You and your child do not necessarily want every relative and friend to know that she has an eating disorder. Before you tell others about the diagnosis, you need to talk this over with your child. Who will communicate what to whom? The answers to this question vary widely from one family to another, depending on the age of the patient and the quality and styles of relationships among family members. Serena and her mom looked back on how they managed challenges related to privacy.

Serena’s Perspective
“I wasn’t fussy about which adult relatives knew about my eating disorder. What worried me was how kids at school would react.

I didn’t tell any of my ninth-grade classmates about my problem.

Now I realize that most of them knew anyway. They didn’t give me a hard time about having anorexia. They mostly stayed away from me and vice versa. I wanted to know why my three former friends had dropped me but was afraid to ask them. Back then, I could not come close to describing how alone I felt.

“At about that time, a childhood friend came back into my life. Until Ricky and I were 11, his family had lived in the apartment down the hall from us. Ricky and I did a lot of bike riding back then; we were good buddies. But then his family moved about an hour away. Ricky and I stayed in touch, but we didn’t see each other often. One afternoon in ninth grade-when my eating disorder was at its worst-I’d just started the walk home when a yellow bus pulled up to the school’s athletic field and members of a visiting team filed out, among them Ricky. I wanted to run away before he saw me, but it was too late. We exchanged greetings.

It felt surreal. He phoned me that evening, and I told him I had anorexia. As we talked, I sensed that he didn’t just want me to look better, he wanted me to feel better, and that meant a lot to me.”

Understandably, many individuals fear that their eating disorder will draw ridicule from peers. You should warn your child, as Roberta did, that it is not unusual for young people to promise they’ll keep a secret but then tell others, perhaps thinking, “I’ll just tell her a tiny bit about it,” or “She won’t mind if so-and-so knows.” Thus, your child needs to be judicious regarding which friends she tells about her struggles.

Roberta’s Perspective
“When Serena’s eating disorder struck, I’d been divorced from her father, Russ, for four years. But he’d stayed in the area and maintained positive ties with Serena. He and I were on fairly good terms as well. Though I harbored unspoken fears that Russ might blame me for Serena’s illness, she and I both felt strongly that he should be the first to know. That turned out to be a good decision. Though Russ and I had some awkward, intense conversations during that time period, for the most part, my fears proved unfounded. I have to say that Russ totally came through for us; in fact, he was the one who finally convinced Serena to try talk therapy, and he was supportive to her throughout treatment. Plus, he kept everything confidential. Unfortunately, I can’t say the same for every adult relative we told. But I suppose some gossip was inevitable, and it seemed to bother me much more than it did Serena.”

Once you decide whom to tell, you’ll want to think about what to tell them. How much detail will you include? Will you play the illness up-or down?