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Kim Umble, MSW, LCSW, Program Director, Remuda Programs for Eating Disorders

The importance of healthy parent-child communication can never be stressed enough. Parents first need to talk with their teenager. Asking questions about friends, school, or activities may open doors to a discussion of feelings, moods, etc. Simply opening lines of communication, when done with love and concern, can render positive results. T,he parents may discover what is motivating the eating disorder and be able to provide help.

In addition to talking, a second essential ingredient is time. Spending more time together is recommended. This can improve communication about difficult issues and allow for parents to more carefully observe possible problem behaviors. Having meals together is especially important. Not only is this a good venue for increased interaction, but it gives parents the opportunity to observe first-hand any changes in the teen’s eating habits. In two-parent households, both must be equally involved, presenting the child with a unified front.

If, according to the adolescent, nothing appears to be “wrong,” then a therapeutic assessment is advised. This is best done by a counselor who specializes in eating disorders. Assessment by a registered dietician is also beneficial. If the assessment reveals a full-blown eating disorder, certain steps must be taken. If the disorder is anorexia and involves high levels of exercise, restrictions must be put in place to curtail the teen’s activity. With bulimia, if parents suspect the child is leaving the home to binge and purge, restriction may be placed on driving. The child must start seeing a therapist on a regular basis. Therapy appointments should be presented as non-optional. If the teen refuses or conveniently forgets about scheduled sessions, additional restrictions may be required. Privileges including extra-curricular and social activities may have to be denied. When the teenager attends appointments, parents may want to reinforce this with a movie or special outing. However, it is always ill advised for parents to bribe the child by promising to purchase things, especially large material items. This skews the teenager’s motivation and ultimately proves counter-productive.

The parents might also consider marital or family therapy. This will send a positive signal to their child about the value of therapy. It also shows how much they care about her and how far they are willing to go to help her. It indicates that they don’t blame her exclusively for the eating disorder or believe it is all her fault.

Although parental actions must convey love and concern, there must never be ambiguity regarding the seriousness of the situation or of the parents’ intent. The teenager must understand that if outpatient therapy proves ineffective, a higher level of care will be sought. Knowing this may actually help motivate the adolescent to take the current therapeutic approach more seriously.

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