By Lauren Muhlheim, Psy.D. and Therese Waterhous, Ph.D.
Families often ask whether they should proceed with a previously scheduled trip or take a well-deserved “break” during the refeeding process. We advise that travel during Phase 1 of FBT be avoided if at all possible. We know several families who have vacationed with a child well along in treatment for anorexia and found their child lost 5 to 10 pounds over the course of a week, erasing months of progress. Children and young adults with anorexia have difficulty with change; if a child is having difficulty completing meals in the home, it is unlikely that they will be able to do so on vacation, where most meals will be eaten in an unfamiliar setting in the presence of non-family members.
During vacation, parents may be tempted to give in more easily to the anorexic thinking and behaviors because they do not want to upset other diners in a restaurant or because they “don’t want to ruin” the vacation after they’ve invested a lot of money in getting there. The food may be different than that available at home, or it may be difficult to get the types of foods on which the family has been relying. Children and young adults with anorexia are inflexible; if the food is different than that to which they are accustomed, they may refuse to eat at all. Sightseeing often involves a lot of walking, which can burn a lot more calories and require even greater caloric intake to offset. Many vacations occur in warm climates, where health problems related to malnourishment or dehydration may be magnified. If families do travel during Phase 1 or Phase 2, they should be cautioned that it may cause a setback and prolong the recovery process.