Please note that this is an Archived article and may contain content that is out of date. The use of she/her/hers pronouns in some articles is not intended to be exclusionary. Eating disorders can affect people of all genders, ages, races, religions, ethnicities, sexual orientations, body shapes, and weights.

By Carly Erickson, MPH, CHES
Family Educator and Patient Experience Liaison at Center For Change

If you’re reading this, there is someone in your life that you are concerned has an eating disorder and you’ve been told or suspect that they will require more intensive treatment. First things first, take a deep breath and know that there is evidence-based care and support available. At Center For Change, we have been successfully treating eating disorders for 30 years. There are years of collective experience, empathy, and caring in all our locations. We have done this a time or two (or thousands), and you can trust that we know the process and will treat your loved one well.  Recovery is not only possible, but likely with proper treatment. If you feel like this whole diagnosis and journey has your brain in a blender, let me lay out some basics for you.  Here are some things you may want to know about the process of coming to and the importance of treatment.   

Eating Disorders have some quirks 

Firstly, it is important to understand that eating disorders present unique challenges that other mental illnesses don’t have. While these unique factors can provide many challenges to entering treatment and committing to recovery, most of these difficult factors are rooted in personality strengths. Once they are in recovery, they can use these traits and strengths in a healthy way and live an amazing life of their choosing. In general, people with eating disorders are extremely intelligent, diligent–and when the eating disorder isn’t numbing their feelings–they tend to be the most emotionally aware person in any room. Your loved one is already a worthy and wonderful person, and they can live a life the reflects their true selves in recovery. When your loved one is deep into their eating disorder, this can manifest as being incredibly stubborn, protective of their eating disorder, and either emotionally numb, or all over the place—often lashing out at those closest to them. As a loved one—you’ve probably caught some strays, or maybe even a LOT of strays.  

Ditch the Shame 

If you are a parent or family member, please know that a loved one developing an eating disorder is not your fault. Holding on to shame is unnecessary, and can be detrimental to you, your loved one, and your relationship. Being a supportive part of the treatment team is a powerful influence for good. Eating disorders are extremely complex bio-psycho-social disorders, meaning biology and mental wiring play a role in addition to the environment we live in. Recent studies have shown genetics also play a role, with markers on certain genes being found as common in anorexia patients (Bulki, 2019). We expect the same results will be found in other eating disorders (once there is funding to run the research). Eating disorders are obviously fixated on food, but often they do not stem from the desire to lose weight—it can be a way to seize control over themselves, their body, and their emotions in the face of feeling out of control—and then the disorder becomes rooted in appearance and body change after that control begins. The environment in which we all live plays a part in the development of eating disorders, but that environment is not remotely limited to the home. Take a look around at the current trends in entertainment, movies, social media, and targeted ads. Are you a woman over 40 like me? The internet knows and will endlessly barrage you with ads for cosmetics “for mature skin,” med spas for a mom-bod makeover, and GLP-1s. SOOO MANY GLP-1s! 

 What is happening to my loved one? 

There are several eating disorder diagnoses in the DSM-V with complex diagnostic symptoms, but they all share certain traits. At the Center we treat these shared traits and utilize best evidence-based practices while tailoring the treatments to your loved one’s individual therapeutic needs. Eating disorders (EDs) include Anorexia Nervosa (AN), Atypical Anorexia (which is actually more common than other types of Anorexia, just to be extra confusing), Binge Eating Disorder (BED), Bulimia Nervosa (BN), Avoidant/Restrictive Feeding and Eating Disorder (ARFID), and Other Specified Feeding or Eating Disorder (OSFED). All these EDs have subtypes as well, and you do not need to remember all these acronyms. There will not be a quiz later.  Patients may change their behaviors and therefore diagnosis, but patients can only be diagnosed with one eating disorder at a time. Some patients benefit from knowing their exact diagnosis while others do not. A treatment team will get to know your loved one and work with them to decide what is most helpful for them. What IS common in all eating disorders is that they make actual neural pathways changes in the brain. It does not matter if your loved one is binging/purging/restricting–the changes in their brain are already happening.  

Your loved one has choices, but they did not choose to have this disorder; they aren’t “looking for attention,” and the risks are not overblown (Baird, 2026). Only 6% of eating disorder patients are clinically “underweight” by BMI (ANAD, n.d.), and changes to their bodies and brains have already taken place when a patient is assessed as needing more intensive care. Brain activity in the prefrontal cortex is severely inhibited by an eating disorder (Hawkins, 2026). The frontal lobe of the brain controls several things, but most notably for loved ones to know this includes empathy for others, emotional regulation, and the ability to think about the future or consequences to choices now (Hawkins, 2026). You can likely see how this puts you and your loved one on the back foot when it comes to realizing there is a problem and deciding to seek treatment.   

Why are they fighting with me about my concerns? 

It is very possible that your loved one doesn’t believe or even fully register the consequences of continuing in their eating disorder even if you or their own doctor or therapist has told them many many times. The great news is that with 90 days of consistent nutrition and restoring what the body needs—this lack of function in their frontal cortex starts to heal—and after a few years in recovery (depending on age and co-occurring disorders) your loved one’s brain could be totally indistinguishable from a healthy brain on a functional MRI scan (Hawkins, 2026). Recovery is possible!  

Here are the specific processes that also hinder your loved one’s ability to understand their own body and mind in an eating disorder.  Many eating disorders include a degree of anosognosia and are egosyntonic. Anosognosia is a neurological condition where the person suffering does not realize something is wrong—a very complicated way of saying they don’t know how sick they are. In addition, ego-syntonic means that the person believes the disordered behavior is in line with their own core values and priorities and therefore is less likely to see eating disorder behaviors as a problem. In an eating disorder the values that behaviors go along with may be a need to be in control, discipline despite obstacles, and maintaining order by following “rules” around food or eating. Ego-dystonic means the opposite—those are conditions where the person is upset by the symptoms and compulsions and doesn’t like having them. A good example of these opposites is major depression compared to an eating disorder. When someone enters treatment for severe depression, any break in the clouds is a relief and provides hope that things can continue to get better. With an eating disorder, the very hallmarks of healing (weight restoration, the return of emotions, better medical outcomes) might feel like a “failure” and cause great distress. It can be very difficult to understand and observe as a loved one, but this is not an unexpected element for our treatment teams. This is one reason why entering eating disorder treatment takes a huge amount of trust and can be extra intimidating or become distressing as soon as healing begins. These elements can also make getting a loved one enter or consider treatment an uphill battle. The choice to get help is a very difficult one and requires a lot of your loved one, but it is worth it.  

If I push for treatment, will my loved one hate me? 

Given all that is going on–or is definitely not going on–in a brain with an eating disorder, it’s really no wonder that the person you love is all over the place and lashing out. Add to that, eating disorders thrive in secrecy, encourage isolation, and constantly bully your loved one with a repeated listing of all their perceived flaws and failures every waking hour. Of course they’re distressed! Treatment requires them to face absolutely everything they are afraid of—including facing food six times a day—and that can feel like a huge leap into the dark. That’s a lot to ask. We wouldn’t ask it of them if we didn’t know they were absolutely up to the task, and that life in recovery is so much better than anything they can conceive of right now. The eating disorder only offers false numbing and false friendship, while recovery offers real connection with others, a full spectrum of emotions and experiences, and whatever future they choose to embrace.  

The process of treatment at CFC re-nourishes the brain as a first priority. The process can be physically and emotionally uncomfortable. This rebuilding is necessary for the lasting effectiveness of therapies and insights they will need to continue making good choices for themselves after discharge. It is not unexpected that your loved ones will want to return to the short-term comfort of eating disorder behaviors and will respond to you with a wide range of emotions that change from day to day or even moment to moment. They may feel like entering treatment was a mistake or claim they are not “sick enough” to be in treatment as they compare themselves to things they see in other patients. Please note that if they are in treatment, they are sick enough to be there, and are being monitored medically, dietarily, and therapeutically by experts in the field.   

What is my role in treatment? 

Please encourage your loved ones to engage in the treatment process fully, trust their team, and not discharge early from treatment for the wrong reasons. You are always welcome to share concerns you may have with your loved one’s therapist and ask questions about what is normal during this time. As treatment progresses, with proper engagement, your loved one will have more insight into their own behaviors and be able to set reasonable goals. Treatment helps return your loved one’s ability to make healthy choices for themselves better than it was before the eating disorder took root. As your loved one grows in their commitment and engagement in recovery, they will have increased opportunities for visits and passes. It is most helpful for you to engage in family education opportunities and make sure that you understand what the goals and expectations are for visits and passes so you can support your loved one in a way that speaks to them and helps them feel loved. We are here to help you learn the things you don’t know yet and help you be a wonderful asset to the treatment team.   

The most important thing for you to do from now through recovery is to show them you love them and nurture a healthy supportive relationship. You cannot recover for your loved one, and you may be the bad guy in the early days of this journey or in the harder times. That is especially true if you are the parent of an adolescent, and you are literally making them go to treatment whether they want to or not. Your first phone call home probably won’t be effusive thanks for bringing them to treatment, but there is a first time for everything. When their frontal lobe has healed and they are living in recovery and able to look back clearly—they will appreciate that you fought FOR them, not WITH them. It may be helpful to always frame it this way–it is never you against me—it is always you and me against the eating disorder.   

Your loved one can do this. You can support them and help them. We can help them save their own lives and help you understand what is happening along the way.  

References  

ANAD. (n.d.). Eating disorder statistics | ANAD – national association of anorexia nervosa and associated disorders. Eating Disorder Statistics. https://anad.org/learning-library/eating-disorder-statistic/ 

Baird, G. (2026, June) Nine Truths about Eating Disorders. Family Education Days. Orem; UT. 

Bulik, C. M. (2019, July 5). Anorexia nervosa genetics initiative (angi) part 1: The results | exchanges. Exchanges Blog of the UNC Center of Excellence for Eating Disorders. https://uncexchanges.org/2019/07/15/anorexia-nervosa-genetics-initiative-angi-part-1-the-results/  

Gregertsen, E. C., Mandy, W., & Serpell, L. (2017). The egosyntonic nature of anorexia: An impediment to recovery in anorexia nervosa treatment. Frontiers in Psychology, 8, Article 2273. Retrieved April 28, 2026, from https://doi.org/10.3389/fpsyg.2017.02273 

Hawkins, N. (2026, July). Body Image. Family Education Days. Orem; UT. 

María Roncero, Amparo Belloch, Conxa Perpiñá, Janet Treasure, Ego-syntonicity and ego-dystonicity of eating-related intrusive thoughts in patients with eating disorders, Psychiatry Research, Volume 208, Issue 1, 2013, Pages 67-73, Retrieved July 9, 2026 from https://doi.org/10.1016/j.psychres.2013.01.006.   

Rushani S, Salvato G and Sellitto M (2025) The adamant adherence to a prior belief: the case of anosognosia in anorexia nervosa. Front. Neurol. Retrieved July 9, 2026, from 16:1670485. doi: 10.3389/fneur.2025.16704855