Despite common misconceptions, full recovery from an eating disorder is possible with proper treatment. For children and adolescents, the support of parents, family, and caregivers is critical for recovery from an eating disorder. In addition, receiving early and appropriate medical, nutritional, and psychological care is key in the recovery process.
Recovery from an eating disorder involves physical, behavioral, and psychological components. Physical recovery includes restoring the body’s weight and nutritional status to a healthy level for the individual and reversing medical complications from the eating disorder, including those from malnutrition. Behavioral recovery means improvement in the behaviors which accompanied the eating disorder, including restrictive food intake, over-exercising, and avoiding social situations that involve food. Psychological recovery includes improvement or resolution of the thoughts and feelings that accompany the eating disorder which may include fear of certain foods or fear of bloating or abdominal pain, significant preoccupation with healthy eating, or body image issues.
We know that early engagement in treatment is predictive of better recovery for many young people. Thus, it is important to prioritize treatment over other commitments when a young person has developed an eating disorder.
For many families, the period of time prior to seeking treatment can be challenging. Families or other individuals in a young person’s life may notice changes in the young person’s weight, eating patterns and behaviours, exercise patterns, and mood. When the parents discuss these concerns with the young person, the eating disorder may cause the young person to minimize or deny the concerns. When the idea of seeking treatment is discussed, the eating disorder may cause the young person to be hesitant or reject the suggestion.
Remember, that eating disorders are serious medical conditions and require appropriate treatment. Bring your child to see a general practitioner, family practice physician, polyclinic, or pediatrician to assess your child’s physical and psychological health and discuss referral to specialised treatment.
In the meantime, start eating regular meals with your child. Meal times are often difficult times for young people with an eating disorder and they often need a caregivers’ support and supervision. Try to provide regular meals and snacks.
Encourage your child to stop any additional exercise and ask the physician for a letter to excuse from Physical Education class in school. You can also consider requesting an excuse from Co-Curricular Activities.
For any urgent safety concerns, seek care urgently.
While the support of parents and loved ones is critical for recovery, treatment for an eating disorder generally involves care from a multidisciplinary team which can include physicians, psychologists, dietitians, nurses, and other health care professionals. Treatment is individualised to the young person and family depending on the type of eating disorder and other factors.
Reversing a young person’s malnutrition and restoring the body to an appropriate weight and nutrition is a critical first step in recovering from an eating disorder. With the reversal of malnutrition and reaching an appropriate weight, the dangerous medical complications that accompany malnutrition can start to be reversed including the impact of malnutrition on the brain which can distort the way the brain thinks about food, weight, and exercise. In eating disorders, “food is medicine”, and young people will need support and supervision from families to ensure they are receiving adequate nutrition.
For restrictive eating disorders, which is characterised by weight loss, the first line psychological approach is often family based therapy, also known as the Maudsley approach. In this method, psychologists and the treatment team partner with families to re-nourish the affected young person. Parents, and families, play a critical role in re-nourishment as they know their child and how to care for them best. After nutrition is restored, the focus transitions to re-establishing independent eating for the young person as well as working to address any underlying body image issues or other concerns.
In addition to nutrition and psychology support, some young people may benefit from medications to help with mood symptoms that accompany the eating disorder or involvement of a psychiatrist in their care. The goal of treatment is full recovery from the eating disorder as well as re-establishment of independent, normal eating patterns.
Relapse is not uncommon amongst young people with eating disorders and may occur especially during times of stress. Stressful events may include significant exams, school transition, death of a loved one, divorce or other changes in the family structure. Signs of relapse may include the return of restrictive eating habits, trying to eat alone, weight loss, increased exercise, and changes in mood including increasing anxiety, depression or worry. As each individual’s eating disorder looks slightly different, relapse may also manifest differently in each individual.
Spending time together as a family, especially during mealtimes, is an important part of relapse prevention as family members are better able to notice early changes in eating and behaviours which may suggest relapse of eating disorders(see above section on warning signs of eating disorder)
Developing a plan to recognise and address relapse is an important part of care. If you feel that your young person with a history of an eating disorder is displaying signs of relapse, then please seek care early as it is easier to recover from relapse when it is identified and addressed early.
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