Fear of Frying: Why Parents of Anorexia and Bulimia Patients Dread Mealtime

Horror films don't come close to raising blood pressure like the prospect of mealtime for a parent of an eating disorder patient. Forget the knives and chain saws: the sight of a fork and spoon can be send the pulse racing. There is hope, however, in having a plan.

Until recently, parents were generally told to stay out of food decisions, discussions, and even thoughts when a loved one was diagnosed with an eating disorder.

The Food Police

"It's not about the food."

"Don't be the Food Police."

This kind of advice was well-meaning and had a purpose. It was meant to help the family understand that their loved one had a serious problem and not just an appetite or dieting issue. This advice was given to put a stop to unhelpful fighting and conflict over food. These are both important messages for parents to hear, but it is important not to stop there.

The message to not worry about food was also based on what modern clinicians know were two tragic mistakes. The first error was not understanding the role of low nutrition in both triggering and maintaining many of the mental symptoms of an eating disorder. Eating too little for one's maintenance and growth causes the body to go into emergency mode and tells the brain to focus very narrowly on certain issues, often excluding rational thought. This doesn't just happen at gravely low weights but - especially in a growing child or adolescent - at any sub-optimal weight or amount of food. Food is medicine for someone suffering from eating disordered thoughts and body image distortion. Although food is not the only medicine or therapy, without full nutrition the brain suffers damage every day that lowers the possibility of recovery.

Coaching Parents to Feed Anorexia and Bulimia Patients

The second mistake of telling parents not to worry about food was in thinking that parents could not play a positive or important role. This idea has been clearly demonstrated to be untrue and damaging. Parents, when educated and coached to do so by trained professionals, can be expert team members in restoring a patient to normal nutrition and healthy weight, as is seen with the Family-Based Maudsley therapy approach. Parents have special knowledge, skills, and connection with their loved ones, as well as the commitment and staying power that a eating disorders treatment environment can only provide for a limited time. Most families will find this task extremely challenging and require a great deal of support and coaching during the process, and it is important to have a back-up plan in place so the family has the safety of knowing that full nutrition and safety is guaranteed whether at home or in a hospital.