By: Amber Parris, LICSW, CEDS
Recovery from an eating disorder is truly a journey, and it is often a long journey with many ups and downs that requires significant support from family and friends. Having a loved one with an eating disorder can feel confusing and overwhelming. It can be hard to know how to help this person, especially if they don’t seem to want help. But don’t lose hope. Full, sustained recovery from an eating disorder is possible, and the prognosis improves with earlier intervention.
Hopelessness at the Wrong Level of Care
Hopelessness can be one of the biggest barriers to eating disorder recovery. Feelings of hopelessness are likely to occur when a person with an eating disorder is trying to recovery at the wrong level of care.
There are five basic levels of care in eating disorder treatment.
- Inpatient hospitalization
- Usually a short term stay in a hospital setting and focused on medical stabilization.
- Residential treatment (RTC)
- Clients live at a residential program and are entirely focused on all aspects of eating disorder recovery, including medical, clinical, relational, nutritional, and movement.
- Day treatment (PHP)
- Clients spend their days in therapeutic programming, but spend nights and usually weekends at home or living in nearby apartments.
- Intensive outpatient (IOP)
- At the IOP level, clients integrate back into normal life, such as school or work, while still engaging in several hours of programming each week for support.
- Clients generally see their therapist and dietitian weekly for support in their normal life.
Your loved one may be trying to recover, but if the level of care does not offer them the support they need, full recovery is unlikely. When they don’t succeed in eliminating eating disorder behaviors, they’ll begin to feel like they’ve failed and they’ll never be able to recover. In an attempt to overcome these feelings of shame, failure, and hopelessness, they may cling tighter to the eating disorder—the thing they know they’re “good at.”
How to Approach Your Loved One: Lovingly Direct
When approaching someone about their eating disorder, be empathetic. This person you love is hurting, and though the behaviors may not make sense to you, they’re coping in the best way they know right now. Your loved one will respond much better to a compassionate approach rather than being strong-armed with anger and frustration.
At Alsana, one of our six guiding principles is to be “lovingly direct.” Although it can be uncomfortable to bring up sensitive discussions, such as body or behavioral changes that seem off, it’s really the kindest thing you can do. Being lovingly direct means saying things that may be hard to hear in a loving, compassionate way.
Part of being lovingly direct may include setting boundaries. As parents, it can be hard and scary to set boundaries with your child around the eating disorder. Perhaps you have to tell your child they can’t enroll in school if they don’t get help. Setting these boundaries with compassion and firmness is a kind way to let your loved one know that life can’t continue in this way. Don’t be afraid to lean in with some discomfort to help your loved one consider their treatment options.
In your conversations with your loved one, point toward some type of hope as to why they would even consider acknowledging or working on the eating disorder. Remind your loved one of the things the eating disorder has taken away and offer them hope of how things might be different in recovery. Maybe their grades have fallen or they didn’t get a promotion at work. Perhaps their significant other broke up with them, or they can’t go out with their kids for ice cream because they’re too afraid to eat it. With time, the eating disorder will take more and more, but there is always hope in recovery.
Decisions are Difficult in the Disorder
An individual entrenched in an eating disorder will have a very difficult time making the right decisions about their own treatment. While one day they might acknowledge the eating disorder and their need for help, the next day they might be back in denial. An overwhelming fear of life without the eating disorder can make it very difficult for them to choose a higher level of care on their own.
Even if your loved one is an adult, they will most likely need your help making decisions about the kind of help they need. Don’t be afraid to lovingly share why you think they need a specific level of help.
How to Talk About Going to Treatment
When you’re preparing to talk to your loved one about treatment, have a conversation with their outpatient provider (such as a therapist, dietitian, or medical professional) about the level of care they need. The outpatient provider relationship is crucial throughout the entire treatment journey, and being aligned with their provider(s) will send a strong message to your loved one about the help they need.
If your loved one doesn’t have an outpatient treatment team or you’re not able to speak with their providers, you can call Alsana’s eating disorder helpline https://www.alsana.com/helpline/ to discuss the appropriate level of care.
Your loved one will probably try to convince you that they can be successful at a lower level of care than you and their treatment team are recommending. You might hear that them say that they’re committed to following their meal plan this time, so higher levels of care won’t be necessary. Honor the work they are trying to do, and gently bring them back to the reasons you believe they’ll be more successful at a higher level of care.
You are Brave as a Support System
Just as you have compassion for your loved one, we at Alsana also have compassion for you as the support system. It is never just the client who goes through this process. We understand that it takes a lot of bravery from you to have these difficult conversations with your child or loved one, to find resources, and call providers and treatment centers. Recovery is a long road not only for your loved one, but for you, too.
If you have any questions or would like to understand more about treatment options for your loved one, we would love to hear from you and be a part of this journey with you. You can call us at 888.822.8938.
If you would like extra support from others who know what you’re going through, we would love you to join our weekly loved ones support group https://www.alsana.com/family-online-support/.