Sarah and Dan have four young children. Their eldest son, Elliott, was diagnosed with anorexia when he was 16 years old

It all started with one comment. When Elliott was 15, he invited a couple of friends home after school. Up to that point, his parents say, he was a happy and intelligent boy, full of life. One of the friends noticed a photo on the wall of Elliott on holiday in Spain and commented that he looked fat. That was the beginning of Elliott’s long relationship with an eating disorder.

“It took us some time to really get to grips with what was going on,” says Sarah. “He was very careful to hide his behaviour, and at first we simply thought he was trying to be healthier by not eating certain foods. But as the months went by, I noticed he was exercising obsessively, his school packed lunch was going untouched and once we went to a restaurant and he asked the waiter which meals had less than 500 calories.

“There was another incident when we said he couldn’t go to the gym and he tried to climb out of his bedroom window, three storeys up.”

Elliott also started to have terrible mood swings. He seemed furious with everyone, but particularly Sarah. He’d get aggressive, purposely picking a fight, punching holes in doors and screaming at her. One day he pushed Sarah hard into a wall.

“We were surviving, rather than living,” she remembers. “The whole family was affected. There was terrible confrontation with his siblings, and Dan was blaming me for the arguments. The pressure on us as a couple grew and there were periods when I thought we’d end up divorcing.”

Eventually, the family’s GP referred them to the Eating Disorder CAMHS (Child and Adolescent Mental Health Service) team. It was the beginning of a year in therapy. Julia Matthews, a family and systemic psychotherapist, says: “One of the first steps we take is to encourage parents to look after themselves. We aim to strengthen the parental relationship because we believe the greatest resource in any family is the parents. If they are strong, the rest can be supported better.”

In Elliott’s case, he was encouraged to use a technique that separates the patient from the problem. He was asked to give his condition an actual name (from then on, it was referred to as Caesar); the idea is that you are placing the onus on a third party, which helps to alleviate the guilt and shame that people feel. “Caesar” can then be viewed as something that has invaded everyone’s life, a separate force, which can hopefully be tackled and managed.

“For so long we’d felt helpless,” says Dan. “We thought we were terrible parents who had done everything wrong. Slowly those beliefs started to change. The therapy helped us consider how we could work together as a family to confront ‘Caesar’.

“Elliott’s sisters came to some of the sessions, and they really enjoyed the chance to express their feelings and the constructive input they could have. For so long, Elliott’s eating disorder had dominated everything.”

‘Fortunately, Dan and I have bonded again, and we can be optimistic about our future’

Matthews adds: “Children diagnosed with anorexia often have complicated issues. But strategies to manage Elliott’s situation were put in place, and the parents were supported to take charge of his dietary intake. Dan had to change his job to give him more time at home, and there was continual management of the heightened emotion in the family. But eventually this helped Elliott to understand how the eating disorder was controlling him.”

Sarah admits she is still reeling from the experience. “The change in our situation is so much more positive, but as parents we have been through a lot of pain. Fortunately, Dan and I have bonded again, and we can be optimistic about our future. Elliott’s relationship with food is healthier now and we can talk about the situation without fear. That, in itself, is amazing.”