Are you worried about anorexia in your teenager?
It started innocently enough. Amy, 13, decided she wanted to “be healthier” and “get in shape.” First, she started cutting out sweets… then carbs, then fat. Soon, Amy began to supervise the preparation of all food in the household. Later, she would only eat what she would prepare herself. Amy’s meals were “ultra-healthy” but lacked the fat, starch and calories she needed; she was losing weight. Amy developed an interest in cooking shows, baking, and recipes; it was odd that she was showing so much interest in food yet denying herself more and more. Amy’s parents noticed the weight dropping, but it wasn’t until they brought her in to see her pediatrician that they realized just how far the dieting had gone. She had dropped 20 pounds.
Some – or maybe all – of this story may be familiar. The pathway to anorexia is often remarkably consistent: either deliberate weight loss via restricted diet or perhaps accidental weight loss from illness or increased activity which seems to jump start the process of further and faster loss. Often it’s not until the behavior and weight loss have gone quite far that it becomes clear that there is a problem.
If you are a parent reading this article and relating to this story of Amy, it is important for you to consider the following ideas.
1. Talking doesn’t help.
All the persuasion, negotiation, talking in the world will not penetrate the starved, malnourished mind. The key intervention when an individual is starving is food. We don’t do traditional “talk therapy” with our teen anorexia patients; trying to penetrate and influence the malnourished patient wastes precious time and resources. Therapy is helpful once the individual is restored and is stable medically. It’s worth noting that weight restoration itself resolves many of the mood and behavioral symptoms that you would address in therapy.
2. The cause is not important right now.
It doesn’t matter what got your child here in the first place. There are many factors (genetic, biological, cultural, social) that contribute to the development of anorexia. Trying to figure out the “why” will waste critical time. Regardless of the cause, the treatment is the same: eating. And please note that parents do NOT cause anorexia… but they can play a central role in curing it.
3. Take control.
Yes, the anorexia wants total control and your intrusion as a parent will enrage the disease. But this is not the time to give your child space. The anorexia is not a message to you that your child needs more control and independence. It’s not a time to back off. It is a time to take over – the food. He/she has lost control to the illness and cannot get it back on his/her own.
4. Maudsley treatment for anorexia is the gold standard.
When anorexia is severe, hospitalization is a reasonable option and a necessity if there is an acute medical condition resulting from the AN. But the research is clear that Family-Based Treatment (“Maudsley method”), is the best course of medically stable children and adolescents with anorexia. It is an outpatient treatment that allows continued engagement in school and home life. It is time and cost efficient and of course, spares the child of the upheaval of a hospital stay.
Melissa Gerson, LCSW, Certified Family Based Treatment Therapist, is the Founder and Clinical Director of Columbus Park outpatient center for eating disorders.