This is often the first stop you come to if you are on a journey through your child’s eating disorder.  It may be that they have confided in you some of their problem.  More common however is the situation where you have suddenly become aware of what is going on.  Perhaps you found something – hidden food, evidence of someone being sick, or a letter or diary.  Perhaps someone else has alerted you – schoolteachers, a youth worker or friends.  Or maybe you have arrived at this point because you have noticed changes in your child – not just in their eating and weight, but also in their mood and personality.

However you have got here, this is a very frightening place to be, and we want you to know that you are not alone in struggling to deal with this.  This is the step where things may seem most frightening: where you have suddenly found something horrible lurking in a place where you least expected to find it.  You may have found evidence of behaviours that horrify or even appaul you.  You may find it hard to believe that this is happening.  And now, hardest of all, you have to decide what to do next.

The first question to ask yourself is whether YOU are the right person to approach your child about what is going on.  Just because it is you who has made the discovery does not always mean you are the best one to speak to them.  Think about your relationship with them:  are you usually close to them and able to talk things over with them?  Do you think you will be able to keep calm and rational whilst chatting to them?  If the answer to either of these questions is ‘no’ then it may be that there is someone else better equipped to bring up such a difficult subject with them.  If you think this may be the case then you need to think very carefully.  Your actions need to balance the need for confidentiality with the need for someone who can get alongside your child and help them to start the walk towards recovery.  Most important is that they do not feel betrayed in any way.  Avoid therefore telling lots of people, or anyone who you think they really wouldn’t want to know.  If you do decide to ask someone else to intervene you need to think carefully about how they will do this.  Will they admit that you told them?  Or is there someone else who will already know who you could talk to?  Think about how things will seem to your child and if in doubt, don’t talk to anyone until you have got some advice.

It is important that someone speaks to your child.  An eating disorder can be a cry for help: a signal from someone who can tell you in no other way how bad they are feeling.  If this signal is ignored then the person can become even more desperate.  Secondly, it is important that someone suffering from an eating disorder sees their GP and discusses it with him/her.  An eating disorder can have serious effects on the physical health of the sufferer and it is important that someone is keeping an eye on these things.  The GP is also the person who often will refer the sufferer for further specialist treatment if it is required.  One of your aims in talking to your child should be to help him/her to take this first step towards getting some help.  This is particularly important in younger children because they simply do not have the physical reserves of someone older and therefore can become very ill very quickly.  A child under 16 should not be losing weight, and if they have lost a lot of weight it is very important to get them to their GP to be checked out.  The other reason this is important is because younger children have a more naïve understanding of weight and calories, and therefore can stop drinking as well as eating.  Obviously this can make them very ill very quickly.

In confronting someone about their eating disorder, it is vital to remember how frightened they are.  An eating disorder often makes someone do things that they would never normally do, through the fear it sets up in them.  One main fear is of losing control of the eating routines that are helping them to cope with the way they are feeling.  This is why discovery can provoke such a defensive reaction: there is often a great fear that once others know this control will be taken from them.  For this reason, it may be easier for you to avoid the issue of food and weight if you can.  Think of other signs that something else is wrong: changes in their mood or personality, changes in things they do (for example stopping favourite activities).  Avoid mention of any falling standards of achievement in schoolwork or any other area as these may be interpreted as criticism.  Your aim is to communicate to your child that you can see they are unhappy, and that you want to help them to feel better.  If you mention their eating, you may risk them thinking ‘s/he just wants to make me fat’.  Obviously you cannot avoid the topic altogether.  However, if your first focus is not on eating this may help you to start a conversation without being shouted out of the room!

Remember whilst you are chatting to them, that to a sufferer, an eating disorder is like a battle.  They are aware that they are fighting against the illness, or against their own fears, and they fear that instead of helping them in this fight, anyone else who gets involved will just end up as yet another enemy to fight against, trying to make them eat and taking control from them.  The best thing you can do for them, therefore, is to show clearly that you are on their side.  Try to talk as little as possible, and listen to them.  Resist the temptation to correct them, or to contradict them (for example if they are talking about how fat they are).  For example, if they say ‘I am just so fat and I can’t bear it’, rather than responding ‘well you’re not fat though, you actually could do with putting a bit of weight on’ (you can see how this might terrify someone who fears your taking control from them and making them eat), try to respond in a way that shows them real empathy whilst also showing that you disagree with them.  Something like ‘I can see that you feel really fat and that that makes you feel really bad.  It’s obviously something that is making you feel really desperate.  I don’t think you are fat at all, but I’m so sorry that you feel so terrible and perhaps if we work together we can help you to not feel so bad.’  Emphasise the teamwork aspect of things, rather than saying things like ‘I can help you …’ or ‘I will do …’.  This avoids a fear that you will take control and emphasises the sufferer’s own role in controlling what will happen to her.  Don’t be afraid to show how you feel, and to admit that this scares you as well.  You do not have to pretend you have all the answers.  The most valuable thing for you to do is to show them that you understand how you feel, and that you will be alongside them and work together with them to try to help them to find a way out of the nightmare they have found themselves in.

Some helpful do’s and don’ts!

DO

Empathise with them – be clear that you understand how they feel. 

Let them correct you if they feel you have not quite understood

Let them talk

Try to focus on how they are feeling, NOT on what they are or are not eating

Help to find a way that they can see their GP.  Perhaps it would help if you made the appointment, or went with them – or even if you spoke for them.

Emphasise that you are in this with them and that you will work with them to help them to feel better and happier. 

DON’T

Make decisions for them.  You can make suggestions, but the decision MUST come from them.

Issue ultimatums (e.g. ‘if you don’t go to the Dr I will tell your teachers/friend/husband/wife what is going on’)

Tell lots of people unnecessarily

Use emotional blackmail (e.g. ‘Do you know what this is doing to me?’)

Get caught up in endless arguments about issues surrounding food and weight – for example whether they are or are not fat, whether eating certain foods would or would not make them fat.  It is pointless and will probably just end up with both of you frustrated, upset and fed up!

Focus on food and weight too much.  For example, make sure you talk about recovery in terms of how they are feeling, and how they are coping with their life rather than in terms of putting weight on.