19-year-old daughter has anorexia. After a hospital stay, we followed
up at home and she is now at a healthy weight. She lives at home and
attends community college. She will eat what my wife and I put in front
of her and she will eat at restaurants. The problem is that she refuses
to take ownership of eating by herself, i.e. preparing her own food.
She simply won't eat on her own. Any suggestions?
Kara Fitzpatrick, PhD responds:
It can be a challenge when anorexia becomes complacent in our re-feeding efforts and prevents our children from feeling comfortable and confident in taking over their own re-nourishment efforts. First, it might be helpful to recognize that your child may be feeling very “stuck” and afraid of these next steps – taking back control may mean facing her own concerns about whether or not she will gain or lose weight. Many individuals feel comfortable with parental control: they see that you will not let them binge or gain weight too rapidly, but they fear what will happen when it is up to them! Second, work with your therapist to begin to identify ways in which she might have supported independence. These may be “baby steps” toward her taking control, such as choosing the restaurant you are eating at, choosing her own beverage at meal times or plating her own food. Work toward mutual goals and identify areas in which having regained independence will foster feelings of confidence and adjustment in your daughter. Reinforce those changes and continue to find ways to support increased independence – around food as well as around other independence goals, such as friendships and academics. Remember that re-nourishment efforts are key, but so is continuing to develop into an independent, healthy young adult!
Kara Fitzpatrick, PhD
Dr. Fitzpatrick is a psychologist working with Eating Disorders at Stanford University/Lucile Packard Children's Hospital and serves as clinical advisor to Maudsley Parents. She is widely trained in a variety of models for treatment and performs research in applied clinical treatments for adolescents and neuropsychological factors associated with eating disorders.