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January 3, 2016

Family Dynamics at the Dinner Table

Family sitting down for dinner with new meal plan

Contributor: Ami Marsh, MFT, LCADC, Clinical Director, Center for Hope of the Sierras

Eating is a social practice. We learn some of our earliest lessons at the table. Ideally, this is where we teach culturally appropriate table manners, like chewing with our mouths closed, using a napkin and more practice with saying please and thank you. Eating can also be a very bonding experience as we share a meal, enjoy stories about the day, laugh, and help clean up. Sharing a meal is an activity that crosses social, economic and ethnic lines-all human beings need to eat and in all cultures, it tends to be a very social phenomenon with customs and traditions.

Unfortunately, the United States has seen a decline in the amount of meals a family shares at the table. A majority of American families report they do not have a daily meal time. Dinners are frequently eaten on-the-go in the interest of saving time, trying to get to various activities or rehearsals. Often parents are crunched for time as both are working to support the family. Meal time is often another chore or afterthought after a long day.

It’s no surprise, then, that in the average family, meal times can be stressful. When a family has a loved one who is suffering with an eating disorder, this stress is increased tenfold.

Eating Disorders are Not Primarily About Food

woman eating vegetablesFamily therapy is an integral part of treating eating disorders. Eating disorders are not primarily about food; maladaptive eating behaviors are used as a coping skill to manage stress, distract from problems that one has not been able to solve and power and control dynamics in relationships.

As a client becomes more aware that disordered eating behaviors have been used to manage the stresses of relationships, new, more adaptive skills must be learned. Family therapy provides the opportunity to learn and practice new skills.

Eating Disorders may Represent Problems in the Family

meat-569073_640The eating disorder frequently takes on a life of its own and can become a part of the family system as it engulfs the individual struggling. There are often themes the eating disorder can take that represent larger problems in the family system as a whole. In some families the eating disorder can be a way for the child to keep parents focused on them, rather than problematic relational dynamics in the family system, such as unresolved conflicts with parents. The eating disorder can also become an identity for the child and a way to stand out in a family system.

Power and control dynamics are pervasive in some family systems and the eating disorder can be a way for the child to wield power over parents. The therapist has the opportunity to learn these themes as the client progresses in treatment and help the family learn new ways of interacting, resulting in the dissolution of the eating disorder as it no longer serves a function in the system.

Family Based Therapy is Important for Family Relationships

Family therapy sessions are also a place for family members to learn how to best support their loved one. Healthy boundary setting can be accomplished in these sessions, allowing all participants to experience each other in new, adaptive ways. Ultimately the goal of family therapy is to help the client and their loved one navigate their relationship and have interactions that are free of the eating disorder.

Community Discussion – Share your thoughts here!

How do you support your loved one suffering from an eating disorder at the dinner table? If you are suffering with an eating disorder, how do you best receive support at the dinner table?


About the author: Ami Marsh, MFT, LCADC, has treated children, adolescents and adults struggling with mental health issues and substance use disorders for nearly a decade. Licensed as a marriage and family therapist and clinical alcohol and drug counselor in the state of Nevada and certified in EMDR and Guided Imagery, Ami contributes a wealth of expertise and leadership to the Center for Hope team.


The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on January 3, 2016
Published on EatingDisorderHope.com

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