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How to Help a Loved One with an Eating Disorder

For the Family

Family Therapy is Cutting Edge Treatment for a Family Disease




How to Help a Loved One with an Eating Disorder

Approach the person privately when there is enough time to seriously discuss the issue. 

Offer your observations in a caring but direct manner. Try to be as specific as you can regarding your observations and concerns.

Tell the person you are worried and would like them to seek help. 

Encourage the person to express their feelings openly and listen intently. Do not be judgmental instead ask questions about what was expressed.

Do not argue with the person as to whether or not they have an eating disorder - this will not help. Emphasize that you have heard their feelings and be compassionate. Re-focus on your concerns and fears and indicate that you do not feel things will change without intervention.

Gather information and resources for eating disorder treatment. Present the information to your friend or loved one. Further, express the desire to be of help. Ask them to at least see a professional once before making a "snap judgment" on treatment.

In some cases there is concern that the disorder has reached a life-threatening stage. If the disorder has reached this point enlist mental health professionals who can help you intervene. Stand united and confront the victim strongly and compassionately. Also, if a person is suicidal make sure you get professional help immediately.

Denial is frequently part of the illness, so expect that anger and refusals to seek help may present themselves. You cannot force someone into treatment you can only express your concerns and observations. This scenario may leave you feeling frustrated, angry or helpless. Remember that you can always broach the subject in the future.  Let your friend or family member know that if your concerns continue that you would like to discuss the issue with them again and DO IT!

Tell yourself that you have done what you can do. Realize that approaching the subject with your friend/loved one has opened the door to further discussions. These discussions may be more open, honest and may lead to treatment. One can only attempt to intervene but realize that the most effective form of treatment will involve the sufferer wanting and accepting the help provided.

Remember there is hope, there is it for yourself if necessary.

*Adapted from "How to help a loved one into counseling" by Dr. Kevin Grold

* Adapted from EDAP, Eating Disorder Awareness and Prevention, 1998, "How to help a friend.", see

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For the Family

Focus on feelings and interpersonal relationships - not on food and weight.  Family members are often the forgotten members, especially other children.  It is important that they talk about their feelings.

Do not let the eating disordered family member disrupt the entire household. The family should go on with their lives as normally as possible.

Do not allow the eating disorder family member to shop, cook or feed the family. Do not let the eating disordered family member dominate the rest of the families eating patterns. In nurturing others, eating disorder sufferers are denying their own need for food.  Families should go on with normal eating patterns. These details will need to be worked out with the therapist.

Set limits in a caring, reasonable, but firm manner.

Help the family show affection and appreciation for each other. Underneath disordered eating is a lack of self-worth; thus unconditional love goes a long way.

Work on how to avoid power struggles and find alternative ways of dealing with problems as they arrive.  Let the therapist and/or physician deal with "highly-charged" issues such as weight.

Realize that there are no quick solutions.  Demanding change, and/or berating the eating disordered family member will not bring about change or a positive result. Be patient.

Avoid having the eating disordered family member make too many decisions about food and other issues.  Control is a big issue that must be addressed in therapy.  One can not attempt to over control the eating disordered family member.  The therapist can help balance out these issues.

Parents will need to examine alternatives to their current behaviors (i.e. yelling, pleading, etc. Family members should write in journals, write letters to each other, call the therapist, and write down situations that they need assistance with and provide to therapist and family sessions.

The family needs to talk about all kinds of issues - not just focus on the problems or the eating disorder.

*Adapted from Your Dieting Daughter: Is She Dying for Attention? by Carolyn Costin, M.A., M.Ed. MFT published by Brunner/Mazel, New York, New York. see

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Family Therapy is Cutting Edge Treatment for a Family Disease By Abigail Natenshon

Eating disorders are family diseases.

Eating disorders are family diseases. Everybody who comes in contact with the eating disordered individual suffers, including parents, siblings and grandparents. 

Parents tend to be the primary diagnosticians of an eating disorder in their child. Eating disorders show up around kitchen tables, and in family bathrooms, rarely in the doctor’s office. Their presence is typically silent in laboratory tests. 

Recovery too, happens at home, over time, alongside parents and siblings, throughout the course of daily living, particularly in the face of the restrictions and limited services provided through managed care. Patients typically spend 45 minutes a week with their therapist or doctor. For the rest, 24/7, kids live their recovery at home, or at school. 

In research carried out a the Maudsley Hospital of London England, it has been proven that family treatment is more effective than individual psychotherapy for anorexics living at home that have been ill for less than 3 years. 

The nature of parental involvement will vary widely with the age and needs of the child, the skills and capacities of the parent, and the nature and quality of the ever-changing parent/child CONNECTION. 

Parents and siblings are also deeply affected by an eating disorder within the family system. They need an outlet to understand the disease and recovery processes, a forum to communicate their concerns and needs with the patient and with each other, and the opportunity to learn how best to support the problem-solving and recovery processes. They often need personal support and bolstering in the face of what can be an extended, convoluted and at times discouraging recovery process for the afflicted individual. Family therapy provides that vehicle.

The individual child’s efforts to make recovery changes are facilitated and enhanced not only by a family that understands the recovery process, but by family members who make their own parallel personal changes alongside the patient to accommodate the needs and requirements of the changing child and family system. 

Eating disorder psychotherapists are responsible to grow the relationship between parent and child, for that is where the greatest and most effective capacity for cure lies. Therapists must demonstrate respect for the power of the family system in either sustaining or eradicating disease. 

The potential for the family unit to bring about constructive change is far greater than the sum of its parts. The quality of a child's function within the family parallels the quality of the child's interpersonal function in every other life sphere.

Loving your child is not enough. 

Parents need to act on the knowledge they acquire. Parental involvement will vary from providing on-going and unconditional support day in, day out, planning, providing, and eating nutritious meals with the child, monitoring food intake and managing symptoms, engaging in family treatment to support the child and recovery process and resolve underlying emotional issues that may be driving the dysfunction. 

Psychotherapist Abigail H. Natenshon has specialized in the treatment of eating disorders with individuals, families, and groups for the past 31years. She is the author of When Your Child Has An Eating Disorder, A Step-by-Step Workbook For Parents And Other Caregivers, Jossey-Bass, 1999. Based on hundreds of successful outcomes, this book shepherds concerned parents step-by-step through the processes of eating disorder recognition, confronting the child, finding the most effective treatment for patient and family, and evaluating and insuring a timely recovery. A guide to eating disorder prevention, this book is useful to parents, health professionals and school personnel alike in countering the pervasive epidemic of unhealthy eating and body image concerns, and destructive media and peer influences. Her work can be reviewed further at, and .

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Your Dieting Daughter: Is She Dying for Attention? by Carolyn Costin, M.A., M.Ed. MFT published by Brunner/Mazel, New York, New York (1997). Carolyn Costin is an eating disorder specialist and the director of the Monte Nido Treatment Center: A Residential Treatment Center for women suffering from anorexia, bulimia, and exercise addiction

Natenshon, Abigail. When Your Child Has an Eating Disorder: A Step by Step Workbook (1999). 

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*We cannot diagnose or treat eating disorders by email, but we can send you information and assist you in finding resources. Information provided by the Eating Disorder Referral and Information Center is not a substitute for medical treatment or psychological care.  It is vital that you talk with your physician and a qualified mental health professional regarding eating disorder symptoms and treatment.

*While includes articles and links to sites which provide additional information on eating disorders and related topics, does not endorse or recommend any site, product or service provided on these links.


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