It can be hard to truly understand what your child is going through when they have disordered eating or an eating disorder. You may feel worried, confused, or unsure of how to help. But your love, patience, and support can make a big difference in their healing journey. They will feel less alone if you let them know that you are there for them. You are in the best place to support your child even if you’re unsure of next steps, or if your child doesn’t think they need help. 

It can be hard to know where to start. As a parents or caregiver, a great first step would be learning more about:        

• Eating disorders
• Treatment options
• Available resources

You can work together with health professionals to create a care plan that includes both a deep understanding of your child and the right medical support for them.

It’s important to remember:

• Your child did not choose to become unwell.
• They may be struggling with their mental health or an aspect of their life. 
• They are not trying to create worry or hardship for you or your family.
• Trying to understand the worries and fears your child has about food and their body doesn’t mean that you agree with these fears.

Let your child know you believe them, and that you are there to support them.

At first, an eating disorder may seem to help a young person feel better. They may feel more able to manage their anxiety, or cope with other stresses in their life. Some youth describe their eating disorder as a strong, critical “voice” inside - not a hallucination - but a constant pressure that feels real and overwhelming. This can be very frightening for them, especially in our world that often rewards weight loss and promotes body ideals that are unrealistic.

• Fear. They may worry about:
  • Losing control over what they eat
  • Being judged by their peers
  • Upsetting you
  • Choking or other negative experiences when eating
• Anxiety. Many people with eating disorders also experience anxiety. Their eating habits may provide comfort or a sense of control.
• Shame. They might feel embarrassed or afraid to admit they have an eating disorder.
• Beliefs. They may see their body as flawed or feel pressure to change it. Controlling food might feel like a way to control other parts of their life. The messages they see all around them about body shape, size, or food choices can also play a role.

Your child may not agree they have an eating disorder or think it’s not serious. They may want to stop but are not sure how to. You can help by listening to their feelings and let them know it’s okay to feel scared to change. Talk with them about treatment and appointments so they feel involved in their care. Be clear about what they can negotiate and what they can not.

 For example:

• If your child needs to see the doctor, the non-negotiable part is that your child needs to go to clinic or healthcare facility, but the negotiable part is they can have a say in how that happens. 
• Discuss who your child wants to go to appointments with them. Perhaps it’s you, another caregiver, or a trusted adult. 

As a caregiver, it can be helpful to remember that your child is still themselves and the eating disorder does not define who they are. Focus on their strengths and the qualities you love about them. Healing is a journey, and your support will help them find their way. Healing can take time, and setbacks are a normal part of the process. Connecting with treatment or other supports can help. Even when the youth doesn’t engage in treatment or appointments, parent or caregiver support can help change a child’s eating behaviours.

It can feel overwhelming to talk to your child about these behaviors. You may worry about upsetting them or straining the relationship. The type of conversations you have will depend on your child’s age and stage. They may be old enough to be responsible for some of their own health choices, but your concern for their well-being is also important and you can still play an important role. Your support, empathy, and guidance can be helpful as they take next steps. These conversations can happen over time, and it’s important to be thoughtful about how best to talk to your child.  

This does not have to be a single conversation. Try not to be discouraged if your child is not willing to talk when you first attempt to have a conversation. Here are some examples of strategies to respond to common eating disorder thoughts you might hear:

It’s important not to wait until your child wants to have that conversation and seek professional help  if:

• Your child is medically unstable
• Has experienced significant changes in physical well-being 
• There are safety concerns like self harm or suicidal thoughts
• Needs medical intervention

There may still be an opportunity to let your child make choices like whether they want a caregiver in the room with them during appointments. Sometimes you may need to be firm, but you can also be open and curious. This may help show your child that you’re on the same team, rather than feeling like it's you versus them or you versus the eating disorder.

Families are not to blame for disordered eating or eating disorders and can be the best supports for their child. It is important to acknowledge that you may never know what triggered these behaviours in your child, but you can still help your child work towards recovery. Focus on how to offer positive support. You haven’t caused this to happen, but it is something that you can help heal. 

• Learn about eating disorders. This will help you understand your child’s behaviours, feelings and mood swings. There may be aspects of the illness that are hard to understand or don’t seem to make sense. For example: 
• Maybe your child dislikes their body shape and wants to lose weight even when they are already active and healthy. 
• Maybe they worry about gagging or vomiting if they eat, even if this has not happened before.
• Eat together as a family when possible. It’s important your child sees you and the family enjoying a variety of food. 
• Try to put yourself in their shoes and understand that this feels true for them even when you don’t agree or understand. 
• Be mindful of not making comments related to appearance and diet about yourself or others. It is important and powerful to show you accept people of all sizes and shapes. 
• Discuss how your child would like to manage family and social gatherings and understand which gatherings may be helpful and which may be stressful.
• Try to build up their self-esteem by sharing the qualities you value about them that are not related to appearance (for example, kindness and honesty).
• Find positive ways to spend time with your child outside of mealtimes. It can be helpful for families to think about the eating disorder as separate from their child. This way, they can know when they’re seeing eating disorder behaviors (externalizing) rather than their child’s true self.
• Try using a technique called the ‘four C’s’ that can be helpful when you interact with and support your child, particularly around mealtimes:
• Calm. Find ways to manage your own anxiety as this can affect your child’s feelings and behaviour. The Breathr app can help you find ways to manage big feelings in the moment
• Confident. Your child can feel more secure if you show confidence in your decisions and plans.
• Consistent. Be consistent with your decisions. This gives the eating disorder less room to grow. 
• Compassionate. Understand and acknowledge that this is a scary time for them and let them know that you are there to support them. 

It’s important to find time to take care of yourself when there is so much going on in your family. Self care will help you to show up in the way you want to for your child and family. You deserve to give yourself the love, care and attention that you give to others. Practice self care by doing what makes you happy. When you look after yourself, you are in a better position to look after others. 

Parenting a child with an eating disorder can be stressful. It is normal for parents and caregivers to react differently when their child is struggling. Some of the treatments, including family-based treatment, support parents and caregivers in navigating how to develop a united front, and discuss different approaches in supporting the youth. It can also help to talk to your own therapist about some of the feelings that come up for you during this time.     

An eating disorder affects everyone in the household. If you have more than one child, it can be helpful to provide support to siblings. Family dynamics can change when one child needs more attention and support than another. Check in with the siblings to see how this experience is for them. Some approaches, like family-based treatment, invite siblings to take part. 

You can help them understand what their sibling is going through by: 

• Educating them about eating disorders. 
• Helping them see the eating disorder as separate from the person.
• Reminding them that families are not to blame.
• Being honest and realistic (as appropriate depending on age and stage).
• Giving them an option to be included in appointments. The BC Children’s Hospital has a Sibling Support Centre, more information here.
• Making space for one-on-one time.

Support from others who understand can provide comfort and validation. You are not alone. Ask your healthcare provider about parent or caregiver support groups, counselling and online resources.