How to talk to my daughter with Anorexia Nervosa, Dr Anita Tsang, Public Education Series No. 3 (2013)

Many parents are totally at a loss of what to do when they start to suspect their daughter of suffering from anorexia nervosa  This has never come to their mind as they might have only noticed her eating “healthy “ food and thinking that many teens just want to keep fit. It is not until that she is eating much less and others are commenting that she is losing weight then they become aware that there is a problem. They may think that all will get back to normal by asking her to eat more. Soon they will find out that this not only does not work but in fact make things worse. There are constant conflicts over food. Parents become more frustrated and she is getting thinner. This is because she is suffering from a disease with many complex factors contributing to it.  It is not just about “eating” or “not eating”.

The difficulty in dealing with the situation lies with the paradox that on one hand you need to deal with her eating, yet on the other hand, you cannot just talk about food and weight.  You need to understand her feelings and emotions behind.  Here are a few tips for you.

1. Listen to her. Don’t lecture about food.

• When she talks to you about eating issues, listen to her. Don’t lecture about food. Ask her why she can’t eat, just listen. Don’t correct. She wants someone to understand the struggle she is going through. Just listen. Nod your head or say “uh-huh”. Don’t preach.

2. Avoid placing blame, shame or guilt on her actions or attitudes. 

• Don’t use “you” statements like “You just have to eat” or “You are acting irresponsibly”.
• Use “ I” statements like “ I am concerned about you because you are not eating your lunch.”

3. Avoid power struggles over eating. 

• Do not force them to eat. Do not beg them to eat. Do not criticize their eating habits.  Often anorexic girls are struggling with control in their lives. Do not demand them to change for your sake.  Avoid emotional blackmail. This may make things worse.
• There will be arguments over food and eating. Don’t let them continue.  Respond calmly and firmly. Re-state your expectation. Express your concern. Tell her “we can talk about this later” without any anger.

4. Do not comment on how she looks or how you/others look.

• She is already very obsessed about weight and appearance issues.  Any further comments on these issues will only reinforce her on their importance. 
• Do not say "You are not fat". Instead try to help her to explore what are her fears about being fat and what she wants to achieve by being thin. 

5. Don’t act like a “food police”.

• Many anorexic girls complain that their parents always spy on them to see what they are doing and how much they have eaten. They feel like being put under a microscope. The feeling of loss of personal space suffocates them. They need someone to support them to go through the struggle, not a policeman/calorie counter over the dining table. 

6. Take care of yourself.

• Do not deal with this on your own. Seek help from professionals - the doctors, school teachers, social workers, and counselors. Bring in circle of support – your spouse, your family, your friends or parent support groups. 

Seeking help early will help you to better support your daughter in overcoming the disease and becoming healthy again.

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Disclaimer: This Education Material is for information only. Users will be responsible for making their own assessment of the matters discussed herein which should not replace advices from their health care professionals.

This material is made possible with the assistance from adolescent volunteers. Free download http://hksah.blogspot.hk/