When an eating disorder is trying to take over a client, dietitian Lucy Carey says there are 3 rules health professionals should stick to.

I see a lot of teens and adolescents who are flirting with an eating disorder. It may not have completely gripped them yet, but it is in the budding stages. They’re not really eating like they used to and often they are starting to cut down on how much they eat. Intervention at this point is essential to stop the eating disorder taking hold completely.

But one thing that trips up my students, who are health professionals learning how to treat disordered eating, is being too ‘gentle’ at this point. That sounds silly but give an eating disorder an inch and it will take a mile.

Over the last 10 years of working in this area, I have landed on 3 essential rules to adhere to if you are going to squash that eating disorder before it takes firm hold.

1. Be the Bad Guy

The eating disorder will resist the treatment plan and it can be really hard for a parent to enforce it. They are used to dealing with their smart, competent teenager, not a manipulative eating disorder. As the health professional, it’s important to make firm decisions and be clear that these are not negotiable.

This allows the parents and the teen to blame you, the professional, instead of the teen blaming their parents and the parents having to take on the role of bad cop. If the parent can say, “We’re following the dietitian’s plan so you have to eat this,” it can give them some much needed space from the situation. I’ve found that this relieves some of the family tension.

In fact, one of the best pieces of advice I’ve received over the years is to be prepared for your young client to hate you. The more of a threat you are to the eating disorder, the more it will push back. I often find myself explaining to the parents of my young clients, “Everyone hates me at the start. But they love me in the end.”

2. Don’t Negotiate with Terrorists

In this context, the ‘terrorist’ is the eating disorder. It pains me to see health professionals ask ever-so-politely if the plan is okay with the teen and start to negotiate with the teen how much they need to eat, etc. I love empathetic and compassionate coaching, but when you are dealing with an eating disorder that is infecting your client, you need to understand that a soft approach is being soft on the eating disorder.

I give the same advice to parents. There is no agreeing to skip meals or reduce portions, as this is allowing the eating disorder to maintain control. The plan is the plan and they are to stick to it come hell or high water.

This approach can help the teen and their family to unite against the enemy – the eating disorder – rather than feel like they are fighting against each other.

3. Externalize the Eating Disorder

You may have picked up on it already, but I talk about the eating disorder as a separate entity from the client. Encouraging the family and teen to externalize the eating disorder by giving it a name (Anna and Ed are common picks, as a name-form of anorexia and eating disorder).

Again, this helps the teen and their family fight against the eating disorder rather than blaming the child. It’s not that their precious child is refusing to eat, it’s the eating disorder talking. It’s not the apple of their eye is calling them names and lying to their face, it’s the eating disorder. It helps to maintain that separation. I also encourage parents to spend time with their child doing things that don’t involve food, as it can feel like the eating disorder takes over their whole life otherwise.

This externalization approach also helps the teen. It reduces feelings of shame and guilt and helps them to accept help. I will often ask the teen what the eating disorder sounds like and looks like. It helps them to recognize when the disorder is influencing their thoughts. In fact, I will encourage them to tell the eating disorder to “Shut up and go away” if that helps the teen to get through their meals and snacks.

Next time you have a teen or adolescent on the verge of an eating disorder, don’t waste any time beating about the bush.

Put your foot down immediately by being the bad guy, not negotiating with terrorists and externalizing the eating disorder. Hard and fast early intervention like this can make all the difference.

And if you’d like a proven framework to follow in your disordered eating consults, download the S.T.R.I.C.T. Nutrition Method in cheat sheet format. I developed this approach over the last 10 years and it works. Take the guesswork out of your consults by following a clear approach to disordered eating.

Confidently support your clients as they leave food guilt behind, achieve their natural weight, and unlock lasting food freedom! Download the cheat sheet version of the S.T.R.I.C.T. Nutrition Method today.