Mom Discovers When to Be Tough With Anorexia

After struggling for 10 years, a mom's ultimatum started to reach her daughter.

April 5, 2010, 6:26 PM

April 6, 2010— -- Emily Troscianko's anorexia was so severe that when she was 26 she was barred from a treatment program because her weight had dropped so low. Therapists said she was a medical liability; they were afraid she might collapse at any time.

Her mother, Susan Blackmore, tried everything she could. Then, by accident, she spoke some honest, harsh words.

"Your anorexia is not welcome at my house… I'm not having your anorexia wrecking my new home," Blackmore says she told her daughter, who is now 28. Emily was finishing her postgraduate studies in German at Oxford University at the time, and often came home during breaks.

When Blackmore and her partner, Adam Hart-Davis, moved from Emily's childhood home she decided she wanted Emily in her new house, but did not want to shelter her anorexia.

"For both of us it was a really pivotal statement, a turning point," said Blackmore."I liken it to the dementors in Harry Potter -- she would walk through the house and you could feel the cold.... you felt as though all the energy was being sucked out of you because of this waif."

At the time Troscianko didn't take her comment well. "I thought 'She's being stupid, how could she think that there is a me that isn't an anorexic me' because that was my whole identity then," said Troscianko. "It did make me think and it did make me upset and scared of alienating the closest member of my family."

Troscianko gradually began to eat again. She went from 83 pounds to 145 and feels she's finally healthy today.

The family shared their story with the U.K.'s Daily Mail, and Troscianko also writes about recovering from anorexia in her blog, A Hunger Artist, for Psychology Today.

Despite their success fighting anorexia, Blackmore said she'd hesitate to give other parents advice. For years she felt meetings with psychiatrists, in seminars and in treatment groups, didn't give a single good answer. Meanwhile she watched other parents "turn their lives upside down" trying to find the right treatment. A few mothers even quit their jobs to help with their children's treatment.

Parents Can Feel Helpless Over Anorexia

"My very strong impression is that no one knows what to do," said Blackmore."Nobody knows how to help anorexics get out of it because they don't want to get out of it."

Experts interviewed by wouldn't go as far to say there's no parental influence -- but they do agree treating an eating disorder can be one of the toughest challenges in therapy.

"The statistics say somewhere between 20-21 percent (of patients) will die of their eating disorder," said Tyler Wooten, a child, adolescent and adult psychiatrist at UT Southwestern Medical Center in Dallas, Texas. Those deaths can be caused by heart irregularities, starvation and suicide.

Wooten thought Blackmore's conversation with her daughter was an example of saying the right thing at the right time, but not so-called tough love.

"They are telling an adult that we love you and we would love to have you in the house for visiting, but if you do not get treatment… you cannot come into our house," said Wooten. "That is an effective thing at her age.

"But to say that tough love will work for anorexia is a big misconception because it does not work," said Wooten. According to Wooten, neither does pouring love and attention over someone suffering from anorexia.

Wooten said he often sees parents go to extremes when they realize a child suffers from anorexia. One family tried duct-taping food over a child's mouth only to have child services remove her from their care.

At the other extreme, Wooten said parents "walk on eggshells, they don't want to upset anything because if she gets mad she won't eat, if she gets scared she won't eat."

"They often end up sleeping with the kid in the bed at night and what happens is that the kid starts to get really regressed," said Wooten.

In Troscianko's case, her parents didn't go to either extreme at first -- they sent her to a child psychiatrist.

"I was 15 and-a-half when I started to skip breakfast and I started to lie about other meals. Looking back at my diary, there were the (predictable) things about feeling fat and ugly and wanting to lose weight," said Troscianko. "But there were more complex things -- learning how addictive hunger can be."

Anorexia Had False Appeal

Troscianko said she literally got a "high" by feeling dizzy and lightheaded when she was hungry. There was also the feeling of success and an idea that she was stronger compared to others because she could resist eating.

Her parents noticed something was wrong when she returned from a summer trip abroad looking very thin at age 16 and-a-half.

"I think they were just quite confused and quite desperate -- my father was a lot more proactive with trying to force me to eat and trying to scare me with stories of what would happen if I didn't eat," said Troscianko.

At first, she said, friends admired her stamina, or complimented the way she looked. But within a few years Troscianko started to see how anorexia had taken over her life.

"I really liked skiing and I didn't have the muscles or the energy to enjoy it," said Troscianko. "Also, social situations -- you avoid situations that involve food, which is quite a lot of them."

Troscianko was so busy with anorexia in college that she barely made any friends. She said her father's warnings about her health had temporary effects, but since she hadn't had heart trouble yet or hadn't been on the brink of death yet the warnings "lost their potency."

Once, in 2003, her father threatened to bring her back from study abroad in Germany unless she started eating. Troscianko said that prompted her into eating more, but she soon fell into her old ways until 2008.

"I wouldn't say that I had been fighting against anorexia for all those years, I was in thrall to it," said Troscianko. "The main struggle was actually before making the decision to get better -- it was trying to make myself want to get better."

Troscianko said she couldn't imagine life being any different than her 10 years as anorexic, and she didn't believe her life would get better if she decided to start eating.

Once Troscianko made the decision to eat, it took just under five months to get back to a healthy weight. She now has a boyfriend, friends and is still flourishing in her academic career.

Therapists who treat anorexia said parents may have more influence over their anorexic children if they catch it in early adolescence.

Some Parents Find Success Stopping Anorexia

"The consequences you might set with an adult child that might be ill and you've been down many roads with are different than the consequences you might set for a 13-year-old, whose been sick for three months," said Jennifer E. Wildes, an Assistant Professor of Psychiatry at the University of Pittsburgh Medical Center.

In children younger than 17, Wildes said therapists can teach parents how to keep their children on "refeeding" plans to increase their calorie count. When the child doesn't eat, Wildes said parents have to form a unified, consistent and reasonable front and not back down.

She said families might run into trouble swaying back and forth. "Parents might say earlier in the week, 'You'll be grounded for the rest of your life if you don't eat!' and Saturday she's off to prom with no change in behavior," said Wildes.

Wooten agreed, and has recommended families take away cars if their teenage daughters don't follow eating plans.

But no matter what the age of the child, experts say separating the person from anorexia is a useful tactic. In part, it finally worked for Troscianko.

"To the extent that parents can separate the illness from the child, that can be helpful -- you can love the child but not the anorexia," said Wildes.