Focus on feelings and interpersonal relationships - not on food and weight. Family members are often the forgotten members, especially other children. It is important that they talk about their feelings.
Do not let the eating disordered family member disrupt the entire household. The family should go on with their lives as normally as possible.
Do not allow the eating disorder family member to shop, cook or feed the family. Do not let the eating disordered family member dominate the rest of the families eating patterns. In nurturing others, eating disorder sufferers are denying their own need for food. Families should go on with normal eating patterns. These details will need to be worked out with the therapist.
Set limits in a caring, reasonable, but firm manner.
Help the family show affection and appreciation for each other. Underneath disordered eating is a lack of self-worth; thus unconditional love goes a long way.
Work on how to avoid power struggles and find alternative ways of dealing with problems as they arrive. Let the therapist and/or physician deal with "highly-charged" issues such as weight.
Realize that there are no quick solutions. Demanding change, and/or berating the eating disordered family member will not bring about change or a positive result. Be patient.
Avoid having the eating disordered family member make too many decisions about food and other issues. Control is a big issue that must be addressed in therapy. One can not attempt to over control the eating disordered family member. The therapist can help balance out these issues.
Parents will need to examine alternatives to their current behaviors (i.e. yelling, pleading, etc. Family members should write in journals, write letters to each other, call the therapist, and write down situations that they need assistance with and provide to therapist and family sessions.
The family needs to talk about all kinds of issues - not just focus on the problems or the eating disorder.
Eating disorders are family diseases. Everybody who comes in contact with the eating disordered individual suffers, including parents, siblings and grandparents.
Parents tend to be the primary diagnosticians of an eating disorder in their child. Eating disorders show up around kitchen tables, and in family bathrooms, rarely in the doctor’s office. Their presence is typically silent in laboratory tests.
Recovery too, happens at home, over time, alongside parents and siblings, throughout the course of daily living, particularly in the face of the restrictions and limited services provided through managed care. Patients typically spend 45 minutes a week with their therapist or doctor. For the rest, 24/7, kids live their recovery at home, or at school.
In research carried out a the Maudsley Hospital of London England, it has been proven that family treatment is more effective than individual psychotherapy for anorexics living at home that have been ill for less than 3 years.
The nature of parental involvement will vary widely with the age and needs of the child, the skills and capacities of the parent, and the nature and quality of the ever-changing parent/child CONNECTION.
Parents and siblings are also deeply affected by an eating disorder within the family system. They need an outlet to understand the disease and recovery processes, a forum to communicate their concerns and needs with the patient and with each other, and the opportunity to learn how best to support the problem-solving and recovery processes. They often need personal support and bolstering in the face of what can be an extended, convoluted and at times discouraging recovery process for the afflicted individual. Family therapy provides that vehicle.
The individual child’s efforts to make recovery changes are facilitated and enhanced not only by a family that understands the recovery process, but by family members who make their own parallel personal changes alongside the patient to accommodate the needs and requirements of the changing child and family system.
Eating disorder psychotherapists are responsible to grow the relationship between parent and child, for that is where the greatest and most effective capacity for cure lies. Therapists must demonstrate respect for the power of the family system in either sustaining or eradicating disease.
The potential for the family unit to bring about constructive change is far greater than the sum of its parts. The quality of a child's function within the family parallels the quality of the child's interpersonal function in every other life sphere.
Loving your child is not enough.
Parents need to act on the knowledge they acquire. Parental involvement will vary from providing on-going and unconditional support day in, day out, planning, providing, and eating nutritious meals with the child, monitoring food intake and managing symptoms, engaging in family treatment to support the child and recovery process and resolve underlying emotional issues that may be driving the dysfunction.