Eating Disorders And Adolescents

Eating Disorders and Adolescents: Finding balance and defining roles for parents, caregivers and the children affected by eating disorders

By Doris Breen

Contributed for use by Sandie Rauch, CMA, Melrose Institute.

Copyright for this work is retained by the author; excerpted or referenced inclusion in any other work may be reproduced if attribution is included acknowledging this article’s author. This article may not be used in any commercial or non-academic manner, in part or whole, without prior written permission from its author.

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May 2009

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Eating Disorders and Adolescents: Should Laws Be Changed to Seek Treatment Without Parental Consent? In an ideal world, there would be no debate as to the right of a parent to be fully informed about the well-being of their child. Ideally, every parent would share the highest level of concern for their sons’ and daughters’ physical and emotional health; their natural protective instinct would be supplemented with an understanding of the complexities behind mental disorders, physical impairments and behavioral conditions that are difficult to understand unless experienced firsthand. In this same ideal world, our adolescent children would be communicative and engaged with their parents about their lives, feelings, fears and needs. There would be no stigmas attached to certain health matters (both inside and outside the home), and thus no need to hide or disguise those diseases that the nonideal society could not or would not accept as legitimate, real or worthy of an empathetic response. Freed from constraint, the child afflicted with an eating disorder (or any serious health matter) would not hesitate to involve their parents early and with complete honesty, knowing that they will be heard, understood and protected no matter what they say or how they say it. The ideal parent would respond rationally, without judgment and demonstrate their unconditional support by obtaining the best available crisis care treatment for their child, securing long-term aftercare, and being an active and empathetic participant in their sons’ or daughters’ process of recovery.

Finding Solutions in a Non-Ideal World It goes without saying that the world we live in is not the one hypothesized above. Biases exist with and without malice; teenagers rarely count their parents among those in their support system; and society remains (for the most part) illinformed and suspicious about many, if not all, emotional and psychological disorders. Shame is a very real and powerful factor, both for the afflicted child and the adults who are part of their life.

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With such a wide disconnect between the world we live in and the world we idealize, the matter of parental notification requires accepting some difficult truths: 

Not all parents are engaged or interested in their children’s inner lives;

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Eating disorders are often viewed as a matter of choice or lack of willpower, and not understood to be as involuntary as a heart attack or other traditional physical malady;

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The stigmas attached to eating disorders are powerful and pervasive enough to cause many otherwise responsible parents to ignore or deny a child’s health condition outside society’s zone of acceptance and empathy;

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Even where robust support systems exist outside of the home, few people know where to go or how to address treatment of eating disorders and other emotionally-associated conditions.

This sampling of uncomfortable truths is by no means complete, but it does demonstrate the need for a ‘safe haven’ for kids in which they are able to disclose their situation without fear of parental reaction, interference or judgment. The safe haven in many cases for many children exists only with a general medical professional, their therapist, a social worker or through a representative of their church or spiritual organization. It is no coincidence that in each of the examples above, state and federal law in most cases protects both the adult in those professions and the person seeking their counsel from disclosure of any aspect of their interactions. So what happens if that legal protection no longer exists? It is less than reasonable to expect parents to step into the breach, for biases to dissolve or for teenagers to suddenly embrace the wisdom of their parents. More likely, without such legal safe havens, our children would be deprived of a rare opportunity to have their health condition recognized, addressed and treated with respect by individuals with relevant ethical and professional training. Is it in the best interest of the child to give the parent absolute right of disclosure if it causes disclosure to occur less often?

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We must consider how willing we are to risk the health, well-being and lives of the children we love, particularly if satisfying our curiosity comes at the cost of denying comprehensive, compassionate care to our children at a time when they are desperate for help and feeling pain that is very, very real.

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