There are a lot of misconceptions about the role of family in eating disorders and in recovery.  The most common misconception is that families cause eating disorders.  This is absolutely not true.  Eating disorders stem from a complex mosaic of factors that contribute towards their development and maintenance, so in no way is it accurate to say that families cause eating disorders.  In fact, families can do much more good in terms of recovery from an eating disorder than they could ever do harm.  So it becomes impingent upon the individual struggling with an eating disorder to decide what role they wish their family to play in their recovery.
It is also helpful to do some reflection about your relationship with your family and your family’s relationship with different aspects of the eating disorder.  For example, what is your family’s relationship with food like?  Does your family welcome foods of all kinds, is food an important aspect of how you relate?  Did you have family meals growing up?  Was there a strong emphasis on appearance, fitness, thinness, success or otherwise in your family?  Some of these questions can help identify different patterns or dynamics around food in your family and are useful to have awareness of them.  One interesting exercise we do in treatment is to have clients create a living sculpture representing their family of origin’s relationship with food.  Sometimes they will depict a family meal, or a disjointed depiction of food within the family.  This helps identify patterns and dynamics around food that the individual may not be fully aware of.  Again, these dynamics do not necessarily cause eating disorders but it can help you develop valuable insight needed to understand how your beliefs or ideals around food may have been shaped by your family.
The understanding that a family does not cause an eating disorder is an important one, because if a family caused the eating disorder than only a family could fix it, and that would be a disempowering situation for the individual.  Many individuals recover from their eating disorders, and while the help of their family is usually welcomed and encourage, it is the individual in recovery who has to make the changes at the end of the day.
How can a family help their loved one struggling with an eating disorder?  The short answer is unwavering support.  However, that may take different forms at different times.  There may be times at which family members will have to be exceedingly understanding, accommodating and gentle.  There may also be times at which you will need to be firm, direct and even confrontational.  The approach varies based upon what a person needs in their recovery at the time.  And often the client will not know what they need, so it is extremely important that treatment providers and family members maintain a good collaborative relationship.  Sometimes treatment providers will need to relay to the family what they observe the individual needs from them, which may be different from what the individual, who is being somewhat controlled by the eating disorder reports.  If treatment professionals maintain a belief that families somehow caused a person’s eating disorder this collaboration cannot take place.  At Cielo House we understand the importance of the family’s role, and it is not one of blame or responsibility for the eating disorder, it is one of support.

By Matt Keck, MFT
Founder and CEO of Cielo House