Co-dependency in Eating Disorders Caregiving

There is often a fine line between being a supportive parent or caregiver of a person with an eating disorder, and experiencing co-dependency in eating disorders caregiving.

Melody Beattie's definitions of co-dependency are by far my favorite.  She has a few versions listed on, Challenges Recovery Communications Network,  that help to clarify what she means by her official definition: "A codependent person is one who has let another person's behavior affect him or her, and who is obsessed with controlling that person's behavior." I also like the simplicity of her abbreviated shortened version:

Codependency is the lack of having a life.
A codependent does not have a life.
A codependent in recovery is getting a life.
A recovered codependent has a life. ~ Melody Beattie

To put the definition in the language used by some in the eating disorders field,  "Skills-based Learning for Caring for a Loved One with an Eating Disorder" by Treasure, Smith and Crane gives us animal metaphors to describe different caregiver responses to helping a loved one. When our loved one is so incapacitated by an eating disorder we can unintentionally create a 'pouch' of care to protect them. Their 'Kangaroo' metaphor is used to describe the 'carer' who instead of guiding becomes overprotective and ends up teaching the sick loved one to avoid responsibilities.

To the uninitiated it may not be apparent what is typically involved in parenting a child in recovery from an eating disorder or how stressful it can be. To get an idea of what is typically involved, you may want to read the stories in my book, "Just Tell Her To Stop: Family Stories of Eating Disorders".  To understand how stressful it can be, I share a quote from the team working with Dr. Janet Treasure, a top researcher in the field who works with the Maudsley Hospital in London, "...the main carers of anorexia show much higher rates of stress than the carers of psychotic patients" (Treasure et al., 2000). So even if you have not been in this tragic position of being a caregiver this gives you a perspective of how very stressful it can be.

This same research team also discovered what Grainne Smith shares in her 2004 book, "Anorexia and Bulimia in the Family", "..the most successful treatment for anorexia, developed at the Maudsley in London...with greatly reduced death rate and fewer relapses, involves training families to support the work of caring professionals..."

Depending on personality and many other factors including what treatment model used, the parent may invest all of their time and energy into helping their child while neglecting their own feelings and needs. To an outsider, it may seem as though the parent or caregiver is simply being self-sacrificing in order to help their child to the best of their ability.  However, when caregivers sacrifice themselves 100% to help the sufferer and  feel as though they need to “fix” their child,  this type of relationship often begins to take a toll on both the sufferer and the parent.  It doesn't help either party. The sufferer begins avoiding responsibility and becomes more demanding of her caregiver to the point he/she is in control (or the eating disorder is). The child then can become too reliant on the parent for help, feeling as though they need their parent to get better. They may also feel without their parent, they will not be able to deal with their eating disorder.

The caregiver will experience burnout, exhaustion, and will no longer be able to remain calm.

This can hold true when a child is in a Family Based Therapy program.  With this, the entire family becomes involved in order to help the person who is struggling.  While this type of therapy has much research regarding its effectiveness, there is the potential as with any treatment model to walk a fine line between care giving and slipping into a co-dependent relationship.

It is important for family members to be able to take a step back from the eating disorder and reduce our expectations of ourselves and stop protecting our ill loved one from every problem that comes along. Find a balance of guiding a very ill loved one and letting him or her experience some self-esteem from solving some challenges. It is essential to be involved, but it is also crucial to recognize there is a limit to what you can to do help your child.

Co-dependent relationships are harmful to both parties involved, and there are ways to help without entering into this unhealthy relationship.  For ways to help, be sure to talk to your child’s treatment team for ideas that are healthy for both you and your child. And watch this blog and Becky's Facebook pages for guidance and services that can coach you through this challenge.

Written by Hope Network, LLC Intern, Kylie MacLeod