In winter of 2017, a debilitating disease, anorexia nervosa, shattered my daughter’s life. The battle against this disease is intense and requires all of the mental, emotional, physical and social resources that a family can muster. Though my daughter’s disease had probably been in her mind and body for several months prior to her diagnosis, once the disease took over her body, it was relentless in its pursuit to take her life, literally.
First, every child/person/patient is different and you need to be attuned to what your child needs personally. On the other hand, this disease is remarkably similar in all patients and that is because it IS a disease with a disease pattern and a specific etiology. Therefore, the first step is to acknowledge that this is a real illness, as serious as cancer. Solicit professional help from a doctor who specializes in eating disorders as soon as possible. Early intervention can be the difference between a one-year recovery or two- to three-year recovery period.
Second, realize that this illness developed over a longer period than you realize so recovery will take just as long. You and your family are in for the long haul; this process will most likely consume all of the collective time and energy of your immediate family for at least several months to a year or two or longer. Your main job for the first several months is simply to support your child is becoming re-fed. You may not have the time or the energy to do anything else. Like feeding a newborn, this can be a round-the-clock job.
Third, recognize that the battle against this disease is intense and requires all of the family’s mental, emotional, physical and social resources. The best defense is to recruit the help of a doctor, a counselor and a nutritionist. Your child will likely need a child psychiatrist as well, since there are some medications that are useful to treat co-occurring disorders such as obsessive-compulsive disorder and anxiety. At one point in my daughter’s recovery, we were taking her to four different appointments per week just to keep up with the intense needs of fighting this illness.
Fourth, if one intervention does not work after a few months, try something else. In the yearlong process of my daughter’s recovery, she went first to a partial hospitalization program (for 3 months). After 6-weeks at home, she relapsed and went to an inpatient program (for 1 month). Rather than go back to a partial hospitalization program (which is the recommended step-down from inpatient), we choose to implement an intensive, modified Maudsley approach at home. I took a partial family medical leave for about 9 months during this time. When we employed the Maudsley approach at home, either my husband or I ate every meal with her.
Fifth, if there are two parents or caregivers in the family, always present a united front. Your day-to-day tactics with your daughter or son needs to be unified. The anorexic mind will look for any opportunity it can to find any ambiguity in your system. Together, you must both be diligent in encouraging your child to eat and rest. Be supportive to your child and to each other.
Sixth, be willing to give up old family habits, even good ones. Our family prided ourselves on our daily family dinners around the kitchen table, where we shared our day. With our daughter’s anorexic mind, that custom became impossible. As long as she was terrified of eating, we had to find ways to distract her. Humorous TV shows worked. At one time in our lives, we derided the notion of eating family dinner in front of the TV and now each meal required us to watch about three episodes of humorous TV shows including Seinfeld and The Office. Nevertheless, that new custom helped our daughter to smile and eventually she relaxed enough to eat her meals.
Finally, if you find a food or food group that he or she will eat; let them eat it as much as they want, even if it does not comprise a balanced meal. At one point, our daughter lived on peanut butter and bananas. In our house, we probably went through several jars per week, but clearly her body and brain needed that kind of nutrition and she was willing to eat it.