Now we know our daughter has an eating disorder. What do we do?

When an eating disorder (ED) is diagnosed, it's normal to experience a multitude of fears and doubts. This is a particularly critical moment because it confirms that the physical, cognitive, emotional, and behavioral changes you've been noticing in your child are indeed indicative of an ED. In addition to this initial shock, you're likely dealing with what's known as low motivation for change . This means your child isn't truly aware of the problem, doesn't see the need to change, and consequently, rejects treatment.

When anorexia nervosa, bulimia nervosa, or binge eating disorder is diagnosed in an adolescent or young adult, it is common for the following to happen:

• You may experience a whirlwind of emotions such as helplessness, fear, hopelessness, or frustration. These feelings intensify when your son or daughter expresses this resistance at the beginning of treatment. It's important to accept that this thought will be present for some time, and that's normal; it's a resistance that needs to be addressed during treatment.
• Feelings of guilt and a certain obsession with knowing the causes often arise. It's important to remember that no one is to blame for having an eating disorder, nor is there a single cause that leads to its development. Feeling guilt and shame is common in these cases, but these feelings don't help with recovery. In this regard, we always explain to families that it's more important to focus their energy on starting treatment and recovery, where family involvement is fundamental, rather than on searching for the cause of the disorder, which we will address later.
• You should start searching for as much information as possible about the disorder online and on social media because you need to better understand what's happening, why, and what to do, ultimately trying to dispel the uncertainty that arises at this stage. It's important that you know how to distinguish reliable and accurate information from all the search results. We recommend prioritizing information backed by scientific sources, mental health organizations, and associations of people with lived experience of mental health issues and their families. And if you have any doubts, always consult the therapeutic team that is treating your son or daughter.

Treating an eating disorder is a long and complex process that requires the attention of an interdisciplinary team and the support of your entire family.

The family in eating disorders

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Both your son or daughter and the rest of the family will go through different phases during treatment and recovery. In reality, no one is ever truly prepared to face a serious health or mental health problem. There are no magic solutions, but there are some starting points that can help you better cope with what lies ahead:

• Don't expect to rush or get immediate results from treatment . As we mentioned before, recovery from an eating disorder is a marathon, not a sprint . In this sense, you also need to pace yourselves, learn to manage your own emotions, learn to work in coordination with the therapeutic team, and understand how to support your son or daughter to provide them with a positive and encouraging environment.
• Trust the process . Eating disorders have multiple causes, so treatment involves addressing both the physical and psychological aspects of the disorder. Eating disorders can be cured, but it's not a sprint; it's a marathon, not a sprint. Therefore, there is no immediate, definitive, short-term solution. It's important to have confidence in the healthcare team and the treatment process.
• Understand that your son or daughter's actions and reactions are influenced by the eating disorder itself . You've probably heard the expression, "It's not the person speaking, it's the eating disorder." This means that it's important to filter your child's attitudes and words by understanding the emotions and behaviors associated with an eating disorder, which are characteristic of the disorder, not of the person's personality. Having a clear understanding of this helps families process and manage tense situations, such as when the person with an eating disorder directs their anger toward their caregivers, or when they talk obsessively about their weight or body, or when they refuse to eat, isolate themselves, don't want to talk to anyone, make excuses to avoid following treatment instructions, question professionals, and disagree with the follow-up they are receiving. These are clear examples of attitudes and reactions that are a result of the disorder, not of who your son or daughter really is. On the other hand, when he expresses his suffering to us, when he apologizes for speaking badly to us, when he expresses positive feelings towards us, and when he expresses future plans or wishes for how he would like his life project to be, that is when our son or daughter is able to prevail in his own thinking without the interference of the disorder.

With this starting point, the specialized professionals who care for your son or daughter will develop a therapeutic plan with the guidelines to follow. Although each therapeutic plan is personalized and adapted to each case, there are some guidelines that are common to all families and will help you in these initial stages:

• Be strict in following the dietary guidelines you are given. These guidelines are designed by a team of specialized professionals to achieve specific therapeutic goals.
• Try to adapt the habits of the rest of the family to be consistent with the guidelines provided by the therapeutic team.
• Try to understand and be empathetic to your son or daughter's difficulties.
• Avoid negotiating on topics related to food.
• Avoid comments or conversations related to aspects that are critical for your son or daughter, such as body image, food, weight and development.
• Practice active listening , showing interest in understanding how they feel emotionally, what worries them, or what motivates them, while respecting any difficulty they may have in sharing their emotions. Sometimes, this takes time.
• Avoid pressuring them, judging them, or making comments that might make them feel guilty.
• Express explicitly to him that he will always have your support and affection, and that together you form a team to overcome the eating disorder.
• Value the efforts they make , however small they may be. Every small step is a step forward, and understanding the difficulty they face in carrying them out, it deserves recognition.
• Be honest about your emotions and feelings, but express them in a respectful and calm manner.
• Remember that to help your son or daughter, you also need to be well physically and emotionally. Self-care will allow you to find time for rest, emotional well-being, and greater control over situations.
  

  Self-care guidelines for families in cases of eating disorders

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  Helping a son or daughter with an eating disorder is far from easy; there are many challenges to overcome. Therefore, if you feel you need emotional support, don't hesitate to seek help, whether from a professional or from support groups run by associations for families of people with eating disorders.