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Family Support in Nutritional Rehabilitation
Contributor: Louise Albrecht M.Ed.RD LDN CEDRD, Penn State Hershey Medical Center, Eating Disorder Program
Simply put, families equipped with the right tools, can be the best ally for recovery. Family members need to be educated on the nature of eating disorders and stop blaming themselves for the onset of the illness. Families need to understand that eating disorders are not about food but rather an expression of what is literally “eating them”.
What are the most important tools a family can use help their loved one recover from their illness? First, understand the nutritional needs of the afflicted member. If your loved one is a child or adolescent, know that their caloric needs are different from yours or their peers especially if weight loss has occurred.
Healthy Weight, Not Perfect Weight
The goal of nutritional rehabilitation is not to make anyone overweight but rather at a healthy weight for them. A nutritionist, along with other team members, will assess a healthy weight based on height, weight and BMI history.
Providing such a history to your treatment team is extremely helpful to establish a realistic goal. Understand that in developing children and adolescent, this number is constantly changing due to growth and development, and that weight restoration is vital to restore health and well-being.
Setting an Example for Healthy Eating
Secondly, look at your own eating habits.
- What example do you set?
- Are you a good role model?
- Do you eat three meals per day?
- Do you have family dinners?
If not, it is time to consider starting to eat together which is an excellent bonding time. Are you avoiding any type of food for any specific reason? If your nutritionist recommends your loved one to eat their “fear foods”, will you be able to accompany her or him for support?
The Importance of a Meal Plan
The meal plan is the pillar of nutritional rehabilitation. In the process of developing an eating disorder, not only the relationship with food is broken but the digestive system is not working as well, creating fullness and discomfort when refeeding starts.
You may need to keep encouraging and supporting your child to eat beyond what they call fullness in order to fulfill the requirements of the meal plan. Your child will feel full and will complain in order to stop eating due to; the dysregulation of the digestive system; the nature of having an eating disorder; and anxiety.
Know that the hormones that regulate hunger and fullness do not work as well and need some realignment so your child can not and should not rely on their hunger and fullness cues, which are often non-existent at the early stage of refeeding.
Setting Realistic Expectations for Recovery
Parents need to set limits and have realistic expectations. The eating disorder did not happen overnight and will not resolve itself overnight either. Let’s not talk about weight, dieting, appearance or any other similar issues in front of your child as this will ignite more of the eating disorder thought process.
Thirdly, be an active participant in the treatment team. Listen to your treatment team on how to best treat your child. The team is well experienced in treating eating disorders and knows what it takes for recovery.
If you have any concerns or questions in regard to your child’s treatment, address them in a private setting and not in the presence of your child, especially if you disagree with your treatment professional. Your team always has your child’s wellbeing and best interest at heart.
As a team member, parents should inform the treatment team of any valuable information that will help your team to establish an appropriate treatment plan.
Managing Eating Time and Moods
When meal and snack time arrives, observe your child at all times and never trust the eating disorder language (Ex: I am not hungry, this is too much food). Help your child to realize that you don’t trust the eating disorder, but that you trust them. Help your loved one follow their meal plan.
Rather say “it is not that I don’t trust you but I don’t trust your eating disorder”. Make sure the meal plan has been completed by the end of the day by reviewing with your child, the food intake for the day.
If there are items missing, your child need to understand that there are consequences for not eating such as having to make up the missing food the following day. Not eating is not an option. It’s about how it will get done.
Remember how your child’s eating habits were prior to developing an eating disorder as with proper care and treatment, you will have your child back again and live a life without the eating disorder.
Community Discussion – Share your thoughts here!
What is your experience with maintaining nutritional balance in your family?
Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on November 11th, 2014
Published on EatingDisorderHope.com