This week’s blog is an excerpt from my upcoming guide to eating disorder treatment, Give Food A Chance (PSI Press, 2010).  This excerpt deals with the essential role of the family in successful eating disorder treatment of children and why it’s sometimes one of the hardest message to bring to parents.

At the Kartini Clinic, over the years, we have made just about every kind of mistake. One thing we have learned never to do, no matter how tempted we are to care for a “high-pro?le” patient, is to accept care of a child whose parents will not be involved. It just doesn’t work. Without a supportive adult caretaker, the prognosis for an eating-disordered child or young adult is grim. I discuss the special situation for young adults at greater length in the chapters on the Day Treatment Unit (also sometimes called “Partial Hospitalization”), but for now let me say that parental unity with the team has proven to be the critical –  the essential – ingredient in successful treatment: Parents and doctors in coalition against the disease, on behalf of the child. Nothing else works as well.

Over the years we have also learned to avoid what can only be called “enabling” of the eating disorder. This occurs when the patient is allowed (by the doctor) to stay at a suboptimal weight because parents are unable to supervise meals adequately or cannot be convinced to keep a food journal or cannot bear their child’s distress at weight gain. It occurs when families refuse family therapy participation because they insist that their child is “the one with the problem,” or when families demand outpatient treatment (or doctors propose it) when the child is too medically compromised to bene?t from it.

Over the years we have watched individual therapists, physicians and nutritionists continue to see terribly compromised patients in an outpatient setting in the belief that “some treatment is better than none,” with the result that the child is enabled to remain in a limbo of partial weight restoration. This situation, although not good for adults either, is particularly grave for children, who have a ?nite window of opportunity to achieve normal growth and brain development and to lay down bone mass. It is essential that parents ?nd providers who have the courage of their convictions and who will act in their child’s best interest.

You need a doctor who will give it to you straight, not be afraid to tell you what you may not want to hear. Parents are a child’s best advocates. Doctors: Tell them what they need to know and what they will have to do and then be there for them when things get difficult.

excerpted from Give Food a Chance, PSI Press, 2010. All rights Reserved.