Supporting a Loved One with an Eating Disorder
A handout for family members and partners of someone with an eating disorder: what to expect, how to talk about it without escalating, what helps at mealtimes, and how to look after yourself. Informed by the New Maudsley carer skills approach and family-based treatment principles.
About this resource
Families and partners are usually the first to notice an eating disorder and the ones who live with it every day. Their responses matter: research on carers, particularly the work of Treasure and colleagues at the Maudsley, shows that families commonly fall into patterns of accommodation (going along with rituals, reassuring, avoiding conflict) or confrontation (arguing, policing food, expressing anger), both of which are understandable and both of which can inadvertently maintain the illness. Carers also carry high levels of distress and often feel excluded from treatment.
This handout gives family members a clear account of what an eating disorder does to thinking and behaviour, a set of communication principles drawn from the carer skills literature (staying calm, validating feelings without validating the illness, separating the person from the disorder, avoiding comments about food and bodies), practical guidance on mealtimes that is consistent with family-based treatment where the loved one is a young person, and a section on carer self-care. It does not give calorie, weight or meal plan targets; those belong with the treatment team.
The professional version notes that the handout is designed to be given alongside, not instead of, treatment, that carers of adolescents in family-based treatment will receive more specific mealtime coaching from the treating team, and that carers of adults should be encouraged to support autonomy and treatment engagement rather than take over. Signs of medical risk that require urgent attention are listed for the clinician to review with the family.
How to use it
- Give the handout to family members or partners who are involved in the client's care, with the client's consent where the client is an adult.
- Read the 'What helps when you talk' section with the family and ask which of the common traps they recognise in themselves. Normalise them; nearly every carer has done all of them.
- For adolescents in family-based treatment, use the mealtime section as an introduction to the more specific coaching the family will receive in session.
- For adults, discuss how the family can support treatment attendance and regular eating without taking over the client's decisions.
- Review the medical warning signs with the family and make sure they know how to reach the treatment team or emergency services. Attend to the carers' own wellbeing and point them to carer support where available.
References
- Treasure, J., Smith, G., & Crane, A. (2017). Skills-based Caring for a Loved One with an Eating Disorder: The New Maudsley Method (2nd ed.). Routledge.
- Lock, J., & Le Grange, D. (2013). Treatment Manual for Anorexia Nervosa: A Family-Based Approach (2nd ed.). Guilford Press.
- Treasure, J., Schmidt, U., & Macdonald, P. (Eds.). (2010). The Clinician's Guide to Collaborative Caring in Eating Disorders: The New Maudsley Method. Routledge.
