This blog is asking for help from those of you who have a child with anorexia nervosa but who may have experienced an eating disorder yourself.

Any clinic or provider who treats pediatric eating disorders will sooner or later see children whose families have more than one affected (or partially affected) family member. This is the fancy way of saying that when you do a careful history you are likely to find other family members who have eating disorders in addition to the child.

This makes sense, of course, when you consider that anorexia nervosa is a highly heritable brain disorder. It makes sense—but it’s it’s hard to manage nonetheless.

Why hard to manage? Well, start with the guilt. We are very proactive (and always have been) in telling parents that they did not cause their child’s eating disorder, no matter what their circumstances are. Parents don’t cause eating disorders. Period. But now imagine you are a mother (or father) who has struggled for years with your own eating disorder, or did when you were younger. You would love to be able to spare your beloved child going through what you have gone through. And sometimes, no matter what the doctor says, it feels like you are to blame. Did your own eating disorder interfere with your judgement? Did you bring your child in too late? Too soon? For the wrong reasons? Maybe the doctor says they don’t blame you, but when you start answering the therapist’s many, many questions, it feels like the implication is that you blew it somewhere along the line.

Then there’s the food. If you are active in your own eating disorder you may be terrified that the doctors will force you to eat in such a way that you yourself gain weight. Your carefully crafted survival foods, ones that diminish your anxiety about your weight and about getting older, may be challenged. How terrifying would that be? What if you were forced to reveal your own bingeing and /or purging? How would your spouse react? Would he/she blame you for your child’s behavior?

Children notoriously do not respond well to “do as I say but not as I do.” Would anyone? If an eating disordered child is “forced” to eat adequate calories, including fats and carbohydrates, imagine how they feel if you yourself restrict fats or carbs. How would your child respond to you keeping diet/low calorie foods or even “foods” such as Medifast in the refrigerator alongside their whole milk yogurt? What can you say?

And then there’s the issue of exercise. The therapist creates a moment for your child to explain to you and your spouse that when you go running every morning and come to family therapy appointments in your tight workout pants, she/he finds it very triggering and…well…unfair. But you know that you have controlled your own terror of weight gain by exercising every day in order to be able to eat at all. What should you do? How do you hide your irritation at the invasion of “your space” by these people who are helping you care for your eating disordered child?

You think this doesn’t happen? You think it’s rare? Think again.

The real question is, how do we manage it? How do we identify accurately when we have another affected family member, and approach the need for them to get help with compassion, understanding but yet with honesty?

Ideas, anyone?