Parenting a child with an eating disorder is among the most frightening and exhausting experiences a family can face. Whether caring for a young child, a teenager, or an adult living at home, caregivers often find themselves carefully orchestrating meals to match shifting preferences, laboring to prepare just the right food, and quietly allowing meals to go uneaten rather than face the distress and conflict that eating demands. Many caregivers are also genuinely uncertain about what expectations are reasonable to hold around food, meals, therapy, or tending to household needs, and are unsure whether to push, accommodate, or simply wait. While these responses come from love and a genuine desire to help, they can also inadvertently interfere with progress towards recovery. These behaviors are known as family accommodations, and research finds they are understandably prevalent among caregivers of individuals with eating disorders. While accommodation often reduces distress in the short term, it can quietly reinforce illness-maintaining patterns over time.

This presentation draws on SPACE (Supportive Parenting for Anxious Childhood Emotions), developed by Eli Lebowitz, Ph.D. at the Yale Child Study Center, an evidence-based parent-only treatment model to reduce parental accommodation. The therapy is designed to help parents understand why accommodation develops, what it costs both parent and child, and how to begin responding differently. Participants will leave with practical tools for managing caregiver distress in high-stakes moments, language for responding with both warmth and confidence, and a structured, compassionate approach to reducing accommodation, one targeted change at a time. This talk is designed for parents and loved ones of individuals of all ages, from young children to adults, living with restrictive eating disorders, binge-purge disorders, ARFID, or other forms of disordered eating. The aim is to help caregivers show up for their child in a way that actively supports recovery without compromising their own wellbeing in the process.

Chief Clinical Officer, Center for Evidence Based Treatment

Amy Kalasunas (she/her), LPCC-S, CCMHC, is a behaviorist with over 25 years of experience working within evidence-based treatment models. A DBT-Linehan Board of Certification Certified Clinician, she has extensive training in Dialectical Behavior Therapy (DBT) and its sub-specialty area of DBT for Multi-diagnostic Eating Disorders (MED-DBT), DBT-Prolonged Exposure for Borderline Personality Disorder, and DBT supervision and consultation team adherence practices. In addition to her DBT-LBC Certification, Amy co-chairs the DBT LBC Communications Committee. A sought-after instructor, she consistently achieves the highest evaluation scores when presenting two- and three-day workshops on the topics of comprehensive Dialectical Behavior Therapy (DBT), DBT and Multi-diagnostic Eating Disorders, and DBT-Prolonged Exposure and Eating Disorders. Amy has also developed, piloted, and researched interventions for parents of multi-diagnostic adult children using an adaptation of the Supportive Parenting for Anxious Childhood Emotions (SPACE) protocol and DBT.

Genetic research has changed how eating disorders are understood, first for anorexia nervosa and now for binge eating disorder. Large-scale genetic studies have identified risk factors that fall across two domains. For anorexia nervosa, the signal lands partly on psychiatric traits including anxiety and obsessionality, and partly on metabolic traits including how the body regulates insulin and blood sugar. Body composition plays a role in both anorexia nervosa and binge eating disorder. Together, these findings support a model in which eating disorders arise from the convergence of psychiatric vulnerability and metabolic predisposition, and not from psychological factors alone.

This talk closes on what these findings mean for families. Genetic evidence identifies biological pathways that treatments can target, and grounds eating disorders firmly in the body as well as the mind. It is important to understand, however, that this research describes populations rather than individuals. It does not, and cannot, predict who will develop an eating disorder or who will recover. What it does do is give us a clearer and more complete picture of these illnesses, and that is meaningful for every family navigating them.

Gerome Breen is Professor of Psychiatric Genetics at King’s College London, Academic Director of King’s Genomics and Chair of the NIHR Mental Health BioResource. He leads EDGI-UK, the UK arm of the Klarman Family Foundation Genetics of Eating Disorders Program coordinated by the Broad Institute of MIT and Harvard, and the Eating Disorders Clinical Research Network, which connects NHS eating disorder services so that people in treatment can take part in research wherever they live. His group runs long-read sequencing studies of anorexia nervosa and binge eating disorder at King’s Genomics, looking for the parts of the genome that older methods could not read, and works with the Psychiatric Genomics Consortium Eating Disorders Working Group.

Alongside this he co-founded the GLAD Study of anxiety and depression, one of the largest mental health cohorts in the world, and researches how genetic differences shape response to psychiatric medication. People with lived experience and their families shape the design of every study his group runs.