One of the first skills we have to learn as responsible parents is figuring out what our child needs so we can provide it. Is the baby crying because they are hungry, sleepy, sick, or need a diaper change? Those problems are easy to diagnose with the process of elimination and have easy solutions. But as children get older, the problems we face as parents get more complex. And when a child has an eating disorder, helping them can feel every bit as overwhelming as trying to calm a screaming baby in the middle of the night in those early, sleep-deprived days of new parenthood. It’s a new challenge, but there are guidelines that can make the path to recovery much easier for parents and children.

Get Help Early

Early intervention is key in treating eating disorders in children. So, if a child is exhibiting signs of an eating disorder, it’s important to address it head-on sooner rather than later.

Parents can usually tell when something is going on with their child. Early signs of an eating disorder can include avoiding food or mealtimes, refusal to eat certain groups of foods, comments that reflect a negative body image and low self-esteem, a preoccupation with food, secretive eating or hiding food, and withdrawn, secretive behavior. Eating disorders can affect people at all weights, so it’s important not to brush off signs that a child may be engaging in disordered eating because of their gender or weight. (And in fact, eating disorders are very often dismissed and undiagnosed in men and higher weight individuals, which can be a life-threatening oversight.)

Seek to Understand as a Responsible Parent

It’s important to realize that anorexia nervosa and bulimia nervosa are not the only eating disorders in town. For instance, Avoidant/Restrictive Food Intake Disorder (ARFID) looks like being a “picky eater,” and may even resemble anorexia to outsiders. This is why it’s important to seek help and get a diagnosis. A diagnosis can provide a road map for recovery, and help us understand what our children are going through. It can feel scary and overwhelming when a child has an eating disorder, but a diagnosis can help put a name on the issue and help us find a way forward.

Cultivate Trust

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Children are born trusting their parents. Babies are essentially helpless, so they are hard-wired to trust their parents to tend to their needs and help them survive. That trust can wane as children age, as their needs shift from diaper changes to wanting independence, but trust is imperative in helping children with eating disorders. We need our children to talk to us, to come to us when they need help or assistance, to let us know if they are suffering. But trust doesn’t come as easy as it does when our children are babies. Here’s how to build trust with your child:

  • Active listening. Nodding our heads and saying “uh-huh” is not enough. Active listening is a technique used to make the person talking to us feel heard. To listen actively, we need to pay attention and indicate that we’re providing our full attention. That means looking our children in the eye, shutting off the TV, and not engaging in side conversations (like a spouse trying to talk to us from another room or another child interrupting). We can ensure we’re understanding our children by paraphrasing what we were just told (“What I’m hearing you say is ____, is that what you mean?”) and asking questions to follow up or clarify things they’ve said (“When ____ happened, how did that make you feel?”) And it also means that conversations with our children are “no judgment zones” where they can feel comfortable saying what’s in their hearts without fear of it turning into an argument or experiencing rejection. A child with an eating disorder may have to reveal some hard truths to us, and tell their parents things that are hard to say, so the least parents can do is provide a safe space to talk. And the more comfortable our children feel talking to us, the more we will be able to understand their struggle and help them.
  • Tell the truth. It seems pretty obvious that a lie is the quickest way to torpedo trust in a relationship, but parents can sometimes have a difficult time telling kids the truth. It’s essential that we not withhold the truth or tell lies to our children if we want to cultivate a trusting relationship. That means giving them honest answers when they have questions and never withholding information they have the right to know. (For instance, some of us may feel like we need to lie or bend the truth to get our children to a doctor’s appointment to discuss their eating disorder, or to an emergency room for an acute medical emergency. But all that does is frustrate them and teach our children to distrust us.) And this can also mean owning up to it honestly if we make a mistake or mishandle something as parents.
  • Stay attuned. This goes a step beyond listening; it means staying in tune with a child’s nonverbal cues and body language. We can notice when they seem to be anxious, depressed, or even in a happy, positive state of mind. And that means we can meet their needs, like providing extra support when they feel nervous, or even just doing something thoughtful to cheer them up on a bad day. This builds trust by letting our children know we really truly see them and understand them. This works for children when they’re young and when they’re adolescents.

Provide a Stable and Consistent Home Environment

For many people, eating disorders develop out of anxiety or exist alongside anxiety. And anxiety can be created or at least increased by chaos and instability in their homes. So, creating structure and a routine (while still making time for fun and downtime) can be helpful to a child with an eating disorder. That doesn’t mean every moment needs to be structured, and children can’t have time on their own. We don’t need to rigidly adhere to a schedule, or pack each day with structured activities. But it does mean that home should feel predictable and safe to children. When children know what to expect, they feel safe. Some things that can disrupt our homes, like divorce or the death of a loved one, can’t really be avoided. But establishing safe routines children can count on, such as family dinner, or gathering on the couch for a movie on Friday night, can go a long way in developing a stable home life, and lives up to you being the responsible parent that you are striving to be.

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Part of a stable home environment is also providing food for our children. Many families struggle with food insecurity, and unfortunately, feelings of scarcity can trigger anxiety around food. Knowing that food is available to them when they are hungry can help our children feel more at ease around food. Parents of children with an eating disorder may be tempted to restrict their child’s access to food (especially if they tend to binge) or control what they eat, but that can backfire and cause disordered eating to worsen. As you are able to, provide access to a variety of food, and allow children to eat when they are hungry.

Build a Network of Support

Parenthood can be isolating on its own. And when we have a child with an eating disorder, it can be even more isolating. We may refrain from telling people in our lives, due to shame or fear of being judged a bad parent. But it’s essential to have support around us, and to recognize that you are a responsible parent as you address your childs issues. We need people to confide in, go to for advice, or even just vent our frustrations to after a bad day. Spouses or co-parents can be immensely helpful, as can our own parents, close friends, family members, and so on. Finding in-person support groups or even online forums for parents of children with eating disorders can provide comfort, advice, and important emotional connections.

Practice Self-Care while being a Responsible Parent

Parenting a child with an eating disorder can cause us to feel like we cannot focus on anything but them. But as parents and human beings, it’s important to practice self-care. You can’t pour from an empty cup, as the saying goes. Self-care looks different for everyone. Some of us might prefer a night of face masks and bubble baths, while others may get the most benefit out of a night out on the town with our spouse or friends. Self-care can also be as simple as asking for help from your spouse, co-parent, or a family member when we’re feeling underwater.

Model a Positive Relationship with Food

We all know the saying, “Little pitchers have big ears,” right? Well, those ears are even bigger than we know. Our children look to us to learn how to navigate the world, and they learned most of what they know about food and caring for themselves from us, as well. And unfortunately, they may have picked up some unhealthy attitudes about food from us. If we talk about food in moral terms, as being “good” or “bad,” or praise eating less and judge eating more, our kids notice that. They can internalize those messages, and as responsible parents we need to do our best to model a positive relationship with food.

But food is morally neutral. Food is neither good nor bad, and all kinds of food have a place in our lives. Food is much more than its nutritional value — food is stability, community, family dinners, birthday cakes, memorable nights out, even ties to our cultural heritage. (And if you feel it’s necessary to emphasize the importance of nutritionally dense food, remember the man who survived in the snow for five days on nothing but packets of taco sauce in his car. Even food we might label “empty” or “unhealthy” has value! Those trips through the fast-food drive-through saved his life.)

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In practice, this means editing ourselves when we talk about food. It means eating when we’re hungry, getting seconds if we’re still hungry, and stopping eating when we’re satiated. It means not dieting. It means exciting words like “indulgent” or “sinful” from our vocabulary when we talk about food. And it also means refraining from nitpicking about what our children, and other people, choose to eat.

This can be a hard process, and having a child with an eating disorder can really open our eyes to how much work we need to do on our own relationships with food. (And just how many of those attitudes about food we may have had passed onto us by our own parents.) But it’s worth doing the work to untangle our own complicated feelings about food if we want to help our children recover from an eating disorder.

Start Dealing with Your Own Body Issues

Eating disorders and body image issues tend to run in families. Now, there’s a strong genetic component to this, but it’s also environmental. If we grow up hearing certain messages about weight and our bodies, we absorb and then internalize those messages. Whether it’s comments about our own bodies or other people’s bodies, our children hear and understand them. We, unfortunately, live in a society with an extremely profitable diet industry that floods us with messages about the importance of being thin and the dangers of being fat. If these messages are not countered at home and instead get reinforced, it’s easier for these negative messages to take root. So, when trying to help our children recover, it’s essential that we start unpacking our own attitudes about bodies and weight as well. After all, it’s hard to make the argument to our children that they shouldn’t take drastic measures to control their weight when we’re restricting our food to control our body size.

It’s helpful to learn about Health at Every Size (HAES), which uses an intersectional lens to reframe health as a spectrum, instead of a fixed point or something that can be easily quantified by one’s Body Mass Index. HAES is a weight-inclusive approach to health that focuses on holistic health and takes into account the entire person, not just the size of their body.

Recognize that Recovery is an Ongoing Process

While it’s important to believe in recovery, there is usually no point where an eating disorder is “fixed.” The work may be ongoing for the rest of our children’s lives, and as responsible parents, pushing through the hard times is what can make the difference in your children’s life. There may be relapses, and times when additional support is needed. It is possible and entirely common that there won’t be a point where we can say, “There! The eating disorder is gone.” And that’s okay! With a healthy support system and strong family connections, children with eating disorders are much more likely to recover and lead healthy, fulfilling lives. Our job as parents is to provide unconditional love and support so they can heal and thrive.

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Linda Gerhardt is a writer and content creator who works in nonprofit technology by day and runs a fat activism & Health at Every Size-focused blog called Fluffy Kitten Party by night. She lives in northern Virginia with her husband and rescue pets.