recover from an eating disorder, but it can take time. Recovery depends on many factors, including how long they have had the eating disorder. It’s OK to sit down with the therapist and ask how treatment is going. You should have some sort of treatment plan to guide the process.

5. What is evidence based treatment for an eating disorder?

Answer recap: Evidence-based treatments have been tested with group studies in which there have been random assignments to different treatment types. Certain therapies have been statistically proven to be more effective. It’s important to ask the therapist or treatment center what it means to use “evidence-based” treatment and how do they use it?

6. Why, if the eating disorder behaviors are under control, does my child still need therapy?

Answer recap: When someone recovers from an eating disorder, they may still have trauma symptoms, anxiety, depression, self-harm, and other residual symptoms that existed in addition to the eating disorder. These conditions and symptoms can be a good reason to continue therapy beyond eating disorder treatment.

7. If my child has trauma and an eating disorder, will an eating disorder treatment center treat both?

Answer recap: If possible, find an integrated treatment approach that addresses eating disorders and other challenges like trauma, self-harm, etc. Be sure to ask your treatment team or therapist whether they are using an integrated approach.

8. How do I find a good therapist for my child who has an eating disorder?

Answer recap: Ask a lot of questions! The therapist is a guide, and it’s their job to facilitate recovery with the child and the parents. We should be available to answer parents’ questions. If your child is not responding to treatment, it’s not always because the therapist isn’t “good,” but it is important to talk to the therapist about the treatment plan and that they can communicate with you and your child.

9. Our therapist told me to be patient with my child who has an eating disorder – what does that mean?

Answer recap: I’d ask “what does ‘patient’ mean?” and try to find out what the therapist is asking for. Yes, treatment takes time, but you should see some results. If your child is medically compromised, you don’t have time to be patient. But if you’re talking about therapy, it’s a process. It does take time. Ask what you should be doing while you’re “being patient.”

10. My child’s in treatment for an eating disorder, what should I be doing?

Answer recap: Ask your child’s therapist! You should receive suggestions from the program or therapist regarding what they think will be helpful. Your outpatient therapist should regularly give you recommendations about what to do. I suggest parents provide support, love the child, supervise the food, weight, eating, and be mindful of purging. If the child is at a more acute stage of eating disorder behavior, parents may need to be more active in preventing the 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 eating disorder recovery.

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Can a person fully recover from an eating disorder?

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 biopsychosocial 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.

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.

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.

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.

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 disorders. She’s the founder of and a Parent Coach who helps parents navigate eating disorder recovery.

See Our Eating Disorder Treatment Guide For Parents

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Best care package ideas for a person who has an eating disorder

care package ideas for eating disorder recovery

Do you know someone who is being treated for an eating disorder? Do you want to show them that you care? A care package is a great way to connect with someone who has an eating disorder. It’s a wonderful reminder that people who love them are cheering them on.

Why send a care package to someone who has an eating disorder?

An eating disorder is a serious illness. However, unlike other illnesses like a broken arm or even cancer, most people don’t really understand eating disorders. Like all mental illnesses, eating disorders carry an unnecessary stigma, which can make it hard for friends, family, and loved ones to know how to respond.

People who have eating disorders can feel lonely and isolated. They may feel ashamed or guilty about their illness. But just like anyone who is facing a medical challenge, friends, family, and loved ones can really help by showing up, talking, and helping to care for someone who has an eating disorder.

Sending a care package is a great way to show support for someone who has an eating disorder. Whether the person is in treatment at a care facility or at home, it’s a loving, wonderful way to show that you care.

Sending a care package to an eating disorder treatment center

Eating disorder treatment facilities are a place where eating disorder recovery takes place in a managed care setting. These facilities make an effort to make the living conditions home-like. But just like any situation when you’re away from home, it can feel a bit institutional, and it’s nice to receive packages.

If you’re thinking of sending a care package to a person in an eating disorder treatment facility, it’s a good idea to call the facility and ask about their policies first. Unfortunately, not all facilities accept care packages, and many will check the package before it is given to the person in care. It’s best to know what you can and cannot do before you start putting a care package together.

But if you can send a care package, then I recommend that you do. Everyone I’ve spoken to who received a care package during eating disorder treatment was grateful and appreciated the thought and care. A care package is a great way for family members, loved ones, and friends to connect with a person while they are recovering from an eating disorder. They are a great way to remind someone that you are thinking about them, love them, and support their recovery.


Great care package ideas for eating disorder recovery

I asked people who have been in eating disorder treatment what they want. Here’s what they said:

Art/Craft Supplies

  • Sketchbook/Pads of art paper
  • Gel pens
  • Markers
  • Watercolors
  • Colored pencils
  • Coloring books
  • Macrame yarn/thread/string
  • Knitting/crochet/embroidery supplies

Boredom/Anxiety Management

  • Word searches/Crossword puzzles
  • Puzzles
  • Fidget spinners
  • Silly putty/slime/play dough
  • Stress ball
  • Slinky
  • Rubik cube


Just like home


  • Journal
  • Gel pens
  • Stationery and stamps
  • Stickers


  • Letters, postcards, and cards
    • Avoid requests to “hurry home” or “get better soon.” Instead focus on messages like “I’m proud of you,” “I’m rooting for you,” etc. Funny and corny are good choices, too!
    • Avoid images of food or bodies, which may be triggering.
  • Photos of loved ones, pets, and favorite places
    • Avoid images of the person in recovery. Remember that they may be sensitive to their appearance.
  • Personalized pillow or blanket. For example, add a custom quote or favorite pet’s face.
  • Paint/design a personalized inspirational message
  • A souvenir from a favorite place you have traveled together. For example, a miniature Eiffel Tower, London Bridge, snowglobe, etc.

Restricted Items

  • Food and drink items are typically restricted.
  • Each treatment center may have items that they do not allow residents to receive. It’s a good idea to check with the treatment center before sending a care package to ensure delivery.


The BuddyBox, developed by the Blurt Foundation, is a care package designed to make the recipient feel good. The contents are carefully selected to avoid psychological triggers. Blurt is an organization dedicated to helping people who have depression. But the BuddyBox is gender-neutral and applicable for many types of mental health conditions. BuddyBoxes are available as a monthly subscription or a single box.

Wrapping and delivery

One of the best parts of getting a package in the mail is unwrapping it! It’s so exciting to get a gift! Therefore, here are some ideas for getting creative:

  • Wrap the gift in gift wrap with a bow
  • Add confetti or glitter to an envelope
  • Add stickers on the outside of the envelope or package
  • Find a pop-up card, card with googly-eyes, or a singing card
  • Use a map of a favorite place, like Disneyland, London, or your home neighborhood, as wrapping paper
  • Use sheet music of a favorite song as wrapping paper
  • Enclose a personal voice recording or recording of a favorite song
  • Have a cousin, niece or nephew draw a picture on the wrapping paper

What to write in a card to someone who has an eating disorder

Once you have planned everything for the gift or care package, the final touch is a card or note. But what can you say to a person who has an eating disorder? And are there things you should not say? Here are some ideas for what to write in a card:

  • I’m thinking of you and can’t wait to see you again!
  • I’ll always remember when you/we …
  • We’re all behind you and support you
  • I believe in you
  • This is hard, and I’m so sorry
  • I’m here for you
  • Call or write to me anytime
  • I’m so proud of you
  • We’re looking forward to having you back home when you’re ready
  • Can’t wait to watch Riverdale with you for the thousandth time!

These may be obvious, but here are a few things not to say in a card to a person who has an eating disorder:

  • Can’t wait to eat cake with you again!
  • I wish you weren’t there
  • It’s ridiculous that you’re there
  • Hope they aren’t being too mean – haha
  • We’re having tons of fun without you
  • I found someone else to do things with
  • I started a new diet and lost a ton of weight
  • So much has happened since you left

Understanding eating disorders

A care package is a wonderful way to show someone that you care. But the greatest gift you can give a person in recovery is your understanding and acceptance. Our society is very uncomfortable with eating disorders. It can feel very lonely to have an eating disorder even though they are fairly common.

Disordered eating is common

Recent estimates say eating disorders impact about 10% of the population. But disordered eating, which is a milder but still serious form, is very common. Estimates put it at up to 80% of the population. Above all, knowing that disordered eating is common can help you be more understanding of your loved one.

Disordered eating is societally-driven

There are many factors that contribute to an eating disorder. But we cannot ignore the fact that our diet culture drives many of the behaviors and drivers of eating disorders. Therefore, understanding the societal drivers of eating disorders can help you be more compassionate towards your loved one.

Eating disorders heal in community

While eating disorders are often treated privately and in eating disorder treatment centers, the healing takes place in the community. Every person needs to eat, and eating is a part of our social fabric. When neighbors, friends, and loved ones understand eating disorders, they are less likely to make unintentionally hurtful comments. In other words, when communities commit to understanding eating disorders, they are healthier for 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 eating disorder recovery.

See Our Eating Disorder Treatment Guide For Parents

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What’s new in eating disorder treatment? An interview with Jennifer Rollin, MSW, LCSW-C

We sat down with Jennifer Rollin, an eating disorder therapist and founder of The Eating Disorder Center based in Maryland, to find learn what’s new in the treatment of eating disorders.

1. What do you think has changed about the way we treat eating disorders in the past 10 years?

I think there have been a lot of changes in eating disorder treatment, and we still have a ways to go. One of the big things is a shift towards more evidence-based treatments. We now have a higher emphasis on treatments that have been demonstrated by research to be effective. This will hopefully lead to improved care.

We have also seen the incorporation of Health at Every SizeⓇ (HAESⓇ) principles into eating disorder treatment. We’re experiencing a push towards more weight-neutral care, and are reducing the fat phobia that has been deeply steeped into so many treatments in the past. Providers are finally recognizing is that eating disorders impact people of all body sizes. We’re working hard to eradicate fat phobia in the eating disorder treatment space because it is incredibly harmful.

I think some residential treatment centers are lagging behind, especially in terms of supporting males who have eating disorders. We have two local treatment centers, and only one of them accepts males. Residential treatment has a long way to go in terms of equalizing eating disorders in terms of gender, race, size, and abilities. We are seeing a shift in terms of providers being more welcoming to people of all shapes and sizes, but we still need a lot more education that people who have eating disorders can be any body size, race, class, and gender.

We still need a lot more progress in terms of being welcoming to people in all types of bodies. A lot of people who have eating disorders don’t ever seek treatment because they don’t fit the stereotype and don’t seek treatment or when they do, they are not treated appropriately. Diet culture has completely normalized disordered eating so people don’t even realize they have a problem. Larger people who have eating disorders are often seen as someone who’s trying to “be healthy” and “lose weight.”

2. How do you work with adolescents who have eating disorders?

The first thing that’s most important when working with anyone, but especially teenagers, is building a relationship. It can be hard to earn teens’ trust, especially if they don’t feel a connection with their therapist or healthcare provider. We can have all the best clinical skills in the world, but if we can’t connect with a teen, we won’t get buy-in or trust, and then we won’t be effective. Personally, I think it helps that I’m younger, and I work to keep in touch with teen trends so that they feel I can relate to their world and, therefore, their deepest struggles.

When we’re working with a teenager, we have the benefit of being able to work with the family, which can really help treatment. I will utilize the family in the treatment process as much as makes sense. We have to look closely at the family dynamic and determine the best way to work in partnership for optimal treatment.

Sometimes I will use modified Family Based Therapy (FBT), especially if I’m working with a younger child and it’s a purely restrictive eating disorder. I find it’s most helpful to modify eating disorder treatment for each child and each family system. Anybody who says that any one treatment is a panacea for eating disorders is problematic – we must look at each case individually. Not everything is appropriate for everyone, and not every family can or should take on FBT.

3. How do you involve parents in a child’s eating disorder treatment?

This totally depends on the person and the situation. I always share with parents that they can be involved as much or as little as they want. Sometimes I need to push for more involvement if I feel it will serve the child’s recovery. I am the child’s therapist, but I will send weekly email updates to parents, and I encourage parents to email updates to me so that I can be aware of what’s going on at home. I will invite parents into sessions and sometimes do family sessions, depending on what makes the most sense. But I always remain aware that my client is the child.

It can be very tricky to navigate fat phobia and diet culture. Parents are so well-intentioned and love their kids, but I can still see that they are trapped in our societal expectations regarding weight. A HAES-informed recovery process involves accepting the body as it is, but I still have great parents asking whether they can help the child lose weight in a healthy way. This is where we still have a lot of catching up to do in terms of educating people about the futility and dangers of intentional weight loss.

When treating a child who has an eating disorder, I become very aware of parents’ thoughts about weight. I take a gentle educational approach and tell parents that in my professional opinion, any focus on weight loss is not helpful for anyone, especially someone who is in recovery for an eating disorder. I know parents want what’s best for their kids, and diet culture has convinced them that certain foods are bad or higher weights are bad. Parents just want to do the right thing, but unfortunately, even though they are trying to help, they don’t understand that it can hurt.

I sometimes recommend that parents meet with a HAES-informed dietician who can help them understand these concepts. The analogy is that having diet foods in the house, talking about dieting, and focusing on weight loss is like going on an alcohol bender while living with someone who is in recovery for alcoholism. We have to be mindful of what we do when we live with someone who is in recovery.

4. What do you think parents most commonly misunderstand about a child’s eating disorder?

I think the most common misunderstanding is that an eating disorder is a choice. Even if parents have been told that it’s not a choice, it’s hard to accept that. We naturally want to understand responsibility and want kids to recover. Well-intentioned parents may feel upset when a child doesn’t follow a recovery plan exactly, they will say things like “you have all these skills, why aren’t you using them?” But this is where it gets tricky. An eating disorder is not a choice, but recovery is. This means that the eating disorder can slip in at any time and take over, and a person who is in recovery has to exert tremendous effort to constantly make the choice to recover. It’s so helpful to know that recovery is a process, not an event. And recovery looks different for every single person.

Of course you’re concerned about your child, and of course you’re disappointed when you see them struggling. But parents need to understand that they are going to have these feelings, but they don’t always need to say them out loud, especially with their child. Disappointment is normal, but parents can unintentionally make kids feel they are disappointed in them for struggling.

I have some clients who feel very guilty for making their parents’ life complicated and scaring them. And it’s true that parents do have to work harder when a kid has an eating disorder, but if the child had cancer, the parent would do it and recognize it wasn’t the child’s fault that they have cancer. That’s what I’d love to see when a child has an eating disorder.

I see some parents who are resigned to the idea that their child will always be sick. Then I have parents who think that if the weight is fine, the child is fine. We have to find a balance and recognize that you can’t judge an eating disorder based on someone’s physicality. Ultimately it’s a mental illness, and we can’t tell how healthy someone is based on how they look or their behaviors.

5. What is advice would you give a parent who has a child who has an eating disorder?

First, have compassion for yourself. A lot of parents blame themselves for a child getting sick. It’s natural to think about what could have been done differently, but ultimately parents have to move forward. Make time for your own self-care. Helping someone in recovery can be emotionally draining.

Second, have compassion for your child, and have compassion for the eating disorder behaviors. Sometimes eating disorder behaviors are the best way your kid can cope in the moment. The eating disorder is serving a purpose for them, otherwise they wouldn’t’ have it. Your child is trying to help themselves – they’re just going about it in a way that is not helpful.

Clearly, I’m passionate about helping people to recover from eating disorders, but I also believe in starting with radical acceptance, which is a concept in Dialectical Behavior Therapy (DBT). Acceptance doesn’t mean you like it, it just means you acknowledge it’s there and you don’t have to make it the enemy. The eating disorder is currently a part of your child. When we make it the enemy, it can feel disapproving or critical to the person. Instead, seek ways to reduce anxiety and help your child meet the needs that their eating disorder is currently meeting, in other more life-affirming ways.

jennifer rollin eating disorders

Jennifer Rollin, MSW, LGSW is a Psychotherapist specializing in eating disorders and body image. In addition to her psychotherapy practice, she also offers recovery coaching via phone or Skype. She has published numerous articles regarding children, adolescents and eating disorders. Website

See Our Eating Disorder Treatment Guide For Parents

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Understanding therapy for eating disorders – an interview with Colleen Reichmann, Psy.D.

We interviewed Dr. Colleen Reichmann to find out more about what it’s like to be a therapist who specializes in eating disorders. 

Q: Why did you become a therapist?

I became a therapist because, quite simply, I wanted to give back! I have struggled with my own mental health issues, and have seen first hand the healing power of therapy, which inspired me to pursue a career in psychology.

Q: What made you decide to go into eating disorder treatment as your specialty?

I mainly made this decision because of my own past history-I struggled with an eating disorder for around a decade. I was told that I would be a “chronic” patient and felt so hopeless at times. When I finally began to really recover, I realized that I wanted to use this journey to help others who are struggling with eating disorders. This is not to say that I understand your eating disorder, because everyone is different. My past history simple gives me what I like to call an “empathy chip” for this particular illness and journey.

Q: What training have you received to be an eating disorder specialist?

Unfortunately, I did not receive much specialized training in the core parts of my graduate program, as it was a generalist program. I sought out research experiences (assistantships and my masters thesis and dissertation) that focused on eating disorders. I also attended conferences and trainings outside of school as much as I could. I completed my predoctoral and postdoctoral internships at inpatient eating disorders units, which were huge training experiences. Currently, I am pursuing my CEDS specialist, and expect to be finished within a year or so!

Q: How do you pursue ongoing education as an eating disorder specialist?

I attend conferences. Specialized eating disorder conferences are absolutely crucial. I make it a point to find training opportunities that offer an inclusive, Health At Every Size perspective on issues within the ED community.

Q: How do you typically approach treating a child (up to age 18) for an eating disorder?

Typically I utilize family based therapy (FBT) if at all possible. (I have received some specialized training in FBT). If parents are invested, involved, and ready to learn, I find it is ALWAYS best to include them in the treatment process. After all, you know your child far better than I do! If this is not possible, I offer interpersonal/feminist-relational therapy, with cognitive behavioral therapy techniques threaded throughout. I believe that insight-focused work AND behavior/action-focused work is necessary when it comes to recovery from an eating disorder.

Q: What treatment format do you typically recommend for a child (up to age 18)? For example, how often do you like to meet, for how long, and do you involve family members? Do you involve other caregivers like doctors and nutritionists?

I recommend at least weekly individual session, (50 minutes each), and every other session would ideally involve parents. I also recommend monthly (or more if needed) meetings with an eating disorder-informed MD, and weekly meeting with a dietitian (pediatric dietitians are very helpful for children under 12/13), and non-diet, fat-positive dietitians for everyone else!

Q: What would you like parents to know about having a child who has an eating disorder?

I would like parents to know that this is not your fault. This is a serious mental illness with research-proven genetic underpinning. You cannot “give” your child an eating disorder. You can, however, be a powerful piece of their recovery. I would also like to remind parents who feel helpless/powerless that you likely fed your child successfully for many years. You have the power and the knowledge to help your child-all you need now is guidance and support in how to apply that power now that your child is struggling with an ED.

Q: What mistake(s) do you think parents make when parenting a child who has an eating disorder?

I commonly see parents trying to “appease” their child when it comes to recovery. This is understandable-if your child is begging you not to eat something, to make something different, or to eat less, it is so common and human to want to comfort your child by giving in. To this I say, much like other aspects of parenting, the most comforting action for your child is not what will be best for him/her/them in the long term. Empathic firmness works best here.

I also see parents trying very hard to understand the eating disorder or rationalize what is happening to their child. Often times, it is impossible to find the rationality in someone who is struggling with an eating disorder. Please know that this is an illness with a largely fear-based brain component. Meaning that, neurochemically, your child’s brain is likely reacting similarly around food to someone who struggles with an extreme phobia and is being asked to confront it. So please do not feel hopeless if explaining the rational need for food/eating does not get through to your child.

Q: Do you see any promising new research or techniques that you think will make an impact on the future treatment of eating disorders?

I have recently seen some research that involves “bridging the gap” between research and field work when it comes to family based therapy. (This “gap” refers to the difference between the great outcomes that we have seen in controlled studies, versus the less-powerful outcomes that we see when this research is applied to real-life clients). I think this idea of focusing on the gap and how to close it will be very helpful to the field.

Additionally, we are seeing more and more providers discussing the role of intersectionality, identity, oppression, and marginalization when it comes to eating disorders. This is helpful because it allows us to begin addressing and confronting the environment that leaves some people vulnerable to eating disorders.  (Versus acting as if recovery happens in a vacuum).

colleen Reichmann psyd

Colleen Reichmann, Psy.D. is a licensed clinical psychologist who specializes in the treatment of individuals with eating disorders and body image issues. She has worked at various inpatient eating disorder treatment facilities and is the blog manager for Project HEAL. She lives in Virginia Beach with her husband and golden doodle and currently works at a group practice.

See Our Eating Disorder Treatment Guide For Parents

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How to pay for your child’s eating disorder treatment

Eating disorders are chronically underfunded, both from a research and a treatment standpoint. Many healthcare providers are ill-equipped to diagnose and treat eating disorders, and many insurance companies will severely limit treatment or deny treatment altogether. This is seriously depressing, especially since we know that eating disorders that are caught and treated early are less likely to turn into more serious forms that can require even more extensive (and expensive!) care.

There are several organizations that are working to address the inadequacy of eating disorder treatment and payment. But, meanwhile, if you have a child who has an eating disorder, you have to figure out how to pay for it.

Insurance coverage

Your first step is to get a formal diagnosis and find out what your insurance provider offers in terms of treatment. Depending on the diagnosis, your insurance provider, and various other factors, your child’s eating disorder treatment may be covered up to a certain point. But it is unlikely that the ongoing treatment required to maintain recovery will be covered. So, unfortunately, parents are in the uncomfortable position of figuring out how to pay for at least some of their child’s treatment for an eating disorder.

Grants for eating disorder treatment

There are two organizations that offer grants to help pay for eating disorder treatment. Project Heal is a major US-based organization that administers several grants, which you can check out here. The Manna fund offers scholarships for inpatient treatment programs in Atlanta, which you can check out here. Unfortunately, those are the only two organizations that we can currently identify as actively providing help with eating disorder treatment, but ask your treatment program or provider whether they have any grants or scholarships available.

Low/No Cost eating disorder treatment

If your child is currently enrolled in K-12 school, you should check with the school psychologist and/or counselor to find out how they may be able to help. Some schools have the resources to provide free counseling for students who have eating disorders.

If your child is currently enrolled in college, you should check with the school health center and psychology department. Often students can receive free counseling and therapy for a period of time.

Sometimes universities and research hospitals offer eating disorder treatment programs as part of their research. For example,  the Columbia University Department of Psychiatry has linked to RecruitMe, a recruitment tool meant to connect those who want to participate in clinical trials or research studies to the researchers that are conducting them, to help you find one. You can also check the national list of ongoing clinical trials here.

The non-profit organization Open Path Psychotherapy Collective is a network of mental health professionals dedicated to providing in-office mental health care to individuals, couples, children, and families in need. Open Path therapists provide in-office sessions ranging from $30-60 for an individual and $30-80 for couples and families.

Budgeting for eating disorder treatment

Unfortunately, like insurance coverage, both of these options are limited in scope and time. While they typically cover inpatient treatment, they may not cover ongoing treatment that is often necessary to maintain recovery. Eating disorders are complex and multi-faceted disorders that typically require ongoing treatment for underlying conditions such as anxiety and depression.

This means that parents are in the unenviable position of needing to fund their child’s recovery treatment out-of-pocket. If you are struggling to pay for your child’s treatment, please know that it’s absolutely not fair that we live in a society that grossly under-treats this serious condition. This totally sucks. Many parents go into debt, deplete retirement savings, and resort to other desperate measures to save their child.

Here are some basic budgeting concepts to help you plan for treatment.

1. Avoid expensive solutions

Many parents don’t realize that they don’t have to send their child to inpatient treatment for an eating disorder. Residential treatment programs cost an average of $30,000, but many times less expensive treatment is an excellent option.

In cases in which your child is not in immediate medical danger, you may be able to utilize outpatient treatment centers or even a less structured solution utilizing regular sessions with therapists and nutritionists. Remember that eating disorder treatment is a marathon, not a sprint. Very few of us will become instantly cured, and parents need to have the finances and energy for ongoing treatment for the foreseeable future.

Do your research. It’s hard to make big decisions when we’re really stressed, but as long as your child is medically stable, take some time to think through your options. Learn about eating disorders and treatment options, and don’t just blindly follow a treatment center’s recommendation. Remember that no matter how nice and authoritative they seem, treatment centers are running a business and need to recruit customers. That doesn’t mean they’re bad people, but we must always take their advice with this in mind.

It is better to hire one excellent and highly-qualified therapist or registered dietitian than to work with a low-cost, poorly-qualified team. Ideally, we recommend finding a weight-neutral therapist who has been certified by the IAEDP and has at least 5 years of clinical experience working specifically with eating disorders.

2. Create a budget

The biggest mistake people make when budgeting is not writing down the expected costs. Most of us just think about money one day at a time, but it will really help you avoid financial ruin if you can look at the costs of your child’s treatment clearly and in writing.

Whatever treatment you decide upon, you should ask your providers to give you a budget for at least six months of treatment. For example, if you were paying out of pocket, you might pay the following fees:

  • Therapy for your child: $150 per session, with twice-weekly sessions for four weeks, and once-weekly sessions for the following five months.
  • Nutrition therapy for your child: $100 per session, with four sessions spread over four weeks, with follow up once-monthly sessions for the following five months.
  • Family therapy: $150 per session, with twice-monthly sessions for six months.

This means you can budget as follows:

TherapistDietitianFamily TherapyMonthly Total
Month 1$1,200$400$300$1,900
Month 2$600$100$300$1,000
Month 3$600$100$300$1,000
Month 4$600$100$300$1,000
Month 5$600$100$300$1,000
Month 6$600$100$300$1,000
6-Month Total$4,200$900$1,800$6,900

Once you have estimated your monthly costs and the total cost for six months of treatment, you can begin to think about how you are going to afford treatment.

3. Create a savings plan

Before you start considering dipping into savings and using credit cards to pay for treatment, create a savings plan – you may be surprised by how little changes can make a big impact on your ability to pay for treatment. Think of every way you can reduce existing expenses first because this is going to help you avoid going into debt. Most of us have at least some non-essential expenses that can be cut to afford major expenses like eating disorder treatment. The key with a savings plan is to write it down and commit to your savings plan in writing.

Paying for your child’s eating disorder treatment is an unfortunate side effect of living in a society that undervalues and under-treats mental illness. Be careful about over-investing without thinking through the actual costs and creating a financial plan to make sure you don’t end up in an unsustainable situation.

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 eating disorder recovery.

See Our Eating Disorder Treatment Guide For Parents

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When your child gains weight in eating disorder recovery

woman looks at herself in the mirror and worries she has gained weight after an eating disorder

Stephanie’s daughter Nova had been doing well in eating disorder recovery … until she started to gain more weight than she expected. “I feel like weight gain has thrown everything off,” says Stephanie. “I’m terrified we’re going straight back to where we started.”

It’s quite common for your child to gain weight in eating disorder recovery. Regardless of your child’s current or previous weight, recovery can result in weight gain. This is due to many factors, all of which can be explained and intellectually understood. But someone who has an eating disorder is typically terrified of weight gain. And while they may accept weight gain intellectually, at some point they may balk as the weight continues to come on.

Weight gain in eating disorder recovery

Weight gain is expected, and so is a negative reaction to weight gain. While eating disorders go much deeper than weight, weight stigma and fear of fat are a critical symptom.

When a child gains weight in eating disorder recovery, they may believe that recovery is bad or wrong. These feelings can reduce them to tears. When they go to put on a favorite outfit, an outfit that they remember as being loose, they may discover that it is too tight. Fear of weight gain is a normal and natural part of recovery, and the only way out is through.

Here are a few tips for parents who are supporting a child who gains weight in eating disorder recovery.

1. Accept your child’s weight

Your child probably hates the size of their body. It’s very traumatic to gain weight in eating disorder recovery. It will take time for your child’s body to adjust to non-disordered eating. And it will take at least as much time for your child’s mind to adjust to a non-disordered body size.

You may be surprised by how much weight your child gains in eating disorder recovery. You may even be shocked and uncomfortable with it. Some people fluctuate up and down dramatically during eating disorder recovery. You may worry that your child is swinging too far.

We live in a fatphobic society, and your concerns about your child’s weight are understandable under these circumstances. But your concerns will not help your child heal from an eating disorder. It is very important that you accept your child’s body at every size throughout recovery and beyond. 

Take some time to learn about Health at Every Size, which can help put your fears to rest. The health impacts of having adipose tissue are small compared to the health impacts of an eating disorder.

Your child will sense if you are uncomfortable with their body. Even if you say nothing out loud, they know. This is an unfortunate fact of parenting. But it’s something we can work on. Notice every time you have a negative thought about your child’s weight, and change your mind.

Practice: first thought/second thought

You will probably have negative thoughts about your child’s body size. When that happens, notice the thought, and then change your mind.

For example, your first thought might be about how she looks: “she looks fat in those shorts!” Notice that thought, and replace it with something positive about how your child feels. “I’m so glad she’s feeling strong and healthy.” Alternatively, replace it with something positive about what their body does. “Her body is getting stronger every day.” This takes practice, but it’s essential in helping your child heal.

2. Trust your child’s body

Someone who has an eating disorder has learned to ignore feelings of hunger and satiety. An eating disorder requires a disconnection from the natural instinct to feed and move the body in healthy ways.

Eating disorder recovery includes reconnecting the mind and body. It involves building mind-body communication pathways. Someone in recovery must learn to trust a body that they have previously determined to be untrustworthy. This is hard.

Intuitive eating can be very helpful, but it is an advanced concept. Intuitive eating requires listening to the body and giving it what it needs. This is something that takes time to develop, especially for someone with an eating disorder.

As your child learns to trust their body, you can help by trusting their body. This goes against the cultural messages that tell us bodies must be controlled. But controlling the body resulted in an eating disorder for your child. It’s time to try something different.

Parents must trust their kids’ bodies, even when our kids don’t feel they are trustworthy. We must trust even when we are scared that our kids will get “too fat.” We can’t know whether they will fully recover, but we can trust that their bodies will try to survive.

Body trust-building statements

Here are some trust-building statements to say out loud to yourself, other family members and your child:

  • If we listen to our bodies, they find balance.
  • Our bodies are naturally self-regulating.
  • It takes time to tune into how our bodies feel and what they want, and we’re working on it.
  • We were born knowing how to eat, when to eat, how much to eat, and what to eat. Sometimes our thoughts get in the way of this inborn knowledge. But, with practice, we can reconnect with our intuitive body wisdom.

3. Be prepared for the fallout of weight gain during eating disorder recovery

While eating disorders are about much more than food and body size, food and body size are massive triggers for someone who has an eating disorder. When bodies gain weight in recovery, alarm bells ring. Eating disorders tell us that weight gain is very, very wrong. Your child will have to face weight gain in order to succeed in recovery. It’s not easy, since our society insists that weight gain is always bad. Be patient, and be prepared for messiness.

Your child may rage and scream. They may cry and mourn. Their body has become your child’s expression of self-worth. As their body changes, your child may feel worthless and unlovable.

These feelings not over-dramatized or exaggerated. Your child is truly hurting and mourning the loss of the eating disorder’s role in their life. The eating disorder was a valuable and important coping mechanism, and losing that coping mechanism is traumatic.

It is hard to see our children suffer. It is hard not to want them to calm down and stop feeling angry and sad. But it is critical that our children receive the space they need to express the very real panic, fear, and despair that comes with losing an eating disorder and gaining weight.

When the fallout comes, and it may come all day, every day for a while, take a deep breath and remember that it’s real, and it needs space.

Feel the feelings

When your child gains weight during eating disorder recovery, they will have a lot of feelings. Don’t try to distract your child from the pain. Don’t try to take it away or tell them that it’s overblown. Listen to your child every time they want to talk about this. Let the pain come. It will pass. Help your child feel their feelings. The best thing a parent can do is to be present and supportive through their child’s feelings. Your ability to tolerate feelings will help your child learn to tolerate feelings.

Stephanie was relieved to realize how normal Nova’s reaction is. “I’m still scared, but now I feel like I know what I can do to help her. And I’m going to talk to her eating disorder treatment team to see if there’s anything in particular they want us to work on at home.”

Navigating eating disorder recovery is challenging, but Stephanie’s got the right attitude, and she’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 eating disorder recovery.

See Our Eating Disorder Treatment Guide For Parents

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When your child refuses to get treatment for an eating disorder

refuses treatment eating disorder

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

Why people refuse treatment for eating disorders

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

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

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

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

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

1. Don’t engage in debates or power plays

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

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

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

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


2. Get help for yourself

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

While your child is the one who has an eating disorder, you can make a significant impact on their recovery. This is because parents and families are often part of the eating disorder formation. Find a qualified therapist or coach who works with parents. Parents can also work with a dietitian who can help you with food and weight beliefs and meal behaviors.

Ideally, seek someone who is familiar with Health at Every SizeⓇ (HAESⓇ) and will not mistakenly discuss your child’s body as a problem. We have a directory of professionals who can help.

In therapy/coaching, you can work on your beliefs, assumptions, and parenting skills. You’ll also get someone who has compassion for your experience. Parenting through an eating disorder is not easy, and you deserve support.

Q: Which should I try, therapy or coaching?

A: Both are an excellent way to get in touch with your parenting style and help you navigate eating disorder recovery. A therapist is a licensed professional who helps people develop better cognitive and emotional skills and cope with life. A coach helps people identify and achieve life goals. The difference is mainly style, and therapists and coaches vary greatly. So the best thing is to find someone who feels like a good fit for your needs. You need someone who you can trust to help you get through this and grow in the process.

3. Repair your relationship with your child

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

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

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

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

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

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

4. Attend family therapy

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

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

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

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

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

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

5. Enjoy your child

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

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

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

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 eating disorder recovery.

See Our Eating Disorder Treatment Guide For Parents

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When your child has an eating disorder relapse

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 treatment 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 disorders. She’s the founder of and a Parent Coach who helps parents navigate eating disorder recovery.

See Our Eating Disorder Treatment Guide For Parents

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Eating disorder + trauma = specialized treatment

treatment Trauma plus an eating disorder requires specialized treatment

by John Levitt, PhD

Estimates tend to vary, but data suggests that approximately 68%-98% of people who attend eating disorder treatment programs report histories of sexual, and other, abuse or trauma. This suggests that when we treat eating disorders we need to be prepared to treat a potentially underlying trauma history and even, possibly, Post Traumatic Stress Disorder (PTSD).

When I work with someone who has a persistent eating disorder, coupled with potentially long-term Post Traumatic Stress Disorder (PTSD), they have often had a very hard time receiving comprehensive treatment. Unfortunately, many providers who treat trauma regularly are not as well-versed in how to treat eating disorders; and many people who regularly treat eating disorders are not as well-versed in how to treat trauma. That is, they struggle with providing a unified approach to treating both!

Indeed, while most of our treatments for eating disorders are interdisciplinary in nature, models of treatment for long-term persistent problems that include trauma generally need an integrated approach to address both.

Trauma-specific treatment

The majority of evidence-based trauma-specific treatment models are 12 -16 weeks or so. These approaches may be effective for treating cases of an immediate response to a distinct traumatic event. In such situations, therapists can move quickly to address the trauma before symptoms can be entrenched and before the client develops trauma-related symptoms such as dissociation and/or other complex secondary coping mechanisms such as an eating disorder.

But I find that eating disorder/trauma clients’ treatment generally requires considerable time, skill, and patience! The majority of my clients have experienced multiple traumas over a long time. Their eating disorders, drug use, cutting, and other behaviors are often employed as one of their way of managing trauma symptoms.

The greatest challenge I frequently face is that I must support a person undergoing eating disorder treatment without re-traumatizing the person by addressing the trauma too quickly or too aggressively. It has been my experience that if I push too hard on the trauma, I can actually exacerbate the eating disorder behaviors. That is why I have developed an integrated approach to organizing treatment for both eating disorders and trauma-related disorders or symptoms.

Getting started

The first thing I do when I’m working with a client who has PTSD-like symptoms and an eating disorder is to teach them how to manage both the eating disorder as well as the trauma-related experiences. Trauma-related reminders such as body changes, like arousal and numbing, along with traumatic intrusions (e.g., memories) often serve as “triggers” for eating disorder behaviors.

I educate the client about how to regulate their behavior and emotions in such situations as well as how to modulate their mood, eating, and sleep patterns. Once those elements are stable, there may be an opportunity for addressing the memory components of the traumatic experience.

The clients I work with are very sensitive to re-traumatization, so exposure therapy too early can kick their eating disorder and other coping mechanisms into high gear. Instead, I work over time to educate and empower the client. With time, the person is able to reduce their reliance on self-defeating coping mechanisms and regulate much more effectively.

Eating disorder as comfort

In cases of PTSD, the eating disorder has often become a comfort. It is a powerful management tool, and if we take it away too soon, or if we don’t adequately support the development over time of new alternative coping skills, then we can leave the person in a tenuous recovery situation. At this point, relapse, or exacerbation of eating disorder symptoms, may become more likely. I see relapse as a sign that more time and more practice are needed to integrate understanding, skills, and support mechanisms. This is one reason why complex eating disorders individuals often require time to fully recover. And, importantly, we need to remember that healing looks different for everyone.

Once we have built confidence in terms of handling traumatic feelings and experiences with adaptive behaviors, we may choose to address the trauma head-on, but that is always dependent on the client’s individual choice and situation. Not everyone who has undergone trauma must re-experience the events to recover from PTSD. It is definitely case-dependent.

Something that we have to address when working with PTSD and eating disorders is the acknowledgment that we live in a victimization-oriented society. We tend to see people as victims, especially when they are traumatized as children. It’s true that trauma is devastating and often criminal, but my goal as a therapist is to move a client from being a victim to being a survivor who can cope, and who is empowered to live a full, satisfying life. People who have been traumatized are not responsible for what happened to them, but that doesn’t mean we need to view them as victims. They are capable of becoming responsible for how they interact with their current world.


Considering abuse

When I’m working with someone who has an eating disorder and has PTSD stemming from abuse, my goal is to take steps to help that person accept responsibility and implement efficacious actions for their own recovery. Rather than potentially re-traumatizing the person by “taking away” the eating disorder, I believe that healing must remain within the person’s own power, control and choice.

In the case of working with children or adolescents, this is why I tell parents that I’m not “fixing” their child, but I am here to help the child to become empowered to make more effective choices in their life rather than feel victimized by others, or their disorder.

How parents can help

Parents can be really helpful when they recognize that their child’s PTSD treatment is not generally about what the parents did or did not do to protect their child, but is focused instead on supporting the child’s coping skills over time. It doesn’t take long to learn coping skills conceptually, but they take time to become integrated; especially if they are replacing a powerful behavior like an eating disorder.

It should be said that if parents do feel “guilt” for what happened to their child, whether from abuse or the eating disorder itself, they would be best advised to seek out their own individual, and/or couple treatment.

I’d also like parents who have a child with both PTSD and an eating disorder to remember that their child’s behaviors are not criminal acts. Yes, it is frustrating, unhealthy, and hard to watch one’s child struggle with any problem. An eating disorder can appear to a parent as disobedient or possibly even “crazy.” This does not mean parents should not set limits or expect healthy behaviors, It does mean that the less charged the parents are around the eating disorder behavior itself, and the more they can support their child in learning new coping skills, the easier it is for the child to find their way towards recovery (and the easier it will be for the parent to live with the child).

John Levitt, PhD

John Levitt, PhD, CEDS, FAED, FIAEDP has been treating people who have complex eating disorders, including trauma and self-injury, for more than 40 years. He teaches classes at Argosy University on trauma and counseling which covers the complexities involved in treating trauma-related disorders such as PTSD and associated disorder, such as eating disorders. John is the co-editor of the books Self-Harm Behavior and Eating Disorders: Dynamics, Assessment, and Treatment, Personality Disorders and Eating Disorders, and Handbook for Assessing and Treating Addictive Disorders. He was on the Editorial Board of Eating Disorders: The Journal of Treatment and Prevention. He can be reached at Email: Phone: (847) 370-1995

See Our Eating Disorder Treatment Guide For Parents

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Antidepressants for eating disorders

antidepressants eating disorders

Antidepressants and other psychiatric medication are often prescribed during treatment for eating disorders. Deciding to use medication to support your child’s recovery is deeply personal and individual. If your child’s psychiatrist is recommending medication, you can ask the following questions:

  • What are the symptoms you are hoping to treat?
  • Why are you choosing this specific medication and dosage?
  • What is the evidence of this medication being effective in my child’s specific situation?
  • How long do you anticipate my child will need to be on this medication?
  • How will you evaluate whether the medication is successful?
  • Do you have a plan to eventually taper or reduce my child’s prescription?
  • What should I look for at home and when and how should I report troubling side effects?
  • Is there anything my child should not do when taking this medication?

When facing a big decision about whether medication will be helpful it’s very tempting to seek input from friends, family members, and even strangers on the Internet. You also probably already have strong opinions about whether psychiatric medicines are good or bad, helpful or unhelpful. Use caution when jumping to conclusions or seeking advice from anyone who is not either a psychiatrist and/or directly involved in treating your child.

There is a lot of stigma about psychiatric drugs, and while I do believe in being cautious and thoughtful about medication plans, I recommend you seek scientific evidence rather than opinions and ideas from individuals who mean well but are not qualified to give medical advice. 

If you do conduct your own research, keep the following guidelines in mind: 

Check your sources

It’s easier to read a blogger’s opinion about medication, but consider whether they are telling you a personal account or referencing scientific peer-reviewed research studies from professional psychology journals. These studies have undergone rigorous evaluation by experts and are thus more likely to be credible and accurate. Lay people mean well and are much more engaging than scientific reports, but they are also very likely to misinterpret or misunderstand key elements of the original research. Whenever possible, find the original research and take a look at it yourself. Then ask your child’s psychiatrist for their opinion.

Check your biases

All humans have something called “confirmation bias,” which means we seek to support our existing beliefs. This can be dangerous on the internet, where we can go down rabbit holes that support our beliefs without considering the alternative perspectives. Evaluating something scientifically begins with knowing your biases and challenging them. So if you believe that medication for ADHD is dangerous, begin your research by seeking confirmation that it’s useful. Simply taking this step will help you avoid the confirmation bias trap and give you a more complete view of the potential benefits and drawbacks.

Assume a mixed prognosis

Almost nothing in psychiatric medicine is clear cut. Every medicine has its pros and cons. Go into your research assuming that even a “magic bullet” may not work for your individual child. Medicine may work like magic, it may help a little, or it may not help at all. You really won’t know until you see it in action. Knowing this in advance can help you take a more scientific approach to medication.

Beware of personal anecdotes

Every medication will have message boards on which people praise the medicine, calling it a lifesaver, and message boards on which people bash the medicine, calling it a dangerous mistake. These personal anecdotes are all individual people who have their own unique experience with medication. I found these message boards when I was considering a particular medication and it completely freaked me out. But when I stepped back, I noticed that there were just as many people singing its praises as there were people saying it was terrible and useless. The feedback from individual people was very mixed. So I went back to the peer-reviewed journals to get the evidence and help me make the best possible decision at the time. 

Some data on antidepressants in eating disorder treatment

The data on antidepressants for eating disorder treatment is mixed. For example, a study in 2008 found no statistically significant differences between antidepressants and placebo for the frequency of binge-eating episodes, but a study in 2022 found significant reduction in binge frequency with antidepressants. A 2006 study concluded there was not enough evidence to draw a definite conclusion regarding antidepressant use for acute anorexia. And a study in 2003 found that antidepressants were clinically effective for bulimia but also had a higher rate of dropout from the study, suggesting there were other side effects.

One thing to think about is that the placebo effect is real. Just because an antidepressant doesn’t perform better than a placebo doesn’t mean it’s not working at all. Because placebos work! So consider that sometimes when someone is in pain, there is tremendous relief in being prescribed medicine to help. And if a sugar pill works as well as an antidepressant, that means either one can help.

Also, your child’s psychiatrist may prescribe an antidepressant not for the eating disorder symptoms themselves, but for other conditions. Antidepressants are frequently prescribed for other conditions that co-occur with eating disorders, including depression, anxiety, ADHD, and OCD.

Additionally, keep in mind that many prescriptions are short-term, used to help a person get through the worst of their depression. Meanwhile, a therapist can work with your child on anti-depression strategies like movement, emotional regulation, and sleep.

The bottom line is that you should consult with your child’s psychiatrist and make a personal decision based on their advice.

emotional regulation

Other options

Depression is a serious condition that must be taken seriously. The question is not whether to treat depression but how to treat it: with or without medication. Your child may benefit from antidepressants to get through this stage of their recovery. That absolutely may be the best decision right now. But at the same time, consider the power of lifestyle influences on depression. Lifestyle changes that are known to reduce symptoms of depression, often at higher rates than antidepressant medication, include:

  • Sleep hygiene
  • Emotional regulation skills
  • Exercise
  • Close family connections
  • Belonging to social groups
  • Meaning and purpose

Also, don’t underestimate the impact your own mental health can have on your child’s mental health. If your child is in eating disorder treatment, it will help if you pursue therapy or coaching as well. This is a great way to reflect on the patterns in your family and how your behavior impacts how your kids feel. Such self-reflection can have a huge impact on how your child feels. Therapy is not a punishment for being a bad parent. It’s a way for you to continue to learn and grow so you can meet your child’s needs and remain close even as they face their own mental health issues.

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 eating disorder recovery.

See Our Eating Disorder Treatment Guide For Parents

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Why is my child gaining weight in eating disorder recovery?

Weight gain is often a natural and healthy part of eating disorder recovery. Parents must accept their child's weight gain to support recovery

If your child is in eating disorder recovery, you may be noticing they are gaining weight. Sometimes you are prepared and even desperately want this. If your child has been dangerously weight suppressed, then, of course, you want them to gain weight. But for many parents who have kids in recovery, there comes a time when they worry their child is now “swinging the other way” or “going too far” in recovery.

That’s what happened to Kari and Ian. Their daughter Bailey is in recovery for anorexia. After hospitalization, she went into residential treatment. She did well, and Kari and Ian implemented Family-Based Treatment (FBT) while Bailey gradually stepped down from full residential to lower levels of care.

“I read all these stories about kids not recovering, so I feel really lucky that it seems like the treatment worked really well for Bailey,” says Kari. “But the truth is that now I’m a bit worried. Bailey’s weight has passed the point of where she was before the eating disorder. Her doctor seems a little concerned, but her therapist and nutritionist assure me that this is how it should be. I’m pretty confused and just want to do the right thing.”

Restriction and eating disorders

Almost all eating disorders begin with dietary restriction. A child can be anywhere on the weight spectrum when they start the cycle of an eating disorder. Due to a cascade of physiological factors, the restriction can beget more restriction. For many others, it leads to a restrict-binge cycle. Either way, the body and brain are not receiving the nutrition they need to maintain “homeostasis” or a steady weight.

Once in the cycle of most eating disorders, the person may become increasingly food- and weight-oriented. They find themselves thinking about eating or not eating many times per day. They may plan exactly how to avoid eating or what to eat next. Rules and restrictions take over their lives, leaving little room for anything else.

Most eating disorders begin with a diet. Whether your child remains in the restrictive phase (anorexia), or cycle between restrict-binge (binge eating disorder) or restrict-binge-purge (bulimia), restriction is a core behavior. 

Multi-layered disorders

While this is happening, most* bodies respond by slowing down the metabolism to meet the unstable access to food. The body does not like weight loss or unstable food supplies, so it triggers a famine response in which the body becomes extremely efficient with every nutrient and calorie it receives. This is why most efforts to lose weight result in regain, often with some extra pounds to protect against the next famine.

*In people with anorexia, their bodies may go into hyper-metabolism, which can remain a symptom for many months following weight restoration.

Why is my child gaining weight?

This effect can also happen with an eating disorder. Even after recovery, the body can continue to run slowly and hold onto calories and nutrition in an attempt to avoid the deadly impact of famine. Many people accept that they carry extra pounds in eating disorder recovery simply because their eating disorder triggered their body’s famine response.

While this can be challenging in our anti-fat society, it’s a necessary part of recovery for many people.

If your child is gaining weight during recovery from an eating disorder, it is because weight gain is a natural and physiological natural response to the restriction they endured. Your child’s weight during recovery may fluctuate wildly as the body recovers a new state of homeostasis.

How much weight will my child gain during recovery?

Weight gain during recovery depends on how big of a factor weight was in your child’s eating disorder, how long your child has struggled with an eating disorder, his or her individual metabolism, the total weight lost and gained throughout the eating disorder, the number of weight cycles, and more. These factors will combine to make each recovery journey unique.

Because most eating disorders involve restriction, recovery often includes weight gain. Recovering bodies need to return to a natural weight and will likely add pounds in response to the restriction endured during the eating disorder. It is impossible to estimate your child’s recovered weight, especially since it may take years for your child’s body to settle into a new “normal.”

What you must know is that once recovered, no number on the scale will ever measure your child’s health. Full recovery from the eating disorder, not body weight, will dictate your child’s health and the likelihood of a successful, meaningful, and joyful life.

It can be uncomfortable

The good news is that your child’s weight, with proper eating disorder treatment, will eventually stabilize. The bad news is that your child’s new weight may make you uncomfortable. This is why you need to work on your own biases about body weight and food restriction.

  • Do you believe low body weight is a sign of health?
  • Do you believe that your child can only be happy and successful in life if his or her body meets a narrow societal standard of body size?

These are the questions that Kari and Ian had to consider as Bailey gained weight.

“Our primary goal, of course, is for her to be mentally healthy,” says Kari. “Of course, we don’t want the eating disorder coming back, so we’re going to be vigilant about not allowing restriction and dieting anymore. We’ve gotten rid of all our diet foods and are careful about how we talk about food and weight now. But the truth is that we still struggle with the idea of gaining weight. I guess it was just so ingrained in us, as kids of the 80s, that thin is best. I’ve been watching my weight my whole life. This is a major shift for us.”

This makes so much sense. Weight gain is a challenging issue in our society. When a family faces an eating disorder, our cultural weight biases become critically important. We have to evaluate how and where they seep into our beliefs and thoughts and work to overturn them.

That’s what Kari and Ian are working on now. “I can see that we still have a lot of work to do about our own weight biases,” says Kari. “We’re working to understand weight science and accept our own bodies and Baileys. It’s not easy, but her life and health are worth it to us!”


Is it ever too much?

Now that you understand that weight gain is a natural and healthy part of eating disorder recovery let’s just consider if there is such a thing as “too much.” I believe that most of the time weight gain makes sense during recovery, but since an eating disorder can swing between restriction and binge eating, weight gain can sometimes (not always!) be a sign of an ongoing eating disorder.

Unless your child’s doctor is an eating disorder specialist, I take any concerns they have about weight gain with a grain of salt. Unfortunately, our healthcare system has a lot of weight stigma, and most doctors don’t understand eating disorders. On the other hand, I would do a quick check-in with your child’s dietitian and therapist.

What I would ask the dietitian:

  • Are you still focusing on a weight gain goal?
  • Is the current weight gain unexpected?
  • Are we on track to guiding our child toward an Intuitive Eating approach?
  • Do you have any concerns about my child’s weight gain?

What I would ask the therapist:

  • Do you see signs of reduced or increased food obsession and compulsion?
  • Do you believe my child is still actively in an eating disorder?
  • What skills are you teaching that we can reinforce at home to support recovery?

Kari and Ian took these questions to Bailey’s therapist and nutritionist, and they felt greatly relieved. “Both of them explained in detail the signs of recovery that they were observing and what they were still looking for,” says Kari. “They were confident that Bailey’s weight would even out over time and that any gain at this point is not a sign of a new or different eating disorder. I feel so relieved, but we still have work to do on our own feelings about her recovered body. I know this is for us to work on and has nothing to do with her. So we’re working on it!”

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 eating disorder recovery.

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

See Our Eating Disorder Treatment Guide For Parents

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A treatment team for your child’s eating disorder

When your child is diagnosed with an eating disorder, you need four types of professionals to make healing faster and easier

The most common form of eating disorder treatment is putting together a treatment team. This team typically includes a doctor, therapist, registered dietitian and psychiatrist. I’ll provide information on each, but please keep in mind that I recommend finding providers who are specifically trained in and receiving supervision in eating disorders. The majority of providers do not have this experience, but I would insist on finding at least one provider who does, especially the therapist and/or RD.

Additionally, it’s best to find providers who practice from a non-diet, weight-neutral perspective whenever possible. Your child’s eating disorder treatment team is essential to their recovery, so it’s worth investing in finding the best people you can. Eating disorders tend to get worse, not better, over time, and comprehensive treatment is invaluable.


If possible, find an eating disorder specialist who is qualified to diagnose and treat eating disorders. This is a pretty rare specialty, but an unqualified therapist can unfortunately do more harm than good. For example, a therapist who is unaware of their own weight stigma can unintentionally perpetuate harmful beliefs and behaviors.

Your child’s therapist will help your child learn to process anxiety, sadness, and loneliness in adaptive ways in order to leave the eating disorder behaviors behind. This will take time and patience. Therapists have just one hour per week (on average) to work with your child, so their impact depends on whether your child is doing homework and practicing skills at home between sessions. You can help by becoming involved and getting advice from your child’s therapist about what you and the family should be doing to support recovery.

Family Therapy

Family therapy is a way for your whole family to explore communication patterns and expand connections. Families are ecosystems. The paradox is that no single person is responsible for the family’s health or disease, and yet each person impacts the ecosystem’s health or disease.

Not every family with an eating disorder needs therapy, but most do. Think of it as an opportunity to have a tune up and get some valuable feedback and advice from a trained professional. Bring your curiosity and if the therapist gives you advice, consider it thoughtfully.

Therapy or Coaching for You

Parents who personally engage in their child’s recovery from an eating disorder can make a huge impact. We are all overwhelmed by today’s parenting standards. There is no single book and no magic bullet to creating the happy family of our dreams. It is often when we admit our own vulnerability and seek support and growth as parents that we can achieve true family connection and health.

Since you’re the person reading this article, you clearly are interested in how you can help your child heal from an eating disorder. The fact is that we can never change another person. No matter how much we love our child, we cannot force him or her to stop having an eating disorder. But we can look in the mirror and, with the help of a qualified therapist or coach, learn how to improve our parenting in light of our child’s condition.

Engage a therapist or coach who can help you be a better parent. Not because you are a bad parent, but because we can all be better. It is 100% true that no parent is responsible for a child’s eating disorder, but it is also 100% true that we can all contribute to full healing and health if we pursue self-growth through the recovery process.

Registered Dietitian (RD)

A Registered Dietitian (RD) can be an invaluable member of your eating disorder treatment team. RDs who are trained in eating disorders are qualified to diagnose and treat eating disorders. Just be sure to find one who is both qualified in eating disorders and offers a non-diet approach to health. Unfortunately, it can be very dangerous for your child to engage with an RD who is not familiar with how eating disorders work and the problems with weight stigma.

A dietitian’s knowledge and expertise includes nutrition, physiology, and promoting behavior change. They understand the complex interactions between psychology, social, and cultural aspects of eating. RDs are qualified to provide medical nutrition therapy (MNT), an evidence-based nutrition process designed to treat specific medical conditions, including eating disorders. MNT is developed and implemented by an RD, often in concert with the patient’s doctor.

Medical Doctor

Medical monitoring is necessary for your child with an eating disorder, and every doctor is capable of conducting this monitoring. Your child’s doctor should complete a physical exam measuring weight and height and checking vital signs regularly to monitor health.

There are two types of doctors when your child has an eating disorder. First is the doctor who has been specifically trained in eating disorder treatment. The second type of doctor is a primary care physician who has not been trained in eating disorder treatment. Both doctors mean well and can provide adequate care for your child, but the latter type are likely not aware of the many landmines involved in treating eating disorders, nor do they have the time in the typical 10-15 minute appointment to sensitively address your child with an eating disorder. But as long as you know this, you can work with it. Ask doctors who are not eating disorder specialists to assess your child’s vital signs of health and not provide any counseling or advice. 



Depending on your child’s psychological symptoms, their treatment team may recommend seeking advice from a psychiatrist. Psychiatrists are medical doctors and most of them focus primarily on prescribing psychiatric medication to ease symptoms. Your child’s psychiatrist must work in tandem with the doctor treating your child’s medical symptoms and will likely also consult with other team members.

IAEDP is the leading foundation recognized for certifying professionals who work in the eating disorder field

Individuals with iaedp Certification designations (CEDS, CEDRD, CEDCAT, or CEDRN) are health care professionals who have met rigorous educational and skill requirements, have accumulated a minimum number of hours of qualifying work experience, have made a commitment to stay abreast of current developments in the field through continuing education, and have agreed to comply with the Association’s ethical principles.

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 eating disorder recovery.

See Our Eating Disorder Treatment Guide For Parents