How common IS parentectomy these days?

Pretty common! When an eating disorder patient is away at residential care, or hospitalized and visiting hours are limited or must be earned, that's still a parentectomy to me.

I know it is meant well, and I also know that some clinics do it because they truly think it works. I know there is a practical part to it when there are facility activities going on a schedule to be maintained. I know the policy is not meant to give the message to a child that their parents are optional, marginal, subordinate to the doctors, and a conditional element in their life. It isn't meant to blame parents for the illness or consider their influence toxic or unhelpful.

But here's what happens. When a clinic only allows "visiting hours" for parents for eating disorders it makes eating disorders different than other medical illnesses. That practice is largely gone in most hospitals, where parents routinely live in the hospital with their children and have unlimited visitation.

A parent at Around the Dinner Table put it well: "...if the child were in hospital for cancer and chemo treatment - would the drs use a visit from the parents as a bribe to get the medicine into the child? Sorry, you can't see your mom or dad until you take your medicine? It just doesn't feel right."

When patients lose "privileges" to see parents then parents stop being part of the treatment team and become a pawn. Consequences and rewards imply the patient is choosing their behaviors instead of UNABLE to comply.

When a child can choose when to see and when to send away a parent then the parent child relationship can easily become consciously manipulative. "I hate mom for making me come here and I feel like hurting her." "If dad is mad at me I can keep him away." "I feel guilty for making them stay at the hospital. If I don't eat they'll get to go home."

I believe access to one's parents is a human right, and that access to one's child is a parental responsibility. F.E.A.S.T. made a clear statement on this early in our history.

I'd like to talk all eating disorder facilities into ending this stance on parent visitation. We need your support in having our kids see us as part of the team and as interested in being there as we would if it was a burn injury or an infection. Even without the sad legacy of blaming and marginializing parents during eating disorder care it is bad policy to separate families.

P.S. This includes siblings.


  1. Parentectomy occurs in non-hospital settings too. When a therapist calls Mom back to his/her office and not Dad or siblings, the implication is that Mom is more important to the treatment team than Dad and siblings. Additionally, Dad starts to feel left out or at worst, incompetent, while Mom feels alone and fully responsible. Communication with other family members about the plan becomes Mom's responsibility. Mom's plate is already overflowing with the multitude of hats she's been given to wear as her child is refed. While not intentional, this type of parentectomy leads to triangulation within the family and only serves to fuel ED.

  2. Laura - I also want to add that this happens at doctor appts. too. I was aware of this at the clinic we used and let them see our d alone at the first visit (fine, go ahead and ask her if she been abused) and then told them that I would stay in the room at the rest of her appt. I was told the reason they like to see the patient alone is that the patient might reveal something to them that they might not reveal to us. Like vomiting. I watched mother after mother sit in that waiting room week after week as I went in and accompanied my daughter. I shudder to think how this process would have gone had I not been in those appt. as I believe this medical professional would have listened to ED a great deal. ED require very assertive parenting!!

  3. Those are both incredibly insightful points! Thank you!!

  4. I heard a hideous story today of parents seperated from their anorexic son FOR TWO YEARS and their phone calls (one a week) were monitored and, if the listener felt the parents were being negative, the phone call would be terminated.

    This was 12 years ago.

    When I asked d what she thought of that she replied that she would not have wanted to get better at all. In fact, she would have rather died.

    I agree with d.

    Shocking and, to my mind, inhumane.


  5. I think we should print this out, send it to all eating disorder facilities with as many family signatures on it as we can gather.

    How's that?

  6. Laura, I have been reading your blog for some time. I'm a 24 yo recovering bulimic who is also a drug addict and I believe strongly that my addiction and ED are the same disease--21 days in drug rehab (even though the rehab really had NO CLUE what an ED was) helped more than 7 years of outpatient. Anyway, I'm kind of neutral on Maudsley I guess,while I would have hated it I can see how it would have been effective in some of my friends and maybe me as well (though I don't know about in the long-term).

    Anyway the point of this comment is, I like how you challenge treatment centers and clinics and whatnot on certain things they do and say what you would like changed. I am just curious, after having been in rehab, this seems like a tall order for facilities. How do you propose they run their day with parents in and out all the time, or staying overnight, etc.? What would your ideal treatment facility look like?

  7. Fair question. I've thought a lot about this, actually - building a facility of my dreams. I actually even have a site I'd put it...

    What I would like to see is that family be alongside the patient 24/7. This is assumed in pediatric medical wards, now, and progressive hospitals now offer rooming in for family of adults as well.

    During ED treatment there are times when the patient would have activities on their own (group, individual therapy, recreation, some tests, etc.) but those are times when the family could get a breather, take care of family responsibilities, spend one on one time with siblings, and - especially - receive training and coaching and therapy themselves.

    I am looking at a family-based model where instead of the patient being the one being treated the whole family is the patient.

    Financially, this is a different model entirely. But if it WORKED it would be more cost-effective.

    The biggest barrier, however, remains the idea that treating the patient alone is effective. I haven't seen much evidence of that. I think it is time to consider new models.

  8. "What I would like to see is that family be alongside the patient 24/7. This is assumed in pediatric medical wards, now,"

    I doubt that is common-place.

    What about adult ED patients? Do they have a right to their parents as well? If they are 18 or 19?

    It's nice to include siblings if they are wanted but some can do more harm than good.

  9. that pdf statement isn't downloading properly.

  10. Thank you, Anonymous!

    The new site has different addresses for all the pages, so all F.E.A.S.T. links go to the main page, I'm sorry to say. I fixed it on this post, though, thank you!


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