Eating Disorders and the Family: Turmoil and Solutions

By Gejia Capasso, Family Therapist for Remuda Ranch at The Meadows



Historically, families have shouldered the blame for a loved one suffering from an eating disorder. This has been met with controversy from both families and treatment teams. We know that eating disorders are complex and that families do everything in their power to fight the eating disorder. Watching someone you love suffer from an eating disorder is painful, scary, and can create anger and confusion. The stress and division within the family can seem overwhelming as each person involved is impacted in different ways. Loss of trust in family relationships, not knowing what to say or how to say it, and not knowing how to support the person who is quite possibly questioning if they even want to get better are all common experiences. Families describe, “Walking on eggshells,” thinking “Everything I say and do seem to make things worse,” and equally “Everything I don’t say and don’t do seem to make things worse.” Here come the shame and blame that families find themselves walking through as they try to understand a disorder that thrives on secrecy, dishonesty, and isolation.

As the family week therapist at Remuda Ranch at The Meadows, I believe, and have witnessed, families benefiting from education around both the mental and physical effects of eating disorders. In addition, it is important to learn about the complexity of its origins, the role other co-occurring mental health diagnoses play in eating disorders, and the “addictive” process within the experience of the eating disorder.

Though everyone has her own journey into and through recovery, know that recovery is possible.




First, I recommend finding professionals who can guide and support you and your family through this journey. Plug into a team of professionals that will be straightforward and honest in providing education, make clear recommendations, and offer an understanding of everyone’s difficult circumstances while being professionally firm in holding people accountable for the safety of the patient within this process.
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Second, realize and remind yourself often that recovery takes time. This is not going to be a short-term process and it will present with many ups and downs along the path to recovery. Remain calm even in difficult discussions and bring in compassion and empathy. It will be important to listen to learn, not listen to agree with, and not listen to speak. Ask yourself “What can I learn about your experience?” Avoid rationalizing, defer to the professionals for treatment and recovery decisions and acknowledge that this is difficult and affects everyone.

Finally, if treatment is what is necessary to help reverse malnutrition and contain the behaviors surrounding the eating disorder, acknowledge this reality and move in that direction. Treatment is a special gift to all affected by this disorder and a wise investment in recovery.

To learn how Remuda Ranch at The Meadows can help, please call 866-332-5209 today.

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Aaron Carter Opens Up About His Eating Disorder

During an interview with Entertainment Tonight, Aaron Carter addressed his recent arrest on DUI and marijuana related charges and shared about his personal battle with having an eating disorder. Carter stated that his eating disorder is caused by a hiatal hernia, which he was diagnosed with 10 years ago at age 19. In the interview, Carter apologizes to his fans, saying, “I am sorry for the way that I look… To everybody I say, ‘Give me a break so I can look better, so I can eat.’”

You can view the interview here.

Help Is Available

Eating disorders can lead to death. In fact, an ED is the diagnosis that leads to death more than any other DSMV diagnosis. Both secrets and withdrawal from family and friends are parts of this disorder, which can lead to grave misunderstandings.


Remuda Ranch at The Meadows was recently featured on an episode of The Doctors, where we discussed treating a woman that had lost a significant amount of weight and was very ill. We offered her 90 days of treatment and helped turn her life around. Our experienced staff understands the severity and the pain that eating disorders bring. For more than 25 years, Remuda Ranch at The Meadows has been helping people recover from eating disorders. There is hope. There is help.

Give Remuda Ranch a call today at 866-331-5926; let’s discuss how we can help you.

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Emotional Trauma and Eating Disorder Treatment

One question often asked is, “Why do people develop eating disorders?” The answer is complex and varied but often an eating disorder develops initially as a solution to another problem.

Often times a person will experience trauma, which can be trauma with a capital “T”, like physical abuse, a natural disaster, or a sexual assault, or it can be trauma with a small “t” which could be an emotional or relational trauma. In addition to experiencing a trauma, the person often does not have the skills or personal resources to cope with the trauma. This may lead to feeling emotionally or mentally out of control and lead the individual to use food restriction, bingeing, or bingeing/purging to gain a sense of control and avoid the discomforting results of the trauma. As the disturbed patterns related to food increase, an eating disorder may develop, which becomes their primary method of distracting themselves and regulating their emotions.




As most people are aware of what constitutes a capital “T” trauma, we will spend some time discerning small “t” emotional traumas. In order to develop into a capable adult, we require certain things from our primary caregiver, such as trust, feeling understood, responding to our needs, and teaching us how to regulate our emotions through both modeling and teaching us skills. If these criteria are not met, an emotional trauma can develop. Additionally, by nature, some people have a more sensitive temperament such that they are more attuned with their environment. These individuals need “super caregivers” who are very responsive to slight changes in their demeanor and highly responsive to their needs. These “super caregivers” also need to regulate their own emotions well when interacting with the sensitive person. At times, an emotional trauma can occur when a primary caregiver is overwhelmed with either their own needs or a family or work situation may pull them in multiple directions so that the young person does not feel heard or understood. Later in life, emotional trauma can occur from significant others, peers, and other important people in someone’s life.


At Remuda Ranch at The Meadows, the treatment team recognizes that eating disorder treatment has to take into account the origin of the eating disorder and if emotional trauma played a part in its development. Knowing this, the clinical team recognizes that all features of trauma must be treated along with the eating disorder. If not, the related consequences of maladaptive behavior will pop back up through the person’s life and lead to a relapse of their eating disorder behaviors or to another maladaptive coping strategy such as using substances or self-harm.

The first step in effective eating disorder treatment includes nutritional rehabilitation. The Registered Dietitians at Remuda Ranch guide this process specific to the needs of the individual patient. The clinical teams know that if the brain is not well nourished then accomplishing the necessary therapeutic work is not possible because the patients’ thinking is not clear. Additionally, most patients are unable to develop insightful connections between their maladaptive behaviors and past events on their own.

At Remuda Ranch we work to meet the needs of the individual patient. There are several program feature which may be used such as EMDR, Acupuncture, equine therapy, cognitive restructuring, family work, psychodrama, and use of the on-site Brain Center. Our goal is for patients to process the traumas and recognize the impact on their lives, which may manifest in any number of ways including, but not limited to, eating disorder behaviors. The final component of treatment is to help patients gain further connections in their lives for the reason that people tend to heal through relationships and by learning how to establish healthy boundaries.

At Remuda Ranch at The Meadows, we see patients as complex individuals with common needs of nurturance and respect. Our staff strives to support each patient in learning to live in peace with others, with food, and with themselves. We find that a solid foundation in recovery is possible using the multitude of resources made available to those who seek treatment at Remuda Ranch.
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Netflix’s ‘To The Bone’ Could Harm Those In Eating Disorder Recovery

Netflix recently released a trailer for To The Bone: a soon-to-be-released movie about a teenage girl with anorexia. The roughly two-minute and thirty-second trailer has prompted hours and hours of conversation on social media about the complex double bind that often results from depicting eating disorder behaviors in the media. While films like To The Bone can raise much-needed awareness about these often misunderstood illnesses, they can also potentially trigger relapse in those who are in recovery from an eating disorder and inspire those who are “on the brink” to engage in dangerous eating behaviors.

Raising Awareness or Glamorizing a Dangerous Illness?

Both the writer/director of the film, Marty Noxon and its star Lilly Collins say they have struggled with anorexia themselves and made the film with care and sensitivity. Noxon said in a statement posted on Twitter:

“Having struggled with Anorexia and Bulimia well into my 20s, I know firsthand the struggle, isolation, and shame a person feels when they are in the grips of this illness. In an effort to tell this story as responsibly as we could, we spoke with other survivors and worked with Project Heal throughout the production in the hopes of being truthful in a way that wasn’t explosive. My goal with the film was not to glamorize EDs, but to serve as a conversation starter about an issue that is too often clouded by secrecy and misconceptions,” she said. “I hope that by casting a little light into the darkness of this disease we can achieve greater understanding and guide people to help if they need it.”

However, as the National Eating Disorder Association points out in their guide to Responsible Media Coverage of Eating Disorders, the complex interplay of biological, psychological, and social forces that combine to ignite the onset of an eating disorder make depicting the stories of those who struggle with these diseases especially challenging.

Many eating disorder specialists have pointed out that the ways in which the To The Bone trailer shows detailed depictions of the lead character’s eating disorder behaviors can be triggering for those who are currently struggling or have a predisposition towards an eating disorder. They fear that the film can serve as inspiration and as a feature-length “How To” video for secretly and severely restricting food intake.

There is also some concern that the film may reinforce unfortunate stereotypes about what people who struggle with anorexia look like. The story centers around a young, white woman who looks very emaciated. While there are, of course, some people effected by eating disorders who fit that description, eating disorders can and do strike people of all genders, ages, ethnicities, and body types. Many people do not look extremely thin or ill in any way, even when they are deep in the throes of the disease. Reinforcing a false assumption about what those struggling with an eating disorder look like, makes detection of the disorder in those who don’t fit “the profile” much more difficult and puts them at greater risk of permanent physical damage and even death.

Should I Watch ‘To The Bone?

Project Heal, a not-for-profit organization that raises money and awareness for eating disorder treatment and prevention, sent an email this week in which they answered some of the Frequently Asked Questions about their involvement with the film. On the question of whether the film is potentially triggering to eating disorder sufferers, co-founder Kristina Saffran said:

“Eating disorder recovery was the most challenging journey in my life, and in the early stages, I was triggered by many things—friends from treatment, diet talk amongst peers, stepping into a gym, and seeing very underweight people. I had to understand where I was in my journey and avoid those triggers. As I progressed in recovery, I was able to be around those triggers, and now, facing them solidifies how strong I am in recovery and how I never want to go back. I hope that our community can keep this perspective in mind when carefully evaluating whether to view this film.”

If you are in recovery or are struggling with an eating disorder, it’s important that you be honest with yourself about where you are in your own recovery before you decide to sit down and watch this movie. It’s perfectly natural for you to be tempted by curiosity, especially when the film seems to be offering some validation and empathy for your previous struggles. But, if you have any doubts at all, don’t take a chance on compromising your recovery.

If you are not someone who has struggled with an eating disorder, but you intend to watch the movie in the hope that it will help you get a better understanding of what it’s like to battle one of these illnesses, take what you see on the screen with a grain of salt. And balance out what you see in the movie by reading the stories of the many different types of people who have struggled with the various types of eating disorders on the Project Heal, Eating Disorder Hope, and Remuda Ranch websites.

Ultimately, we do hope that the release of the film will lead to positive outcomes for those who struggle with eating disorders and their families by raising awareness of not only the dangers of the disease but also of the hope and healing that can be found with the right treatment program.

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Amy Winehouse’s Struggle with Bulimia Nervosa

Saying that there is an unhealthy expectation in our culture when it comes to weight and female celebrities is an understatement. Disordered eating is so normalized in our society that few people acknowledge the gravity of the disease unless they’ve experienced it first hand.

The documentary Amy, which won the Documentary Feature Oscar Sunday night, skims the surface on the subject of disordered eating in female Hollywood and its role in the life and death of famous singer-songwriter Amy Winehouse. Unfortunately, it’s still a far cry away from bringing to light the gigantic reality of Winehouse’s probable battle with bulimia nervosa.

As well documented as Winehouse’s struggles with alcohol and drug addiction were, the possibility of her untreated eating disorder was rarely mentioned. Her thin frame and swollen face were perpetually mocked in the media, but they were always attributed to drug and alcohol addiction. But the documentary does reveal how Winehouse struggled with disordered eating habits from a young age. The singer’s mother recounts the moment a young Amy tells her about a new “diet” she’s discovered – eating and then vomiting, which allows her to eat without gaining weight. Amy’s mother says she essentially ignored the statement, attributing it to a phase that she would grow out of. Amy’s father also dismisses the mention of her eating disorder when it’s brought to his attention.

The Contributing Factors for Eating Disorders

There is not just one cause of an eating disorder. Multiple factors are involved, including genetics, metabolism, psychological issues such as trauma, personality and coping skills, and mood disorders like anxiety, PTSD, OCD and most commonly, depression. According to the National Eating Disorder Association, "substance abuse can develop before, during, or after treatment for an eating disorder," and that reliance on drugs and alcohol is "both ineffective and counterproductive in that emotions remain unaddressed, problems go unresolved, and healthy strategies to cope are not developed."

A person with bulimia nervosa can carry on bingeing and purging for a long time while otherwise maintaining a high level of functionality. The same goes for those with anorexia nervosa, binge eating disorder and purging disorder. An eating disorder can be masked in the way its sufferers are typically able to tend to the demands of relationships and daily life. This makes it easy for friends, family members and peers to overlook the disease, as the footage and interviews in Amy make clear.

The Egosyntonic Nature of Eating Disorders

One of the biggest challenges when treating a patient with an eating disorder is the fact that EDs are egosyntonic, meaning the patient views their eating disorder as being in harmony with the rest of her personality and ego, and many sufferers don’t want to get better. For many ED sufferers, their disorder is misunderstood and their treatment is incomplete; they aren’t addressing the core issues of their disorder and they don’t realize the devastating effects the eating disorder has on their body.

Eating disorders have the highest mortality rate of any mental disorder, but many people don’t know that this is the case. Those who suffer from an eating disorder may die from a medical complication like heart or organ failure, caused by the EDs toll on the body. Unfortunately, these types of medical complications are reported instead of the eating disorder that compromised the person’s health, allowing the eating disorder to remain a powerful, yet silent killer.

Remuda Ranch Can Help

At Remuda Ranch at The Meadows, we provide individualized treatment for eating disorders and co-occurring conditions affecting adolescent girls and women. We offer an acute level of care as well as inpatient and residential programming in a safe, nurturing, and non-institutional environment. Our multidisciplinary team helps patients uncover and understand the underlying cause of their eating disorder and gain the courage and skills to return home and continue on the path of recovery. Please call us at 866-332-5209 or complete the form on our website to find out if our program is right for you.

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