Eating disorders

Parents and family

The young people we talked with often lived at home with their families. Being diagnosed or treated for an eating disorder often had a major impact on their parents and carers, brothers and sisters and on extended family. Family relationships could also be affected when young people had moved out.

Young people said that family relationships were involved with their eating disorder in complex ways. Some felt that family issues in the family had played a role in them developing an eating problem in the first place. Parents and other family members were also often among the first to realise something was going wrong and to encourage people to get help. For some people, parents had been actively involved in treatment (e.g. family therapy) or took responsibility for care at home. Others had never even told their parents they had an eating problem. Whichever way, having an eating disorder often had a deep impact  on how young people felt about their parents and family.

Although it was often difficult for people to know why they had developed an eating disorder, many had had a difficult relationship with food early in their childhood. Some felt that their attitudes to food  had been learnt at home. Disrupted family lives, or experience of divorce, violence and death of a loved one within the family could play a major part in them developing an eating disorder. Some of those we spoke with said they had never felt understood or cared for by their family see ‘Early experiences of food and eating’).

Impact on family relations
Living with an eating disorder can have a practical and emotional impact on family relations. Young people described a mix of emotions such as sadness, concern, guilt and anger towards family members.
 
During the worst times, the eating disorder could take over every aspect of family life. Sometimes parents took time off work to be able to care for their child at home. Parents and siblings had to “accommodate” to the needs of the person with the eating disorder and were sometimes unable to go on holidays or spend time together outside of the house. When Zoe was very ill she was “constantly monitored” by one of her parents; Charlotte’s parents took the locks out of the bathroom; and some people were “locked in” the house and constantly followed to make sure they weren’t purging, exercising or running away.
 
Because of the disruption and distress eating disorders could cause, there was a lot of tension and arguments particularly at mealtimes. Understanding eating disorders was often hard for parents as they had to watch their child behave in ways that seemed irrational and destructive and didn’t know how to help.
It could be difficult for young people to see what their families were going through. Zoe saw her dad cry for the first time when her parents took her into hospital. Seeing their parents upset and desperate could make people feel guilty. Many had wanted to protect their parents’ feelings. Chloe, Craig and Zoe all said that the main reason they got help for the eating disorder was for the sake of their families. Katie and Fiona-Grace were upset to see the negative impact of the eating disorder on their family members as they always wanted to “please” people and make others happy. Although eating disorders mainly affected parent-child relationships the stress of dealing with an eating disorder could cause arguments between the parents too;
 
“Mum and Dad would have a massive argument about it and they’d be arguing all the time cos my Mum felt like my Dad was doing the wrong thing. I never want to see that happen again and it just caused problems between them and watch them being upset all the time.” -Jasmin
 
One of the most important issues in the family that the eating disorder affected was trust. Because of the illness, many young people described becoming secretive, increasingly hiding their thoughts and behaviour the more ill they became. The more parents tried to help the more pressure some people experienced.
Breaking the child’s trust could be very damaging but was sometimes necessary to keep them safe and get them into treatment. Elizabeth emphasised how important honesty was. She said, for example, that tricking children into eating more calories could damage the trust. On the other hand some said that in they could now see how desperate their parents were and understood why they had felt the need to risk losing their trust. People could become trapped in a vicious cycle' the less people felt they could trust their parents, the less their parents  trusted them, this could lead young people to become more secretive. Some people who were under 18 were told they couldn’t get treatment without parental consent and felt pressure to tell their family about their problems.
When trust was broken between parents and children it could leave a lasting impact. Young people said their parents had become so distrustful that they struggled to move on and trust their children again, even as they were getting better.
 
“I think my parents won’t let go of the eating disorder because even if I say, “Oh I’m not hungry,” they can’t just accept that you’re not hungry if you’re actually not hungry. Because everything’s sort of labelled and interpreted in a certain way which I can find frustrating sometimes.” -Katie
 
Support
 
The support that family could offer to young people could be better than anything else. Rachel received “constant support” from her parents, Hannah O said her parents “stuck by” her through everything and Sara described her family as “integral” in her recovery. Rob said that even though his parents didn’t necessarily understand anorexia nervosa they were always supportive and remained “a close knit family”. Some said their parents had done a lot of research into eating disorders and taken steps to help by, for example, exploring treatment options.
For some, the difficult experiences brought the family closer together. For some, the family situation was easier after they moved out of home, to university for example, and their relationship improved.
Role of family in treatment and home care
Family can play an important part in helping people get treatment for eating disorders in a variety of ways:
 
• Enabling people to attend hospital appointments, 
• Providing support 
• Having open conversations
• Going to family therapy with them. (For more about people’s experiences of the pros and cons of family therapy see ‘Staying in hospital’). 
• It was often family members who were the first to pick something was wrong and tried to encourage people to get help (see  ‘Realising something is wrong and seeking help’).
 
Sometimes people were looked after by their parents at home. This could be because they couldn’t be go into hospital (because they didn’t want to, or didn’t fit certain criteria) or, for example, during the period between discharged from hospital and  being well enough to return to school. Rachel was glad not to be admitted to hospital and was cared by her mum fulltime'
 
”There were no beds available so I was looked after by my mam 24/7. I owe my life to my mam as without her I would not be here today.” Rachel
 
Sometimes parents had to take time off work, or a career break, to look after their children. Zoe's parents worked “shifts” looking after her and she was with either one of them at all times. At this stage, parents were often fully in charge of what people ate at home, often with guidance and meal plans from the hospital.
 
Brothers, sisters and grandparents
“There was obviously the fighting at home that upset her [sister] sometimes, and I can remember her crying once because she thought I was going to die when I was really unwell.” -Katherine
 
Eating disorders can have a big impact on siblings (brothers and sisters), grandparents and the wider family. Growing up in a family affected by an eating disorder can make siblings feel  ignored, scared and worried about their sibling’s health. This can leave them feeling angry and bitter. Some said they understood why their siblings might feel resentment when family life seemed to revolve around one person's needs. Others felt that there had always been competition between the siblings or they had always felt like the “problem child”, which partly contributed to their eating problems. It was important that parents tried to give attention to all the children in the family, ill or not.
People often felt distant from their siblings and didn’t want to talk to them about their problems. Some said their sisters or brothers were too young to really understand. Zoe said she had never realised what a big impact her illness had on her sister until her mum had told her how upset her sister had been. Some had siblings who also developed an eating disorder. One woman said her and her sister both becoming ill with an eating disorder was the result of problems in the family.
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It could be even harder for grandparents to understand eating disorders than it was for parents. Some said there was a generation gap with grandparents when it came to talking about mental health issues. Katie said her grandparents were from an “era” when difficult things weren’t really talked about. People often didn’t speak to their grandparents about eating problems and Nikki said her parents didn’t tell anyone else in the family, even when she was staying in hospital. Katherine didn’t speak with her grandparents face to face but knew that they talked about her weight behind her back. Some said their grandparents had made comments in passing about weight or food portions without realising how upsetting and insensitive people could find this. Others had different experiences. Rebekah had very supportive grandparents who she moved in with. Even though her grandmother had struggled to understand eating disorders or self-harm, she had always wanted to support her in every way she could.
 
There were also people who chose not to involve their families. Some had tried telling their family but felt their parents didn’t want to know. Others had never told their family because they didn’t want to upset them, or because they didn’t feel close and comfortable enough with them to talk about difficult issues. Emily didn’t really want to tell her family about the eating disorder because she felt her family life played a part in her developing an eating disorder.
 
If you are worried about yourself or someone else and would like to speak to someone in confidence, see 'Mental Health and Wellbeing Resources' for list of helpline numbers. 

Last reviewed July 2015.

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