A guide for parents to help with feeding kids who have eating disorders
Feeding is an essential role for parents to take on in eating disorder recovery. And yet the last thing a child with an eating disorder wants to do is eat balanced, regular meals with their family. Power struggles and negotiation are common but unhelpful. Parents who learn how to feed a child with an eating disorder will be more successful, but it’s hard!
This is a good time to review your own relationship with food and update any unhelpful beliefs about weight and eating that may hold you back from supporting your child.
You don’t have to do this alone! There are dietitians, coaches, and therapists who can help you build a healthy relationship with food and your body.
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Eating disorders have both physiological and psychological causes and symptoms. A hungry and chaotically-fed brain is an angry, obsessive, and anxious brain. It struggles to think clearly. It’s wallowing at the bottom of Maslow’s hierarchy of needs, barely sustaining itself. Eating disorder treatment must involve regular, healthful feeding for both physical and psychological recovery.
Of course this can be challenging. Someone with an eating disorder does not want to eat with you. They don’t want to follow your rules. Feeding someone with an eating disorder is hard, but you’ve got to do it. And this applies to all eating disorders, since they all involve restriction and chaotic eating patterns. The first-line treatment for all eating disorders is regular, structured meals.
You can make a huge difference in recovery if you help your child get enough food on a consistent schedule. A person in recovery should be eating every 2-4 hours. This includes three meals and two snacks per day. And since this can be a slippery area when you’re working with an eating disorder, the definitions are:
- A meal consists of all four of these elements: carbohydrates (~50% of the meal), protein, veggies/fruit, and fat
- A snack is at least two of the elements
Exactly what you feed your child is something you can figure out intuitively, or you can work with a non-diet, eating disorder Registered Dietitian (CEDRD). You can also reference Plate by Plate, which gives more information about what to serve and how to eyeball reasonable portions. If your child needs to restore their weight in eating disorder recovery, they need to eat a lot of food. This can be tough, but psychological recovery cannot begin until weight restoration is achieved.
Eating meals together has always been an act of community. It is only very recently that humans have eaten alone. Families should strive to eat together as often as possible.
Studies have found that more frequent family meals, placing a high priority on family meals, and a positive atmosphere at family meals are positively correlated with fewer cases of disordered eating. Family meals are also linked to improved dietary quality, including eating more fruits, vegetables, grains, and calcium-rich foods and fiber. Eating family meals together reduces food restriction and avoidance, binge eating, and purge behaviors.
Families facing an eating disorder should prioritize family meals on most days. This is not easy, but it will make a big difference.
In our society it’s normal to talk about food as if it has inherent “good” and “bad” qualities. For example, potato chips are considered “bad,” and kale is considered “good.”
In eating disorder recovery, it’s important for families to embrace an “all foods fit” approach to eating. You make all the difference, since the way parents talk about food influences how kids feel about food.
Here are a few phrases to eliminate:
- That’s so healthy/unhealthy
- I can’t eat that or I’ll gain weight
- That’s junk food
- If I start eating that I can’t stop
- I’m eating clean
- I ate too much and now I need to be good
Family Based Treatment (FBT)
If your child needs weight restoration to recover, Family-Based Treatment (FBT) may be your best bet. FBT is considered by many to be the first treatment of choice for adolescents with anorexia. The primary focus of FBT is weight gain and it is a viable alternative to residential treatment.
FBT is an effective intervention for teens with anorexia. Also, preliminary evidence suggests that it may be effective in treating teens with bulimia. This treatment is very effective, but only when parents learn the skills to make it successful. Because the truth is: it’s hard. You deserve support and guidance when doing FBT with your child.
Emotional eating is usually considered a bad thing. But food and eating are inherently emotional. And there is nothing wrong with eating for emotional reasons. However, binge eating, which is a different but related thing, causes tremendous distress. Therefore, we do want to get to the bottom of it.
The most common reasons for binge eating are: hunger, chaotic feeding structure, poor sleep hygiene, and emotional dysregulation. If you are worried that your child is binge eating, attend to these core structures.
Intuitive Eating, which is commonly used in eating disorder recovery, reduces food restriction and avoidance, binge eating, and purging. It also improves both physical and mental health in these important ways:
- Blood sugar
- Cholesterol levels
- Intake of fruits and vegetables
- Body satisfaction
While Intuitive Eating is very helpful for people in eating disorder recovery, it is not typically recommended in the early stages of treatment, especially if weight restoration is needed. During this period your child’s hunger and fullness cues will be thrown off by the eating disorder. Talk to your child’s treatment team about when to introduce Intuitive Eating.
Food Refusal & Picky Eating Printable Worksheets
Give your child the best tools to grow into a confident, calm, resilient eater!
< More About Treating Eating Disorders
Key Articles About Feeding Kids With Eating Disorders
free cheat sheet: Parenting A Child With An Eating Disorder
⭐ Get ready for recovery and find out how you can prepare yourself for maximum success.
⭐ Find out the essential steps and family rules you need to have in place for recovery.
⭐ Make your home recovery-ready with six simple steps that anyone can do.