How to approach?
One of the most common questions we receive at ACHE is from a parent/family member who is concerned about a child/teenager and is seeking advice about how to approach them about what is going on. It can be very tricky, and a lot of teenagers in particular react very defensively to any kind of questioning about their health, weight or eating. We would offer two main pieces of advice for the moment – but if you are in this situation then do get in touch and we can offer you more specific guidance. We also have some very useful guide booklet to help you. Please see our publications page.
Avoid challenging them about their eating/weight.
The aggressive, defensive responses which you are trying to avoid stem mostly from the fear of losing control over eating, or of being made to change eating and gain weight. A lot of sufferers feel that all the people around them want them to do is just get fatter and stop causing trouble. It is really important that you show that you are concerned about much more than this – about how they are feeling in general. For this reason, if you can, it is better to start off by talking to them about some of the other changes you have noticed, and how they are feeling in themselves. So if you have noticed a change to their mood, or emotions, or to things that they used to enjoy doing, this is a much better thing to start to talk about. Be empathetic and sympathetic, and view this first chat as a chance to start communicating. You may not even get to mention the weight/eating issue in this first chat and that is fine. You need to get their confidence, and make it clear that you are on their side.
Do not confront
When talking to someone who is struggling with an eating disorder you have to remember that for them life has become lived on a knife-edge of anxiety. If therefore they feel that in any way you are pushing them, or trying to take control from them, they are likely to react by digging their heels in and refusing to cooperate. They will also be likely to feel that you, like everyone else, are against them. For this reason, avoid being confrontational when you chat to them. Instead adopt as relaxed a style as you can, and try to gain as much understanding as possible about how they are feeling. So avoid statements like ‘Well you just need to eat a bit better, don’t you!’ and try to use things like ‘So you want to eat a bit better but feel really scared about losing control, is that right?’. You may still find that they become emotional and tense – and if this happens you might want to withdraw and maybe start up the conversation at another time. Most of all, avoid the temptation to give in to your own fears and try to take control. This is a very understandable response, particularly if the child is younger – but often is counterproductive and just makes things worse. Remember that your first aim is to get communication open, and to give them some support because they are probably feeling dreadful.
If all else fails ….. It may be that you have already tried to approach your child and it has failed, or that you feel you do not have the right kind of relationship with them to be able to approach them. If this is the case then do consider whether there is someone else who might be better placed to talk to them – perhaps a trusted teacher, friend or aunt. Be very careful however, about who you decide to tell, as it is vital that your child does not feel that they are being talked about. It is much better if the person who does speak to them has already noticed what is going on themselves. If your child is very defensive and you find you are unable to say anything to them at all without being shouted at, one thing that sometimes works is to use short notes or cards. You can leave a note/card somewhere where they will find it, even at a time when they will be unable to immediately come and shout at you. This means you can be totally non-confrontational, and that if your child finds it impossible to talk to you face to face, s/he does have another way of communicating. You can suggest in the note that they reply by another note, and where they could leave it for you. Some parents have even agreed in the note that they will never mention these issues face to face unless the child brings it up first. All of this helps them to feel really secure and in control – but does ensure that some form of communication begins.