FBT Parent Coaching for a Child or Teen with Anorexia

(FBT = Family-Based Treatment for Anorexia Nervosa)

When your child or teen is diagnosed with anorexia, it can feel like your entire world stops. Every meal becomes a battleground, and every day feels like an emotional marathon. Parents often tell me they feel helpless, terrified, or completely burned out trying to get their child to eat.

Many families believe they have only two options: convince or beg their child to eat, or send them to a residential treatment center. But there’s another path, an evidence-based approach that allows your child to recover at home with your direct involvement.

That approach is Family-Based Treatment (FBT). With FBT parent coaching, you can learn how to help your child eat, gain weight, and begin recovery, all while staying emotionally grounded and supported yourself.

What Is Family-Based Treatment (FBT)?

Family-Based Treatment (FBT) is the leading evidence-based therapy for anorexia nervosa in children and adolescents. Instead of requiring the child to be motivated for recovery, which is often impossible early on, FBT places parents at the center of the healing process.

Parents become the primary agents of recovery. It’s an approach that respects the child’s agency while recognizing that they need help with nutrition right now.

In the first phase of FBT, parents take full responsibility for feeding and weight restoration, while the child focuses on eating and regaining physical stability. As the child improves, parents gradually hand back control and work on emotional and relational healing.

Why FBT Works

Anorexia is ego-syntonic, meaning the person believes their restrictive eating is in their best interest. It’s not rebellion or stubbornness, but rather a strategy grounded in good intentions, but that’s having negative consequences. Brain scans suggest that these consequences are almost always invisible to the person with anorexia until they achieve baseline nutritional recovery.

FBT works because it understands this brain-based difference. It doesn’t rely on convincing the child they’re sick or require the child’s insight or willingness to recover. It empowers parents to take over feeding temporarily, restoring their child’s brain and body so that true healing can begin.

With parent coaching, parents learn how to create structure, supervise meals, respond compassionately to distress, and stay emotionally regulated through high-stress feeding situations. All of this sets the foundation for sustainable recovery and healthier parent-child dynamics over time.

Why Parent Support Is Essential During FBT

While FBT focuses on the child’s recovery, it demands an extraordinary level of effort and emotional stamina from parents. Most parents tell me how physically and emotionally taxing it can be to refeed their child at home.

You are not just preparing food, you’re sitting through panic, tears, anger, and refusal, often several times a day. You may face verbal hostility, negotiation, or complete withdrawal from your child. Meanwhile, you’re managing your own fear, guilt, exhaustion, and grief.

Many parents describe FBT as the hardest thing they’ve ever done, but also the most important. Without proper support, it’s easy to become overwhelmed, discouraged, or burnt out. That’s why parent coaching is such an essential layer of support. It will help you stay grounded, confident, and emotionally resilient while doing this intense work.

The Three Phases of FBT

Phase 1: Weight Gain
Parents take full control of all food decisions and supervision. Meals are structured, consistent, and firm. The goal is steady weight restoration, which typically takes 3–5 months. Parents attend weekly sessions for support and guidance.

Phase 2: Eating Flexibility
As your child gains stability, you gradually return eating control to them. They may begin managing small meals or snacks while remaining supported at others. The goal is flexibility and confidence. Parents usually attend biweekly coaching or therapy sessions.

Phase 3: Maintenance and Mental Health
Focus shifts toward emotional regulation, family relationships, and relapse prevention. Parents may explore topics like identity, anxiety, and body image alongside ongoing supervision. Monthly sessions support continued progress and balance.

Why Weight Restoration Comes First

It’s common for parents to want to address the emotional or relational “causes” of anorexia first, but malnutrition itself makes that impossible. A malnourished brain can’t regulate mood, process logic, or engage in emotional work.

FBT prioritizes weight restoration first because nourishment restores brain function. Once the brain is functioning properly, deeper psychological healing can occur.

Think of weight gain as laying the foundation for recovery, not the full structure, but the essential first step on which everything else depends.

FBT After Residential Treatment

If your child has already completed residential treatment for anorexia, FBT can be a vital next step. Returning home can destabilize progress if structure and supervision fade too quickly. In these cases, parents may begin with FBT Phase 2, focusing on maintaining weight, reinforcing food flexibility, and strengthening emotional coping. Parent coaching can help you navigate this transition with confidence and consistency.

Common Parent Challenges During FBT

Even with training and support, parents frequently encounter challenges that can feel overwhelming. One of the most common struggles is managing meal-time anxiety, both your child’s and your own. It’s normal to feel tense, frustrated, or fearful that your child isn’t eating enough or is resisting too strongly. Many parents worry they are “failing” or that their child will never recover, which can create guilt and self-doubt.

Another frequent challenge is maintaining consistency across households or caregivers. If parents are divorced, separated, or co-parenting, FBT requires close communication and alignment. Differences in approach, tone, or enforcement of rules can confuse the child and undermine progress.

Parents may also face social and emotional isolation. Friends, relatives, or peers often do not understand anorexia, and parents may feel judged or unsupported. This isolation can intensify stress and anxiety, making coaching and peer support essential.

Recognizing these challenges is the first step. With awareness and guidance, parents can anticipate difficult moments, implement solutions, and maintain steady, compassionate leadership throughout recovery.

Emotional Self-Care for Parents Doing FBT

FBT is intense, and taking care of your own emotional health is not optional; it’s essential for your child’s recovery. When parents are exhausted, anxious, or burned out, it can inadvertently escalate conflict or tension during meals and family interactions.

Emotional self-care strategies often refer to solitary activities, but as relational creatures, establishing a supportive relationship with another adult, such as a coach, therapist, or parent support group, is extremely effective at helping parents regain balance. This gives you space to process your emotions and gain perspective.

Learning to set boundaries with your child in a compassionate way is another critical self-care skill. FBT requires firmness around eating, but that does not mean you must sacrifice your own well-being. Parent coaching helps parents maintain this balance, so you can respond with calm authority rather than reacting from exhaustion or fear.

Ultimately, parent self-care ensures you remain resilient, patient, and present, which directly supports your child’s progress and helps your whole family navigate the challenges of recovery.

Coaching Support for Parents Doing FBT

Family-Based Treatment is challenging, and many parents underestimate just how much energy, focus, and emotional resilience it demands. Every day involves managing meals, supervising snacks, monitoring weight, and responding to resistance, anxiety, or anger from your child. It’s common to feel exhausted, anxious, or emotionally drained, even if you’re fully committed to your child’s recovery.

Parent coaching is designed to support you through every aspect of this process. A trained coach helps you stay calm and centered during meals, process your own fears and frustrations, and develop strategies to respond effectively to your child’s distress. Coaching sessions provide a safe space to explore the emotional toll of FBT, to share what’s overwhelming or discouraging, and to receive guidance on maintaining consistency and confidence.

Through coaching, parents learn to balance firmness with compassion, understanding that your child’s resistance is part of the disorder, not a reflection of your parenting. A coach helps you anticipate challenges, troubleshoot difficult moments, and build sustainable routines that reduce family stress while increasing your child’s progress. Over time, parents gain clarity, confidence, and emotional resilience, which not only supports their child’s recovery but also strengthens the entire family’s well-being.

Ultimately, FBT coaching isn’t just about helping your child eat; it’s about helping you be a strong, resilient parent who can navigate this incredibly demanding process with steadiness, compassion, and hope.

You Don’t Have to Do This Alone

Family-Based Treatment can help your child recover, but it also asks more of you than almost anything else you’ve ever done. Coaching can make the difference between burning out and staying steady.

If your child or teen has anorexia and you want guidance on implementing FBT at home, parent coaching can support you every step of the way.

➜ Learn more about Parent Coaching for Eating Disorders or schedule a consultation to find out how to get started.

Important note: Ginny is a coach, NOT a licensed therapist. She doesn’t diagnose or treat mental illness, addiction, eating disorders, etc.