Supporting Your Child Through Weight Restoration
Why Weight Restoration is Important
· Restores Physical Health
o Malnutrition affects growth, brain function, heart health, and hormones
o Improves Emotional Well-Being
§ Nutritional deficiencies can worsen anxiety, depression, and obsessive thoughts
o Supports Cognitive Function
§ The brain needs fuel to help with rational thinking and emotional regulation
o Prevents Long-Term Damage
§ Without proper nutrition, children risk stunted growth, weak bones, and delayed puberty
o Weight restoration is NOT just about gaining weight
§ it’s about restoring the body and mind to full health
Challenges in Weight Restoration
· Resistance from Your Child
o Fear of weight gain
§ Your child may experience severe distress over body changes
o Denial of being underweight
§ Many children with EDs do not see themselves as too thin
o Food avoidance behaviors
§ They may try to skip meals, hide food, or exercise excessively to slow weight gain
o Increased anxiety & irritability
§ Brain starvation affects mood, impulse control, and emotional responses
· Physical Symptoms During Refeeding
o Bloating & digestive discomfort
§ The gut needs time to adjust to increased food intake
o Fatigue & mood swings
§ The body prioritizes healing, leading to temporary tiredness or irritability
o Refeeding Syndrome Risk
§ In severe malnutrition cases, electrolyte imbalances can cause medical complications
How to Support Your Child Through Weight Restoration
· Create a Safe and Structured Eating Environment
o Set Regular Meal & Snack Times
§ Stick to a schedule with 3 meals and 2-3 snacks daily
o Make Meals Predictable
§ Keep a structured meal plan to reduce anxiety around food
o Eat Together as a Family
§ Modeling normal eating behaviors helps reduce fear around meals
§ Limit Food Choices Initially
· Too many choices can be overwhelming
· focus on nutrient-dense meals first
· Handle Emotional Resistance with Compassion
o Validate Their Feelings
§ Instead of saying, “Just eat it,” try, “I know this is hard, but your body needs this to heal.”
§ Be Firm Yet Gentle – Your child may resist eating, but giving in to avoidance reinforces the disorder. Stay calm but ensure they eat
§ Don’t Make Weight the Focus – Instead of "You need to gain weight," say "Your body needs fuel to get stronger and feel better."
§ Use Non-Food Rewards – Praise effort, not weight gain (e.g., "I’m proud of how hard you’re working," instead of "Great job gaining weight.")
o Avoid:
§ Diet talk, calorie counting, or labeling foods as ‘good’ or ‘bad’
§ Weighing your child in front of them (let medical professionals handle this)
§ Commenting on body changes in a way that triggers distress
· What Foods Are Best for Weight Restoration?
o Nutrient-Dense, High-Calorie Foods:
§ Whole milk, cheese, yogurt, eggs, peanut butter, nuts, avocados, and olive oil
§ Pasta, rice, potatoes, whole grains
§ Protein sources like chicken, fish, beans, and tofu
§ Smoothies, milkshakes, and liquid supplements (Ensure, Boost, Pediasure) if needed
o Balanced Macronutrients:
§ Carbohydrates – Provide quick energy for brain function
§ Proteins – Support muscle and tissue repair
§ Fats – Crucial for hormone regulation and brain health
o Start slow and increase portions gradually to prevent bloating and digestive discomfort
Managing Anxiety Around Weight Gain
· Weight gain can trigger intense fear and distress in children with eating disorders. Help them navigate this by:
o Shifting the Focus to Health
§ Instead of “You need to gain weight,” say, “Your body needs nourishment to be strong and healthy.”
o Avoiding Numbers & Scales
§ Weight checks should be done by a doctor—not discussed at home
o Using Distraction Techniques
§ Engage in fun activities after meals to reduce anxiety
o Helping Them Challenge Negative Thoughts
§ Use Cognitive-Behavioral Therapy (CBT) strategies to reframe fear-based beliefs about weight.
o Example:
§ Child: “If I eat this, I’ll get fat.”
§ Parent: “Your body knows what to do with this food—it’s using it to make you strong.”
What to Do If Your Child Refuses to Eat
· Stay calm but firm
o “I know this is scary, but your body needs food to heal. Let’s take it one bite at a time.”
o Offer small, frequent meals if large portions cause distress
o Use meal support strategies like distraction, encouragement, and deep breathing
o Seek medical support if refusal persists—hospitalization may be needed for severe cases
o DO NOT allow food refusal to dictate recovery
§ Skipping meals reinforces the eating disorder’s control
How Long Does Weight Restoration Take?
· The process varies for each child, but in general:
o Initial refeeding (first 2-4 weeks) – The body adjusts to increased intake
o First signs of improvement (4-8 weeks) – Energy levels and mood may improve
o Full weight restoration (3-6+ months) – Growth and health stabilize
o Even after weight is restored, mental recovery continues. Therapy and meal support are essential long-term
When to Seek Additional Medical Support
· Emergency Situations Requiring Immediate Medical Attention:
o Severe food refusal leading to extreme weight loss
o Signs of Refeeding Syndrome (swelling, weakness, heart irregularities)
o Severe depression or suicidal thoughts
o Heart rate below 50 BPM, low blood pressure, or fainting episodes
o If your child is medically unstable, hospitalization may be required
Final Thoughts: Supporting Your Child Through Recovery
· Weight restoration is essential for both physical and mental healing
· Expect resistance, but stay calm and consistent
· Use supportive language and avoid focusing on weight alone
· Work with medical professionals to ensure safe refeeding
· Therapy, family support, and structured meals help long-term recovery
· Remember: Your child needs your encouragement, patience, and love during this challenging time. Full recovery is possible with the right support.
Disclaimer: This information is intended for educational purposes and should not replace professional medical advice. If you or someone you know is in crisis or needs immediate help, please contact a healthcare professional or crisis intervention service immediately.
