Hi, my name is Annyck and I’m a registered dietitian and a Family-Based Treatment (FBT)-informed clinician. If your child is an athlete and has been diagnosed with an eating disorder, you’re likely overwhelmed with questions, fears, and pressure from coaches, teammates, or even your teen themselves to “get back to sport.”
You may also be wondering: Where does a dietitian fit into this? Will I get a meal plan? Should my child work with someone one-on-one?
FBT is different from many traditional eating disorder treatments. Rather than focusing on the teen as the main agent of change, FBT puts parents in the lead role. And as your family’s dietitian, my role isn’t to give you a rigid nutrition plan ; it’s to help you become confident in feeding and fueling your athlete for both healing and eventual return to sport.
Let me walk you through what you can expect when your athletic teen begins FBT and how I’ll support you every step of the way with practical, performance-informed nutrition counseling that puts safety and recovery first.
What Is Family-Based Treatment (FBT), and Why Is It Ideal for Athletes?
FBT is the gold-standard outpatient treatment for adolescents with eating disorders, including anorexia nervosa, bulimia nervosa, and OSFED. It’s especially effective for athletes because it:
- Prioritizes early medical and nutritional restoration
- Halts unsafe exercise patterns
- Treats food as a critical performance and recovery tool, not a point of control
- Mobilizes the family to restore health before the athlete returns to their sport
Unlike therapy models focused on insight or motivation, FBT is behavior-first. The assumption is not that your child must “want” recovery to begin healing. Instead, you take the lead, and together, we focus on action over insight in these critical early weeks.
As a dietitian trained in this model, I support that action by helping you fuel your teen’s body and brain—even in the face of resistance from the eating disorder.
Phase 1: You Take Charge—and I Help You Fuel for Healing
Phase 1 of FBT begins as soon as your child is medically stable for outpatient care. It’s the most intense phase, and if your teen is an athlete, it often includes one very difficult step: a full break from physical activity.
This can be heartbreaking. You may worry about lost seasons, missed opportunities, or falling behind. Your child may beg to return to training. But healing from an eating disorder isn’t just about eating a little more—it’s about rebuilding what the illness has taken from the body and brain, which may be incompatible with sport in early recovery.
My role in Phase 1:
- Help you understand what full nutritional restoration means—not just “healthy eating” but eating enough to repair physical damage and reverse the energy deficit.
- Support you in designing meals and snacks that meet recovery needs, including high-density options.
- Teach you what appropriate portion sizes and structure look like for your athletic teen’s healing body.
- Help you handle pushback, anxiety, or rituals around food, which often increase when physical activity is paused.
- Collaborate with your physician to monitor safety markers for sport reintroduction later in recovery.
What I don’t do: hand your teen a prescriptive meal plan or coach them one-on-one in early recovery. That would undermine your role and risk reinforcing the very control the eating disorder thrives on.
I’m here to remind you: you already know how to feed your child. I’ll help you apply that knowledge to support healing—and eventually, high performance again.
FBT-Informed Nutrition Counseling vs. Traditional Sports Nutrition
If you’ve worked with a dietitian before in a sports setting, you might expect:
- Individual sessions for your teen
- Macronutrient tracking or calorie goals
- Gradual food exposure exercises
- Pre- and post-training fueling strategies
In FBT, especially early on, we flip that model. I support you, not your child, as the primary agent of nutritional recovery. Why? Because athletes with eating disorders often have impaired hunger cues, deeply ingrained food rules, and difficulty separating the eating disorder from their athletic identity.
My role is to:
- Help you recognize what’s “enough” food, even when your teen insists otherwise
- Troubleshoot resistance, fear foods, or performance anxiety at the table
- Provide education on how under-fueling and overtraining harm long-term athletic performance and health
- Guide safe re-nourishment, while protecting your child’s dignity and identity as an athlete
What Nutrition Sessions Might Look Like
In your first session with me, we’ll focus on you—not your teen. Together, we’ll:
- Review what adequate intake looks like for your child’s healing and eventual training needs
- Identify where meals and snacks may need to be increased in volume, frequency, or density
- Plan for meal supervision, especially around moments when your child is most likely to engage in food rituals or restriction
- Normalize energy-dense foods as a form of treatment
The goal is not perfection—it’s progress with consistency, even when it feels hard.
Phase 2: Rebuilding Independence—and Preparing for Sport
Once your teen has restored enough weight, is medically stable, and eating consistently, we move into Phase 2. Here, you begin handing back some food-related autonomy—with guidance and safeguards.
This is also the point where conversations about returning to sport can begin, but only if the medical team agrees it’s safe.
My role in Phase 2:
- Help you decide when and how to let your teen begin choosing portions or preparing food
- Support the reintroduction of previously avoided foods
- Collaborate on a safe return-to-exercise plan—with close monitoring of symptoms, stress, and eating behaviors
- Educate you and your teen about fueling before, during, and after exercise, once it’s safe to resume
- Watch for subtle signs that the eating disorder may be sneaking back in—like excessive control over meals or overly strict exercise regimens
This is a critical time when many athletic teens may try to return to sport too quickly. My role is to help you navigate that process gradually and safely, protecting both performance and recovery.
Phase 3: Recovery, Resilience, and Long-Term Performance Health
In Phase 3, your teen is no longer in crisis. They’re eating independently, going to school or training, and starting to reclaim life beyond the eating disorder.
This is when we shift our focus to long-term health, confidence, and sustainability—especially important for athletes under ongoing performance pressure.
My focus in Phase 3 includes:
- Helping your family normalize a wide variety of foods across different settings (home, school, travel, competition days)
- Supporting your teen’s ability to trust their hunger and fullness without using exercise as a regulator
- Offering guidance around nutrition for growth, strength, injury prevention, and performance
- Creating relapse prevention strategies for food, stress, or sport-related triggers
- Preparing your teen (and you) for transitions like college athletics, away tournaments, or unsupervised environments
This is also when we may involve your teen more directly in nutrition discussions—but always within the FBT philosophy of keeping caregivers central.
FAQs from Parents of Athletes in FBT
Q: Will you tell us how many calories our child needs?
A: I’ll give you a clear understanding of nutritional needs in food terms—what “enough” looks like on the plate. We don’t focus on calorie counting, which can trigger disordered patterns.
Q: My teen wants to keep training. What if they insist they’re fine?
A: In FBT, we don’t leave that decision up to the eating disorder. Return to sport must be medically cleared and accompanied by adequate fueling. I’ll help you explain this in a way your teen can understand.
Q: Can you help with performance nutrition later on?
A: Absolutely. Once it’s safe, we’ll shift to fueling for performance—helping your teen balance recovery, training, and long-term strength.
Q: What if my child is still hiding behaviors or restricting while in sport?
A: That’s common—and why ongoing monitoring matters. I’ll work with you to adjust food strategies, identify red flags, and protect your teen’s health and development.
Final Thoughts: Fueling Recovery Is a Family Effort
If your child is an athlete, their body is their instrument. But eating disorders damage that instrument—physically, emotionally, and mentally. As a parent, you have the power to help them tune it back to health.
FBT works because it brings that power home to you. My role as a dietitian is to support your family—not just your teen—in doing what feels impossible but is completely achievable: restoring your athlete’s strength, health, and future.
Food is the foundation of both recovery and performance. Together, we’ll use it to rebuild your child’s health—one meal at a time. Contact us to schedule an appointment at 202-738-4726 or info@fuelingforrecovery.com. You can also schedule an appointment directly through the following link.
References
- https://jeatdisord.biomedcentral.com/articles/10.1186/s40337-022-00585-y
Written By: Annyck Besso, Registered Dietitian and Founder of Fueling for Recovery
