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Mental health conditions are hard to talk about. For adolescents, a growing sense of independence from their parents often leads them to avoid talking about sensitive or embarrassing subjects,and for many parents, a desire to give privacy to their children prevents prying. However, severe psychiatric behavior health conditions like eating disorders need professional treatment – the risks are too great without it. Here, we’ll outline some of the ways to make talking to your adolescent about eating disorders, both before they go into treatment and after they complete the program.

How to Broach the Subject of Eating Disorders and Talk About Treatment With Your Child

Every eating disorder is different, from anorexia nervosa to binge eating disorder to bulimia nervosa, but unfortunately, they share a common factor: they tend to first appear during a person’s adolescence. That’s not to say they can’t begin later on (binge eating disorder in particular often starts in a person’s twenties or later), but the root causes of body image distortions, peer pressure, and desire for control are usually present from puberty onward.

Luckily, no matter what type or types of eating disorder your child might have, the general approach to talking about it is the same. And that approach matters – people with eating disorders often try to hide their symptoms out of a sense of shame or a disordered belief that they don’t need help. Because of this, taking the right tactics can mean the difference between getting professional eating disorder treatment right away or being forced to wait until it gets worse.

Here are some key things to know about discussing eating disorders with your adolescent child:

1.Educate Yourself Before Having “the Talk”

As a parent and caregiver, the more you know about eating disorders before discussing treatment options, the better. You can use online resources like the National Eating Disorder Association’s website to learn about behavioral signs and physical symptoms of common eating disorders as well as read testimonials about others’ experiences. Knowing what your child is going through should help you pick the right tone for a discussion about treatment. Your child’s doctors may be able to spot some of the telltale physical signs as well. If they are already seeing a child psychologist for another mental health issue, they are even more likely to spot the signs.

2.Remember to Listen

As a parent, it’s easy to get used to giving instructions and directions. However, the most important thing you can do is remember to let your child express their feelings, even if they are acting sullen or hostile. It’s a stressful situation for everyone involved, and if they feel you are not hearing them and validating their emotions, they are likely to tune out what you are saying. Of course, you should voice your concerns and gently but firmly let them know their options, but always listen carefully to what they have to say. You can try repeating what they’ve said in your response and asking follow-up questions – this will make them feel heard and give them a prompt to discuss more.

3. Don’t Talk About Their Weight or Their Body, Only About Their Behaviors

If they are refusing to eat, or purging after meals, or binge eating, it’s likely they are suffering from a negative or distorted body image (as well as other causative factors). Saying something like “You’re getting too skinny,” or “you’re gaining too much weight” is liable to set off those body image concerns and take the focus away from the need for behavior modification. It’s essential that they don’t feel judged in any of these conversations – you can say you’re concerned about their eating habits, of course, but don’t let the conversation drift towards their body size or shape.

4.Be Ready to Discuss Treatment Options

It helps to have a plan beforehand. You may want to start slowly – have them see a therapist first, who can make further recommendations. You can look at an eating disorder treatment specialist afterward. They can help you decide which course of treatment is appropriate, whether that be a day treatment/outpatient program or a more intensive residential one. Learning more about how eating disorder treatment works and the available options beforehand will help you lay out those options more clearly when you discuss the situation with your child.

How to Approach a Recovered Teenager Following Treatment

When a person leaves any form of eating disorder treatment, re-entering their usual routine and incorporating their recovery lessons is a delicate balance. In many ways, parents and loved ones will need to be just as sensitive when discussing their recovery as they were when discussing the need for recovery. Without the support of their care team, it’s surprisingly easy to fall back into old behaviors.

It’s also easy to think that treatment is all a person needs to overcome an eating disorder, but the recovery community generally considers relapse to be a normal part of the recovery process. In the weeks and months following treatment, urges to return to disordered eating behaviors are normal and should be expected.However, that doesn’t mean steps shouldn’t be taken to prepare for them. The loved ones of a recent graduate should be aware of the best ways to speak to them to avoid triggering a relapse.

The best way to describe relapse as it relates to an eating disorder is resuming disordered behaviors after an extended period of recovery. In many cases, relapses are triggered by intense stress, which prompts a return to previous coping mechanisms. While it is common for newly recovered people to feel guilt or frustration surrounding a relapse (just as they were before treatment), they can be avoided and mitigated.

How Can Parents Talk to Teens Showing Signs of a Relapse?

1.Put Empathy at the Forefront

Eating disorder recovery is often can be a long and difficult process. This means that it is essential for parents and loved ones to show compassion and understanding concerning the recovery process. Recognizing the challenges they are experiencing goes a long way toward showing them you’re on their side and are there for support. Allow them to explain how they feel without interrupting and try to put yourself in their shoes. Not only does this give them the sense you’re trying to support them, but it will also give you insight into how to act when they’re facing a potential relapse.

2.Let them Know That Relapse Is Not a Failure

The worst thing you can do is increase feelings of guilt. Once you’ve got a good footing in empathetic listening, it’s a good idea to let them know that a relapse is just a setback, not the end of recovery.This doesn’t mean you should take a relapse lightly; instead, let them know that you won’t be disappointed or angry. Taking the time to normalize relapses can help them avoid feelings of guilt or shame that can stop them from getting their recovery back on a positive track. This also encourages them to speak up if they are feeling urges to use disordered eating behaviors.

3.Discuss Alternative Aftercare Options

Eating disorders are pervasive and difficult to overcome. Often, a single stay at a residential treatment center will help, but after a long period, the symptoms come back. if they have been experiencing relapse for 2 weeks or more, you may want to discuss a change in their aftercare regime. Instead of a once-a-week meeting with their therapist, you may want to engage in a day treatment program for a limited time to help them navigate the relapse. Or perhaps engaging with an alumni group can give them much-needed support from peers. They can build on the treatment they received earlier and make further progress toward a full recovery.

4.Focus on Long-Term Goals

Attaining a recovered life and keeping to it is 100 percent possible. While the road to recovery can be very challenging, focusing on the short-term challenges can obscure what the long-term goals for recovery are. With the help of early intervention and a reliable support system surrounding them, adolescents newly recovered from an eating disorder can look past the minutiae of their day-to-day symptoms and focus on building a consistently recovered lifestyle.

5. Never Judge

As we’ve mentioned, disordered eating behaviors often come hand-in-hand with feelings of guilt and shame. These can compound low self-esteem and force a person back into the kinds of disordered behaviors they’ve been trying to avoid. This can be hard to understand for loved ones who have never experienced an eating disorder, but showing any kind of judgment, no matter how frustrating a relapse can be. This can only result in them being more likely to avoid asking for help when they feel stressed. Usually, the relapse occurs when stress or anxiety levels are high, and further raising that stress is counterproductive.

Learn More About Eating Disorder Treatment for Teenagers

In the moment, a relapse can feel like a disaster for teens in recovery and their families, but it’s important to remember that relapse is natural and that finger-pointing or assigning blame is never helpful or productive. For teens who have come home after a stay in a residential treatment center for eating disorders, it’s very common to go through several stages of recovery—which sometimes include steps forward and a few steps backward as well.

If you or a loved one has been struggling with disordered eating and are interested in learning more about available adolescent recovery programs, please reach out to your doctor or a quality eating disorder treatment center. Recovery is possible and a recovered life is within your reach.

 

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.