Co-dependency in Eating Disorders
A complex and uncomfortable topic is the suggestion of a co-dependent relationship between a person with an eating disorder (ED) and their parent/carer.
Understandably, a child or adult with an active ED is very dependent on their parent/carer for most if not all aspects of their physical, and at times mental, wellbeing. However, what is less understood is whether the parent may become co-dependent on their ED child, with their parental emotions and actions dictated by the eating disorder.
Co-dependency is a psychological term used to describe individuals who are preoccupied and dependent on another person — physically, mentally, and/or emotionally. Co-dependent relationships in ED may occur if the parent/carer becomes dependent on their loved, in addition to their loved one being dependent on the carer for their recovery.
Parents may take on their child’s ED as a huge part of themselves. Their entire parent-child relationship can become about the ED, which may start to feel unbalanced and fear-based. Co-dependency can be considered unhealthy if the parent removes all agency and tries to control their ill child.
Changes are inevitable in the child-carer relationship during an eating disorder. These changes can still sit in the normal spectrum of parent-child relationship, as in any child who has a chronic illness and requires constant care.
With regards to ED, the first-line treatment for young people and adolescents is Family Based Therapy (FBT), where parents are empowered to bring about the recovery of their child and must make all the early decisions regarding food and eating. This approach is stressful, daunting, and counterintuitive for many carers. However, research shows that people with an ED who have resources, support and social connections have better long-term outcomes.
Often an individual experiencing an eating disorder (ED) is so unwell that the parent or carer unintentionally create an ‘enclosure’ of care to protect them. This can then morphe into overprotection, where their loved one learns to avoid taking responsibility.
Whether co-dependency occurs is difficult to ascertain, however if it manifests beyond ‘normal caring’ it can impact recovery.
Co-dependency can create a family dynamic of disharmony, where the other members in the family (spouse or other children) may have feelings of rejection, fear, anger, pain, or shame. Often these emotions are ignored or denied by the co-dependent family member.
Development of co-dependency
Sometimes there is a fine line between being an engaged and supportive parent or carer and developing co-dependency.
An ED makes everyone involved second-guess themselves. The ED loved one may suffer from low self-esteem and emotional dysregulation as the ED mindset hijacks them on a terrible journey of disordered thinking and self-loathing.
Carers then question their every action and word, particularly in the face of ED’s hostile reactions. It is a sharp learning curve to understand that it is ED, not their loved one, who is saying and doing things so unlike their pre-ED self.
Recognising co-dependency
Caring for a loved one with an ED, including the demands of treatment, takes an inordinate amount of time. However, there is a point where the carer might invest all their time and energy into helping their loved one and neglect their own feelings and needs.
When carers sacrifice all of themselves and become consumed by ‘fixing’ their loved one, the relationship can alter drastically. This takes a toll on the individual experiencing an ED, as well as their family.
Warning signs of co-dependency:
- If the person with an ED –
- begins to avoid any responsibility
- becomes extremely demanding of their caregiver to the point of having complete control
- feels helpless without their carer and unable to face their eating disorder.
- Or, if the carer –
- starts to view themselves as a victim
- becomes fearful of and, more often than not, accommodating of their loved one’s negative mindset
- ignores any of their own physical, emotional, and mental needs and experiences complete exhaustion
- is unable to remain calm
- loses sense of their own identity.
What to do
It is important for carers to occasionally step back from the eating disorder and try not to ‘fix’ it. Instead provide empathy for the loved one to empower them to recover. Easier said than done.
Another carer instinct is to try and protect our loved one from every problem that comes along, but the key is to find a balance of guiding and letting them experience self-esteem and confidence from solving small, incremental challenges. It is essential to be supportive and visible but realise there is a limit to what you can do to ‘fix’ the illness.
Reaching out to community services such as EDFA’s Fill The Gap Counselling Services, as well as our online webinars and our forums that are moderated by the EDFA team. Fellow caregivers share similar experiences, offering valuable advice and assistance, as you discuss the challenges you face and strengths you embody as both a carer and individual.
Should you have any questions regarding the support services offered by EDFA, please don’t hesitate to contact us.
This article was written by a carer who supported a loved one across many years of acute illness, multiple hospitalisations, and now ongoing recovery. They recognise many traits of co-dependency along their journey, including the present day where they find themselves still referring to the past medical journey in often irrelevant everyday conversations. However, they are also passionate about the value of caring, that needing others is normal, and wonder if the label ‘co-dependant’ can create needless blame and guilt.
Karina Smith
