National Eating Disorders Association

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When to force PHP or residential

Past sufferers and parents,
My daughter has been doing ED behaviors for 1.5 yrs-- starting w binging, moving to binge/purge, then restricting and currently very low BMI.

I've tried talking to her about 6 times over the past year after reading how to do that on NEDA. It is ALWAYS met with denial and now rage. She is currently seeing an ED specialist for depression and anxiety--since she won't admit ED. They are trying to do it in a round-about way. She is not honest with the specialist about purging or restricting. She told me she would lie to a dietician. She recently dropped more weight.

When do you force a defiant, strong-willed teen into PHP or residential? I'm afraid it will backfire.

Please help! I'm so scared, and I feel totally ineffective as a parent.


I am not a worried parent but I was the daughter of some worried parents some time back.
Although I did not recognize I had a problem at first, there was a moment in my life when I did and I sought for treatment on my own.
My parents did several attempts that did not work. The sufferer needs to bottom out in order to react and accept treatment. It is then, when you are able to make significative changes.
I know sometimes, it is required to force people into treatment (especially when their lives are in danger). However, I firmly believe that complete recovery can only happen until the person is ready. Before that, people only keeps themselves "alive" and at the minimum weight that can keep them "out of hospital". But they will continue to secretly struggle with their ED. Other times, they become "functional" but are not able to live a full recovered life.

Cheers with your daughter. I just want you to know that eventually, she will be the one asking for help.


Thank you, Annet

It is such a wonderful resource to have insight from you. I'm very appreciative!

Thank you for this insightful

Thank you for this insightful information. I joined today.


I agree that hitting a bottom is a powerful motivator. The problem is, my daughter at age 20 just keeps bouncing off the bottom without any change, and this after two months long treatments for her ED (residential and then IOP).

What then? How can we speak to a child like this?

I have been having this same

I have been having this same question...
Annet thank you again for the insight. I just said to my husband that I feel like it is going to take something to happen before she is open to the help. I just hope that "something" isn't something too bad. :(