How families can help with healing
By Deborah Jeanne Sergeant
Eating Disorders Awareness Week is Feb. 25 through March 2.
The World Health Organization estimated in 2019 that approximately 14 million people worldwide, including 3 million children and adolescents, have eating disorders.
These include anorexia nervosa (restricting eating), bulimia nervosa (bingeing and purging or abusing laxatives) and avoidant restrictive food intake disorder. Orthorexia, although not formally recognized, involves extreme food restrictions that exclude only “healthful” foods with no exceptions. Excessive exercising may also accompany eating disorders.
Eating disorders often represent maladaptive coping strategies for underlying mental health issues.
They can lead to nutritional deficiencies and disrupt normal digestive processes. Most people require professional help to overcome an eating disorder (aka disordered eating). Once professional care is enlisted, the patient’s family often provides much-needed support at home that can help towards health and recovery.
Learning what is helpful for people undergoing treatment can help the family know what to do.
Most patients want loved ones to ask about what they’re going through. But don’t rush to offer solutions — or worse, tell them where they went wrong.
Bruce Brennan, registered dietitian with Liverpool-based Nutrition Service of Upstate New York, advises talking about anything but food at the table if that helps distract the patient from focusing too much on food.
“We want to take some of that tension away from the table,” he said. “Whatever kind of game you could play or topic of discussion might work and leave the discussions about food until after.”
Eating meals together as a family can be helpful but making the dinner table a battleground can generate negative outcomes.
“I also think it’s helpful if the family be supportive but let the treatment team members be the ‘police’ rather than family members,” Brennan said. “They need to be supportive. When they’re in the police role, it becomes argumentative.”
Any time you have concerns about their eating, it is important to go about expressing those concerns in the right way, “a direct but gentle manner,” said Afton Kapuscinski, New York state licensed clinical psychologist and associate teaching professor at Syracuse University. “Having a family member with an eating disorder is frightening and people often understandably feel desperate, but putting excessive pressure on the individual may make them less likely to discuss the problem with you in the future.”
Kapuscinski added that learning from experts in the field can help, along with learning from people who have undergone treatment for an eating disorder. This can help develop “a deeper sense of empathy for your family member.”
It’s also helpful to remember that your loved one is receiving treatment from professionals, so it’s not up to you to try to fix them. Kapuscinski said that it’s better to focus on spending quality time together.
“Family should adhere to recommendations made by healthcare providers regarding meal-planning and groceries,” she added. “However, behaviors that accommodate the eating disorder are not recommended. For example, cooking only low-carb meals, not having dessert in the house or making excuses to others for why the person is not eating will not help the situation in the long-term and may adversely affect other members of the family in the process.”
Avoid any kind of comments about weight and size, even if not about the patient, such as, “I should lay off the doughnuts; I’m getting so fat.” Or “I look like a whale in this shirt.” Or “Chris has lost so much weight since last fall.”
“Eating disorders are often unintentionally reinforced by loved ones through their own responses to weight, shape and food,” Kapuscinski said.
Instead, she wants family members to act as advocates for their loved ones by avoiding body talk trying to change their own approach to weight and food.
In general, having less stress in the household can be helpful for improving the patient’s mental health.
Books that may help families better understand eating disorders include:
Life Without Ed: How One Woman Declared Independence from Her Eating Disorder and How You Can Too by Jenni Schaefer and Thom Rutledge (McGraw Hill: 2003)
Father Hunger: Fathers, Daughters, and the Pursuit of Thinness by Margo Maine (Gurze Books: 2004)
Believarexic by J.J. Johnson (Peachtree Publishers: 2015)