When your son has Bulimia

I am frequently asked for advice by parents who have a son diagnosed with bulimia.  Here are some suggestions on how to be helpful.

1.  Talk with your son about how privacy and confidentiality.  While he needs someone to talk to, he may be concerned that people in your life will find out his personal information.  It is good to have this discussion up front to make sure you respect each other’s needs.

 2.  Offer encouragement and support to help with finding a treatment team that is qualified to help with an eating disorder.  Even in an outpatient setting, most people diagnosed with an eating disorder require key treatment team members including, but not limited to, a therapist, a psychiatrist, a dietician and a physician.  If your son is financially independent, he still might appreciate your assistance in finding the right people.  He may be hesitant to make phone calls or tell people personal information over the phone. 

3.  Establish your own support system.  In urban areas or other places where there is an eating disorder program established, there are frequently free support groups/education classes for family members to attend to learn more about the illness.  It is also often a good idea to establish your own therapist who is knowledgeable about eating disorders and can help you facilitate what role you can play in your son’s recovery.  There are also nonprofit eating disorder sites that provide excellent information relevant to treating men, such as NationalEatingDisorder.org or Namedinc.org. 

4. Focus on how your son is feeling about both his eating disorder and life rather than focusing solely on his food and weight.  Depending on your son’s level of comfort with communicating information to you, he may be willing to share some of the issues he feels led to his binging, purging and other eating disorder symptoms. 

5.  Practice patience with people who do not understand that eating disorders affect both males and females. You may have to educate those in your life as you learn more.  This can often be the case for medical providers as well as other support people.  

6.  Role model healthy self-care and dietary practices.  Sometimes, your son may like you to eat with him to offer support, but it is more effective to do this when you are eating a meal or snack that is good for you.  This does not always mean eating the same foods. Each of you may have different needs based on age, activity and other factors. The important piece here is that this time is meant to be supportive rather than judgmental or stressful.  Keeping the meal time safe can be especially difficult with active family schedules!

7.  Your son may appreciate bathroom support at times.  He may ask you to monitor him in some form when he goes into the bathroom.  This is often most helpful directly after a meal or snack.  Yet, this is an area that you should discuss and establish with your son whether it would actually be helpful.  Sometimes, a third party such as a therapist can help you determine this. 

8.  It is very important to make sure your son has a comprehensive assessment to determine if he has any further issues around substance usage or medical concerns in addition to his eating disorder. While someone’s weight might appear stable, he might still be very vulnerable to both medical and psychiatric effects from purging and poor nutrition. 

9.  Someone on your son’s medical team will guide him on whether there is a need for a higher level of care such as going into an outpatient program or hospital.  Since many treatment programs are limited to treating females only, it is good to research programs that also work with males. 

10.  A family therapist is often very helpful in ensuring that everyone in the family is communicating well and getting needed support.  The entire family needs support and a safe place to ask questions during this time.