Therapy for Children & Teens

Child & Teen Eating Disorder Treatment | Austin, TX

Based in Austin, TX and serving families across Texas via telehealth.

With Alison Pelz, LD, RDN, LCSW, Therapist 

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Something feels off, but you’re not sure what.

Is your child or teen struggling with food, exercise, or body image?

Or maybe you are not sure if you are seeing a full-blown eating disorder. You don’t need a diagnosis in hand to reach out. Together we can figure out what’s going on and what kind of support makes sense for your child or teen. 

Have they been eating less food, over-exercising, or vomiting after meals?

You may notice that your child or teen has: 

  • Started eating “very healthy,” maybe too healthy. 
  • Lost weight in a way that worries you
  • Been avoiding meals, skipping social events involving food, or making excuses not to eat with the family
  • Become argumentative around food-they insist that they have eaten but you can’t remember the last time you saw them eat, or they say that they will eat later but then never do 
  • They eat dinner with the family, but you notice their body shrinking
  • Expressed worry about their body size, shape, or appearance
  • Started over-exercising or throwing up after eating

Bingeing or appearing “out of control” around food

You may notice that your child or teen:

  • Seems to have an endless amount of hunger, and you are not sure what to do or say
  • Hides food in their room despite asking them not to
  • Eats large amounts of food, often quickly or in secret
  • Seems driven to eat highly palatable foods (sugary, salty, or high-fat) more than seems “normal” for them 

Extremely “picky” eating, sensory sensitivities, or fear around food

You may notice that your child or teen:

  • Eats only a small, specific list of foods – sometimes down to certain brands or exact preparations
  • Gets overwhelmed by certain textures, smells, or appearances of food
  • Avoids trying new foods out of fear and/or disgust 
  • Drops “safe” foods, and the list of foods keeps shrinking 
  • Forgets to eat or often isn’t hungry
  • Suddenly developed a fear of eating due to choking, a medical procedure, or an allergic reaction

Or maybe you are not sure if you are seeing a full-blown eating disorder. You don’t need a diagnosis in hand to reach out. Together we can figure out what’s going on and what kind of support/help makes sense for your child or teen. 

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Exhausted. Second-guessing yourself. Not sure what to do next? 

You’re not overreacting, and there is support that can help. Many caregivers reach a point where the usual advice just isn’t helping. You’ve likely spent countless hours worrying, researching, and searching for the right words, or the right thing to do. 

Maybe you…

  • Have endless talks with your child or teen that go nowhere, or end in a fight
  • Avoid the topic because it’s easier than bringing it up again (and you hope it resolves on its own)
  • Aren’t sure what to say because you’re worried you will make it worse
  • Feel like you’re walking on eggshells at every meal.
  • Have talked to well-meaning doctors who don’t seem to understand the severity of the problem
  • Are concerned about your child or teen’s health but feel powerless to help
  • Are concerned about your child’s peer relationships because of their relationship with food

You don’t have to navigate this alone.

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What Life Could Look Like with Support

You may be hoping for the day when food no longer controls your child’s life or your family’s schedule. When meals feel less tense, your child can participate more fully in school and activities, and your family has the tools to respond without every conversation turning into an argument.

Treatment can help your family work toward:

  • Eating meals together with less fear, conflict, or negotiation
  • Your child getting the nutrition they need to grow, learn, and participate in daily life
  • Feeling more prepared to respond when eating disorder behaviors or food-related anxiety show up
  • Helping your child return to friendships, school, sports, travel, and other experiences that have become difficult
  • Reducing the eating disorder’s influence on your child’s choices and your family’s routines
  • Building a healthier feeding relationship and more flexibility around food
  • Knowing how to support your child’s continued progress outside of therapy

You won’t be expected to sit on the sidelines while your child works through this alone. You’ll be actively involved in treatment, learning what to do at home and how to help your child move toward recovery.

How We Work Together 

Eating disorders affect the entire family, which is why parents and caregivers are an essential part of treatment. I use evidence-based, interdisciplinary approaches for anorexia, bulimia, binge eating disorder, and ARFID in children and teens. 

Depending on your child’s age and needs, you may attend sessions together or begin with parent-only appointments. Either way, you’ll receive practical support for helping your child at home, where much of the work of recovery takes place.

What treatment can look like

Anorexia, Bulimia, or Binge-eating Disorder

Family-Based Treatment (FBT) coupled with emotion-focused family therapy. Evidence-based, behavior-focused approach that stops the eating disorder’s progression early.

FBT may be a good fit if your child or teen: 

  • Has anorexia or bulimia nervosa
  • Is medically stable
  • Doesn’t seem “motivated” to recover from their eating disorder
  • Is between 9-14 years old
  • Diagnosed with an eating disorder in the last year
  • Is discharging from partial hospitalization and still needs intensive treatment
  • Wants to attend school and in daily life, rather than entering day treatment or residential care.
  • Is attending outpatient treatment, and it has been recommended by the treatment team to go to a higher level of care and is medically stable. 

FBT Sessions Look Like:

  • Parents and child attend sessions together. I coach you as a team toward recovery.
  • Intensive treatment to stabilize eating disorder behaviors
  • Weekly sessions at first, tapering to every 2–3 weeks in later phases. Typically 20–30 sessions over 10–12 months.

Adolescent–Focused Therapy 

  • This is a particularly good fit for older teens who seem interested in recovering from their eating disorder
  • Teen meets with therapist one-on-one for weekly appointments 
  • Parents attend sessions over the course of treatment so they feel confident in supporting their teen at home

ARFID (Avoidant/Restrictive Food Intake Disorder)

  • Ages 5–12: Treatment starts with parent-only appointments to improve the feeding relationship, ease mealtime distress, and support adequate nutrition using CBT-AR and parent training. 
  • Older children & teens: Parents attend appointments throughout treatment, with a focus on improving the feeding relationship and building skills for independent eating. The child or teen joins sessions later as part of treatment to increase self-understanding of eating style and, if interested, expand food choices. 
  • Sessions are weekly or biweekly, depending on the child’s or family’s needs and medical status. Treatment typically runs 6–12 months.

My approach is integrative, offering treatment that is weight-inclusive, LGBTQ+ affirming, neuroaffirming, and culturally responsive. 

All treatment is delivered as part of an interdisciplinary team. I work alongside your child’s other providers, including physicians, dietitians, psychiatrists, and others as needed, so everyone is working together to support your child. 

Ready to Talk About Next Steps?

Reach out today to schedule a free consultation — let’s talk about what support could look like for your family. Services are based in Austin and available to families throughout Texas via telehealth.

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