Teenagers: Information for Families Struggling With a Child’s Eating Disorder

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Included in a teenager’s hard wiring is the drive toward separation and autonomy, which often means power struggles between them and you. It's important for you to always keep an open communication between you and your teenager. For families who have a teenager with an eating disorder, power struggles are often frightening for parents and self-defeating or destructive for their child.

Eating disorders serve many purposes; one of them is as a vehicle to express, through behavior, what cannot be expressed verbally. Though teens typically use their behavior instead of their words to get a point across, teens with eating disorders are at an increased health and safety risk. Typical developmental issues around separation, finding a voice, anger, and autonomy are instead expressed through the language of the eating disorder.

Most people with eating disorders have a difficult time experiencing and expressing emotions. Symptoms are a behavioral way to express what cannot, or is not, being expressed emotionally. So, a typical child who is angry at a parent may slam their door, sulk, avoid contact, or not follow through on household chores. A child with an eating disorder might choose to not eat or vomit.

It is easier to have consequences for the power struggle that ensues when a child won’t take out the garbage; but it is painfully sensitive and scary to have consequences for the child who chooses not to eat as a way to express their dissatisfaction or wish for autonomy.

Either way, my advice for families is the same. Helping a teen find an emotional – not a behavioral – voice is key in dismantling power struggles. For families who have a child with an eating disorder, this is paramount. Words need to replace destructive or life-threatening behaviors. Here are things to consider for families struggling with their child’s eating disorder:

  • Separation and autonomy are inevitable and necessary tasks of adolescence. Supporting healthy separation of a child with an eating disorder is a key in recovery.
  • Children with an eating disorder have an increased difficulty in working out these tasks and expressing their feelings, especially anger. Understand that their eating disorder is not a willful act, but one of helplessness and pain. Their attempt is ultimately not to thwart you, but to hurt themselves.
  • Teens with an eating disorder need your voice of understanding, sensible limit setting and compromise. Talking about what they are – or are not – eating is typically not helpful and often provokes the power struggle. Point out when you see your child using their symptoms as a weapon, and ask whether they can share in words what they are feeling.
  • A parent’s anxiety is likely to be understandably escalated during the course of their child’s illness. Keeping your anxiety in check will help with rational thinking in your responses, particularly when your child’s behavior is provocative and scary.

Most importantly, seek the help of professionals. Solid family therapy can teach all members how to understand and interpret power struggles and how to dismantle them so that eating disorder behaviors are replaced by communication and appropriate teenage rebelliousness.

How do you handle your teenager's urge to be rebellious?

Photo courtesy of Flickr.

Dr. Scheel has been treating eating disorders for more than 25 years. She is the founder and executive director of CEDAR Associates, a private outpatient practice specializing in the treatment of eating disorders and other self-harming behaviors. She is also the recent author of When Food is Family: A loving approach to heal eating disorders, which looks at how childhood relationships and experiences can play a role in contributing to the development of eating disorders. More can be found at A member of the National Eating Disorders Association (NEDA), Academy for Eating Disorders (AED), and the Eating Disorders Coalition, Inc., Dr. Scheel emphasizes the importance of mutual respect, empathy, trust, and the need to live authentically in eating-disorder treatment approaches.

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