Vegan, Paleo, Whole 30... Oh My!
Should you "eat clean" when your child has an eating disorder?
Posted Oct 10, 2016
Are you watching your diet? Trying to eat "clean"? Are you a paleo aficionado or a devotee of the Whole 30? Even if you are none of these, do you have a special eating plan aimed at managing your weight? Does your child have an eating disorder? Do they mimic your behaviors?
If your answer is "yes," to any of the questions above, please keep reading.
Under normal circumstances, your eating plan might be just that, yours. If your child has an eating disorder, however, there are different rules to the game and the stakes are high.
If you are cutting carbs, avoiding sugar, fasting, or engaging in any variety of diet-related rituals, your child may use your behaviors and statements about them to justify restrictive and unhealthy eating patterns. He or she is likely acutely aware of your restrictive eating patterns and the significance of this cannot be minimized.
If you are using family based treatment (FBT) to heal your child, it is crucial that you try to eat foods similar to what your child is eating as often as possible. Why? Think of your child's eating disorder as a phobia. This phobia involves a fear of food. The only way to overcome any phobia is to eventually be exposed to the feared item (in psych lingo this is known as "exposure therapy"). One of the most important ways that you can show your child that the fears she has about certain foods are irrational is to eat them comfortably yourself. This demonstrates that there is nothing to be feared, and that the fear of the particular food is the result of the eating disorder... not a reflection of a truly dangerous situation.
As you probably know, re-feeding from anorexia often takes many thousand calories a day and usually requires nutrient dense food that would be flat out scary to the typical dieter. In my experience, at the beginning of FBT, parents frequently express reluctance to alter their own or their family's eating habits. Parents often have very fixed ideas about what is and is not "healthy." I frequently see resistance to adding carbs, fats, desserts, and other foods that are not "clean." Please know that it is nearly impossible to achieve full physical and psychological recovery from an eating disorder on "clean" foods alone.
Furthermore, some parents may recognize that their ill child needs to eat a wider variety of foods but continue to eat in an regimented and restrictive way themselves. You can be certain that if this is you or your spouse, your child is very well aware of this. The mixed messages that emerge out of this typically make the task of re-feeding exponentially more difficult.
When I point this out to parents, they very reasonably express concern about gaining unneeded weight themselves. Rest assured, healing your child from an eating disorder does not require that you sacrifice your own health. I advise parents to serve everyone in the family the same foods and to vary portion sizes based on individual need. If your ill child questions the varied portion sizes, a simple metaphor works very well. In recovery from an eating disorder, food IS medicine. Each person in the family requires a different dose. Simple as that!
Keep in mind that if you are committed and consistent with re-feeding, you will see encouraging results—meaning that you all will not need to eat this way forever! Try to keep the big picture in mind. This will really help with any anxiety you may be feeling over the changes.
Eating the same foods as your child will empower her to heal. Once recovery is secure, it may be appropriate to return to your previous plan. Or not. You get to decide!