Author Archives: Alison Pelz, LD, RD, CDE, LCSW

The Power of Validation: Supporting Your Child Through Eating Disorder Recovery

The Power of Validation: Supporting Your Child Through Eating Disorder Recovery

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Is your teen struggling with an eating disorder?

As a parent, witnessing that struggle and feeling like nothing you say helps or wondering if you’re helping or are making things worse, can be one of the most difficult obstacles to navigate as a parent. And if you’ve felt this way, know that you are not alone. These aren’t experiences most of us know how to prepare for–there are no tools for caring for a loved one with an eating disorder in general parenting books. Unlike clinicians who go to school and receive on-going training to help people in recovery, parents have no such roadmap.

Witnessing your child struggling with an eating disorder can feel overwhelming, confusing, and deeply painful. As a parent, you naturally want to help, but knowing how to respond in the most effective way is not always intuitive. One key tool you can use to support your child’s recovery is validation–understanding what it is, why it matters, and how to practice it can make a world of difference for both your child and your family.

What Is Validation (And what it is not)?

Validation is the act of recognizing, understanding, and accepting someone’s feelings or experiences as real and meaningful.

Caregivers often worry that their validation will give their child permission to restrict food or purge–but that’s not the effect that validation has. Validating your child’s emotional experience doesn’t mean endorsing or encouraging damaging behaviors. What it does mean is that you are able to acknowledge their emotional reality without judgment. This practice lets your teen know that you are someone safe to turn to, because you will listen without assigning “right” or “wrong” to what they are feeling, and are instead there to try and understand their experience so you can better support them. Practicing validation can also be helpful for parents or caregivers in the moment because it often diffuses intense reactions you may be experiencing, and give you a moment to listen rather than react.

What validation is:

  • Actively listening and showing empathy.
  • Communicating that their feelings make sense, given their perspective.
  • Offering a safe space for them to share their struggles without fear of criticism.

What validation is not:

  • Agreeing with unhealthy behaviors or distorted beliefs about food, body, or worth.
  • Dismissing your own boundaries or enabling harmful actions.
  • Fixing their problems or trying to reason them out of their feelings.

Why Validation Is Crucial in Healing

Validation is a cornerstone of emotional healing because it helps your child feel heard, understood, and less alone. Eating disorders often thrive in silence and shame, and by validating the emotional experience your child is having, you help dismantle the isolation that fuels their struggle.

When your child feels validated, their nervous system can move out of a heightened state of stress or fear (often referred to as “fight, flight, or freeze”) into a calmer, more regulated state. This shift is essential because a regulated nervous system allows your child to:

  • Think more clearly and process emotions more effectively.
  • Develop healthy coping mechanisms.
  • Engage more fully in therapy and other forms of treatment.

Fears Parents May Have About Validation

Parents often worry that validation might:

  • Encourage unhealthy behaviors: It’s important to remember that validating your child’s feelings is not the same as endorsing their actions. For example, “I can imagine that it is very hard for you to complete your meal right now because it makes you anxious” is letting them know that you understand what they are struggling against, without encouraging them to restrict themselves.
  • Undermine parental authority: Validation doesn’t mean you have to compromise your boundaries or expectations. In other words, because you understand how hard it is for them to eat, that doesn’t mean you let them go unnourished.
  • Reinforce disordered thoughts: Validation focuses on emotions, not necessarily agreeing with the thoughts driving them. For example, saying, “It makes sense that you feel overwhelmed right now” doesn’t mean you agree with their belief that they “must” restrict food to feel in control.

Barriers to Validating Your Child

It’s not always easy to validate your child’s emotions, especially when:

  • Their feelings seem irrational or extreme. For example, your child may be fearful that they will gain a bunch of weight if they eat a piece of bread or that if they get a B in a class they won’t get a good job.
  • You’re feeling triggered, stressed, or unsure of how to respond.
  • You’re worried about saying the “wrong” thing and making things worse. The important thing is that you are trying and your teen will see that you are trying to understand them and what they are experiencing.
  • Your own emotions—such as frustration, fear, or sadness—are taking over in the moment. If this is the case, you may need to take a step back and come back later to your teen and validate them later. It is never too late.

Validation often doesn’t come naturally to us (I know when in my personal relationships I often find it challenging, and I am a therapist!). The good news is that validation is a skill that you can learn and practice.

Examples of How to Validate

Here are some ways to practice validation in everyday conversations:

  1. Listen Without Interrupting: Show you’re fully present by maintaining eye contact, nodding, and responding with short affirmations like “I’m listening” or “Tell me more.”
  2. Reflect Their Emotions: Paraphrase what they’ve shared to make sure you understand what they are saying. For example, “It sounds like you’re feeling really anxious about eating today, am I understanding that correctly?”
  3. Normalize Their Feelings: Help them see their emotions as a natural response. For instance, “I can understand why you’d feel overwhelmed; this is a big change for you.”
  4. Acknowledge Their Struggle: Recognize the difficulty of their experience. For example, “I can see how hard this is for you, and I’m here to support you.”

Ways to Practice Validation

Validation is a skill that can be developed with practice. Here are some tips:

  • Pause Before Responding: Take a deep breath to ground yourself if you’re feeling reactive. This both gives you a moment to decide how to respond, and helps to regulate your emotions so you are more able to respond intentionally.
  • Practice Empathy: Try to see the situation from your child’s perspective. Ask yourself, “How might this feel for them?” If you don’t know how they are feeling, ask.
  • Use “I” Statements: For example, “I’m here for you” or “I want to understand how you’re feeling” or “I can see why this feels overwhelming” rather than focusing on what they “should” do can help show your teen that you want to be an active support for them, and don’t want to blame them for what they are struggling with.
  • Role-Play Scenarios: If you’re working with a therapist or support group, practice validating responses to common situations.

A Path to Healing

Validation is not a magic cure, but it lays a critical foundation for healing. By helping your child feel seen and understood, you create a space where they can face their struggles without fear of judgment. Over time, this fosters the emotional resilience and trust they need to move toward recovery.

As a parent, you don’t have to be perfect—and there will be times when you stumble. 

But each effort you make to validate your child’s emotions is a step toward connection and healing. Remember, you are not alone in this journey. Reach out for support, whether from therapists, support groups, or other parents who understand the challenges of eating disorder recovery. Together, you can help your child find their way to health and hope.

As a therapist who is also a dietitian, I can help you understand what is going on from both angles. If you are in Texas and interested in working with me, click here to fill out a contact form. I would love to support you and your child on your journey to health.

Supporting Your Child Through an Eating Disorder: A Guide for Parents

Supporting Your Child Through an Eating Disorder: A Guide for Parents

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Feeling overwhelmed, frightened, and unsure of how to help when your teen is struggling with an eating disorder is a common and natural experience for parents. And while eating disorders are complex and often misunderstood, with the right resources and support, recovery is possible for your teen. And as a parent, you play a crucial role in your teen’s healing journey.

Below you can find compassionate guidance as well as therapist recommended resources to help you support your teen through their eating disorder recovery effectively.

Start With Understanding:

Eating disorders are complex, but that doesn’t mean they are unknowable. Education is one of the most powerful tools you have at your disposal, not only to help you find effective methods of support, but also to help expand your understanding of what causes and may impact eating disorders, so you can give informed care to your teen–rather than having to rely on guess work and risk causing harm. Understanding the nature of eating disorders and their impact on both physical and mental health can demystify the illness and empower you to provide informed support to your teen.

Here are some highly recommended resources to deepen your knowledge and help you in supporting your child:

When Your Teen Has an Eating Disorder by Lauren Muhlheim:

This book provides practical advice for parents navigating their child’s eating disorder, offering evidence-based strategies rooted in Family-Based Treatment (FBT) in a non-clinical manner so they’re accessible to the non-clinical reader. Muhlheim is the founder of Eating Disorder Therapy LA, an outpatient treatment center, has trained many clinicians and is a frequent speaker at eating disorder trainings and conferences. You can read my full review of this book, and why I consider it a must read here.

Sick Enough: A Guide to the Medical Complications of Eating Disorders by Jennifer Gaudiani:

Dr. Gaudiani’s offers a compassionate exploration of the medical side of eating disorders throughout Sick Enough, helping parents understand the seriousness of eating disorders and how to advocate for their child’s car by breaking down the impact of dietary restriction on your children’s bodies and brains, providing descriptions of common medical problems associated with eating disorders, as well as common co-occurring medical issues that complicate diagnosis and treatment.

Dr. Gaudiani is a board certified-internal medicine doctor who specializes in the treatment of eating disorders, as well as the founder of the Gaudiani Clinic: an outpatient medical practice specializing in the treatment of eating disorders, and a highly respected physician in the eating disorder community.

How to Nourish Your Child Through an Eating Disorder by Casey Crosbie and Wendy Sterling.

Authors Crosbie and Sterling are registered dietitians who specialize in the treatment of eating disorders. How to Nourish Your Child focuses on the Plate-by-Plate approach, a  resource which gives parents actionable steps to help their child restore nutrition-without counting calories or macros.This book helps parents answer the question, “what and how much should I be feeding my child,” especially for parents of teens with eating disorders.

Anorexia and Other Eating Disorders: How to Help Your Child Eat Well and Be Well By Eva Musby.

Eva Musby’s lived experience as parent supporting a teen daughter through in an eating disorder makes her book a wonderful resource. She provides invaluable tools for parents, including guidance on communicating with compassion, handling mealtime challenges, and navigating the emotional toll of supporting a child with an eating disorder. You can visit her website for free resources and updates.

Lean on Community

Try to remember that you are not alone in this journey. Many parents have walked this path and found solace, guidance, and strength in connecting with community and many who have found healing in connecting with others who understand your struggles.  Some places to start:

FEAST-ED.org:

F.E.A.S.T-ED (Families Empowered and Supporting Treatment of Eating Disorders) is an organization that offers resources specifically for parents and caregivers of children with eating disorders. Their community of parents provides support and shared experiences, and resources like forums, educational materials, and a library of researched back information

The Alliance for Eating Disorders Awareness:

This organization offers support groups, treatment referrals, and education for families. Their resources can help you find professionals and programs tailored to your child’s needs.

Practical Tips for Supporting Your Child Effectively:

  1. Practice Patience and Empathy: Recovery is a marathon, not a sprint. Validate your child’s feelings, even when you don’t fully understand them. If you want to learn more about why validation is important (and how to do it) in your child’s recovery I highly recommend this video on emotional coaching.
  2. Focus on Nourishment, Not Blame: Approach meals and food with a goal of healing and restoration, rather than criticism or punishment.
  3. Prioritize Your Own Well-Being: Supporting a child through an eating disorder is emotionally taxing. Seek support for yourself, whether through therapy, parent groups, or trusted friends.
  4. Communicate Openly With Your Child: Foster an environment where your child feels safe to share their thoughts and feelings without fear of judgment.

A Final Word

As daunting as this journey may seem, remember that recovery is possible. By equipping yourself with knowledge, support, and compassion, you can help your child reclaim their health and happiness. Keep taking it one step at a time, and don’t hesitate to reach out for help when you need it. You are not alone in this fight—and neither is your child.

Do you have a teen who is struggling with an eating disorder? Working with a therapist who is experienced in Family-Based Treatment can help. If you are in Texas and interested in working with me, click here to fill out a contact form.

Book Review: Binge Eating Disorder: The Journey to Recovery and Beyond is a Must Read

Book Review: Binge Eating Disorder: The Journey to Recovery and Beyond is a Must Read

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Binge Eating Disorder: The Journey to Recovery and Beyond by Amy Pershing with Chevese Turner, seamlessly blends clinical knowledge with the lived experiences of those affected by BED, making it an invaluable guide for individuals experiencing BED and their families. Divided into three parts: understanding BED, addressing its root causes, and finding sustainable recovery strategies, this book is a must read for anyone looking for an insightful and compassionate resource on binge eating disorder (BED).

Understanding Binge Eating Disorder

Binge eating disorder (BED) is the most common eating disorder, it can develop at any age, often in childhood, and can impact people across diverse identities and backgrounds. It is characterized by recurrent episodes of eating unusually large amounts of food in a short period, accompanied by feelings of loss of control. 

BED affects an estimated 2.8 million individuals, making it the most prevalent eating disorder in the United States. Despite its high prevalence, BED often goes undiagnosed or misunderstood, in part due to societal weight bias and outdated treatment paradigms. 

Understanding Binge Eating Disorder Symptoms

BED is not a one size fits all diagnosis, and can often affect people in unique ways, but there are some hallmark symptoms that are commonly observed, which include:

  1. Frequent Episodes of Binge Eating:
    • Consuming more food than most people would in a similar time frame and situation.
    • Feeling unable to stop eating during a binge episode.
  2. Emotional Distress Around Eating:
    • Intense feelings of shame, guilt, or embarrassment during or after binge episodes.
    • Experiencing disgust or self-loathing related to eating habits.
  3. Behavioral Indicators:
    • Eating rapidly or at an unusually fast pace.
    • Eating until uncomfortably full.
    • Consuming large amounts of food even when not physically hungry.
    • Preferring to eat alone to hide the behavior from others.
  4. Physical Symptoms:
    • Fluctuating weight due to consistent overeating and undereating.
    • Gastrointestinal discomfort or other health issues linked to excessive eating.

If these symptoms occur at least once a week for three months, it could indicate BED, and you should talk to a trusted care provider.

Who experiences Binge Eating Disorder?

BED doesn’t discriminate—it can affect people of any age, gender, race, or socioeconomic background. Please note that people of all body sizes can experience binge eating disorders. 

Why is Binge Eating Disorder: The Journey to Recovery and Beyond by Amy Pershing with Chevese such a powerful resource?

  1. It Addresses the Root Causes:
    Authors Chevese Turner and Amy Pershing provide a thorough explanation of how the diet industry, weight bias, and weight stigma all work together to contribute to the development and persistence of eating disorders. Many individuals with BED have endured significant weight stigma and bullying, which often begin in childhood. Tragically, these experiences are pervasive in peer groups, families, and even healthcare settings. In an attempt to avoid further stigma, many people turn to dieting as a way to change their bodies, but this often worsens their relationship with food and deepens the cycle of disordered eating. It is estimated that up to 70% of those experiencing binge eating pursue weight loss services often making the eating disorder worse. They also delve into systemic oppression and its role in fostering BED.

    The book also makes it clear that effective treatment for BED lies in psychological support and nutritional rehabilitation—not weight loss interventions.

  2. It Makes Sense of Binge Eating:
    Within the chapter “How BED Happens and Why It Makes Sense” Pershing and Turner offer a groundbreaking discussion of the nervous system and its stress response. They explain how binge eating functions as a coping mechanism, helping individuals feel safe during times of stress or overwhelm, which helps to make sense of binge eating as an adaptive (though ultimately unhelpful) response, which in turn can foster self-compassion and reduce the shame often associated with this behavior.
  3. It Offers Inspiring Personal Narratives:
    Chevese Turner courageously shares her story of binge eating, starting from her childhood experiences with food. Amy Pershing complements this narrative with her years of clinical expertise, sharing lessons from her work with clients in recovery. These interwoven stories remind readers that they are not alone in their struggles. By reducing isolation and shame, the authors create a sense of solidarity and hope.
  4. It Provides A Roadmap to Recovery:

    Binge Eating Disorder: The Journey to Recovery and Beyond offers a framework for improving readers’ relationships with both food and their bodies. Rather than prescribing rigid meal plans, it focuses on reclaiming a sense of self. Chevese Turner and Amy Pershing introduce concepts from Internal Family Systems (IFS) therapy, such as “parts work,” to help readers understand their binge eating behaviors and work toward recovery. They also address body shame and body image distress, reframing the body as a home—not an object to be judged, but a vessel for experiencing life, joy, and even pain.

    The authors critique diet culture and thin privilege, empowering readers to navigate these societal pressures while staying true to themselves.

  5. It Expands Perspectives:
    One of the book’s greatest strengths is its ability to broaden readers’ understanding of binge eating. Binge Eating Disorder: The Journey to Recovery and Beyond explores how societal and systemic factors influence BED, and help to shift the focus away from individual blame and toward a more compassionate, holistic view.

I wish I had discovered it earlier—it would have allowed me to recommend it to more clients sooner. Those I’ve shared it with have found it incredibly helpful and affirming. If you are experiencing binge eating please consider reaching out for support.

Whether you’re a generalist clinician seeking to understand better binge eating disorder or an experienced eating disorder specialist, this book deserves a place in your professional library. Once you read it, you’ll feel confident recommending it to clients with BED—and they’ll thank you.

Text in the bottom left corner reads "Treating Anorexia Nervosa in Teens: The 5 Tenets of FBT" and the rest of the graphic shows a stock photo of a white woman hugging a teenage girl on a couch.

Treating Anorexia Nervosa in Teens: The 5 Tenets of FBT

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You may feel confused, scared, frustrated, and maybe even hopeless if your teen has an eating disorder like anorexia nervosa. You have seen your fun-loving and bright teen change drastically, becoming a shell of their usual self. 

There are many types of treatments for eating disorders that work for teens and their families. Cognitive behavior therapy (CBT), dialectical behavioral therapy (DBT), Family-Based Treatment  (FBT), and Acceptance and Commitment Therapy (ACT) are a few of the common treatment modalities that are used in eating disorder recovery. Additionally, there are different levels of care available for those with eating disorders, such as hospitalization, residential, partial hospitalization, or outpatient treatment.

Looking at all of the treatment options for anorexia nervosa in teens may feel daunting.

In this article, the focus is on family-based treatment (FBT), one type of treatment for eating disorders that is used for treating anorexia nervosa in teens. In particular, this article discusses the nuances of family-based treatment, which are referred to as the “Tenets of FBT”. 

The focus of FBT is to empower you, the parent, to provide nutrition rehabilitation and restore your child back to health with the guidance of a treatment team. FBT is an outpatient treatment that can be used in place of residential treatment or partial hospitalization if your teen is medically stable. That means your teen can stay at home during treatment. 

The tenets of Family-Based Therapy guide me as a clinician, and you as a parent, during eating disorder treatment and recovery. When working with families and teens throughout treatment I refer to these guiding principles frequently.

5 Tenets of Family-Based Treatment for Anorexia Nervosa in teens

Agnostic view of the eating disorder

In FBT, the focus shifts from why your teen developed the eating disorder to treating the eating disorder.

Eating disorders are complex disorders and can develop for a myriad of psychological, biological, social, and medical reasons, and beyond. The parents and the teen are not to blame for the eating disorder. I know it may feel like your teen is choosing their eating disorder because they are restricting food or purging, but they are not.

Additionally, parents don’t cause eating disorders-so let yourself off the hook.

How this is helpful:

It reduces blame, guilt, and shame for the teen, as well as their parents. It focuses on stopping the eating disorder in its tracks, restoring your teen’s health, shortening the length of illness, and preventing the eating disorder from becoming chronic. 

This is similar to if you found out you had cancer. You or your doctor initially wouldn’t spend a lot of time figuring out why you have cancer but rather focus on how to treat the cancer. Treatment for an eating disorder is similar, including for anorexia nervosa in teens.

Externalization of the illness

Externalization of the illness is a tool to understand that the eating disorder is separate from your teen. Although it may appear on the surface that your teen is refusing food, it is the anorexia that causes the food refusal. 

Externalization is commonly utilized in the treatment of OCD, schizophrenia, and other mental health conditions. 

How this is helpful:

This helps families understand how to separate their loved one from their eating disorder which can reduce blame and shame. The spirit of treatment feels more like us (family and teen) vs. the eating disorder, in contrast to parents vs. the teen. FBT helps you call on your years of parental experience and wisdom to help heal your child.  This can often increase parental empowerment leading to more successful nutrition rehabilitation.

An increase in connection between parents and teen is what I have observed when working with families during eating disorder treatment. Increased connection can contribute to improved physical and mental health for the whole family.

The therapist takes a non-authoritarian stance

In traditional adolescent-focused therapy, the therapist works predominantly with the teen, and the therapist is leading the treatment. In contrast, in FBT, the therapist acts more like a coach.

“The therapists are experts on eating disorders and parents are experts on their family and teen,” is something I learned during my training in FBT.  This lends itself to high amounts of collaboration between the therapist and family. Additionally, FBT utilizes the strengths of the teen to help aid in the healing process.

How this helps:

FBT is “not a one size fits all approach” to treating anorexia nervosa in teens. In Family-Based Treatment, the therapist activates the problem-solving skills of the family.

In other words, the therapist is there to help guide you and your child through recovery – but you know your child best and what has helped them with other struggles in the past. This knowledge is essential as you work together toward recovery.

Additionally, FBT appreciates the uniqueness of each family and their teen including culture, gender, abilities, exceptionalities, neurodiversity, religion, and family values to name a few.

Parental empowerment

Simply put, parental empowerment means that parents feel confident about taking care of their children. Some parents have some experience with feeling empowered with things like setting a curfew, boundaries around school work, and expectations around chores, while others might second-guess their parenting choices. FBT is an opportunity for growth in this area.

One of the tasks of the FBT therapist is to help you harness the skills and confidence that you already have as a parent, and apply them to renourishing your teen. 

How this helps:

Empowered parents can be more effective at renourishing their teen. Since you, as the parent, are in charge of feeding your teen, it reduces distress and second-guessing about what and how much to feed your teen. 

Furthermore, empowered parents provide structure, consistency and boundaries that help children and teens thrive. 

Pragmatic approach

The initial focus of FBT is symptom reduction rather than focusing on why the eating disorder developed. In the case of anorexia nervosa in teens, parents are tasked with the nutrition rehabilitation of their child, similar to the staff at a residential treatment center. This allows the family to stay together during treatment.

How this is helpful:

This approach stops the eating disorder from getting worse, which can lead to medical complications or potentially death. Stopping the eating disorder behaviors will help keep them from becoming habitual for your teen.

One hypothesis for why eating disorders develop is that eating disorders have a function. That is, they are helpful in some way, despite causing physical harm. For example, if someone smokes a cigarette, although the cigarette is physically harmful, it reduces stress for the smoker in the short term. Eating disorders are thought to function in the same way.

In my work, I have witnessed families rally around their teens, and through connection and compassion help their teen develop new skills to manage life stressors so the eating disorder is no longer needed.

Do you have a teen who is struggling with anorexia nervosa? Working with a therapist who is experienced in Family-Based Treatment can help. If you are in Texas and interested in working with me, click here to fill out a contact form.

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Levels of Care in Eating Disorder Treatment: How to Choose the Right Option

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Treatment for eating disorder recovery isn’t a one-size-fits-all approach.

Every person is unique, and not everyone recovers in the exact same way. This is why eating disorder treatment is categorized into different levels of care, depending on what the person in recovery needs.

This post will provide a brief overview of the different levels of care available during eating disorder treatment.

What are levels of care?

Levels of care refer to how much support is needed to reduce eating disorder behaviors during treatment. Several levels of care may be utilized throughout treatment for an eating disorder, based on what is necessary for the person in recovery.

Treatment choices can be overwhelming if you or your teen are newly diagnosed with an eating disorder. Residential, day treatment, or outpatient care – what does this all mean?

Levels of care in eating disorder treatment are selected based on many factors including:

  • Medical: This often is the driving factor in selecting the level of care. If you or your teen are medically compromised more care may be needed.
  • Severity of malnutrition: Different levels of care offer varied amounts of support for nutrition rehabilitation.
  • Co-occurring conditions: Often those with eating disorders have other medical or psychological conditions that also need to be treated.
  • Social support: Social support improves mental and physical health. The different levels of care offer varying levels of social support.
  • “Motivation”: Most of us want to feel better and be healthy. However, change can feel scary, overwhelming and downright impossible at times. Those who feel more stuck in their eating disorder may need more support to feel like change is possible.
  • Access to care: Proximity to treatment, insurance, and specialty care are all considerations. Virtual treatment by clinicians and treatment programs are being utilized to increase access to care.

What are the different levels of care in eating disorder treatment?

In-patient hospital care

In-patient hospital care is used when a person with an eating disorder needs round-the-clock medical care. Since eating disorders have significant medical consequences due to malnutrition and/or purging, medical stabilization may be needed during treatment.

Residential care

In this level of care, round-the-clock care is provided in a therapeutic environment. This allows for intensive psychological treatment and nutrition rehabilitation, while also monitoring medical status. The residential care environment is highly structured and allows for the reduction of eating disorder behaviors.

Partial hospitalization

In a partial hospitalization program, the person attends several hours per day most of the week. Partial hospitalization provides psychological treatment (individual therapy, group therapy, and family therapy) and nutritional therapy, including therapeutic meal support. This level of care is very similar to residential care, just without spending the night. In this level of care, you or your teen may go in several days a week, and each day have a meal or snack at home.

Intensive out-patient (IOP)

This level of care is when you or your teen spend the majority of time at home and engaged in usual activities such as work or school. The person in eating disorder treatment usually has a therapist, dietitian, and doctor and attends several groups per week.

Outpatient

Outpatient care is considered the lowest level of care in eating disorder treatment. In this level of care, you or your teen are spending 2-3 hours a week in treatment with an outpatient treatment team. Oftentimes, outpatient services are utilized first because it allows the person in treatment to stay active in daily activities such as work or school. Outpatient care can be easiest to access because most areas, particularly with telehealth options available, have qualified eating disorder outpatient providers.

Family-based treatment (FBT) is an outpatient treatment for teens. It is particularly effective for teens with anorexia nervosa. FBT can be an option in place of residential care or partial hospitalization, if the person in treatment is medically stable.

How do I know which level of care is right for me?

First, consider your medical needs with your doctor. The more medically compromised the person with the eating disorder is, the higher level care they may need.

If residential treatment is recommended, that doesn’t mean the eating disorder is worse than others. It just means that you need this level of support to get back to health.

If you or your teen are utilizing outpatient care, your treatment team will work with you to help determine the level of support needed.

Many treatment centers provide multiple levels of care residential, partial-hospitalization, and IOP. The treatment center will help determine the level of care needed via an assessment, which is usually free and done over the phone.

It is not unusual to utilize multiple levels of care during the course of recovery.

For example, someone in treatment may start out as an outpatient. If the person in treatment and their treatment team determine that their eating disorder symptoms are not getting better, they may benefit from a more supportive level of care (which is also referred to as a “higher level of care”).

Eating disorders usually don’t go away on their own. They can progressively get worse over time. My hope is that if you, or someone you care about, is suffering with an eating disorder that you make the initial call to get help.

Hi! I’m Alison Pelz, a psychotherapist and registered dietitian in Austin, TX with over 16 years of experience in eating disorder treatment.  If you or someone you care about is struggling with an eating disorder, don’t hesitate to reach out for help. To learn more about eating disorder treatment and levels of care, schedule a consultation with me today.

Are you a clinician? Sign up for my mailing list and get a coupon for 10% off of one of my CE courses!

Book Review: When Your Teen Has an Eating Disorder is a Must-Read

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In the book When Your Teen Has an Eating Disorder: Practical Strategies to Help Your Teen Recover from Anorexia, Bulimia, and Binge Eating, author Dr. Lauren Muhlheim discusses eating disorders and their treatment in great depth.

If you think your child or teen has an eating disorder this is a must read.

Eating disorders can perplex many parents and clinicians alike. Your teen may not be acting like their usual self, and it’s hard to know if this is just normal teenage angst or something more serious. If your teen has an eating disorder, they may have changed greatly right before your eyes: refusing food, feeling anxious around eating, or experiencing changes in mood and energy.

You may have tried several times to talk with them about the importance of eating and try to reassure them that they are not gaining weight. (In fact, they are likely losing weight.) But, your child’s struggles seem to be getting worse not better.

If your teen has not seen a doctor yet about their eating disorder this is the first step to make sure they are medically stable.

This book can help guide you and your family in treatment while establishing an eating disorder treatment team consisting, at minimum, of a doctor and therapist.

About the Book

When Your Teen Has an Eating Disorder discusses the complicated concepts surrounding eating disorders in teens in a non-clinical manner, so it can be more easily understood. The book provides helpful information about eating disorders, an overview of various treatment options, and goes into depth about a unique and well-studied treatment called Family-Based Treatment (FBT).

The author of the book, Dr. Lauren Mulheim, owns a counseling and training center in southern California called Eating Disorder Therapy LA. She uses Family-Based Treatment in her clinic and has been instrumental in training many of the eating disorder therapists in the Los Angeles area and beyond. She is currently serving on the advisory panel of FEAST (an organization providing support to families of those impacted by eating disorders) and is a regular speaker at national eating disorder conferences.

If you are a parent worried about your child and unsure how to help them overcome their eating disorder, or a clinician wanting to learn more about FBT, this book is a must-read. As an eating disorder therapist myself, I recommend this book to all of the families that I work with and to other clinicians. It will be a great resource and provide a glimmer of hope to you on your journey.

What is discussed in When Your Teen Has an Eating Disorder?

When Your Teen Has an Eating Disorder outlines the complexities of eating disorders and the impact that they can have on your teen (and your family’s) life.

A thorough list of the early warning signs of an eating disorder are discussed. These warning signs include:

  • Changes in eating and/or exercise habits
  • Frequent trips to the bathroom
  • Changes in body weight
  • Loss of menstrual cycle
  • Complaining of of feeling cold all of the time
  • Lack of growth
  • Obsessive thoughts about food, body image
  • Changes in overall mood
  • Poorer concentration

Muhlheim highlights the importance of early detection and intervention with trained clinicians, so that the eating disorder can be addressed before it escalates or becomes chronic.

Dr. Muhlheim provides the reader with an excellent explanation of how malnourishment impacts your teen’s ability to understand how the eating disorder is impacting their mind and body. Parents often feel perplexed when their bright, loving child begins to act irrationally around food. Parents will also learn how to separate their child from their illness, one of the basic assumptions of family-based treatment.

The majority of the book really gets to the heart of the matter: What parents really want to know when their child has an eating disorder. You might be asking yourself questions like “What do we do?” or, “How do we improve our child or teens’ health and get them feeling better again?”

This book can help you answer those questions. In it, Mulheim:

  • Outlines the path to help your child or teen heal from their eating disorder using family based treatment (FBT). Parents will then learn what the path to recovery from an eating disorder looks like using Family-Based Treatment.
  • Discusses the three stages of recovery-nutrition rehabilitation, eating independence and relapse prevention-in depth.
  • Provides parents rationale behind each step so parents can feel empowered to help their child.

Discover Practical and Helpful Tools to Help Your Teen in Eating Disorder Recovery

This book is a practical guide that provides effective, concrete strategies for eating disorder treatment, and examples of how to use them.

Muhlheim helps parents become empowered agents of change amid their child’s eating disorder. The book provides general guidelines about what to feed your child and how to structure meal times. It also highlights how to effectively interact with your child at each stage of treatment, and how to be empathetic with them when they are struggling.

Not only does this book share concrete strategies and practical steps, it also covers the challenges that parents might face during treatment. The book details what to do when your child refuses to eat. It also explains how the parents can get support throughout the difficult journey of helping their child get better. This helps parents know about the hard aspects of treatment they should expect beforehand, so that they are prepared.

Muhlheim provides all of this information while also sharing real-life examples throughout the book. The stories within this book help parents feel less alone about what is going on with their child. It also provides them with a realistic picture of what they are facing. These examples make parents feel more confident about applying the practical tools needed for recovery.

It is normal for parents to worry about how treatment will affect their relationship with their teen. When Your Teen Has an Eating Disorder emphasizes the importance of your relationship with your teen in the treatment of their eating disorder.  It talks about how to further develop a family culture of unconditional acceptance and respect and focuses on the importance of trust, empathy, and understanding to support your child in their recovery. Furthermore, it provides the reader with strategies of how to talk to their teen about food and body image during the recovery process.

When Your Teen Has an Eating Disorder is a Great Resource For Parents

Whether your teen is struggling with anorexia, bulimia, or binge eating disorder, this book is helpful for parents. This book will help you if your child is newly diagnosed with an eating disorder, in early stages of treatment, or if your teen has been through several rounds of treatment already.

This book will empower you to support your child’s recovery. If you are seeking treatment for your child, it will give you enough information to decide whether or not Family Based Treatment is right for your family. If you decide that FBT is the best treatment option, this book walks you through how to create a treatment team that will be the best fit for your child and family.

As a therapist and parent, I appreciate how this book (and FBT in general), takes a very non-blaming stance on eating disorders. Parents aren’t faulted for the disorder and the child isn’t isolated from their family. This book recognizes the family-based treatment approach and belief that parents are the experts on their child. It emphasizes how treatment for eating disorders needs to include the family for best results and also the importance of meal support and nutritional rehabilitation for recovery. I highly recommend reading this book!

If you think your teen has an eating disorder please consult their doctor for assessment and medical care as eating disorders can be life threatening. If you are a parent and are interested in family-based treatment for your child in Texas, you can schedule a consultation with me here.

If you are a clinician looking for a book that can help you understand eating disorders and family-based treatment, you can get CEU’s for reading this book by clicking here.

*Please note this book is not a substitute for professional help from a doctor and eating disorder treatment professionals.