I can’t tell you how many parents report their child with anorexia nervosa (or bulimia nervosa, binge eating disorder, fill in the blank…) becoming very irritated, not to say ANGRY, at them for something we call “externalizing the illness”.

What does this term mean?  It actually refers to a very positive attitude adjustment undergone by both parents and patients whereby they are able to separate the sufferer from the illness and blame the illness, not the sufferer, for how hard life with an eating disorder can be.

That’s good, right?

It is, but it comes with an odd twist.  As a child moves through their treatment and recovery, they start to resent it when everything they do is attributed to their eating disorder. Some parents, adopting the slang of the internet and blogs, even anthropomorphize their child’s eating disorder and refer to it as “Ed”—someone(thing) outside their child who is causing all the pain.  And at first many patients are relieved to have blame for their symptoms assigned to something outside of themselves.  Who wouldn’t be?

But there comes a time when irritation breaks out at all of their moves being ascribed to “Ed”. Big time.  And parents are left scratching their heads:  “Well, does she want me to blame her for this behavior?”

Not exactly.

What is hard, as a child begins to move through the earliest phases of medical stabilization and weight recovery, is to recognize when a behavior you don’t like is due to your child’s eating disorder or because they are a teenager/normal kid.  Which is worse—eating disorder acting out or bratty kid acting out? It’s hard to say.  But at least there have been volumes and volumes written on managing children and teens, and it is something your friends can empathize with and understand -- even advise you about.

In the early stages of an illness like anorexia nervosa or related eating disorders, compassion is in order.  Not only do parents not cause eating disorders, but children do not choose to have them.  So that means they are as stuck as you are (parents) in this hell of dangerous symptoms.  In the beginning of treatment it is critical to get as educated as you possibly can about childhood eating disorders, their presentation, their treatment, their physical and psychological ramifications, as well as what treatment will mean for the rest of the family.  The availability of information on the web, like this blog, like the FEAST website, like the blog written by the director of the NIMH, Tom Insel, and (for the science minded) the glorious Pubmed, all mean that you can access critical information for your family every bit as easily as I – or any other doctor – can.  And it is the responsibility of every parent to do so.  Get educated, stay informed, ask questions and then – after a while – let it go.