The Role of Family Members in Eating Disorder Treatment

Thrive • August 26, 2021

UNDERSTANDING EATING DISORDERS AS SEVERE PSYCHOLOGICAL ILLNESSES

Without clinical support, it can be difficult for family members to understand their loved one’s eating disorder and all that it encompasses. These severe psychological illnesses are complex, dangerous, and can coincide with other mental health struggles. To make things even more complicated, there are many different kinds of eating disorders, including anorexia nervosa, bulimia nervosa, and binge eating disorder – all of which are unique and require specialized treatment. Left untreated, eating disorders such as anorexia nervosa and bulimia nervosa can cause their victims to systematically starve themselves, which can lead to malnutrition and related health issues.

Thrive Sacramento’s Clinical Director, Dr. Tony Paulson, Ph.D., began studying and treating eating disorders over three decades ago after leading an eating disorder support group. Reflecting on his initial experience with eating disorder treatment, he said, “In essence, the individuals in the support group were dying, and they couldn’t do anything about it. My driving force became to learn as much as I could and develop programming that meets the complexities of these illnesses.”

PROMOTING FAMILY EMPATHY DURING EATING DISORDER TREATMENT

The severity and complexity of eating disorders can be overwhelming and even traumatic for families, leaving them unsure of where to even begin when supporting their loved one’s recovery. Through eating disorder treatment that involves the family as a whole, family members are able to develop a better understanding of their loved one’s eating disorder, learn their active role in aiding their loved one’s recovery, and foster healing for themselves as well as the entire family.

During family therapy and psychoeducation sessions, families can come to accept that although genetic and environmental factors can play a role in the development of an eating disorder, no one is to blame for their loved one’s eating disorder. Additionally, family members can better grasp how eating disorders and their corresponding behaviors change the victim’s brain — cognitively, psychologically, and emotionally. As a result, family members can more easily practice patience with their loved one’s mental, emotional, and physical states as they experience and heal from the illness.

Throughout eating disorder treatment, family members can also come to discern how their loved one uses eating disorder behavior as a means of coping with emotional pain. Dr. Paulson said, “People respond to emotional pain differently. Some starve themselves, some binge and purge, some self-abuse, but pain is pain. We can all relate to human pain.” Once family members have increased insight into their loved one’s eating disorder, they can take a more empathetic role in their loved one’s recovery.

CREATING A STRONG SUPPORT SYSTEM FOUNDED IN FAMILY

Eating disorder treatment can empower family members to support their loved one’s recovery. By creating barriers to the eating disorder, families can help curb and correct their loved one’s eating disorder behaviors with clinical guidance. From there, clinicians are able to dive into the psychological factors that are contributing to the eating disorder. Together, the family and clinicians can form a strong support network as they work to help the individual achieve lasting recovery.

“Humans are social beings. My philosophy in life is that you can’t avoid emotional pain. You can only try to collect a little more love to offset the pain. Once you open yourself up to that love from your community and family, it makes the emotional pain more tolerable and manageable.” said Dr. Paulson.

Thrive supports clients and their families throughout eating disorder recovery. You can learn more about our eating disorder treatment programs and family support by reaching out to us .

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When Mealtimes Become Battlegrounds: How ARFID Impacts Families

August 21, 2025

When Emma was 8, her parents noticed her food choices shrinking. At first, they assumed it was just picky eating — “She’ll outgrow it,” friends said. But by 10, Emma would only eat crackers, cheese, and chicken nuggets. Family dinners became nightly struggles, her growth slowed, and she skipped birthday parties to avoid “strange food.” Her parents felt powerless, her brother grew frustrated, and outings dwindled. What began as food avoidance soon reshaped the rhythm of the entire household. When children avoid food, most parents expect it’s a passing stage. But when restriction deepens, shrinks to only a few “safe foods,” and begins affecting growth or health, families suddenly find themselves in unfamiliar territory. This is often where Avoidant/Restrictive Food Intake Disorder (ARFID) emerges — with effects that extend far beyond the plate. As providers, we need to be attuned to these patterns. It’s tempting to dismiss them as “no big deal,” yet for many families, they are life-altering. Sadly, Emma’s story is not unusual. Mealtimes as Battlegrounds Families living with ARFID often describe mealtimes as emotionally charged, exhausting, and unpredictable. What should be a chance to connect around the table can feel more like a negotiation or even a standoff. Parents wrestle with whether to push their child to try a new food or give in to the same “safe foods” again and again to avoid tears, gagging, or complete meltdowns. This ongoing tension can make mealtimes dreaded rather than cherished. Siblings, too, are affected. Some may feel resentful when family meals are limited to what only one child will tolerate. Others may act out in response to the constant attention the child with ARFID receives. Over time, the dinner table shifts from a place of nourishment and bonding into a stage for conflict, anxiety, and guilt — a pattern that can erode family cohesion and resilience. Social Isolation and Missed Experiences ARFID impacts more than what happens at home; it influences how families engage with the world around them. Everyday events — birthday parties, school lunches, vacations, even extended family dinners — become sources of stress. Parents may pack special foods to avoid confrontation or, in many cases, decline invitations altogether to protect their child from embarrassment or overwhelm. This avoidance can lead to an unintended consequence: isolation. Families miss out on milestones, friendships, and traditions because of the unpredictability surrounding food. The child may feel left out or ashamed, while parents grieve the loss of “normal” family experiences. This social withdrawal can compound the anxiety already present in ARFID and deepen its impact across generations. Emotional Toll on Parents The emotional strain on parents navigating ARFID is significant. Many describe living in a constant state of worry — Will my child get enough nutrients? Will they ever grow out of this? Am I doing something wrong? This worry often spirals into guilt and self-blame, particularly when outside voices dismiss the disorder as mere “picky eating.” In addition, the pressure to “fix” mealtimes can strain marital relationships, creating disagreements over discipline, feeding strategies, or medical decisions. Parents may also feel emotionally depleted, pouring all their energy into managing one child’s needs while inadvertently neglecting themselves or their other children. Without support, this chronic stress can lead to burnout, depression, and disconnection within the family system. The Role of Providers For clinicians, ARFID must be viewed not only as an individual diagnosis but as a family-wide challenge. Effective care requires attention to both the clinical symptoms and the family dynamics that shape recovery. Parent Support: Educating caregivers that ARFID is not their fault, offering psychoeducation, and helping them reframe mealtime struggles as part of the disorder — not a parenting failure. Family-Based Interventions: Coaching families in structured meal support, communication strategies, and gradual exposure work so parents don’t feel powerless. Holistic Care: Involving therapists, dietitians, occupational therapists, and medical providers ensures that the family does not shoulder the weight of treatment alone. When families are validated, supported, and given practical tools, the entire household can begin to heal. Treatment is not only about expanding a child’s food repertoire but also about restoring peace, resilience, and connection at home. Moving Forward ARFID may begin with one individual, but its ripple effects are felt across the entire family system. By addressing both the psychological and relational dimensions, providers can help transform mealtimes from a source of conflict into an opportunity for healing and connection. For those who want to go deeper, we invite you to join our upcoming training on ARFID , where we will explore practical strategies for supporting both clients and their families.

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Is It OCD or an Eating Disorder? What Parents Need to Know

July 17, 2025

As a parent, noticing alarming behaviors around food or routines in your child can raise some important questions. You might be asking yourself, “Is this an eating disorder, obsessive-compulsive disorder (OCD), or something else entirely?” Understanding the signs and differences between these disorders is key to getting your child effective, timely treatment. In this blog, we’ll break down the overlap between OCD and eating disorders, what signs to watch for, and how to get professional help. If you're a parent wondering “Is my child’s eating disorder actually OCD?” or “OCD vs eating disorder in teens,” know that you’re not alone and you’re in the right place to find specialized care for your child. What Is OCD? Obsessive-Compulsive Disorder (OCD) is a mental health condition where unwanted thoughts (obsessions) cause anxiety, leading to repetitive behaviors (compulsions) intended to ease that anxiety. OCD can be focused on any subject. Common obsessions include contamination, perfectionism, scrupulosity, and harm, but sometimes, the content of obsessions can be focused on food, body image, or weight. What Is an Eating Disorder? Eating disorders , like anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant/restrictive food intake disorder (ARFID) involve disturbed eating behaviors and intense concerns about body weight or shape. These conditions go beyond dieting or “picky eating” and can become life-threatening without professional intervention. The Overlap: Why It Can Be Confusing OCD and eating disorders often share similar symptoms : Ritualistic eating (e.g., needing to eat foods in a certain order or at a certain time) Rigid rules about food (like only eating certain food groups or certain amounts of food) Excessive checking (like weighing food or body or repeated checking of expiration dates or thorough cooking) Avoidance behaviors ( like avoiding carbs, fats, or other food groups or avoiding places or objects that can trigger obsessions) Distress when routines are disrupted (either around mealtimes or exercise routines) So, How Can You Tell the Difference? Use the following chart to compare and contrast symptoms of OCD and eating disorders.