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Family Involvement in Treatment

Function of Families in the Recovery Process

Eating disordered behavior reflects a dysfunctional relationship with the self. Family members cannot “fix” the eating disordered individual. It is a unique combination of heredity, environment, culture and conditioning that cause eating disorders to develop…..It is not anyone’s “fault”; it is important to remember that everyone has the same goal of a healthy and happy life for the victim of an eating disorder…be patient and non-judgmental, listen, and remember that it is their responsibility to do the recovery work.

Parents and Eating Disorders

Parents possess amazing imaginations. They picture the day when their daughter will graduate from college, marry; perhaps even have children of her own. Here’s what they never imagine: a daughter with an eating disorder. Unfortunately, millions of children, adolescents and adult women suffer from anorexia and bulimia. This means even greater numbers of parents are dealing with something they never anticipated, and worse, cannot possibly understand.

The most frequently asked question is “why?” Regrettably, there isn’t an easy answer. The best course of action for parents dealing with an eating disorder is to get help. A wise first step is to take the daughter to a physician, simply to ascertain the extent of the problem. If she has a full-blown eating disorder, then it is time to seek professional counseling for her, and very possibly, separate counseling for the parents and other children. Three important points to keep in mind: first, eating disorders rarely resolve on their own; second, if one daughter has an eating disorder, the entire family is impacted; and third, parents must not blame themselves the blame game accomplishes nothing.

Remember…Eating disorders are devastating to the individual and highly destructive to the family. You did not cause this; therefore, you cannot fix this on your own.  Please get help.

Relationships and Eating Disorders

Healthy relationships are like the tides: they ebb and flow, especially when it comes to verbal interaction. You get together with a friend who has a new love interest the entire conversation is devoted to this important topic. Conversely, you meet with that same individual a week later and now you have news that takes center stage. But most of the time, it’s back and forth, give and take, which is why it is called a dialogue.

However, if your loved one develops an eating disorder, balance is very hard to maintain. This is because these disorders are by definition egocentonic; this means that the disorder is all important, and therefore, the individual becomes highly self absorbed. Consider this: if anorexia was a real-life person, she would be a huge celebrity, bathed in brilliant lights on an enormous stage, demanding all focus, all attention, be on her.

What should a person do when an eating disorder enters a family? There are many suggestions and guidelines revealed in subsequent articles, such as listening, conveying compassion, extending help, etc. But, keep in mind that you are important too, and your needs also have value.

Remember…Relationships need balance. If you have a relationship with someone suffering from anorexia or bulimia, extend love to them, and to yourself. If you need additional help in coping with the situation, you may consider a support group for an eating disorder.  Until your eating disordered friend achieves recovery, her primary love interest -strange as it may seem will remain her eating disorder.

Siblings and Eating Disorders

Families are like little independent nations, especially when difficulty strikes. Say a ten-year old falls out of a tree and breaks his leg. The troops rally: parents take care of the medical needs, sisters and brothers bring home schoolwork, perhaps even pitch in a do a couple of extra chores until the wounded family member is recovered.

But what happens when a family member gets “sick” and doesn’t get better? Families throughout the United States are confronted with this reality every single day when a sibling has an eating disorder. Although undoubtedly hard on the parents, often it is the siblings who become the unwitting and unnoticed victims, especially if they are young. This is because the parents understandably focus an inordinate amount of time, thought and energy on that one child. But imagine how this is viewed by the other children. “She” gets all the love, all the attention, while “we” get ignored and over-looked. This is a dangerous dynamic that can have immediate and far-reaching consequences. Enormous resentment can build toward the child with the eating disorder, especially if she is ill for a prolonged period. The siblings, in an effort to garner the attention they crave, may start rebelling or acting out in any number of harmful, unhealthy ways.

What makes this situation so very sad is that no one is wrong: the daughter is in the grip of a terrible disorder; the parents want to help their hurting child; the other children want love and attention. This is exactly why professional family counseling is so valuable when an eating disorder is present.

Remember…If an eating disorder is an uninvited guest in your home, everyone is at risk. Please get help, and find an eating disorder rehab center.

Spouses and Eating Disorders

Although men and women often enter marriage wearing various shades of rose-colored glasses, most of us anticipate a couple of minor bumps in the road as we adjust to married life. We prepare for normal differences between men and women, and accept possible changes as two become one. But nothing can prepare one spouse for the onset of an eating disorder in the other. In the vast majority of cases, the eating disorder afflicts the wife; often the husband is utterly unaware of the condition. This is not because the man is insensitive or uncaring; it is because secrecy and deception are a part of the disorder.  A woman with anorexia often denies to herself and others that anything is amiss. It is not unusual for her to exaggerate how much and how frequently she eats. Even as she wastes away to nothing, she will swear that she “eats like a horse.” If possible, bulimia is even more ensconced in deception, but for different reasons. Whereas an anorexic woman is actually proud of her skinny body, a woman with bulimia is extremely ashamed of her behaviors. This is completely understandable; after all, consuming thousands upon thousands of calories, then vomiting, is difficult to explain, rationalize or defend. Therefore, she hides the activity, and if need be, lies.

But here is the bottom line: no matter how skilled at deception, the truth will eventually surface. On so many levels, this is devastating to the husband. What his wife is doing is unfathomable, absurd, and  heartbreaking. To him, an eating disorder makes absolutely no sense; unfortunately, to her, it does. Perhaps the most difficult aspect for a man is that he can do nothing to stop the behavior he has virtually no control.

Remember …Nothing prepared you for this. You can’t control or fix her, but you can take care of yourself. Help is available.

Articles on Family Involvement in Eating Disorders Recovery

  • Relationships are a core part of life. They help us stay in contact with each other and the world around us. Often, when a person become involved with an eating disorder, the eating disorder begins to eat away at their relationships. They become closed off and begin to spiral into a deep abyss.
  • Completing treatment is a beginning, not an end, to the long road to recovery. For families, coming home is a time meant for joy, with possible plans for festivities and socializing. These are times meant for families to draw closer together and to re-affirm love and support, a time to catch up on what has been going on and share with one another hopes for the future. To the individual suffering from an eating disorder, or in the throes of recovery, these occasions can be overwhelming and threatening. We want to be helpful and supportive, but nothing seems to come out right. What do we say?  How can we let them know that we care and are there for them, without being so awkward about it? Read more about how to deal with the uncomfortable feelings and emotions of completing treatment and coming home.
  • With the tremendous amount of pressure placed on people today, especially women and girls, keeping a positive self-esteem and body image can be challenging.  Because of this, dieting is becoming more common than ever, and unfortunately, more men and women are suffering with eating disorders.  Take an active part in promoting true beauty, beginning in your own family!  Read this article to learn helpful tips on how you celebrate your inner beauty.
  • The coming of Summer can me a variety of things for the child in your life-including broken patterns and imbalances in eating and activity levels.  As children today are faced with increasingly more challenges to stay healthy, parents have greater opportunities to lead their children positively.  Learn more about ways you can help your children lead healthy lives by reading this article.
  • If you or someone who love is in recovery from an eating disorder, you may find that the most difficult part of the journey is letting go of what you have held on to for so long.  It is also painstaking to reach out and ask for help, admit your struggles, and find faith in yourself.  However, in doing all these things, you will be empowering yourself to find true freedom and a life you’ve always wanted.  Read this inspiring article by Jenni Schaefer and find encouragement in your own recovery journey and healing process.
  • A supportive family has been shown to be helpful for successful recovery from an eating disorder but what is a supportive family and what if you have an eating disorder and you don’t have adequate family support?


Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on
February 23, 2017
Published on, Online Resources for Eating Disorders Help

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{ 7 comments… read them below or add one }

Les April 24, 2014 at 3:02 pm

In your article you say, “Remember …Nothing prepared you for this. You can’t control or fix her, but you can take care of yourself. Help is available.”

What do you mean by that? My wife has bulimia and anorexia. She’s 5’7″ and weighs <95 lbs. She absolutely refuses to get help even though every one of her friends and family have encouraged her to do so. It has been a discouraging several years since she's gotten worse and worse. If I mentally "let her go" then I feel that I'm giving up on her. If I keep tearing myself up about it I'm going to go crazy. What help is available for spouses? How can you help a person who won't help themselves?

Jacquelyn Ekern, MS, LPC August 6, 2014 at 4:50 pm

Hi Les,

Thank you for your heartfelt comments. We have heard from numerous spouses over the years who also feel frustrated, overwhelmed and unsupported. I would suggest that you reach out to the parent and family network at NEDA to obtain some support. Also, it would be great if you could work with a therapist yourself, so that you can work through your feelings and develop healthy ways to care for yourself, while trying to help your wife recover.

Hope this helps!

angie October 10, 2014 at 11:02 pm

My ED has come back with avengeance. I want my husband to be involved in my treatment but I am afraid of being disappointed. I know it is asking too much, but I need support in making some serious changes in lifestyle i.e. changing eating habits and helping me stay accountable. I feel like an alcoholic asking my husband to stop drinking alcohol at home just because I have a problem with it. I might have been easier if I HAD married a health nut, but my husband leans towards the couch potato category. I know I have to do the recovery work, but is it unreasonable to enlist his suppot by asking him to play a more active role?

Jeremy November 14, 2014 at 10:22 am

My wife had a previous eating disorder and abused laxatives pretty heavily. This was years before we met, however today she informed me that she had purchased laxatives and weight loss pills about a month ago and obviously didn’t say anything. I am glad that she came forward, but I’m afraid that she will get more and not say anything. Should I be the “drug dog” and look through everything of hers constantly ? I believe that her telling me is her cry for help. What are some good resources or people that she can talk to. Thanks for your time.

Susan December 20, 2014 at 5:19 am

My mother’s anorexia took center stage when my sisters and I were ages 7, 12 and 14, but it had been developing for years before. She was hospitalized for a few months only because she became incapable of getting out of bed at ~75 lbs. She had some counseling then but only superficially, and has continued to suffer from AN all these years, and is now in her mid-70’s. Our family still struggles with how to help her. But today, I am not writing about help for her – we’ve ‘been there done that’ for 35 years. I’m writing this post “selfishly” because I am trying to find any resources and articles that can help me as the child deal with issues I need to work on. I’ve always felt that I knew how having a mother with AN had affected me, or not, but now as a middle-aged woman, I’m recognizing that I’m carrying around a lot of emotional debris from my own childhood experiences trying to cope way back then that gets in the way of my relationships today as a wife, mother, sister, friend, and daughter. There is much written about being the parent of a child with AN, but not much I can find about the reverse.

Jake August 6, 2015 at 7:01 am


My fiance has a binge eating disorder that has taken a great toll on our relationship. As the article states above, I was totally oblivious to it for the first year or so, noticing that she was gaining weight and I simply made gentle nudges toward healthier decisions along the way. Eventually, learning through a counselor that she had an actual binge eating disorder, she shared with me that she would secretively plan out when and what she would eat while I was away and then eat until she felt sick. There are many areas of overlap between eating disorders from what I understand but most articles seem to focus on anorexia and bulimia. Is there any specific guidance for family members of those facing binge eating disorders?

Crystal Karges MS, RDN, IBCLC August 20, 2015 at 10:20 am

Thank you so much for our feedback Jake, and for sharing a bit about your own story. We do have an entire section devoted to Binge Eating Disorder on the EDH Website that we hope you will find helpful in your own journey as your support your fiancé. We ill also keep this in mind as we write future articles that address this topic. We hope all the best for you both!

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