Every month I receive at least one heart-breaking phone call from a parent about an adult child who refuses to seek treatment for an eating disorder. The parents are often besides themselves. Their child is either starving and approaching a low weight that is life-threatening, engaging in binge-purge behaviors, compulsively over-exercising or emotionally overeating and secretly hoarding food.
Each of these eating disordered behaviors are worrisome to parents, especially when your child is over 18 years old, financially independent, and in denial about the severity (or even the existence!) of their eating disorder symptoms.
On top of that, the adult child is typically very high functioning in other areas: they are getting good grades in college and involved in many extracurricular activities, they are married and taking care of their own young families, and/or they are holding down a successful job and are financially independent. In this case the parents lack financial leverage over their child to encourage getting help.
The opposite scenario is also sometimes true. I have worked with many families who have their adult child living at home because they have had to drop out of college, a job or a relationship because the eating disorder symptoms caught up to them. Yet, they still refuse treatment. These parents do not want to pose an ultimatum to either go for treatment or live elsewhere (you don’t want your ill child to be sick AND homeless!), but are at a loss about how to force the issue.
In almost all of these cases the parents are extremely caring and willing to go to enormous emotional, physical and financial lengths to help their child recover - which makes it all the more devastating when the child refuses these offers of help.
If you are a parent of an adult child who has an eating disorder and is refusing help, here are some ideas that have worked for many of the parents I have helped over the years:
- If your adult child is dependent on you financially and has refused to seek treatment, it can be difficult, but quite effective, to withhold financial support for college, housing, a car, etc, until they seek meaningful recovery. When presenting this “ultimatum”, you make it clear that as their parent, you are not their friend or buddy, but responsible for their health and safety, their overall well-being.
A sample script could be: “Dad and I love you very much, and it’s our job to make sure you are safe and healthy, even if you get angry at us for trying. We believe the eating disorder is putting your life in danger, so we cannot continue to pay for college (a car, housing) until you see your doctor, a therapist and a nutritionist. As soon as your doctor gives the OK, we will resume our financial support. We want you to be successful and do everything you want to do in life, but in a healthy body and mind”.
- If, on the other hand, your child is financially independent and you cannot use your financial support as leverage, begin by noting the observable changes you have seen in your child that worry you (i.e. “I've noticed that you have lost a lot of weight over the last six months, and you told me you lost your period.” Or “Dad and I see you disappearing to the bathroom after meals, and we notice you have been very worried about gaining weight”).
Have the name of several eating disorder specialists ready, and then tell them you are willing to go with them to a first appointment. Encourage them to at least give it a try and see if they feel connected. A good therapist is often able to convince a reluctant client to continue with sessions.
- Become as educated as you can about the causes of eating disorders and the best ways to talk to your adult child about them. Many times parents use scare tactics, remove food from the house, or threaten to remove all financial support in a way that frightens the child rather than with understanding and calm. Often this type of approach is made out of desperation and a lack of education about the causes of the eating disorder (ie it is not your adult child’s fault or your fault - if they could stop the behavior they would, but they need professional help to do it)
- Consider seeking parent coaching before you try to convince your adult child. A qualified therapist can listen to your worries and fears, reassure you, provide support and help you practice a way to talk to them that is more likely to achieve results. There are also several online support groups for parents of adult children with eating disorders that can provide priceless advice and encouragement.
- Ask yourselves honestly as parents, is your fear and worry causing you to push your child too much, to the point he or she may be tuning out your well-meaning concerns? In a post from the psychcentral.com blog on this subject, Dr. Ashley Solomon writes: “If your (adult child) isn’t interested in having you involved, it could be best to give her space. As a parent of an adult child, it can be hard to step back when you see her struggling. That doesn’t mean that you won’t continue to love her and show her encouragement. Keep letting her know that you are available to listen and to support her.”
Sometimes giving your child some space without being rejecting can actually turn things around.
- If your adult child is living at home with you but refusing treatment, try to pose the question about what is holding them back and REALLY listen to their response without getting frightened or defensive. When you let your child speak freely without interrupting, you may find that he or she is more open to treatment than you thought, but a certain solvable issue is holding them back.
For example, they may worry about burdening you financially with the cost of their treatment, or they may have tried working with a therapist they did not connect with and are reluctant to try another one, or they may falsely believe they just have to live with the eating disorder and can never truly recover so why try?
- I often find that parents are often so terrified about their child’s eating disorder, they over promise about what they can do to help and become resentful in the process. This resentment is unconsciously (or sometimes consciously) communicated to the adult child, who fights back or retreats from the parent.
For example, it is unwise for parents to overextend themselves financially to secure treatment for an adult child - especially if they can’t help but let the child know how “expensive” the treatment is. Let your child know honestly what you can and cannot afford, and then explore the treatment options together within those limits.
Similarly, some parents are able to handle a Maudsley type approach where they sit with the adult child for every meal and snack to provide calm encouragement to eat and not purge. But some parents cannot handle that stressful role, and that is not a failure on their part. It takes enormous patience, support, and sometimes physical and financial sacrifice to use this type of treatment approach, and it’s better to be honest with your child if it is not the best fit for you.
It may feel hopeless when you have an adult child who refuses help when you know they’re really in trouble. Please don’t despair. If you have run into dead ends trying to get through to your son or daughter, it may be time to ask for a fresh set of eyes to come up with solutions you may not have considered. Remember that we provide Emergency Parent Coaching to parents all over the country to do just that!