Dispelling misconceptions about disease and demystifying the therapy process, When Your Child Has An Eating Disorder is not only about eating disorders. It is about child advocacy, parents advocacy, the parent/child relationship, problem solving and personal empowerment. Written in the language of optimism and healing, the book speaks to patients, parents, and health professionals alike. The books pertains to susceptible children who do not yet have an eating disorder, to those who may be victims of disease and need to find treatment, as well as those who are already involved in the recovery process.

Recognizing Early Warning Signs of Disease

In recognizing the early warning signs of disease, parents must understand that eating disorders are not about food, but are the individual's misuse of food to solve emotional problems. Parents must learn to look for signs in attitudes and emotions as well as food abuse:

• Obvious signs of eating disorders are rapid weight loss, compulsive over-exercising, abuse of laxatives, skipping meals, disappearing into the bathroom during or after meals; these signs indicate a disease that has already become entrenched.
  
  
• Less Obvious signs of pre-disease can be seen in extreme, excessive or inflexible behaviors and attitudes that do not necessarily concern food and eating; recognizing early signs is the key to disease prevention. Look for such signs in the child's:
  - problems with self-control or self-regulation,
  - excessive or extreme behaviors,
  - inflexible or rigid attitudes and thinking,
  - difficulty recognizing and accepting his own feelings.
  - difficulty resolving problems courageously and effectively.
  - depression, poor self-esteem.

The resourceful child who is a productive problem-solver is an unlikely candidate to develop a disease whose primary purpose is to supply pseudo-solutions for real problems.

An example of non-food related behavioral excess was seen in an anorexic high school student who wrote term papers two months before they were due, then edited them daily, 60 times each before handing them in. She would tolerate nothing less than perfection.

Remember that not every eating quirk is a disorder. The key to recognizing pathology is the victim's lack of voluntary choice in engaging in these behaviors, and with once benign behaviors begin to interfere with the child's activities and role functions.

What Parents Should Do When Their Child Has an Eating Disorder

When parents do respond, too frequently their responses are ineffective. Here are ways they can become more effective:

• Know that they have already done the most important thing, having become educated enough about eating disorders to recognize that a problem exists.
  
  
• The parent must model good problem-solving. Confront the child with the offer to work together towards a problem solution. The message is not about blame or fear, but about what you as a parent have noticed and steps that must be taken. Your concern is that if not tended, the problem could have a destructive effect on the child's quality of life, capacity to learn and to establish relationships, and on the child's emotional well-being and physical health, quality of life, capacity to learn and to establish meaningful relationships. An eating disorder is a serious disease that can have lethal ramifications. If treated properly and in a timely fashion however, the prognosis is overwhelmingly positive.
  
  
• In confronting the child, the parent's goal is not to take control of the child, but to encourage the child to take control of herself. A child with a malnourished brain does not have the judgment and wherewithal to care for herself. It is left to the parents to take up the battle against disease. If the child had cancer or diabetes, there would be no question about parent's intervening to encourage and find the proper care. This situation is no different.
  
  
• Parents must be all ears, actively listening for the child's perceptions and feelings that underlay behaviors, hearing what is spoken as well as what is not.
  - Anticipate resistance or problem denial and be prepared to deal with it.
  - Find the best professionals to work with your child and your family.
  - Participate actively and fully in the treatment and recovery process where appropriate.
  
  
• Parents must take a positive role to play in identifying problems.
  - Educating their child about the disease
  - Encouraging her to get treatment
  - Helping her find expert professional assistance
  - Participating with family in treatments
  - Evaluating the recovery process
  - Troubleshooting problems in a stalled recovery
  - Making changes alongside their child.
  
  
  

- Vivian Hanson Meehan, president and founder, National Association of Anorexia Nervosa and Associated Disorders