Doctors: Listen to Parents About Eating Disorder Symptoms
This is an excerpt from my upcoming book Give Food A Chance (to be published this summer by PSI Press) taken from a chapter about parents, their essential roles in recognizing symptoms of eating disorders such as anorexia, as in obtaining timely treatment for their child. It is written partially as a plea to other medical doctors to listen to parents, and also partially to encourage parents to continue to advocate for their children in their time of need.
“Even though the literature on eating disorders is replete with stories of 'parents in denial,' it has been our experience that parents generally do a better job than we doctors at recognizing that 'something is wrong' with their child. Perhaps we should not be surprised. Parents are the experts on their own children and, with very few exceptions, should be treated as such. Anorexia nervosa is a life- and health-threatening condition, and parents who have grounds to feel something is not right should not be made to feel invasive if they look through their children’s rooms or bathrooms for evidence of vomiting, food hoarding, diet pills, syrup of ipecac (which “novices” use to induce vomiting), or laxatives. I do advise parents to have a word with themselves before any such search, however, and if they find love letters from unsuitable admirers, condoms, homework assignments with bad grades, and so forth, not to use this search as a springboard to confront their child with
everything they disapprove of. Stick to the life-threatening stuff. Deal with the rest later.
Physicians, if a parent insists that their child’s weight loss is a problem, please do not brush them off. Take a history. Be sure of your diagnosis. A young doctor who ignores the concerns of mothers or grandmothers is foolish; an older doctor who does so is just a plain fool."
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Comments
so why does you clinic condemn parents while the patient in your care and threatening?
My experience at your establishment is not alone. After transfering my child to a far superior establishment I am told that your clinic is particularly hard on the families
As a parent of an ED patient who was at several facilities including Kartini, I take issue with your post. Far from your statements, we found Kartini goes out of its way not to condemn parents, but to recognize ED as a disease like any other. However, parents and family are an essential part of treatment. It's not like you can just drop your child off and pick them up when they are fixed.
We are sincerely happy to hear you found a treatment approach that works for you and your child. We want every child with an eating disorder to benefit from effective treatment.
We would like to respond to the questions we think you are asking: Why is Kartini’s approach to eating disorder treatment different from others? And, what is the reason we ask parents to work so hard with our team to return their child to health?
Because our mission is to treat children and adolescents with eating disorders, our approach to treatment IS different from clinics that predominantly treat adults. Kartini provides family-based treatment for several important reasons – here are just two:
1) Research indicates that family-based treatment is “best practice” for children and adolescents with eating disorders, and we firmly believe in following best practices that are grounded in research. We continuously scan research reports for evidence of approaches that might improve our treatment and outcomes.
2) After over 12 years of clinical practice and 1700 patients, we have learned a lot from our patients! Our patients and their families have taught us “what it takes” to achieve good treatment results. It boils down to this: When the team and the child’s parents are strongly aligned and working together toward mutual goals, the child benefits. Our most positive outcomes have occurred when parents are strongly connected to us, and to each other, and we are all working with the same committed efforts in implementing the child’s treatment plan. We recognize this is hard work for parents who have busy, demanding jobs and complicated lives. We applaud them for the sacrifices they make for their child and we feel honored by the privilege of partnering with such dedicated parents. The treatment of a child’s eating disorder takes a central role for a while, and everyone in the family has to adjust. It’s hard on siblings, too, but ultimately effective family-based eating disorder treatment can benefit the entire family because of the healthy patterns of structure and nutrition that become the “new normal” and eventually become a comfortable part of family life. Because we understand what this means to families, we have always championed and supported the essential role of parents in the treatment of their children, and we firmly resist blaming parents for what we know are heritable medical conditions. We conduct our treatment program in the knowledge that parents don't cause eating disorders and children don't choose to have them.
Without a doubt family-based treatment is challenging, and we understand that it is not always the best fit for a particular family. When this happens, we support and assist parents to seek help for their child elsewhere, and we wish only the best for the child. We are open to hearing what didn’t work and why. We know we will continue to learn from all families. We strive above all for open and honest exchanges between parents and our staff, in pursuit of the very best evidence-based eating disorder treatment and clinical practice available anywhere. In this spirit, we encourage and welcome feedback from parents, positive or otherwise, and invite constructive suggestions for how we can improve our care and provide the best possible treatment for children and their families.