Remuda Ranch

When is it Time for a Parent to Take Action?

Amy Spahr, MSW, LCSW, Executive Program Director, Remuda Ranch Programs for Eating Disorders

Parents need to trust their instincts regarding their children. Mothers, in particular, often possess a heightened awareness of their child’s distress. Frequently, if a mother thinks her child is experiencing emotional difficulties, she is correct. If parents suspect their child may have an eating disorder, several action steps are recommended:

• Pay attention to your child’s changes in eating patterns, weight fluctuations, or mood alterations such as sadness or anxiety.
• Parents will benefit by educating themselves on eating disorders–what they are, how they may manifest, what warning signs to look for. Accurate information regarding these disorders can be located at local libraries or on the Internet at websites such as www.nationaleatingdisorders.org or www.anad.org.
• It is also recommended that parents take a personal inventory of their own eating patterns. It is particularly important for mothers to examine their own perceptions of weight, dieting, and the value placed on their own appearance. Because mothers often serve as a daughter’s role model, the mother’s perceptions can have a profound influence on her child’s thoughts and behaviors. In fact, a daughter may simply be mimicking a mother’s behavior by dieting and becoming inordinately focused on body size. Once recognized, any unhealthy habits regarding food and appearance must undergo change. It is wise to pose such questions as: Do I eat three meals a day with a variety of food groups? Do I label food as good or bad? Am I obsessed with calories, fat, or weight?

If the family does not eat meals together, this is a good time to start. Spending time together, enjoying a balanced meal and one-another’s company can strengthen the family and open lines of communication. Yet, this is not the time to address concerns over a possible eating disorder. Speaking prematurely may cause the child to become more secretive in her behavior.

If parents have educated themselves about eating disorders, accumulated objective information from observing their child, and still believe that an eating disorder exists, then a dialogue is called for. First, it must be decided whether both parents will take part. Depending on the family dynamic, the child may feel more comfortable speaking with just one parent, though it must always be stressed that the parents are in agreement with one another on the need for intervention. The conversation must be well thought out in advance and the time and place must be carefully chosen. The location needs to be as nonthreatening as possible, and the time chosen when other stressors, conflicts, and distractions are at a minimum. When speaking with the child, it is recommended that the parent use “I” statements such as “I feel concerned about you,” and objective statements such as “I’ve noticed your clothes are getting loose on you.” List the evidence that you have accumulated. The parent needs to be nonjudgmental, sincere, empathetic, an active listener, and aware of nonverbal body cues.

Despite best efforts, the child may display resistance, denial, and anger. If a parent can view anger as a legitimate, healthy emotion that is worthy of expression, and not react to the anger with defensiveness or additional anger but with a listening heart, then the talk will have a greater chance of bearing positive fruit. Such fruit would be the child’s willingness to share what is troubling her, such as “John dumped me for Ann because she’s thinner,” or “I’m afraid to go to college.” End the conversation if going nowhere or if the child becomes upset. But leave the door open for further conversations. Have patience: If rejected, try again later, explaining that you are coming back because you think the situation is serious.

Despite these efforts, resistance and denial may prove stronger and negate honesty and openness. In the absence of self-harming or suicidal behavior or talk thereof, if eating disorder behavior continues for more than one month it is recommended that the parents seek professional help. Often this starts with a physician who can establish the medical severity of the illness, degree of malnutrition, evidence of bingeing and purgeing, the discontinuation of the menstrual cycle, etc. A therapist is then consulted to determine level of care, which may be as minimal as weekly counseling sessions or as intensive as residential treatment. If the child is unwilling to visit a professional, the parents may do so on their own for counsel and assistance with the situation. But always respond during emergencies: If the child is throwing up several times per day, passing out, complaining of chest pain, talking about suicide, or engaging in self-mutilating behavior, get help immediately.

If your child is struggling with an eating disorder, call Remuda Ranch today at 1-800-445-1900.