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Every parent is concerned about their child’s well-being, and an eating disorder like anorexia nervosa is no exception t the rule. Despite an ongoing misconception that eating disorders are somewhat benign illnesses, they can dramatically an adolescent’s life for the worse and often last for years. In some cases, they can even be fatal; anorexia nervosa has the highest mortality rate of any psychiatric illness according to many studies. Anorexia nervosa treatment comes in a variety of forms, ranging from weekly outpatient (such as PHP or IOP) sessions to day treatment on a regular schedule, and for the most intense cases, residential anorexia nervosa treatment.

With a mental health disorder with as many risk factors as anorexia nervosa, the margin of error for successful treatment is very small – and that’s why parents need to know what type of treatment is necessary. Better outcomes are often the result of early intervention, so getting started early is essential. Just as importantly, the adolescent who gets the treatment also needs to know what to expect when they go in for residential, the most intensive form of treatment.

Day Treatment or Residential Treatment?

The simplest way to determine if an adolescent needs residential anorexia nervosa treatment is to assess the physical and emotional risks they carry. A doctor and psychiatrist should be consulted for an official diagnosis. There are also various, less formal checklists and questionnaires that may be able to give parents a head start. If a parent is concerned about their child’s eating habits, they should talk to their child before making any moves – it’s usually not best to suddenly spring intense psychiatric treatment on anyone.

In the early stages, the signs of anorexia nervosa are often subtle – dieting, excessive exercise, and some weight loss may not seem incredibly harmful, but when they progress, they can endanger their health. People with anorexia nervosa often obsessively count calories and are preoccupied with attaining a “perfect” body. Eating disorders often cooccur with other mental health symptoms; parents should be aware of potential triggers like depression, anxiety disorders, and especially PTSD. When the disordered behaviors surrounding the disease are endangering the teen’s life, parents should seek out a residential program.

How to Talk about Anorexia Nervosa Before Deciding on a Course of Action

The number one point to remember when speaking to a teenager (or anybody) about a sensitive subject like this is to always remain judgment-free. The idea that a mental health disorder is somehow “bad” or shameful can wreak havoc on an adolescent’s mental state; it can even worsen the condition by triggering negative emotions that lead to disordered coping behaviors. When talking to a teenager about anorexia nervosa, don’t immediately react with a statement like “You have to start eating more” or even “But your body is nice!” These kinds of statements impose a value on what they are saying rather than just letting them be heard.

Instead, ask open-ended questions, and be prepared to simply listen to their answers. Some things may be hard to hear, and even harder to simply accept. Always remember to keep their agency in mind. Instead of proclaiming “You’re going to get treatment!”, ask “How can we help you with this?” Some other pointers about this discussion might include:

  • Start with open-ended questions – Instead of diving right into a lecture about the dangers of anorexia nervosa, ask them about how their feeling. Are they feeling anxious or depressed? How do they feel about themselves? Is there anything that’s been bothering them? Remember that eating disorders are often paired with low self-esteem and negative feelings about their body, so be careful not to react sharply or accuse them.
  • Keep the discussion focused on feelings, not food –Eating disorders aren’t about food as much as a person’s body image and mental state. Very often people with anorexia have a strong sense of perfectionism added to negative body image; although nutritional education and meal planning are major parts of treatment, more time is spent on psychotherapy and behavioral therapy. Stay focused on how they feel rather than what or how much they are eating.
  • Validate their statements – Remember, there is no such thing as a “wrong” feeling. One way to show your teen that you are listening and to help them feel validated is to listen, then restate their sentiments. For example, “I understand. You are feeling that your body is too big and you want to lose weight.” Again, remember to be judgment-free. Understanding their point of view will help you understand what they are struggling with. With time and counseling, you can begin to help them replace disordered thoughts with healthier ones.
  • Make a plan – before talking about a difficult subject like anorexia nervosa, think about what you’re going to say and how you’re going to say it. It’s all too easy to get caught up in an emotional response, especially if your child is emotional as well. Remember to never be accusatory or demanding. Instead, think about how you can be supportive, caring, and calm when broaching the subject at hand. A little preparation goes a long way.

How to Prepare Teens for Residential Anorexia Nervosa Treatment Programs

Residential treatment centersprovide clients with the ideal recovery setting, separating them from the pressures of their day-to-day lives and making it easy to focus on treatment in a structured and safe setting. This kind of treatment by design puts the adolescent in a safe, focused setting so that all their energy can be focused on recovery.  However, these are major lifestyle changes and can be disruptive – so the teenager and her family should be ready. As you are preparing for treatment, make sure to learn all you can about the center, its programs, and what treatment will be like.

What Is Residential Treatment Like?

Residential anorexia nervosa treatment, sometimes called inpatient treatment, isn’t the cold, fluorescent-lit hospital that often pops up in the imagination. That’s a Hollywood misconception. Normally, the facility will be comfortably appointed with furnished rooms and shared spaces, including entertainment rooms, classrooms, and kitchen/dining rooms.  A feeling of safety and comfort is essential for creating a conducive environment for treatment, so quality facilities will feel more like a home than an asylum.

Day-to-day activities are centered around moving steadily forward in treatment. There will be daily therapy sessions, and frequent group sessions which allow for peer support and growth, and for adolescents, there are normally educational programs as well. Continuing the teen’s education is key – some of the best centers even have certified teachers on hand to teach classes. Finally, experiential therapies like hiking, gardening, attending concerts, or going food shopping also round out the activities involved in residential treatment.

How to Prepare Before Entering an Anorexia Nervosa Treatment Center

Managing expectations – positive and negative – is important for teens about to go into residential treatment for anorexia nervosa. Because they will be entering a highly structured environment, teens should understand that they may have designated free time and/or designated phone and visitation hours.

While parents should always listen carefully to their child’s fears, especially when making a major life change like entering residential treatment, they should frame the discussion about treatment in a positive way. This can help calm their nerves and give them an idea of what to expect over the next several weeks. It’s also important to find out what items can and can’t be brought to the facility, and how much outside contact will be allowed.

Some key facts to discuss with teens as they prepare for eating disorder treatment include:

  • The length of the treatment program
  • Therapy options available during treatment
  • How their progress will be monitored
  • When they can expect to phone/visit with family
  • What an average day in treatment may look like

Make Sure to Answer Their Questions – and to Have Your Questions Answered

It’s also important to give children the opportunity to ask questions about the recovery process and the benefits of residential treatment programs. Parents should let them voice their concerns and do their best to provide accurate information. If necessary, it’s perfectly acceptable to reach out to the treatment facility for additional information.

Admissions specialists are available to help parents answer as many questions as possible before committing to treatment. The kinds of practical questions listed above should certainly be discussed but admissions specialists can also help you local a local therapist or psychiatrist to make a formal diagnosis, to help you make travel arrangements, to discuss tutoring and continuing education, and to help navigate insurance and other financial considerations. If your adolescent is struggling with anorexia nervosa or another eating disorder, reach out to a center’s admissions staff today – it’s the first step to a happier, healthier life.


Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.