A family struggle | Health & Fitness | Life | Ottawa Sun

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Parents are the "priceless resource" needed to help a child recover from an eating disorder. So stress two Ontario eating disorder specialists who say "a more specialized or better hospital" is not always the answer for this devastating illness.

"It is you helping your child to eat that will make the difference," say Dr. Ahmed Boachie and Dr. Karin Jasper, whose comprehensive new book, A Parent's Guide to Defeating Eating Disorders, offers guidance to parents who are stymied and scared by their child's refusal to eat.

Unlike books that focus on preventing eating disorders, Boachie and Jasper's book is about how parents can "defeat" the illness that attacks like a stealth bomber to rob their child from them. Where they work at the Eating Disorder Program at Southlake Regional Health Centre in Newmarket, Ont., 80% of their patients are in outpatient programs but parents are partners in the treatment with their children.

"The relationship that parents have with their children is the most important relationship children have," Boachie said in an interview. "It is like the air we breathe - and without it we would not have life."

To help rather than hinder a child's progress requires a mind-shift in a household. For example, parents, many of whom blame themselves for their child's illness, can be especially confused as to how to manage mealtimes - the foundation of recovery. Should they cajole their child into eating by offering and withholding rewards, or should they shift the focus entirely off food?

There are countless other issues, too: To argue against or comply with a child's wishes? To offer different foods or a strict meal plan? Consult another doctor or treatment facility?

Family treatment is what works, says Boachie, who urges parents to "ally with the treatment rather than the eating disorder."

"If parents take some food away, the child will calm down and appear happier," Jasper explains, adding that by minimizing their expectations of what the child should eat, parents inadvertently ally with their child's fear around food.

"However, her body needs enough food to provide for the development of her heart, brain, bones and other organs. So although she will be calmer (with less food), she will also become sicker and eventually medically compromised."

Once parents appreciate that the illness can kill their child or make them chronically ill, they can sit with their child and help them face the food they need in order to survive.

Family therapy requires bravery on the part of parents. It demands that parents - not doctors - take charge of nutrition and weight restoration by managing a child's meals and disrupting their food restriction, purging or over-exercising. Parents learn that the illness has "overtaken" their child and that their child is not being stubborn or disobedient by refusing food.

Granted, it can't be easy, particularly when many wonder why kids with eating disorders simply don't eat their way back to health. But there are serious physical complications that arise with re-feeding someone who is starving.

And telling someone with an eating disorder to "just eat" is "like telling someone who is afraid of heights to jump out of an airplane," says Dr. Jasper. "They are terrified and facing a meal, they feel that everything they have worked hard at to keep themselves acceptable, likeable, attractive and good is about to be ripped away from them."

Not all in their head

While eating disorders are a psychiatric diagnosis, there are both psychological and physical complications, says Dr. Ahmed Boachie. "Often they are not identified until the physical complications make themselves known." Depression, anxiety, and obsessive-compulsive disorders are risk factors for eating disorders and may become worse with the illness. Dr. Karin Jasper adds that when a child is refusing to eat, it is "the authoritarian voice of the eating disorder." That voice can intimidate parents as the child's resolve not to eat strengthens, so parents must separate the psychological and physical aspects of the disease.

Don't blame mom

"Most parents feel helpless and that they are to blame for their child's eating disorder," says Dr. Ahmed Boachie. "They are not. We know that many factors increase the risk that a child will develop an eating disorder, but we do not know the cause."

A slippery slope

Eating disorders start with weight preoccupation and dieting which are normative in our society, says Dr. Karin Jasper. But the moment at which dieting becomes a disorder can go unnoticed: A child may wear loose clothes, complain of flu or stomach aches, lie about when and what they ate, claim fatigue due to schoolwork, or over-exercise in the name of health. Early stages of an eating disorder can mimic other diseases and be difficult to diagnose.

Did you know?

Not just girls

In today's body-obsessed culture, pressure on boys to have ideal shapes and sizes makes them more vulnerable than 20 years ago for eating disorders.

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Source: http://www.ottawasun.com/2012/03/14/a-family-struggle

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