Guiding Your Child on the Road to Food Freedom: Navigating Independence in Nutritional Rehabilitation

Apr 5, 2024

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As your child moves through the different phases of eating disorder recovery, you may wonder when they’re ready to begin having more autonomy over their meals and decisions of what to eat again.

Of course, you don’t want to decide their meals longer than necessary. However, it’s important not to rush this process and to ensure your child has structure as long as is needed to ensure full recovery.

Especially when taking a family-based treatment approach, you’ll decide what your child will eat at most meals and snacks during the early stages of recovery.

But how do you know when they’re ready to gain some of that autonomy back?

This is one of the questions caretakers often ask when navigating how to do family-based treatment. Here are a few signs your child is ready to have more responsibility with eating.

Signs Your Child Is Ready for More Responsibility with Eating in Recovery

Especially if your child is older — in their teen or adolescent years — it can be difficult for you and them for all their meals to be decided by a parent or caretaker. Even younger children will naturally want to have a say in what they eat for snacks and meals.

However, when the eating disorder voice is the dominant voice telling your child what they can and can’t eat, what’s “good” or “bad,” and so forth, your child is not ready to make those decisions.

Once they’ve reached a place in their recovery when they’re doing better and the eating disorder voice becomes a little quieter, you can gradually begin to incorporate them in the decision-making process. These signs of eating disorder recovery show your child may be ready to take on more responsibility.

Nutritional Rehabilitation: Your Child Is Weight and Health Restored

Once your child’s health is restored, they may be ready for more independence in their eating.

Some physical eating disorder recovery signs they’ve had nutritional rehabilitation and their health is restored can include: ¹

  • Weight restoration puts your child in their normal range, and/or they’re back on track with how their growth charts previously trended. ²
  • Digestion is more normal.
  • Strength, energy, and mood improved.
  • Those who ceased having menstrual periods have them restored. ³
  • Electrolyte levels are normal. ⁴
  • Blood sugars are balanced. ⁵
  • Blood pressure and heart rate are normal.

An eating disorder-informed healthcare provider can help you identify when your child’s health and weight are back to a normal range, and they may be ready for more autonomy in eating.

Generally, if your child’s weight is restored, it means they’re eating regular meals and their body is doing well to adjust.

This can be different for every child, but can take a couple to several months or longer. ⁶

However, it’s not the only factor to consider. If your child’s weight is back to their normal range, but they still struggle to eat challenge foods, or there’s a lot of pushback from the eating disorder at meal times, they may need more time to adjust. And that’s okay!

They Show More Independence and Autonomy When Eating on Their Own

As you prepare meals and snacks for your child in their recovery, you have to decide what’s best for them and what they need to eat.

Especially in the early stages, your child may push back fiercely with what you’ve prepared, and they may eat the bare minimum as the eating disorder fights back.

However, as time goes on, you’ll likely notice they start to show more autonomy as they get back in touch with their hunger cues and begin to listen to their bodies.

This may include:

  • They want to eat earlier if they are hungry instead of waiting for you to prompt them for meal times.
  • They allow themselves to eat more if they’re still hungry after an initial portion.
  • They may ask for an additional meal or snack.
  • Challenge Foods Are a Regular Part of Their Diet
  • You may notice that foods your child once regularly enjoyed became something they feared because of the eating disorder.

The eating disorder may make them fear what it could mean if they ate this food — even if you (and they, deep down) know that it’s a perfectly normal thing to eat and enjoy.

When introducing these challenge foods into their eating disorder recovery, they may really be that — a challenge — in the early days. Your child may feel guilt, shame, frustration, and fear as they eat these foods.

However, they’re important to their recovery and challenging the eating disorder. These foods will be eaten more easily and with less pushback over time. They’ll become a more regular part of your child’s routine, and they may even request them at mealtimes.

When your child shows more willingness to eat these foods, you’ll know they are ready to have a little more autonomy.

Navigating Giving Back Responsibility Over Meals in Recovery

There may be a point when you think your child is ready for more independence in eating. Maybe you let them decide their own snacks, and they get to have a say in what they eat for a meal or two.

At first, it seems like they’re doing great! However, you gradually notice the eating disorder voice begins to get louder, and some behaviors return.

Don’t panic — this is a totally normal part of recovery. It’s not uncommon to move back and forth through different stages. And as routines change and your child is given more autonomy, the eating disorder may jump at every chance to creep back in and take over behaviors.

You may have to re-introduce structure and take more of that responsibility back. This does not mean you failed at helping your child recover, and it does not mean that your child is never going to recover. It just means your child is at a point where they need a little more structure as they continue their recovery journey.

You’ve likely heard the saying, “One step forward, two steps back.” This can very much apply in your child’s recovery journey, and it’s completely normal to move between different stages.

Remember that recovery is not linear, and it can take time. With persistence and grace, you can help your child reach a point of full recovery where they enjoy that food freedom and independence once again!

Citations

National Institute of Mental Health. 2023. “Eating Disorders – National Institute of Mental Health (NIMH).” “U.S. Department of Health and Human Services, National Institutes of Health. https://www.nimh.nih.gov/health/topics/eating-disorders.
Muhlheim, Lauren. 2018. In When Your Teen Has an Eating Disorder: Practical Strategies to Help Your Teen Recover from Anorexia, Bulimia, and Binge Eating, 50-53. Oakland, California: New Harbinger Publications.
Gaudiani, Jennifer L. 2019. Sick Enough: A Guide to the Medical Complications of Eating Disorders, 46-47. New York, NY: Routledge.
Gaudiani, Sick Enough, 80-81, 117-121.
Gaudiani, Sick Enough, 56-58.
Crosbie, Casey, and Wendy Sterling. Essay. In How to Nourish Your Child through an Eating Disorder: A Simple, Plate-by-Plate Approach to Rebuilding a Healthy Relationship with Food, 34-36. New York: The Experiment, 2018.

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