How to Talk to Your Child About an Eating Disorder

According to the National Eating Disorder Association, 20 million women and 10 million men in the United States suffer from an eating disorder at some time in their lives.

This is a scary fact for parents, as anorexia nervosa has the highest mortality rate of any psychiatric illness. Odds are you know someone who has or had an eating disorder. But what do you say when you want to help?

If you have a child who you suspect might be struggling with an eating disorder, it’s hard to know where to start the conversation. It can feel as if you’re walking on eggshells—on one hand you want to address the problem, and on the other, you fear that you could say the wrong thing and exacerbate it.

Unfortunately, my parents were stuck in this position when I was 13. I had developed EDNOS, orEating Disorder Not Otherwise Specified. This meant I took on aspects of both anorexia nervosa and bulimia, but did not fit perfectly into either category.

The National Eating Disorder Association characterizes eating disorders by behaviors such as:

  • Intense fear of weight gain or being “fat”
  • Dramatic weight loss
  • Refusal to eat certain foods, denial of hunger
  • Consistent excuses to avoid mealtimes or situations involving food
  • Evidence of purging behaviors, such as abuse of diuretics/laxatives, or throwing up after meals
  • Evidence of binge eating

Once you recognize unhealthy or suspicious eating patterns, it’s important to address them before they grow worse. Ira M. Sacker, eating disorders specialist, tells WebMD that: “People who develop eating disorders feel as people that they’re not good enough. They become obsessed with perfectionism. That perfectionism begins to focus on what they eat. But underlying it is depression and anxiety.” Be mindful that in addressing your child’s eating disorder, you are also addressing the state of their emotions.

Talk to your child in a space where they feel comfortable—they should not feel like they are in trouble. You want to emphasize that they have done nothing wrong, and that any comments you are about to make come from a place of concern and love. Heather Bates, a North Shore therapist who often works with adolescents struggling with eating disorders, recommends that “the conversation be collaborative, not a hierarchy or power struggle. Parents should avoid blanket statements like ‘You have a problem,’ or anything that will make the child defensive.”

Bates also says that parents should not get angry. “It needs to be clear that it’s coming from a caring and compassionate place and that the issue is something they will deal with together.” Approach the matter with sympathy, and start with questions that hold no presumptions. For example, instead of asking, “You’re OK, right?” ask, “How are you feeling?”

Consider phrases that allow your child to talk on their own terms:

  • “I recognize you seem down lately, is there anything you want to talk about?”
  • “I’ve noticed that you are (insert behavior here, e.g.: restricting your food intake, visiting the bathroom after meals), and I’m concerned about you. Do you want to talk about what you’re struggling with?”
  • “Would you like me to find someone you’d feel more comfortable talking to other than myself?”
  • “What is the best way I can support you?”

In order to change a behavior, it must be addressed and acknowledged. In talking with your child, you have successfully taken the first step toward their recovery together. Though it may be difficult at first for your child to acknowledge their behavior, whether it’s because they do not want to modify their behavior for fear of weight gain, or they don’t want to disappoint you by admitting they have a problem, talking will ultimately lead to a happier and healthier life for your child.

Continue the discussion with your child by asking questions such as:

  • “How can I best support you at meal times?”
  • “How can I help modify your eating habits in a way that won’t bother you or make you upset?”
  • “Is there anything I do that triggers you that you’d like if I stopped?”

The most vital thing in talking to your child about their eating disorder is their inclusion in the process of finding the right treatment plan for them. Though they may be hesitant about, or even blatantly against, entering treatment, including them in the discussion of what will best help them heal is an important way to show your support. One day, when they are recovered and healthy once again, they will thank you for giving them their life back, just like I thanked my parents for starting the discussion that led to my recovery.