When our daughter developed an eating disorder, I have explored treatments extensively. She was treated using a variety of methods. Here are our successes, failures and lessons learned about parenting a child with and eating disorder.
Our daughter was diagnosed with bulema-rexia at age 15. She was binging and purging about 1-10 times a day, depending upon her stress level or feeling of helplessness. Once she was taken by ambulance from school when she passed out in class. She hadn’t eaten in three days. She has tried to cut her wrists twice and has ingested pills once; these were a direct result of panic attacks about food issues.
This articulate, talented, generous child is a typical Type A personality. OCD are her middle initials. ‘Be better than the best or be nothing’ is her motto. Her dancing, long rigorous hours of pointe work and ballet damaged several tendons in her foot. This would ultimately lead to other injuries, therapy sessions, time on crutches. Because of a misdiagnosis, she walked on a chronic sprained ankle for about 4 years after the initial injury.
Her mountain of schoolwork was done in meticulous, font-perfect handwriting. She would recopy entire pages of notes to get them perfect. She would go drive to school at 7am, take honors classes, go immediately to her library job after school or to dance class until 9 -10 p.m. every evening, come home and do homework until 1am. She had two other jobs, volunteered at three locations and kept up with her chores at home.
When we discovered the eating disorder, it was well established. We immediately took her to our doctor, priest, a trusted counselor and anyone else we could think of to help. She was prescribed Prozac. She took it, but would often self-medicate by skipping doses or quitting on good days. She maintains that Prozac was of no help.
After her first suicide attempt, on her insistence and her therapist’s advice, we checked her into an ED facility. It was reputed to be very good with eating disorders. It was basically a maximum security psychiatric hospital. She was grouped with cocaine addicts, schizophrenics, and violent, criminally insane adults and teens.
They could have no bed sheets, shoelaces, notebooks, or string of any kind. Each day for three weeks, they walked around a 12 foot square slab of cement for 20 minutes (fitness time). They could not exercise or go to the bathroom too frequently. They were strip-searched, awakened every hour in the night, yelled at, belittled, and force fed.
Our daughter says that the classes for which they were dragged out of bed at 7am consisted of watching videos on the dangers of drugs, incest, rape, and sex crimes. In the few classes actually devoted to eating disorders, the girls mostly talked about the best diets and weight loss programs.
They were made to eat food that most healthy eaters wouldn’t eat. If they didn’t eat their dessert, they had to drink Ensure. The girls adopted the new eating habits in order to get out of the place.
Since this traumatic experience, we have analyzed the subject of food, dieting and eating disorders. I think some of the ideas we came up with might be helpful.
-Eating disorders are more about control issues than food issues. Just as a small child refuse to use the toilet because he needs to feel control or power over his choices, and refusing to eat can serve the same purpose for an older person.
-Parents examine your parenting issues. Are you giving your child the power to make age-appropriate decisions? Are you trying to control too much? Choose your battles.
-Eating disorders tend to develop in high-strung, over-achiever children. Children who are frantically neat, organized, studious, or hard-working, can easily fall prey to this disease.
-Parents, examine your priorities here too. Do you push, nag, or demand? Is your own life high-paced? Are you and over-achiever? You can help your child re-focus, by shifting gears yourself and not living your life constantly in over-drive.
-If you suspect an eating problem, don’t ignore it. Talk openly and without judgment to your child. Listen to her. Don’t try to minimize her feelings or change her thinking. When you say things like ‘Honey, you look nice to me!’ it’s demeaning and mortifying.
-Take their desire to diet or be fit part seriously. Don’t harass, or persuade. Instead, research and discuss safe healthy diet options. Weight Watchers organization it is a good place to begin. WW will help your child understand nutrition and set realistic goals.
-Eating disorders are also about body and self image. A therapist specially trained in eating disorders can be helpful here. Visit with your child if possible. Be there for her, but don’t insinuate yourself into the therapy session. Listen to your child and keep communication open. Is she comfortable with the therapist? Is the experience positive?
-Evaluate your own self-esteem and body-image. Are you kind to yourself? Do you speak negatively about yourself? These things will reflect in your child.
-Show an interest in your child’s social life, beyond just disciplinary issues. Offer to drive them places. Volunteer to take help with things they need or want help with. Invite friends to do special activities. As much as your child is comfortable, take part in their life.
-Don’t force yours agenda or try to control the event (beyond expecting safe and reasonable behavior). Be willing to take a “behind the scenes” role. Teenagers like you to take them shopping, cook for them, help with homework, listen to them play (even if your don’t like the music they play) and watch their performances or games. They do not like you to make a spectacle of yourself waving, shouting or calling reminders.
-Encourage your child to journal. This is not like keeping a diary of events. This is a place to share inmost feelings and thoughts.
-Monitor the online Facebook and online interaction. There is too much vulnerability and access to privacy with these sites, especially for children with emotional issues.
-Treat an eating disorder just as you would any other illness. Nurture. Comfort. Support.
-Like any illness, your child may use it to their advantage. This is normal; when you live with a chronic condition, it wears you down and sometimes you feel resentful. Adults do this too; I know very few cheerful martyrs. Don’t buy into ED guilt trips or power plays. Just accept the angry feelings as part of the process.
-Be honest with your child. This is a very self-absorbed disease. Don’t let them control you or the family with their illness. (I.e.. ‘if you don’t do this, I’ll puke!’ ). Remind them of your expectations and let them make their own choices.
-Provide lots of healthy, nourishing tasty food choices. I cook very mindfully, now that I have to consider that my meals may go down the toilet. Our daughter knows that I read food labels and am conscious of health concerns. If she indulges, she is less likely to purge if she knows how I made it and what’s in it.
-If your child requests certain diet food, be willing to give it a try. You don’t have to be a slave to her whims, and a lot of diet foods are expensive. But you can reasonably agree to try a few Lean Cuisines, Boca burgers or Weight Watchers Ice Cream bars when they go on sale. If she feels that she has some control over her food intake and choices, this can prevent the need to starve or purge.
-Teach your child to cook. Again, they are less likely to avoid eating if they have been involved in the preparation.
-Eating in front of people is often uncomfortable for someone with an eating disorder. You can negotiate this problem by asking that they eat with the family, but not reacting when they do leave the table. It may not be the best manners, but you have to choose your battles.
-Squirreling food is common practice for ED kids. They will hide food in their rooms. This serves two functions. It allows them to binge and purge in secret. It also gives them a sense of control over the rest of the family. I do not allow this practice. It’s unfair to the rest of the family (they will often squirrel all of the granola bars, cookies, etc.). And it enables secretive eating. I don’t over-react (well, not anymore). I just remove the food and say that food needs to be kept in the kitchen.
-Skip the ‘clean plate club’ mentality. When the kids are under 12, my rule is that to get dessert, they must eat all their meal. Fruit is not a dessert. I serve user-friendly portions (quite small). I ask them to take one bite of a new food. I allow them to say ‘no thanks’ to one menu item after they have tried it one time, but not the whole menu. After 12, I don’t tell them how to eat. I let them make their own choices. I plan the dinner menu, but I make what everyone likes. All four of our children are active, slim, healthy and very good eaters.
-Tell others, especially your extended family how you want and don’t want the issue addressed. Many people still think of an eating disorder as behavioral or attention-seeking. It is a compulsion like drinking, drug use and smoking, only it is less invasive to others than those addictions.
It isn’t anyone’s place to tell your child how to eat. Not family, grandparents, siblings, friends or outsiders. They should not be allowed to question, mock and humiliate. When some guy said to our daughter, “You can’t have an eating disorder, you’re not that skinny!’ I almost tore his tongue out of his mouth!
I’ll conclude with a statement I heard an eating disordered man make. It helps me understand the ED dilemma. He said, “It is easier for the alcoholic to quit drinking than the person with an eating disorder. The alcoholic can avoid alcohol for the rest of his life, but you can’t escape eating and food. Think how difficult it would be for the alcoholic to quit if he had to drink three swallows of whiskey everyday to survive. It’s like having an intolerance to breathing air.”
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