I've watched parents and loved ones of people with eating disorders across three decades of clinical practice. These are mothers and fathers who are often so competent and in control in other areas of their life, whose management, or organizational, or legal, or artistic, or even medical skills simply leave them unprepared for the challenge of dealing with a loved one with anorexia nervosa.

I always marvel at parents' ability to persevere and I look for things that can help me understand their situation and provide them with better guidance than I did last year or the year before. Sometimes that better information comes from first hand experience.

A few years back, one of my relatives developed an illness that stumped all of the medical professionals, something you would see on the popular TV show "House" that has everyone puzzled until House himself has an incredible "a-ha!" experience and everything falls into place. Only in my relative's case that "a-ha" never came; it remained a "We've never seen this before."

So, as a caregiver, not as a clinician, what did I do and how did I feel when the doctors didn't know?

First, I used the skills I had to search every database that might shed some light on his condition. I wanted information. Show me the data! If the doctors didn't have it, I looked for it myself and shared it with them at our next appointment. We were all out there in uncharted waters, and I wanted to make sure that the providers who were in charge of my loved-one's care were up on the latest. Even though there weren't enough cases in the world to develop a sound evidence-base for his illness, I needed to know what was out there to guide treatment. The physicians and allied professionals were obliged to give him the most evidence-informed care they could.

In much the same way, this is precisely what we, as health care providers, owe to our patients with eating disorders and their families.

Eating disorders are incredibly challenging. We need to show our respect for the magnitude of that challenge by keeping up on the literature, looking carefully at what has been shown to work and what has been shown not to work, and providing patients and families with the most up-to-date care possible based on what we know.

I don't treat patients now the same way I did back in the early eighties when I was in training. We know so much more now about how to treat these disorders, and we have a moral and an ethical obligation to patients, parents, and loved ones to continually update our approaches as new information about how best to treat these disorders becomes available. In addition, where information doesn't exist, we have an obligation to test new approaches to see if they do work before we market them as effective.

When parents first come to see us, they have hope. Hope that we will be able to provide them with some strategies, something to end the nightmare. Sometimes their hope keeps them from asking the hard questions. Sometimes they're too exhausted to ask the hard questions. Sometimes, they don't know which questions to ask.

We can and should help them ask the right questions. What kind of evidence do you have that what you are going to do works? Can you please point me to the studies that support the types of interventions you are doing? At what point will you realize what you are doing isn't working and try something else? What will that something else be? And, where are my treatment dollars going?

And to parents of children with eating disorders I say, be wise consumers of health care. Ask the questions, get second opinions, and be confident that you are getting the best possible care for yourself or your loved one.