Parenting a Child With an Eating Disorder

Before you can focus on what to say and what to do about a child with an eating disorder, consider how you feel and think. Your mindset will make the single biggest difference to your child’s recovery. There are two key mindsets to keep in mind: the growth mindset and unconditional positive regard.

The growth mindset is the idea that while things may be hard, we can learn and grow. We are not helpless bystanders, but active participants in our own and our kids’ lives. That doesn’t mean that doing hard things is easy or natural. But it does mean we can actively build new skills, and doing so will make a huge difference in our kids’ lives.

Unconditional positive regard is the idea that when you look at and think about your child, you assume they are doing the best they can and mean well. This is very hard to do if your child is oppositional and frequently fighting with you. But in fact, oppositional and defiant behavior are symptoms that you can’t change without unconditional positive regard. Approaching your child with unconditional positive regard vastly increases your ability to motivate them to recover.

Emotional (nervous system) dysregulation is a symptom of most eating disorder behaviors. This means that kids with eating disorders need to build emotional regulation skills to recover. And the fastest, most effective way to do this is to co-regulate with a parent. 

We know through advances in neurobiology that babies are not born with emotional regulation skills. They learn them through a process called co-regulation with parents. Parental co-regulation is when a parent’s nervous system regulates the child’s nervous system. With practice, the child gradually learns to regulate their own nervous system. 

Recent developments in neuroscience show that children’s emotional systems develop in direct relationship to parents’ emotional systems. Even if your child is a teenager or adult, you still influence their neurobiology and make a difference. 

Eating disorder recovery involves learning how to process emotions without using eating disorder behaviors. Parents have a huge influence on how kids manage their thoughts, feelings, and emotions. How we process our own feelings and help kids process their feelings becomes how they do it for themselves.

One of the most effective ways to manage big, difficult emotions is naming them. Neurobiologists have shown that just the act of labeling hard emotions makes them less intense and scary. This requires building emotional literacy, or the ability to recognize and name many different feelings.

You spend far more time with your child and see a greater range of emotions than their therapist ever could. Therefore, you can help your child name, tolerate, and process difficult emotions more than anyone else. The feelings wheel is a great way to build your emotional literacy so you can help your child process their feelings.

Feeding and eating are an essential part of eating disorder treatment. In fact, they are the central purpose of eating disorder treatment centers. Serving a person with an eating disorder well-balanced meals 3 times per day and snacks twice per day keeps them eating every 2-3 hours. This helps them regulate their blood sugar, makes emotional regulation easier, and supports weight restoration if needed. 

A meal consists of all four of these components: carbohydrates, protein, fat, and veggies/fruit. A snack consists of at least two of those components.

If you are doing FBT for weight restoration, you will be entirely responsible for feeding them. But even if you aren’t doing FBT, the more you can take over feeding, the better. At minimum, unless your child no longer lives with you, you should serve a family meal at least once per day.

Almost all families get sucked into enabling or accommodating eating disorder behaviors. This is called “doing the disorder.” It doesn’t make you a bad parent! In fact, the most loving, empathetic parents are the ones who do this the most. 

Enabling the disorder may mean only serving your child’s accepted foods. You might engage in endless discussions and arguments about their body shape, size, and acceptability. Or perhaps you have a treadmill in the basement that you let them use excessively. Parents usually do these things because not doing them results in explosions, crying, and tantrums.

A person with an eating disorder is driven to perform their behavioral symptoms to feel better. Everyone in the family can get looped into accommodating these demands. However, when parents accommodate the eating disorder, they unfortunately reinforce it. Therefore, parents need to learn how to respond to their child’s demands for accommodation differently to support recovery.

We recommend that parents who have kids with eating disorders establish a non-diet household. We know that weight stigma and diet culture are key causes of eating disorders, so perpetuating them in your home during recovery will likely reinforce the eating disorder.

A non-diet household follows these rules:

• We take good care of our health. We eat enough, get enough sleep, move our bodies, and build social connections.
• No negative fat talk. When we talk about bodies, we do so with respect. That includes talking about our own bodies! If you feel bad, talk about your feelings, not your fat.
• No scales*. We measure our health by behavior, not outcomes. This means we move, eat, and connect in ways that feel good and are good for us. Except at the very extremes, the scale cannot measure health.
• We don’t diet. Intentional weight loss is linked to poor cardiometabolic health, long-term weight gain, and eating disorders. 

*Unless medically required and used only for eating disorder treatment.

Having self-compassion for yourself is essential to maintaining hope and strength throughout eating disorder treatment and recovery. Most of us need to work on our self-compassion, as it’s more common to criticize ourselves than to be kind to ourselves. 

Self-compassion begins with speaking to yourself kindly. Right now, do you talk to yourself the way you would a friend? If your inner voice is dripping with judgment and criticism, then that’s the first place to start. Practicing self-compassion involves paying mindful attention to how you treat yourself and changing your automatic patterns of self-criticism. 

Having self-compassion is important for parents, since getting through an eating disorder is hard enough without having a nasty critic inside your own head. But it’s also essential to supporting your child’s recovery. Someone with an eating disorder usually has a critical internal voice. Thus, recovery requires practicing self-compassion. Parents can help by modeling and teaching self-compassion. But it only works if you’re doing it for yourself, first!

Advice

32 worst things to say to someone with an eating disorder

The risks of accommodating an eating disorder

Your feelings of guilt and shame will not help your child heal from an eating disorder

Unlock the best way to parent a difficult child

How to be a good parent when your child has an eating disorder

Two dangerous assumptions that parents make about eating disorders

Skills

How to motivate recovery from an eating disorder

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

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

How to set healthy boundaries when your child has an eating disorder

Am I enabling my child’s eating disorder?

How to listen to your child non-defensively

Self-Care

Afraid, angry, and tired. Parents are at risk of traumatic stress when a child has an eating disorder

Saving your marriage when your child has an eating disorder

Parental burnout and eating disorders

How to stay married when your child has an eating disorder

Co-parenting a child who has an eating disorder

Compassion fatigue when your kid has 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.