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Your role in treatment

Families, partners, friends and other carers can play an important part in helping their loved one to get well. When your loved one starts formal treatment for their eating disorder, how you support them will vary according to their treatment and your relationship with them. On this page, you can read about common treatments for both children and adults and the role you can play.

Because supporting someone with an eating disorder can be so difficult, you should be offered an assessment by your loved one’s eating disorder service to see whether any additional support would be helpful.

My family were absolute saviours throughout my eating disorders. They took time to research and read up on what I was going through, made sure they asked the doctors and dietitians lots of questions and were an unwavering support system. Even at times when I felt so low that not even they could cheer me up, my parents and siblings ensured I knew that they were there even if that just meant sitting in silence or trying to take my mind off things.

Families, partners, friends and other carers can play an essential role in the recovery of their loved one, through ways such as:

The way you can provide support will vary based on your loved one’s treatment and your relationship with them. This page talks about the role of a carer during recommended first approaches to treating eating disorders.

Your role during...

...Eating-Disorder-Focused Family Therapy

Anorexia-nervosa-focused family therapy (FT-AN) and bulimia-nervosa-focused family therapy (FT-BN) is recommended for adolescents diagnosed with anorexia nervosa and bulimia nervosa. You may hear other terms such as “Family Based Treatment” (FBT) and “Maudsley Family Therapy”, but these are all variants of Family Therapy and the NICE guideline does not distinguish between them. If you have questions about the model of treatment that has been offered to your loved one, speak to their clinician.

Eating-disorder-focused family therapies emphasise that families do not cause eating disorders, but instead they can be a vital resource to help their loved one recover. Families, in particular parents, are asked to take a central role in managing their loved one’s food intake and the prevention of disordered behaviours, such as excessive exercise, binge eating and purging. This will mean supervising each meal and snack, and being with them after these to prevent compensatory behaviours. Over time, this role will start to shift, and the person will start to manage some of their own snacks and meals as appropriate.

Although this role is intense, your loved one’s clinician is there to support and guide you through this.

At the time, it was really difficult to have my parents in control of my eating... However, I’m now so grateful for their persistence. They were empathetic, yet firm and reassured me that it was the eating disorder we were all fighting against.

...Individual Eating-Disorder-Focused Cognitive Behavioural Therapy

Eating-Disorder-Focused Cognitive Behavioural Therapy (CBT-ED) is commonly recommended in the treatment of eating disorders. Your role in supporting a loved one during CBT-ED will depend on the nature of the relationship, where the person is in their recovery, and the degree of involvement they would like. You may find the lack of structure difficult, particularly if you have been closely involved in your loved one’s treatment, as is the case during Family Therapy. However, you are still able to play a vital role in your loved one’s recovery – for example, through ensuring a recovery-focused environment and supporting your loved one through the challenges of recovery.

During CBT-ED, the responsibility for your loved one’s eating behaviours lies with them. Firstly, treatment will focus on establishing regular eating, and ensuring that patients are eating three meals and two or three snacks a day without the use of compensatory behaviours (if present). Your loved one becomes responsible for choosing what to eat and for sticking to their plan without using eating disorder behaviours. This is an aspect of treatment where your loved one might value your support, so it could be helpful to talk to them about what they would like your help with.

As CBT-ED progresses, your loved one will work with their clinician to understand the factors maintaining the eating disorder, such as following strict dietary rules and over-evaluation of weight/shape, and the clinician will support them to address these. This may involve introducing avoided foods, learning to deal with triggers, and addressing certain behaviours. The way you are best able to help will vary – for example, for some people, having someone to eat with or to be with during or after a difficult situation can be immensely valuable and can lessen distress.

[My family] weren't judgemental of how little or how much I would eat and kept the focus off the actual food at all times. Mum started coming to see me in my room every night after dinner to ask how I felt, and if I was feeling anxious, she would stay with me and watch a film or chat or read until the feeling had passed.

...Guided Self-Help

Guided self-help is one recommendation for the treatment of binge eating disorder. Your role in supporting your loved one during guided self-help will depend on the nature of the relationship, where the person is in their recovery, and the degree of involvement they would like. This lack of structure can be difficult and result in uncertainty; however, you are still able to play a vital role in your loved one’s recovery. Ask your loved one what would be most helpful for them during this time. For example, it could be that you are able to support them in planning for and shopping for their meals and snacks, or it may be that you can help them to overcome the urge to binge if that arises.

My mum always listened to my fears around certain foods and did her best to be flexible with food. I told my parents that evenings were the times that I binged the most and so they sat with me and watched TV till late to distract me. I really appreciated the support and we still have such a good relationship – if not stronger – now that I am recovered. It’s always worth asking if you can do anything to help.

Support for yourself

The NICE guideline states that family members or carers should also be offered an assessment to establish whether additional support would be helpful. This could be for practical help or for your own mental wellbeing. If you have not had this offer, or if your needs change, you should discuss this with the clinician working with your family.

Beat has a number of support services for carers if you want to talk to someone supportive who is not directly involved in your loved one’s treatment.

It could be helpful to also think about who or what else would be beneficial in supporting you through this period. Are there any friends or family who can offer you support, whether this is helping to look after your loved one, or doing the cleaning so you don’t have to? Would seeking help from your own GP be helpful? If you work, are you able to receive compassionate leave from your employer, or ask for adjustments to the way you work? Often caring for someone who has been diagnosed with an eating disorder can feel extremely isolating and exhausting, so try to be kind to yourself and accept help when it is available.

Confidentiality

Confidentiality is an essential part of maintaining the trust between patients and healthcare professionals. People of 16 and 17 years are entitled to the same confidentiality as adults, while children under 16 years are entitled to decide how information they provide in confidence is used, providing they are deemed capable of making decisions about their treatment. There are however certain situations when confidentiality may need to be broken, such as if the patient refuses treatment for a life-threatening illness.

During CBT-ED, the responsibility for your loved one’s eating behaviours lies with them. Firstly, treatment will focus on establishing regular eating, and ensuring that patients are eating three meals and two or three snacks a day without the use of compensatory behaviours (if present). Your loved one becomes responsible for choosing what to eat and for sticking to their plan without using eating disorder behaviours. This is an aspect of treatment where your loved one might value your support, so it could be helpful to talk to them about what they would like your help with.

For carers, confidentiality can often feel like a barrier between themselves and their loved one, and something that is preventing them from knowing about their loved one’s care and wellbeing. This can be extremely frustrating, especially at a time when you are concerned about your loved one. However, respect for patient confidentiality shouldn’t mean healthcare providers don’t listen to or communicate with you. You should be given enough information by healthcare providers to be able to provide effective care. For instance, although you won’t be able to be told specifics of your loved one’s treatment or their progress if they have requested these to be confidential, you should receive good quality information about eating disorders in general, including their symptoms, treatment and advice on how to manage them.

You are also entitled to see a professional for your own support and to express any concerns you may have – anything you share with a professional should also be treated confidentially.

Supporting someone with an eating disorder

Get general tips for supporting someone with an eating disorder.

Understanding the recovery journey

Learn more about what your loved one may be feeling through the "stages of change" model.