Clinically Reviewed by: Amarra Bricco MSE, NCC, LPC, CCTP
Every eating disorder treatment plan, like every person attending treatment, is different. However, there are universal benefits to having family and/or support persons involved in treatment. Having a loved one with an eating disorder is hard! An active role in their loved ones treatment provides the caregiver with support while making the home environment most encouraging to recovery.
A study published in the Journal of Eating Disorders assessed the problems eating disorder patients were wanting to address with their families and caregivers. The most frequent responses were eating disorder specific assistance, communication, emotional support, understanding and validation, future support, and managing expectations. Interestingly, caregivers reported similar needs.
Family involvement in treatment can help to create a warm environment and effective communication style where each member of the family can feel supported. In treatment, the family will be given skills to function as a unit and address any barriers to change, problem solve, and enjoy stress-free time together.
Below are a list of priorities and things that can be helpful from family involvement in eating disorder care:
Establishing therapeutic rapport
Many families feel desperate and stressed when seeking care. Treatment teams aim to be open and empathetic to the family’s struggles, needs, and fears. Creating relationships with families and caregivers builds the trust necessary to engage in treatment. When family members feel supported, the home environment is the best possible for recovery. The patient themselves is also more likely to buy into recovery, as the people they trust have trust in the treatment providers.
Example: Addy, 16, is struggling with anorexia. She is in her first week of treatment and isn’t sure it’s going to help her. When she and her family sit down to discuss the first week, she sees her parents and siblings invest into the thoughts, ideas, and changes her treatment team has suggested and decides to give it a fair shake.
The unfortunate reality is that many of us can feel blamed or judged by health care professionals. This is no different in eating disorder care. Furthermore, families often blame themselves for their loved ones eating disorder, wondering where they went wrong. From either side, blame isn’t helpful. In fact, the Academy for Eating Disorders rejects any model of treatment that includes the family as the primary cause of an eating disorder. Causes are far more complex and include genetic, psychological, neuro-endocrine, and sociocultural factors.
Example: Tom, 49, suspects his teenage son is bingeing and purging. He is concerned and wants to help but feels ashamed that he has raised his son in an environment that emphasized eating only healthy foods and prioritized exercise. He delays seeking help because he fears he will be blamed for his son’s eating disorder.
Demystifying eating disorders
We don’t know what we don’t know. In our culture we receive a lot of messages and misconceptions about food, dieting, and bodies. Involvement in treatment will provide education around nutrition, body image, food facts, food fallacies, and risk factors, among other things.
Example: Jack, 22, is fixated on building muscle mass. He works out seven days a week and has eliminated all but a few foods from his diet. Still, it doesn’t feel like enough. His friends have told him they’re worried about him but he doesn’t take it seriously, because he believes men don’t get eating disorders or body dysmorphia.
Communicating openly and consistently
Families are kept up-to-date on treatment plans and progress by direct communication from the treatment team. In family sessions, the entire family (including the one receiving treatment) hear the same, consistent messages. Other healthcare providers should also be kept in the loop. The primary care provider and therapist (where relevant) should receive consistent updates on the patient’s progress and anticipated discharge dates so they are prepared to provide care when the patient graduates treatment.
Example: Anna, 38, is ready to return to her outpatient therapist after graduating PHP and IOP. This was not communicated to the therapist who is currently on a waitlist and cannot see Anna for 8 weeks.
Eating disorders are scary. The process of treating them can be intimidating, but it can also be a beautiful journey. When patients and families see that their treatment providers are competent and trustworthy, they feel hopeful their loved one will be taken care of. They gain confidence in their own abilities to manage the hurdles the eating disorder throws at them. They believe in a future where recovery is possible.
Example: Maggie’s daughter is transitioning to residential care after an inpatient stay resulting from dehydration and malnutrition. Maggie had no idea her child was struggling with an eating disorder. This has been the scariest experience of her life. The patience, warmth, and wisdom of her daughter’s new care team has calmed her nerves and made her feel more capable of helping her daughter recover.
Psychology Today – Dr. Riccardo Dalle Grave – Accessed 6-7-23
Eating Disorder Hope – Accessed 6-7-23
The Role of Family Relationships in Eating Disorders in Adolescents: A Narrative Review – Behavioral Sciences Journal – Micheala Erriu, Silvia Cimino, and Lucy Cerniglia – Accessed 6-7-23
Working with families of adults affected by eating disorders: uptake, key themes, and participant experiences of family involvement in outpatient treatment-as-usual – Journal of Eating Disorders – Carmel Fleming – Accessed 6-7-23
Working with families of youth with eating disorders – BC Medical Journal – Pat Roles – Accessed 6-7-23