Self-care guidelines for families in cases of eating disorders

When a loved one is diagnosed with an eating disorder (ED) , like any other serious health problem, it's not easy to accept. Like any long-term illness, an ED takes a considerable toll on both the family and the affected individual, as they must navigate a recovery process fraught with uncertainty.

Caregivers play an essential role in the recovery process. It's important to remember that early detection, intervention by a specialized team, and family involvement during treatment are factors that contribute to a better prognosis.

Treating an eating disorder, whether it's anorexia, bulimia, binge eating, or another type, isn't quick. It's a slow, gradual process, with setbacks and progress. Therefore, we must approach it like a marathon, not a sprint where we give it our all until we're exhausted. We must maintain our strength without depleting our reserves. There will be times of physical and mental exhaustion. These are normal reactions to a difficult situation, but they require support.

Assimilating the diagnosis

Once the disorder is diagnosed and the affected person receives treatment at a specialized center, the family often receives instructions from the therapeutic team even before they've had time to process the situation. In other words, they're expected to act before they can think about and understand how the new situation makes them feel. And, in doing so, guilt often arises. It's an expected reaction, but that doesn't make it true. It's important not to let yourself be trapped by that feeling.

The importance of the family in addressing eating disorders

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The onset of an eating disorder is a real challenge for the entire family, a challenge they didn't anticipate and for which they were unprepared. That's why it's important for families to share their fears and anxieties from the beginning, ask questions, and feel heard and understood by the therapeutic team.

Surviving Eating Disorders

It is understandable and expected that families will experience moments of crisis, physical and mental exhaustion. These are normal reactions to a difficult and prolonged situation. At the same time, because they are expected, they have been studied and share many characteristics with other stressful situations (long-term illness, sports competitions, the current pandemic, etc.), which helps us to prevent them or know how to react.

Strategies for coping with common situations in eating disorders

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Symptoms that may be a sign of caregiver burnout:

• Demotivation and sadness beyond the problem of the affected person.
• Trouble sleeping or excessive sleepiness.
• High levels of stress or anxiety, panic attacks.
• Disinterest in or abandonment of one's own hobbies.
• Lack of interest in making future plans or experiencing new life experiences.
• Easily irritable.
• Constant tiredness, aches or pains, without apparent health problems.
• Lack of interest in having social contact, meeting up with friends, spending time with a partner.
• Feeling "burned out"

Take care of yourself so you can take care of others

When an eating disorder enters a home, it's common for the family to feel distressed and confused. They need information about what's happening to the affected person and what they can do to help. The family can be a tremendous source of strength in recovery.

But, in addition, there may be other sons or daughters who also need to be taken into account, and there are also the needs of the caregiver or cohabitant.

Caring for the siblings of people with an eating disorder

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Let's not fool ourselves: an eating disorder will put the affected person at the center of priorities, and we will often feel like we are rowing through a stormy sea. Let's not forget our inner compass, let's not lose our way: the goal lies beyond the bad weather, upon reaching port.

On the other hand, becoming parents already involves prioritizing children, so it's a task we already have experience with. However, we'll need to learn new skills, take risks and try different approaches, and rethink how we organize family life and our own.

It is highly recommended to share the care of the person with an eating disorder. In the case of single-parent families, it is recommended to ask a trusted person to help. In the case of two spouses, it is recommended to divide tasks according to each partner's strengths and weaknesses. For example, some mothers tell us that, for them, the difficulty lies not in cooking but in how to plate the food or serve it at the table. If the father feels more confident in this area, it is a good opportunity for them to support each other. Social work teams can also assess the case and provide guidance and practical examples on home organization. As mentioned previously, this is a long-term treatment. If there are two caregivers, they can take turns, so that one can provide support where the other cannot.

If you want to take care, take care of yourself

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Tips for caregivers:

• Sleep at least 7 hours a day.
• Get some exercise : walk, or do a little bit of any sport. Half an hour a day is enough.
• Organize your time : distinguish between what is urgent, what is important, and what is not so important. Don't try to do everything.
• Learn to delegate tasks: it's difficult, but it pays off. Remember that you're not indispensable.
• Set aside a few minutes during the day to relax , whether by practicing relaxation techniques or simply listening to silence or soft music, going to the pool, etc.
• Share : Acknowledge your negative feelings and talk to someone you trust. The strength of feeling understood recharges our emotional batteries. It's good to ask ourselves how the situation is affecting us, and to talk with our partner, the therapy team, or other families.
• Where necessary, consider changing your routines , without fear. Just as the affected person is encouraged to confront their problems and explore new ways of managing their emotions, we shouldn't be afraid to try changes.
• We need to set limits for a person with an eating disorder, just as we would with any child. We need to know how to say no to certain demands that are a product of the disorder itself.
• Don't let your guard down when necessary, and relax when possible. At times like mealtimes or during a crisis, it's essential to stay calm, but there will be other opportunities to enjoy time with the person affected, ask questions, and receive support. If there are disagreements between the parents, discuss them separately, not during a difficult moment when you need to join forces. Furthermore, the person with an eating disorder needs boundaries, but perhaps not in every situation. Let's learn and consult on how to differentiate between these, where to focus more attention (food intake, medication management), and where they can relax, so as not to become exhausted from constant vigilance.
• Giving yourself breaks and moments to disconnect helps you stay healthy. Make sure you have time for yourself and your partner, separate from the eating disorder. Nurture your social relationships; set aside time to be with your friends and family.
• Practice your hobbies ; they are a great space to breathe.
• Practice constructive self-criticism , as well as validation . It's honest to have doubts, it's human to make mistakes, and it's wise to correct them. Our sons and daughters don't expect perfect parents; they expect us. Growth is a journey we take together. Let's value ourselves, too, for the efforts we make for our children, even if they don't always turn out as we'd like.
• Use existing resources , such as associations. You'll often find groups of families.
• Ask for help when physical or mental exhaustion is getting the better of you.

Support spaces for families

Various organizations, such as the Catalan Association Against Anorexia and Bulimia , offer support groups . The aim of these groups is to provide a safe space for families to address their daily concerns and anxieties, as well as to receive strategies for coping with the disorder within the family. It is an open group where family members share their experiences, worries, and fears. They provide each other with tools, support, strategies, and perspectives on what has worked for their own families and what might be helpful for others.

It is also important to consider the support groups and spaces offered to families at the various treatment centers. Increasingly, emotional support groups are being offered to families and individuals affected by the condition. These initiatives allow families to express their feelings of distress and share advice with one another. It is recommended that families verbalize their fears and anxieties to the therapeutic teams in order to receive specific support if needed.