On February 6, 2021, we gathered in Murmo’s virtual room to listen to and actively participate in the Thematic Parents’ Club event titled “Eating Disorders in the Family,” hosted by Dr. Mária Sonnevend, a child psychiatrist and psychotherapist. Although we couldn’t meet in person due to the pandemic, it was a silver lining that the online format allowed for the participation of a large number of interested individuals, without any attendance limits.

To engage with her audience, Dr. Mária Sonnevend began right at the start with an anonymous poll, which revealed that more than half of the participants had a family member personally affected by an eating disorder, and that most people wanted to learn more about selective eating and anorexia nervosa.

In Search of the Causes

“I wish I knew why!”—this is what a parent whose child is struggling with an eating disorder might think. It’s important to know that there is no single, clearly defined cause for why it develops. This is precisely why professionals don’t primarily look for causes, but instead focus on four main categories: risk factors (e.g., perfectionism), triggering factors (e.g., peers teasing the child for being overweight), maintaining factors (e.g., peers praising the child for being as thin as a supermodel due to starvation), and protective factors (e.g., strong family bonds, open communication). A thorough assessment of these factors enables the professional to outline the most appropriate treatment plan.

Risk factors may also include biologically determined factors, such as inherited temperament (which may be linked to traits like anxiety tolerance and novelty seeking) or sensitivity to sensory stimuli (SPD). Triggering factors mostly stem from the environment, and controlling them often falls outside the child’s or family’s sphere of influence. The media and the Western body ideal it conveys also play a significant role in eating disorders. Under the influence of the media, social media platforms become the basis for comparison, making it difficult for children to find their place, as they compare their appearance not only with their classmates but with the entire world. The speaker emphasized that since children can always find someone “better and more attractive” than themselves online, this, combined with the fundamental insecurity of adolescence, can make it very difficult for the current “media generation” to cope.

Food is Life

From a parent’s perspective, perhaps the most difficult aspect of a child’s eating disorder is that survival depends on nutrition, so the condition is very risky for the child and deeply concerning for the caregiver. Eating plays a central role not only in terms of survival but also in the family’s own customs; shared meals can be cherished moments in family life, and with the illness, this collective joy may be lost or become unbearable for everyone. As a result, tension surrounding shared eating rituals can become chronic, previously insignificant details can turn into significant and divisive issues, and ultimately, this sense of constriction can spread from the dining table to all other experiences and events within the family.

The most important foundation of family therapy is the systems approach, which views the family not merely as the sum of its members, but as a system in its entirety. Within this system, everyone has their own role, and the illness is integrated into this unity. The specialist drew the parents’ attention to the fact that the family is not the cause of the eating disorder, but rather creates a system in which the symptom has meaning and a specific function that plays a distinct role in the family’s daily life; thus, it becomes an organizing and regulating force, “solidifies,” and persists over time. The eating disorder is both a friend and an enemy to the child; it offers a solution and an escape from a difficulty, and for some reason, the child needs it (e.g., it can stabilize self-image or provide a sense of identity). At the same time, the illness disrupts the family’s fundamental balance and can significantly divide family members.

“One day, when we look back, we will see the years of struggle as the most beautiful.” (Sigmund Freud)

After outlining these difficulties, Mária Sonnevend also offered some relief to the concerned audience; she shared numerous ideas and thoughts that can help the entire family cope. The family is the child’s best observer and also the arena of their development; the child prepares for adult life by learning about the world and themselves through their close relatives. For this reason, family members play a prominent role in recovery alongside the professional. In therapy, it is important to shift the focus from symptoms to relational patterns, as the child’s reactions change when the context changes. Instead of dysfunctional patterns, there is a need to uncover and reinforce functional, alternative ways of coping.

According to the literature, eating disorders are easier to treat during childhood and adolescence and are less likely to become chronic; the results show that, with appropriate therapy, approximately 50% of patients with anorexia achieve a full recovery. According to the speaker, a good parenting strategy may involve striving to understand emotions and show empathy, while at the same time remaining level-headed and gently presenting reality to the child—and ultimately for the child’s own sake.

The child psychiatrist from Murmo provided a comprehensive and in-depth overview of the types of eating disorders, the role of the family, and effective therapeutic options. Her supportive approach and her realistic, concrete examples can offer a lifeline and guidance to anyone who is in any way affected by the topic of eating disorders. To conclude the presentation, the audience received answers to their own questions and positive words of encouragement from the center’s specialists.

The latest events from Murmo and the Pro Juventa Foundation can always be found on the Pro Juventa website and Facebook page. The foundation works tirelessly to provide comprehensive therapy to children and adolescents who cannot access support elsewhere.