How do you get your child to eat in spite of anorexia or a restricting eating disorder?

Last updated on June 21st, 2020

This is a section from Chapter 7 of 'Anorexia and other eating disorders – how to help your child eat well and be well'.

Note that I outline key points in my free helpsheets and on my page: 'How can I get my child to eat'.

You can also hear me explain and demonstrate tips in my Bitesize audios.

For some parents, a few tips are all that's needed. For others it's really useful to read or listen to a lot more around the whole subject (hence my book and my Bitesize audios), because so many things impact your child's ability to eat.

Your child may well feel terror when faced with food

It can seem impossible to get your son or daughter to eat when they're suffering from anorexia or another restrictive eating disorder. Yet refeeding is essential in the early days of treatment. In this chapter I give you all the tips I’ve learned from experience, from our therapists and from other parents. I’ll use a bungee-jumping analogy to illustrate the principles. Later, I’ll offer some examples using practical scenarios of refeeding and of exposure to scary (fear) foods.


In the early days, most of us find it impossible to get our children to eat. We desperately hunt for treatment, and when we find it we’re brought round full circle: we, the parents, are the people at the centre of our child’s recovery. We need to learn how to get our kids to eat.

The tools I’m about to offer you got my child from eating practically nothing, to eating what she needed. They saw her through a whole list of foods she couldn’t previously eat, and freed her up to enjoy other people’s cooking and meals in cafés. These tools deal with fear and irrationality, so they’re relevant to many of the challenges of anorexia and related eating disorders, including the drive to exercise or to engage in obsessive-compulsive behaviours.

Some of what I suggest may not be for you, and that’s fine. We’re all different. Different situations, different resources.

And now, prepare yourself. I’m going to invite you on a bungee jump. I hope you are suitably terrified!

Actually I have no intention of raising your stress levels and I’m going to take very good care of you. The aim of this thought experiment is to help you empathise with your child, so that when you’re in the middle of a meal the tools come to you instinctively and you don’t have to go and consult a book.

The great bungee-jump thought experiment

Your child’s resistance is driven by fear

One day I realised that just about every mealtime obstacle my daughter threw at us was driven by fear. This changed everything. Her behaviour might have looked like contempt, or stupidity, or rudeness, or defiance, but the eating-disorders specialist coaching us suggested that the underlying emotion was fear.

“Before, we knew she was having rages and tantrums, however, on the multi-family therapy week we have all learned together that it is fear and anxiety.”


The bungee jump analogy - help your anorexic son or daughter to eat
Photo credit, and a very relevant description of the bungee experience: Thank you to www.roamingaroundtheworld.com

[Jumping to another section of the chapter…]

Logic doesn’t work

I do hope my friend won’t try logic to get me to jump. I can’t think of anything more stressful than having a geek rabbiting on about Hooke’s law, while I’m staring down into the abyss. Is that Young’s modulus he’s talking about now? He is seriously getting on my nerves. All I can think is, ‘I cannot take that leap. It’s too hard.’ My friend says, ‘But the elastic cord will hold you. Remember when we did Newton’s laws in school?’ I don’t like the look of the rope. It looks frayed. Yes, I’m sure it’s frayed. And it looks too long. I’m going to crash headfirst into the riverbed. My friend is getting impatient. I play for time by starting an in-depth argument about the elastic’s tensile properties. My friend gets annoyed that I am so dense about the laws of physics, which gives me a good excuse to let off steam and scream at him. I am glad to note that while we argue, he’s not making me jump. I simply cannot jump.

When we are scared (and our children are scared at each meal), our brain cannot engage with intellect or aspirations. We are thrown in a state of fight, flight or freeze, which prioritises safety (see my short YouTube video on this subject.)

I still squirm when I recall that I once produced a colourful chart to show my daughter the humongous number of chocolate éclairs needed to gain just half a kilo. She looked at them and nodded wisely. Then she refused the next meal.

Parents quickly discover that rational talk at mealtimes doesn’t work. In Chapter 8 I’ll show you how to avoid discussing calories, quantities and metabolism. Logic may have been a good-enough tool in your toolbox for ordinary life, but with any situation where emotions run high, it’s as much use as an ashtray on a motorbike.

[End of extract from the chapter]

In this chapter:

  • The great bungee-jump thought experiment
  • Planning the challenge
  • Logic doesn’t work
  • Education: the dinner table is not a lecture hall
  • Eating prompts work best
  • Conversation topics: pick with care
  • Distraction: a firm favourite
  • Reassurance: suprisingly not reassuring
  • * Pause for self-connection *
  • Trust me, I’m an expert
  • Shock tactics: short-lived gains, high costs
  • Shouting, intimidating, blaming: counterproductive
  • Threats, punishment, and ‘consequences’: unnecessary
  • Rewards and bribes: handle with care
  • Incentives: a nudge in the right direction
  • Visualisation: access to inner resources
  • Praise: complex and risky
  • ‘It’s your medicine’: worth a go
  • Damage limitation: blame something other than your kid
  • Teamwork: have a break, make a graceful exit
  • Containment: stay close
  • Humour: the best relaxant
  • Feelings: a good start
  • Empathy: powerful when focused on the task
  • * Pause for self-connection *
  • Selective hearing, body-swerving and translation skills
  • Mirroring: model calm confidence
  • Defusing fear: remove the fear of fear
  • Notice indicators of progress
  • Wait a few minutes
  • How long should you persist?
  • Focus on the current step in the present moment
  • Let your kid save face and maintain some dignity
  • All singing from the same hymn sheet
  • Giving uncritical acceptance
  • Putting it all together

Onwards

* How can I get my child to eat? A short piece with key tips*

* Lisa's Tarzan leap for her daughter: facing anorexia fear. A mother's story to help you empathise. *

* Go to Table of contents *

* Next:  chapter 8: See the tools in action: mealtime scenarios *

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24 Replies to “How do you get your child to eat in spite of anorexia or a restricting eating disorder?”

    1. Dear Sara, that's a painful question which I know well. First, even with the best of skills, some of our children just cannot eat with us, and need a spell in a higher level of care. If she won't take even one bite, that sounds urgent. Even if she's eating a little, but isn't eating enough and you can't shift that, you can't allow this to go on for too long. If she's already had a spell in hospital, this time get more help on the transition back home, so as to stop the revolving door. More in my book, starting around page 255. Also there's an account from a mother here describing a hospital that really did take care of the transition.
      I do give lots more tips to help get that first bite started, and then to keep going. Lots in my book and in Bitesize, and also a summary in my free helpsheets. I really feel for you and wish you some progress very soon.

  1. Eva
    What are your thoughts on this? My son repeatedly asks me to confirm how thin he is and wants me to confirm his bones and veins are showing before he will eat. Am I doing him harm confirming these facts? He refuses to eat without this confirmation. (He is back at the refeeding stage having lost 5kgs). I think getting him to eat is the priority but I’m not sure if I’m causing him future harm confirming these thoughts.

    1. Dear Becky, see https://anorexiafamily.com/fat-question/ where I give various options, pros and cons. I have a section on "Am I fat?" in my book and this link is me checking a revision I want to make to it for a number of reasons. When I first wrote my book, I thought that yes, eating and weight gain is the priority, so if confirming he's thin gets the next meal in, then great. At the same time you are right to consider the future, so see if my revision is helpful, and I'll be glad for your feedback.
      Wishing you successes for today!
      Eva

    1. Dear Rebecca, I hope your daughter's diagnosis means she is now getting good treatment. Wishing you lots of good things as soon as possible.
      Eva

  2. Hello
    Our daughter (13) was diagnosed in July with AN. We managed to keep her in school and have got her up to her healthy weight. She’s dipping in weight at the moment because she has been given control back and is struggling.
    My question is this: she has daily meltdowns, they end in hitting, screaming, throwing things, it’s like she’s been ‘possessed’! Camhs tell us this is normal for an anorexic and can go on for months/ years. Is this anyone else’s experience? Reading other people’s accounts, I think I should be happy she is eating ( but not enough) has not been admitted to hospital and has been continuing with school. She also refuses to go out with friends – is this usual too? She’s too anxious.
    Many thanks.

    1. Hello Kirsty, well done for having got her weight back up. I'll do my best to give you pointers, though please remember I don't know the details of your situation!
      So far you've succeeded in weight restoration. That's only part of the treatment. If she is having meltdowns and her weight is dipping, it sounds to me like you are still in the first phase of treatment, where parents need to be in charge of food and of eating-disorder-related behaviours. The meltdowns may be because she is still scared of eating, or very hungry (if her weight has dropped she will be hungry and anorexic thinking will be heightened), so it sounds to me like she continues to need the kind of support you gave her since July.
      "She has been given control back" sounds like it could be too much, too soon.
      When she's more able to eat what she needs without a fight, you will enter phase 2 of the treatment, which is indeed about giving her control back BUT only at the rate she can benefit from it. You will be doing experiments in giving her small amounts of autonomy around food, one at a time, and adjusting depending on how each experiment is working. All this is in my book, so I hope you will get a lot more from that.
      I would say that for most young people, the meltdowns die down as their fear of food reduces. So it could go on for a few more weeks or months, but reducing in frequency and intensity, and no way should it go on for years – that would imply she is not responding to treatment! So it sounds to me like you need to re-focus on supporting her to eat, keep an eye on that weight (is the weight target generous enough?) and do the work of taking her through fear foods (that's in my book too).
      Do check that she has a regular input of plentiful food throughout the day, especially if she is not supervised in school. If she is skipping a decent lunch you can expect meltdowns, and it would also hold back her recovery.
      Anxiety is common and yes, anxiety and anorexia both mess up social life. This may all disappear as her weight and eating stabilise and she can better engage with life. If the anxiety persists even after she's eating easily, then CAMHS would probably offer her individual treatment for anxiety. But don't rush into that – best to concentrate on the eating disorder for now. So… keep up the good work …you can certainly be happy and proud you got her this far. I hope this helps you in the next steps. Feel free to show this to CAMHS – if they disagree with details, it's best out in the open!

    2. Thank you for your reply. She is at the end of phase 1 and it is Camhs that have overseen her gaining back control, but it probably has been too much too soon. You’ve put it back into perspective for us. Thank you.

  3. Tia, I am so with you about how horrible eating disorders are, and the need for people to feel supported and understood. I imagine that this is something you dearly long for for yourself, and I am sending you warm wishes.

    I dearly hope that my book shows how our children can receive so much loving support and understanding and a whole range of possible strategies to help parents find a way to help their child regain weight, so as to get the best chance of recovery. The strategy you are suggesting will be useful for many people much later on in treatment, when they are increasingly able to take care of themselves and to practice doing so.

    On the other hand it can often be unhelpful in the acute stages, when the person is unable to eat enough for weight gain when they have a lot of choice. Parents often find that when they give choices, their son or daughter is anxiously trying to reduce their intake and the trend tends to be downwards. When parents take charge, their child also goes through anxiety, but after a while the anxiety is reduced because there's less internal conflict – plus, at least we know the person is on the path to freedom thanks to the better nutrition and weight gain.

    Parents who use my book or videos tell me they really get how scary and horrible it is for their child. If you read my book, I hope you will warm to it and see how much care and love we parents put into giving our children their life back.

    As you write that you have an eating disorder yourself, I wish you lots of good things, and in particular, lots of understanding and support.

  4. As somebody with an eating disorder I can just encourage all parents don't force your children too eat food or try food
    Try asking them too help you cook or they can choose what's for dinner. Make them feel supported and undeestand not forced and pushed
    Eating disorders are horrible!

  5. Am so glad i stumbled over this site. My daughter was addmitted to hospital with eating problem we felt so alone. We have no idea how to help but reading the comments has made me feel a bit better will try to download uour book.

  6. My daughter (13 years old) is in the early stages of the refeeding.
    She said that the last two weeks were the worst of her life..
    Sometimes she simply close her mouth and stop eating saying that she cant eat.
    What is the best approach to this situation?
    Thanks

    1. Jorge, you're at the most horrible stage, and it's so hard for all of you.
      My best ideas and suggestions are in the book, so I'm wondering what more to suggest for your particular situation.

      Something that is positive is you say she stops eating.
      So I'm guessing that means you managed to get her at the table, you've made it OK for her to sit down, and she has managed to eat something before stopping. Apart from the stopping, these are real successes. Notice what you've done that might have supported her to do all that, and keep doing it. Seriously. In the early days there were times I couldn't get my own daughter to even begin a meal.

      It's great she's telling you she "can't eat", as she is probably telling you 100% her truth. I mean, it's more direct than "I don't need to eat" or "This will make me fat" (which can be expected too). You can tell her you believe her. That you really hear that to her, eating seems totally impossible, and at the same time you know that eating is safe and is exactly what she needs, and you are there to help her, one bite at a time. That way she feels heard and understood and it helps build trust so she can accept your support, meal after meal.

      What may help you, as you support her, is to ask her to have one more bite than she thinks she can manage. I know from your email to me that she is under clinical supervision, so at least she is safe, which means you can try and not panic when she doesn't manage enough food right now. You can only do what is possible, and you are busy learning as fast as you can. I am guessing that although you want her to eat 100% as soon as possible, it may take this one-bite-at-a-time process for a few meals before she really manages to eat quite a bit more and you can breathe more easily.

      She's also telling you these last 2 weeks are the worst of her life. Whether she's screaming it at you or crying (you don't say), hear how she relies on you to be helped, to be understood. Pretend you're an expert already (you will be soon) and tell her this illness is treatable, that you know what to do, and that you will support her all the way through.

      I hope this gets you going for now and send you all my best wishes.
      Eva

  7. Sounds like you have hope as well as resources to help you shift things. I dearly hope that by now you've experienced some kind of success, even if it's just a tiny step in your daughter's ability to take a bite of something else, or in your ability to be by her side, no matter what. I would love to know and send you warm wishes.

  8. Thank you.
    My daughter is only eating oranges and aiming for a weight of 32kilos. Your word have given me some hope to work thru this

  9. Hi Eva,
    you referred me to your site on ARDT forum
    This is EXCELLENT advice, so wise and well worded
    Thank you again
    SnP

  10. Lia, that's most encouraging feedback, thank you. I like to know the humour is OK even though eating disorders aren't funny, and that the bungee jump analogy will help concepts stick in a parent's mind.

  11. I love your use of humour and I think the analogue with the bungy jump is very powerful. This makes it easy for parents to remember waht to do and what not to do during a stressful time. Thank you Eva

  12. You sound like you're up for taking an active role at home, and you'd like to know that's a realistic plan and that you could make it work? What I can tell you is that many other parents have done this, so it's definitely not cloud cuckoo land. It doesn't matter whether your daughter thinks it will work or not: either way she's bound to put up resistance because that's the nature of the illness. But it's a pleasant start that she'd like to come home (we didn't have that luxury). Ideally you'd want to be ready, well supported, and continue to have some kind of medical set up, as this will see you through the ups and downs. Note this article by Harriet Brown on following an FBT approach with a non-FBT team: http://maudsleyparents.org/workingwithanonmaudsleyteam.html

    On the other hand, is there a chance that her residential unit could work for her if, I don't know, communication was improved, something was changed? Either way you'll still have work to do when she's discharged – we certainly did – so it's useful that you're getting yourself psyched up and ready.

    What would you think of asking the same question on the Around the Dinner Table forum? http://www.aroundthedinnertable.org/
    Then you could give more detail, and you'd receive support from not just me but lots of other wonderful parents. I'll go on and look out for you there in case you decide to do that.

    Thanks for asking about how to get your daughter to stay at the table when she gets up to leave. That was a tough one for us too, and I ought to add this to the book. Rather than answer any old how, I'd like to write it up properly and add it to this website. That might take me a few days. Would that be OK for you?

    Meanwhile, thanks for getting in touch, and for giving me the feedback that what I write makes sense – that's really encouraging – and I'm crossing my fingers for you at this possible time of transition.

  13. Our daughter is in a residential programme at the moment but is continuing to lose weight and we are seriously wondering if they are doing anything that we couldn't do at home. We have talked about her coming home but she has said that although she wants to come home she knows it won't work. Are we living in cloud cuckoo land thinking we can manage this? Also any advice on how you get them to stay sitting at the table when they just get up and leave? I'd love to hear your thoughts – everything you said made a lot of sense!

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