What to Expect from Eating Disorder Treatment for Children

When a child is diagnosed with an eating disorder (ED), treatment is essential for their physical health, emotional well-being, and long-term recovery. Early intervention increases the likelihood of full recovery, but the process can be challenging and emotional for families. Here’s what to expect from pediatric eating disorder treatment and how parents can support their child through recovery.

Initial Steps: Diagnosis & Assessment

·         The first step in treatment is a comprehensive evaluation by a multidisciplinary team, which may include:

o   Pediatrician or Family Doctor – Assesses weight, growth charts, vital signs, and medical complications

o   Psychologist or Psychiatrist – Diagnoses the eating disorder and any co-occurring mental health issues (e.g., anxiety, depression, OCD)

o   Dietitian or Nutritionist – Creates a structured meal plan to support weight restoration and balanced nutrition

o   Family Therapist – Guides parents on how to support recovery and address family dynamics

·         Common Tests & Assessments:

o   Growth chart comparison (weight loss or stunted growth)

o   Blood tests (to check for nutrient deficiencies and organ function)

o   Bone density scans (for those at risk of osteoporosis)

o   Psychological evaluations (assessing body image concerns, anxiety, and compulsive behaviors)

Common Treatment Approaches for Pediatric Eating Disorders

·         Treatment plans vary depending on the child’s age, severity of symptoms, and medical stability

o   Family-Based Treatment (FBT) – The Gold Standard for Children (Also called the Maudsley Approach)

§  Parents take control of meal planning, food preparation, and monitoring to restore the child’s nutrition

§  Gradually, responsibility for eating is given back to the child as recovery progresses

§  Focuses on rebuilding trust, reducing anxiety around food, and preventing relapse

§  Best for: Anorexia nervosa, restrictive eating, and younger children who need parental guidance

§  Requires full parental involvement – Can be emotionally exhausting but is highly effective

o   Cognitive-Behavioral Therapy (CBT-AR for ARFID, CBT-E for Other EDs)

§  Helps children challenge food fears, break rigid eating habits, and manage emotions without using food restriction

§  Especially useful for children with Avoidant/Restrictive Food Intake Disorder (ARFID), bulimia, and binge eating disorder (BED)

§  Introduces gradual food exposure to expand variety and reduce sensory-based aversions

§  Best for: Older children who can express their thoughts and work on changing behaviors

§  Younger kids may need modified versions using play therapy and parent coaching

o   Nutritional Counseling & Meal Planning

§  A registered dietitian helps the child reintroduce food groups, understand portion sizes, and restore balance

§  Meal plans are structured to prevent skipping meals and to provide adequate calories

§  If severe malnutrition is present, medical nutrition therapy (MNT) may be needed (including supplements or feeding support).

§  Best for: Children struggling with extreme food restriction or nutritional deficiencies

Medical Monitoring & Hospitalization (For Severe Cases)

·         Hospitalization is necessary if the child is medically unstable, showing signs such as:

o   Dangerously low heart rate, blood pressure, or body temperature

o   Severe malnutrition or dehydration

o   Inability to eat independently

·         Inpatient or residential treatment provides:

o   24/7 medical care and meal supervision

o   Intensive therapy to stabilize the child’s physical and mental health

o   Nutritional rehabilitation to ensure weight gain and organ recovery.

·         This is reserved for life-threatening cases or extreme resistance to outpatient treatment

Emotional & Psychological Aspects of Treatment

·         Eating disorder recovery is not just about gaining weight or eating more—it also involves healing the child's relationship with food, body image, and emotions.

·         What to Expect Emotionally:

o   Anxiety, resistance, and emotional outbursts during meals (especially in restrictive EDs like anorexia)

o   Mood swings, anger, or frustration toward parents for enforcing food intake

o   Fear of weight gain and distress about body changes

o   Ups and downs—some days will be easier than others

·         Parental Support Strategies:

o   Stay calm and consistent

§  Avoid negotiating food intake or allowing restrictions to continue

o   Validate their feelings

§  Acknowledge that recovery is hard but necessary

o   Keep meals structured and predictable

§  Reduces anxiety around eating

o   Work with a therapist

§  Parents also need guidance on managing emotions and avoiding burnout

How Long Does Treatment Take?

·         Recovery is not a quick fix

o   most children need 6 months to several years of treatment and monitoring

o   Early intervention increases the chances of full recovery

o   Even after weight is restored, ongoing therapy is needed to prevent relapse

o   Signs of Progress:

§  More food variety and less anxiety at meals

§  Restored energy, improved mood, and return of growth/puberty progression

§  Developing healthy coping skills for stress and emotions

How Parents Can Support Their Child Through Treatment

·         Be Patient & Supportive

o   Recovery is difficult, but your role is crucial

·         Set a Positive Example

o   Avoid diet talk, body shaming, or food restriction in the home

·         Work With Professionals              

o   Trust the treatment team and follow their guidance

·         Prioritize Family Meals

o   Eating together provides structure and reassurance

·         Monitor Media & Social Influences

o   Limit exposure to harmful diet culture messages

·         Seek Support for Yourself

o   Parenting a child with an ED is challenging—parent coaching or support groups can help

Final Thoughts: What to Expect from Pediatric ED Treatment

·         Treatment requires a full-team approach, including medical care, therapy, nutrition counseling, and family support.

·         Parental involvement is key, especially in younger children, through Family-Based Treatment (FBT).

·         Emotional challenges are expected, but with persistence and guidance, recovery is possible

·         Long-term monitoring is necessary to prevent relapse and build a healthy relationship with food and body image

·         Early intervention, consistent parental support, and professional guidance provide the best chance for full recovery.

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.