Eating disorders are family diseases.

· When children and young adults who live at home become afflicted with an eating disorder, entire  families suffer.
· Parents are most likely to become diagnosticians of an eating disorder in their child. Eating disorders  rarely appear in doctor's offices, showing up instead around kitchen tables and in family bathrooms.  Their presence typically remains undetected in blood and other laboratory tests till the latter-most stages  of disease.
· Eating disorder recovery happens at home, over time, alongside and under the noses of  parents and  siblings, throughout the course of daily living.  Patients typically spend 45 minutes a week with their  therapist or doctor, 24/7 with parents and teachers.
· In research carried out at the Maudsley Hospital of London England, it has been shown  conclusively  that family treatment is more effective than individual psychotherapy for young anorexics living at  home who have been ill for less than 3 years.
· The nature of parental involvement and recovery support will vary widely with the age and needs of the  child, and the nature and quality of the ever-changing connections between child and parent.

Family Therapy is the most effective way to treat everyone's needs.

Family therapy provides treatment to the entire patient and family system. Family members need family treatment as a vehicle to developing an appreciation of the disease and recovery processes; as a forum to communicate their observations, concerns and needs with the therapist, patient, and with each other; as an opportunity to learn how best to support the ever-changing needs of the child in recovery. They often need personal support and professional bolstering in the face of what typically tends to be an extended, convoluted and discouraging recovery process. Parents need to be trained to mentor and advocate for their child though what invariably proves to be a challenging time of change and crisis.  Family therapy and consultation provides that vehicle.

Kids get far better, far faster when families learn to become involved in constructive ways. Recovery changes are facilitated and sustained not only by a family system that understands the recovery process, but through the support of family members who can commit to making their own personal changes which parallel and accommodate the needs and requirements of the changing child. These are known as family system changes. Children who learn to function better within the context of their family system carry invaluable interpersonal skills into their other significant relationships as well, which improve self-awareness, self-esteem, and the capacity to know and communicate their needs and feelings.

The task of the eating disorder psychotherapist is to "grow" the relationship between parent and child. Parents need to learn to be wary of the warnings of certain misguided health professionals who imply that eating disorders are caused by parents, that eating disorder become worse through parental involvement/interference in their children's lives and treatment, or that the disordered adolescent requires separation from parents in order to become independently functioning human beings. Healthfully developing children do require autonomy to mature; eating disordered children are temporarily emotionally ill-equipped to engage in the maturation process by virtue of a malnourished brain deprived of the capacity for responsible judgment and self-care.  Beware of professionals who might exclude parents from the psychotherapy process in the guise of protecting patient/therapist privilege (confidentiality rights). In actual fact, conjoint family therapy insures that there are no such violations where all parties share and hear the same information at once. Splitting, boundary breaches and other therapy corruptions are avoided through this open and therapeutic forum. Therapists who are reluctant to involve families in treatment may be untrained in the benefits of family treatment, inexperienced in treating families, or otherwise uncomfortable working within the context of family systems.

Though parents are not the cause of their child's eating disorder, they may inadvertently touch off genetic predispositions for disease, triggering an incipient eating disorder into full flower.  Here is an opportunity to assess any negative influence you may have on your child. Take this quiz.

1. Are you critical of your child's weight, shape, or appearance?

2. Do you joke about fat people or make derisive comments about television personalities looking too fat  or unattractive?
3. Do you skip meals, restrict food, binge on foods, purge, eat or exercise compulsively, or not regularly  provide meals for your family?
4.  Do you typically skip breakfast, have a donut at 10:00, eat a salad with "lite" dressing on the side for  lunch, then come to dinner famished, overeat, and complain about your weight?
5.  Is the television on during meals, negating opportunities to connect, dialogue and come to know one  another better?
6. Do you avoid confrontation, anger, and conflict, even when problem must be faced and resolved?   Do you avoid discussing your child's poor eating habits so as not to upset her?
7. Does your child eat something different from what the rest of the family is eating for dinner? Does she  only eat a few foods?  Does she eat the same things every day?  Is it okay with you?

When it comes to food and eating, loving one's child is not enough. Eating disorders are always on the move…you can be certain that if they are not actively getting better, they are becoming worse. Parents need to take charge and remain active, intentional and committed to eradicating these insidious diseases fully and completely. Parental involvement will vary and may include:
· On-going and unconditional support, day in and day out.
· The provision of nutritious meals, which they prepare and eat together with the child.
· The monitoring of food intake and symptom management.
· Involvement in family treatment to support the child and recovery process and to resolve underlying  emotional issues that may drive the dysfunction.

The GOOD NEWS is that parents can essentially "eating disorder proof" their child by promoting the child's mental health and a sound eating lifestyle. Children need guidance; out of structure and limits comes freedom.  They need to be educated.  Children need their parents… at any age.

Psychotherapist Abigail H. Natenshon, MA, LCSW is the founder of Eating Disorder Specialists of Illinois, and the author of When Your Child Has An Eating Disorder, A Step-by-Step Workbook For Parents And Other Caregivers.

Learn more about Abigail H. Natenshon.