My husband and I have two teenage boys, the youngest being 14. Our younger son has struggled with anxiety and low self-esteem, issues that were exacerbated during the Covid pandemic. One of his primary challenges is around food. He is very underweight, ranking in the lowest 1% for both height and weight.

While my husband and I generally agree on the nature of the problem and the potential solution-seeking help from health professionals and carefully considering how to support our son’s weight gain, we find ourselves constantly at odds.

He seems to believe that I am largely to blame for our son’s issues, that I don’t take the situation seriously enough. He criticises me for being vegetarian and encouraging our son to follow the same diet – which is not entirely true, he’s a keen animal-lover so hard to dissuade! He also blames me for not involving health professionals sooner and for not addressing the issue in the way he believes is necessary, but then he’s not clear what he expects either.

His increasing obsession with the issue seems to be exacerbating the problem rather than alleviating it. He places the burden and blame squarely on me, which is making the situation more unpleasant for everyone. I feel that my husband tends to catastrophise and that his need to assign blame allows him to avoid confronting his role in the problem.

I’m deeply unhappy with how he speaks to me about this issue, especially within earshot of our children. This dynamic is becoming increasingly toxic, and I’m unsure how to help him see things from a different perspective.

Both you and your husband need to come together for this and stop blaming each other, which will involve compromise on both your parts. Nothing is more important here than your son’s wellbeing and his issues around food may be a demonstration of a greater anxiety that he feels within the home.

I went to UKCP-accredited child and adolescent psychotherapist Lucy Fuller. “You say your son has always struggled with anxiety and low self-esteem so I wonder if he’s finding aspects of his life difficult and this is showing itself in his relationship with food and eating.” In other words the not eating may be a symptom of something else and it’s the something else you may need to get to the bottom of.

“I’m curious,” went on Fuller, “to find out how you and your husband talk to your son about his difficulties and are you able to empathise without trying to correct his behaviours?”

We weren’t at all sure if you had taken your son to see someone to get him help. I also went to Beat, the eating disorder charity, who said “the most important thing now will be to put a plan in place that is in your son’s best interests, seeking input from healthcare professionals. If he is unwell with an eating disorder you may be offered family therapy which could be helpful for you all. If your son does have an eating disorder then he can certainly make a full recovery but the sooner he gets the help he needs the beter his chances of this will be.”

Be aware that children can find it very hard to talk about how they feel and may feel disloyal saying anything critical about their parents – your son may refuse to partake in family therapy because of this.

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However, your son may “just” be small and slight – someone has to be at the edges of percentages. He may not be worried about food, just not overly interested in it – it was impossible to tell from your letter. You told me lots about the challenges you and your husband have but missed out the key details of what your son’s “challenges” around food were despite them being longstanding. Does he only like certain foods (might he have avoidant/restrictive food intake disorder (Arfid?). These are all questions that need focus from you.

Fuller also recommended “if he could see a therapist for his anxiety; I wouldn’t bring food or eating into the work straight away, but just be curious about his anxiety and how that acts out. Explore what the triggers might be.” I would also be trying to foster safe places where he can talk about his general feelings. Car drives are great for this. It may take time especially if your son has learned that his behaviours cause anxiety to his parents.

• Every week, Annalisa Barbieri addresses a personal problem sent in by a reader. If you would like advice from Annalisa, please send your problem to ask.annalisa@theguardian.com. Annalisa regrets she cannot enter into personal correspondence. Submissions are subject to our terms and conditions.

• The latest series of Annalisa’s podcast is available here.