Light at the end of the tunnel

“Light at the end of the tunnel” is an idiom that expresses the hope that a long, difficult period will eventually come to an end. When a child is struggling with an eating disorder or depression, this image is often the first thing that comes to mind for many parents when they experience their first truly good day after months of living in a state of crisis.

As a symbol of hope, this phrase is useful as long as it remains grounded in reality. Anorexia rarely disappears on a specific date. The “tunnel” has twists and turns; sometimes you have to go back a little before moving forward again. Those who know this don’t immediately lose their footing on a bad day, nor do they wait for a definitive end that never comes so clearly.

The prognosis for anorexia is better than many parents believe during the acute phase. Meta-analyses show that ten years after the onset of the illness and beyond, about two-thirds of those affected have recovered—that is, they are free of eating disorder symptoms or score well on standard assessment scales.

At the same time, recovery takes time. On average, it takes five to six years to achieve a full recovery; it rarely happens any faster. In an 18-year study, the average duration of the illness was 3.4 years, and body weight normalized in about 45 percent of cases over an observation period of roughly six years. Eating behaviors and the way individuals perceive their bodies and weight often remain abnormal for years, even though their weight has long since returned to normal.

To be honest: Anorexia is dangerous. The standardized mortality rate is about 5.9, making it the highest among all mental illnesses. Deaths almost always occur in adulthood and rarely affect children. These figures are a reason for early treatment, not a cause for panic at the family dinner table.

Progress is rarely reflected in weight alone. Parents tend to recognize it in small changes in daily life:

• A meal goes by without hours of struggle; the child eats something they’ve been avoiding for weeks.
• Conversations revolve once again around friends, TV shows, or school—and less often around calories and body image.
• The child allows closeness, laughs, and makes plans for the weekend.
• A bad day is more quickly followed by a good one; the intervals between them are getting shorter.

Such signs often feel strange because relief and mistrust are present at the same time. This feeling has a name: the ambivalence of recovery. It’s normal. Supporting the child through weight regain is one of the most challenging phases, and progress during this time is real—even if the child doesn’t yet perceive it as positive.

The risk of relapse is highest in the first two years after discharge from the hospital. About a quarter of those affected are readmitted within the first year following initial inpatient treatment, and about a third continue to struggle with issues such as anxiety or body image concerns even after completing treatment.

For parents, this means that a relapse does not set recovery back to square one. It is a common part of many recovery journeys and highlights what to look out for in the next steps. Hope endures when it is grounded in the direction of progress over months. The mood on any given day fluctuates too much to use it as a measure of recovery. Feel free to jot down what has changed since spring. On a difficult day, looking back at this progress is often more reassuring than focusing on the moment itself.

If an eating disorder or depression is suspected, the evaluation should be handled by a specialist. The first point of contact is the child and adolescent psychiatry department (KJP) or a pediatrician’s office. In cases of severe underweight, circulatory problems, or suicidal thoughts, every day counts—in such cases, the patient should be taken directly to a hospital or emergency room.

It often takes time for a therapy spot to become available. This period can be actively managed, for example, by establishing a consistent meal schedule and maintaining regular contact with your family doctor’s office.

Rückenwind “Eltern” supports you by providing coaching alongside your family. Janike is a social worker and parent coach currently training to become a child and adolescent psychotherapist; she does not make diagnoses and does not replace therapy. The diagnosis and treatment of an eating disorder are carried out exclusively by a child and adolescent psychiatry department or a medical or psychotherapeutic specialist.