Child and Adolescent Mental Health Services
Information for family and friends
On this page, you will find many resources that you might find helpful to better understand eating disorders, the treatments you may be offered, advice on how to best support your child and managing as a family.
There are many helpful resources available, however we have selected the list below using recommendations from parents who have cared for their own child with an eating disorder.
Finding the right website to help you can be difficult. We’re here to help.
There are online support groups for those with eating disorder and their carers.
There are some great videos available that you can watch online.
We recommend several books written specifically for parents and carers.
Our parent forum meets every few months for an informal and relaxed meeting with two or three members of our staff, to canvass views on all aspects of the current service, discuss ideas for service development and hear your views on research.
The questions below have been created collaboratively by clinicians and parents. These questions are ones we are typically asked most frequently. If you have a question that is not here, please ask your clinician at your next appointment or at your assessment if you are new to service.
Please read our What are Eating Disorders? page for more information on the signs and symptoms of eating disorders.
We do not recommend force feeding. It is very important that your child eats and to achieve this, we use family-based treatment. At the start of treatment, parents take full control of food and eating and provide supervision and support at all meal times. It is important that parents set up an expectation that the food presented to the child must be eaten and eating is actively encouraged throughout the meal. A firm but compassionate approach typically achieves the best result. The eating disorder may push back during meal times but we strongly encourage parents to be ‘bigger’ than the eating disorder.
We have a webpage dedicated to this topic called ‘Advice for parents supporting siblings’. Please click here to read. (add link)
Parents find it most helpful to use reassuring and empathetic comments such as ‘I can see this is difficult for you but you must keep eating’, ‘It’s OK, I’m here with you’. Families also find it helpful to use enjoyable activities during and after meals to help distract your child from difficult thoughts and feelings. These might include putting the television/radio on, playing a game, having a fiddle toy. It is common for young people with eating disorders to feel full and bloated after eating because of a gastric delay. Please see our ‘body map’ to look at the side effects of undereating/being underweight. The feelings of fullness and bloating will reduce as eating increases and becomes more regular. Some young people find having a hot water bottle helpful in reducing these uncomfortable feelings.
We would recommend that you ask your child to use the toilet before the meal so you are able to supervise your child for a period after the meal has finished. This is to prevent any self-induced vomiting or other methods of getting rid of the food.
Excessive exercising is a method that some young people may use to lose weight. The purpose of the exercise is not for enjoyment or fitness, but to burn calories. It can sabotage weight restoration and is an unhelpful behaviour that will maintain the eating disorder. Our recommendation would be to try to eliminate all excessive exercising through parental supervision and monitoring. Some parents have found employing an ‘open door’ policy helpful. This involves the child keeping their bedroom door open so exercising can be monitored. When your child’s eating and health has stabilized, our aim is to work towards getting your child back to enjoyable activity such as team sports or previously enjoyed exercise which are not driven by the eating disorder.
All eating is likely to be feared by your child and the approach to fear foods should not be different to any other foods. There should not be any negotiation in avoiding whole food groups such as carbohydrates (potatoes, pasta, rice) or dairy (milk, cheese, yoghurt) as these are essential for a healthy, nutritional diet. It is unlikely that logical explanations of nutrition will be listened to during meal times. Therefore, it is more helpful to take on a reassuring, calm and compassionate approach that is encouraged in the FBT model. Parents should make decisions about their child’s eating and this should involve all foods that their child previously enjoyed.
This is something that can be discussed with your therapist in the sessions. If the child is finding eating very difficult and there are physical health concerns, parents often meet their child for lunch in the school or in the car. Some schools can offer support with eating lunch.
Having an eating disorder makes it difficult to make healthy decisions about food and eating. The first phase of the family-based treatment involves asking parents to take all responsibility in food preparation and serving. This is to help reduce the burden and distress from your child and to ensure an adequate diet is eaten. Stage 2 of FBT starts once your child has made progress in eating and physical health is stable. This stage involves appropriately and carefully handing responsibility of food and eating back to your child.
In addition to the family-based treatment sessions (if this is the treatment your child is receiving), we also have:
A monthly Parents and Carers group held in Oxford.
A Carers Workshop held four times a year.
The multi-family therapy (MFT) programme also running four times a year
Please speak to the clinicians at CAMHS for more information.
The eating disorder parent group meets on a monthly basis at Raglan House on a Monday evening 5.15pm to 6.30pm. It is an informal friendly group starting with a cup of coffee/tea and providing a forum for parents to discuss their difficulties and concerns and share ideas of what helps. It is facilitated by two members of the eating disorder team and usually starts with discussion of a specific topic (agreed in advance by the parents) as well as having time for informal discussion and support.
Link to leaflet on parents’ group
It is very common for young people to feel there is nothing wrong with them and that they don’t need help. The more you try to persuade them the less they will want to have help. However, if you are concerned about your child you will need to find a way of accessing help in order to give your child the best chance of recovery.
You will need to be clear with your child that it is important for them to attend and that the professionals will listen to them and take them seriously. If you are having great difficulty you may find it helpful to ring the ED team to get advice on what to do.
This varies a lot, depending on how ill your child is at the start of treatment, how entrenched the eating disorder is and to what extent you and your child engage with the treatment. Generally, the family-based approach will take 20 sessions, with the last few sessions occurring at wider intervals. On average, the whole course of treatment will take around a year, however, some young people may recover well before this and others may take longer.
Last updated: 31 August, 2018