Family Support in Teen Eating Disorder Recovery

The teen years can be tumultuous and full of mental, emotional, and physical changes. While teens are gaining independence and forging their identities, they’re also vulnerable to toxic and manipulative messaging about their bodies, appearances, and self-worth. Mental health is a major concern for teens, as conditions like depression, anxiety, and ADHD can make the struggles of adolescence more painful and harder to navigate.

Eating disorders are also a threat during the teen years—and that threat is only growing. One recent study reported that emergency room visits for eating disorders doubled among adolescent females during the pandemic. New dieting fads, medications for weight loss, and increasingly unrealistic beauty standards (exacerbated by and disseminated through social media) only worsen teens’ relationship to body image, food, and eating. 

If your teen has been diagnosed with an eating disorder, you may feel like you’re on the outside looking in. Teens don’t always confide in their parents or caregivers about their feelings or fears; they may not be receptive to treatment or want to admit that their eating disorder is dangerous. This is not necessarily unusual. But it’s important to remember that family support is critical at every stage of treatment; teens need ongoing support and family involvement throughout the healing and recovery process. 

The Importance of Family Support in Eating Disorder Treatment and Recovery

Eating disorders are not experienced in a vacuum; they affect the entire family unit. For parents of teens with eating disorders, it may feel like your teen is shutting you out or purposefully isolating themselves from your guidance and support. In reality, they need you more than ever. 

By involving the entire family in the treatment and recovery process, several important things happen:

• Parents, caregivers, and siblings gain a better understanding of eating disorders, as well as the habits, behaviors, and symptoms they can cause. Education and awareness is an essential aspect of providing the right support to teens with these conditions.
• Family involvement positively impacts treatment effectiveness and outcomes. A supportive family protects adolescents from emotional stress and worsening disordered eating behaviors and helps foster adaptive behaviors like communication and independent living skills (1). 
• Research has found that family support in teen eating disorder recovery results in increased emotional well-being and self-esteem, improved coping mechanisms in stressful situations, and improved eating disorder symptoms (2).

At Selah House, our family therapy sessions help evaluate family needs, roles, and processing throughout the treatment journey. A family therapist is involved with each client during treatment to foster cohesiveness and understanding between family members.

Identifying Signs of Eating Disorders in Teens 

Oftentimes, symptoms of eating disorders are dismissed as part of the normal ups and downs of adolescence. As a result, parents may not be attuned to the warning signs of disordered eating. 

Common eating disorder behaviors in teens include: 

• Sudden and strict changes in diet that eliminate food groups or nutrients, especially those associated with weight gain (fats or carbs, for instance); these dietary changes may be couched in health or wellness language
• Preoccupation with food ingredients and reading nutrition labels
• Gastrointestinal discomfort (abdominal pain, bloating, constipation, acid reflux)
• Frequent or obsessive body checking, e.g., excessive time spent looking in the mirror, constant weighing, feeling for collarbones or hip bones, measuring waist or thigh circumference
• Frequently skipping meals or offering excuses for not eating, e.g. I already ate, I’m just not hungry, etc.
• Practicing strict eating rituals, e.g. micro-biting (cutting food into tiny pieces), chewing each bite of food a set number of times, drinking water between bites, etc.
• Stealing or hoarding food 
• Refusing to eat around family and friends
• Wearing baggy or layered clothing
• Using the bathroom during or immediately after meals
• Laxative or diuretic use
• Compulsive exercise
• Rapid changes in weight
• Anxiety and depression (3)

Family members, especially parents, are often the first to observe changes in their teen’s eating habits and behaviors and their emotions surrounding food, weight gain, and body image. By knowing the signs, parents can intervene early and help their teens find the best treatment options for their specific condition. 

Fostering a Supportive and Nurturing Atmosphere

There are practical changes that parents and caregivers can make in the home to support a teen’s eating disorder recovery and provide a sense of safety, empathy, and compassion.

The following are some strategies for creating a nurturing home environment:

• Create a comfortable, clutter-free space for meals
• Plan mealtimes and snacks ahead of time, and be consistent
• Provide activities that encourage relaxation and distraction
• Offer encouragement and positive reinforcement
• Avoid making comments about physical appearance, whether it’s your own, someone else’s, or your teen’s
• Remove triggers for eating disorder relapse: Get rid of the bathroom scale, eliminate diet foods or labels that reference weight loss, and remove magazines or books that focus on achieving a certain weight or adhering to strict beauty standards (4)

Open and empathetic communication are also vital parts of a supportive home environment for your teen. Teens suffering from eating disorders often experience intense feelings of isolation, fear, guilt, and shame, and it’s important for their families to be empathetic to these feelings. 

Strive to always communicate without anger or blame. This doesn’t mean you should hide your feelings and concerns; rather, make an effort to discuss your experiences with as much patience and understanding as possible. 

Studies have reported that individuals suffering from eating disorders have positive outcomes when their family members acknowledge their symptoms rather than ignoring or minimizing them. Teens’ relationships with their families can motivate them to seek treatment and recovery (2).

Collaborating with Professionals

Family members play a critical role in early intervention and recovery for teens with eating disorders. Still, you may wonder how the family fits into your teen’s treatment plan.

Healthcare professionals include families in eating disorder treatment through family meetings and family therapy sessions. Your teen may even be a candidate for a family-based therapy program in which the family leads treatment at home under the guidance of a therapist. 

Parents and caregivers also fit into treatment plans in several other ways:

• You are your child’s advocate within the healthcare system during the treatment process
• You are their source of emotional and practical support
• You are part of the decision-making process and provide input on treatment goals and strategies
• You are responsible for monitoring your child’s behaviors and providing feedback to their treatment team
• You are given tools and resources to help support your teen during treatment and recovery. (5)

Throughout the process, ensure you are engaged in your teen’s treatment plan. Attend appointments when expected, provide a nurturing environment, and communicate openly and honestly with your teen and their treatment team.

Supporting the Support System

Often, families of teens with eating disorders feel intense pressure and emotional strain. You may be worried about your loved one’s mental or physical health or feel constant anxiety over the potential long-term consequences of their condition. 

You may also experience confusion, frustration, anger, and even resentment at various times throughout their treatment and recovery process. These are all valid feelings that occur with caregiver burden. In the same way that your teen needs the support of their family to face the challenges of recovery, you need support for yourself to face the challenges of being their caregiver and advocate.

Family support programs offer a safe space where family members can learn new ways to handle stress, improve communication and relationships, and support their teens. 

Different types of support for families include support groups, which provide caregivers with a forum to share their experiences and struggles, and online resources like the National Eating Disorders Association (NEDA), which gives families educational materials and tools for supporting their loved ones. It is also essential to make time for self-care (5).

As a family member, supporting a teen with an eating disorder can be a challenging experience, full of emotional ups and downs. But it’s important to remember that your support can be lifesaving.

Selah House offers tailored programs designed to meet the distinct needs of teens with a range of eating disorders. Our team of experts provides personalized treatment plans that foster lasting recovery and wellness while improving education, awareness, and communication among family members.

For more information about our teen eating disorder services, reach out to us at 866-324-8081. We are dedicated to supporting you and your loved one throughout the recovery journey.

References

1. Erriu, M., Cimino, S., & Cerniglia, L. (2020). The role of family relationships in eating disorders in adolescents: A narrative review. Behavioral Sciences, 10(4), 71. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7226005/
2. Leonidas, C., & dos Santos, M. A.  (2014). Social support networks and eating disorders: An integrative review of the literature. Neuropsychiatric Disease and Treatment, 10, 915-927. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4039404/
3. National Eating Disorders Association. (n.d.). Warning signs and symptoms. Retrieved February 28, 2024. https://www.nationaleatingdisorders.org/warning-signs-and-symptoms
4. Clemmer, K. (2017). 4 changes you can make in your home to support eating disorder recovery. Eating Disorder Hope. https://www.eatingdisorderhope.com/blog/4-changes-reduce-relapse
5. Rienecke, R. D. (2017). Family-based treatment of eating disorders in adolescents: Current insights. Adolescent Health, Medicine and Therapeutics, 8, 69-79. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5459462/