When a child has anorexia, it often feels overwhelming, even terrifying to the family. An eating disorder takes over the family dynamic, and even overtakes your child’s personality. Anorexia is particularly frightening as body weight declines. Well-meaning friends, coworkers, and even health professionals may offer conflicting, or even detrimental advice. So how do you parent a child with anorexia?

Don’t blame yourself

It is easy for parents to fall into the belief that they are to blame for their child’s anorexia. They may worry that they caused the disorder through something they did; or they may believe that if they had acted sooner, their child would not be in such a desperate condition. This is understandable, as it is common for parents to look for a way they could have prevented any kind of illness in their child. Also, the culture at large is intensely focused on weight and appearance, so it is easy for a parent to believe their own dieting behavior or poor body image caused their child’s eating disorder.

However, eating disorders are complex, with both genetic and environmental components. Ongoing research will help us better understand the causes of anorexia and other eating disorders, but we have come a long way from blaming parents. Many medical conditions, such as asthma, have a biological and environmental component, too. Playing the blame game is not helpful.

Be consistent

Anorexia treatment is tailored to each individual and their family. Consistency is key, even when times are tough. Families may feel strained by the requirements of treatment on top of the stress of living with a suffering family member. Eating disorder recovery is often difficult, as the person with the diagnosis does not necessarily desire treatment, and may actively reject components of it. In-person or virtual support groups can be very helpful.

Keep the big picture in mind.

Eating disorder recovery is an ongoing process. It is not linear; in fact, a path to recovery often looks more like an unravelled ball of yarn. However, full recovery is possible! Keep this in mind, particularly when the eating disorder fights back. It may look like your child is the one doing the arguing, but it is really the eating disorder driving the resistance. It can be helpful to view the eating disorder as an entity separate from your child; an enemy you can fight together.

Avoid commenting on weight and appearance

Eating disorder symptoms go beyond eating and fear of weight gain. However, food and body image are at the forefront of anorexia. Because our culture is appearance-obsessed, it is difficult for someone with anorexia to escape external judgments about their appearance. Even a well-intended comment like “You look healthy” will likely be interpreted as “You look hideously fat” by someone with an eating disorder. Decline to engage in talk about diets, body size, and exercise for weight loss or to “burn off” something that was eaten.

Nurture your child aside from their ED

When anorexia exists in a family, it is physically, emotionally, and spiritually taxing. Treatment often requires parent participation in every meal and snack. It is not uncommon for the eating disorder to be the focus of the family. Therefore, the person with anorexia is the center of attention, precisely because of the illness. However, recovery involves learning to live without eating-disordered thoughts, behaviors, and beliefs. Helping your child broaden their sense of self will help the recovery process. Talk with your child about interests aside from the eating disorder, including school, work, hobbies, and friends.

Barbara Spanjers, MS MFT is a therapist and wellness coach who helps people feel more attuned with food and their body.