Advice for Parents, Family Members, and Friends

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Helping Someone with an Eating Disorder

Advice for Parents, Family Members, and Friends


Eating disorders are serious conditions that cause both physical and emotional damage. While people with eating disorders usually try to hide the problem, there are warning signs you can watch for. Early treatment makes recovery easier, so talk to your friend or family member if you’re worried. You can’t force a person somebody with an eating disorder to change their behaviors or beliefs, but you can make a difference by showing that you care, offering your support, and encouraging the person to seek professional help.

In This Article:

• Understanding eating disorders
• Types of eating disorders
• Warning signs of eating disorders
• Helping a person with an eating disorder
• Treatments for eating disorders
• Supporting a loved one’s recovery
• Related links

Understanding eating disorders

Eating disorders involve extreme disturbances in eating behaviors—following rigid diets, gorging on food in secret, throwing up after meals, obsessively counting calories. But eating disorders are more complicated than just unhealthy dietary habits. At their core, eating disorders involve distorted, self-critical attitudes about weight, food, and body image. It’s these negative thoughts and feelings that fuel the damaging behaviors.
People with eating disorders use food to deal with uncomfortable or painful emotions. Restricting food is used to feel in control. Overeating temporarily soothes sadness, anger, or loneliness. Purging is used to combat feelings of helplessness and self-loathing. Over time, people with eating disorders lose the ability to see themselves objectively and obsessions over food and weight come to dominate everything else in life.
Myths about Eating Disorders

Myth #1: You have to be underweight to have an eating disorder.
People with eating disorders come in all shapes and sizes. Many individuals with eating disorders are of average weight or are overweight.
Myth #2: Only teenage girls and young women are affected by eating disorders.
While eating disorders are most common in young women in their teens and early twenties, they are found in men and women of all ages.
Myth #3: People with eating disorders are vain.
It’s not vanity that drives people with eating disorders to follow extreme diets and obsess over their bodies, but rather an attempt to deal with feelings of shame, anxiety, and powerlessness.
Myth #4: Eating disorders aren’t really that dangerous.
All eating disorders can lead to irreversible and even life-threatening health problems, such as heart disease, bone loss, stunted growth, infertility, and kidney damage.

Types of eating disorders

The most common eating disorders are anorexia, bulimia, and binge eating disorder.

• Anorexia – People with anorexia starve themselves out of an intense fear of becoming fat. Despite being underweight or even emaciated, they never believe they’re thin enough. In addition to restricting calories, people with anorexia may also control their weight with exercise, diet pills, or purging.
• Bulimia – Bulimia involves a destructive cycle of bingeing and purging. Following an episode of out-of-control binge eating, people with bulimia take drastic steps to purge themselves of the extra calories. In order to avoid weight gain they vomit, exercise, fast, or take laxatives.

To Learn More: Anorexia Bulimia Binge Eating

• Binge Eating Disorder – People with binge eating disorder compulsively overeat, rapidly consuming thousands of calories in a short period of time. Despite feelings of guilt and shame over these secret binges, they feel unable to control their behavior or stop eating even when uncomfortably full.

Warning signs of eating disorders

Many people worry about their weight, what they eat, and how they look. This is especially true for teenagers and young adults, who face extra pressure to fit in and look attractive at a time when their bodies are changing.
In the early stages, it can be challenging to tell the difference between an eating disorder and normal self-consciousness, weight concerns, or dieting. As eating disorders progress, the red flags become easier to spot. But a person with an eating disorder will often go to great lengths to hide the problem, so it’s important to know the warning signs.
Restricting food or dieting

The most obvious warning signs of eating disorders involve restrictive eating behaviors. A friend or family member with an eating disorder may frequently skip meals or make excuses to avoid eating—he or she had a big meal earlier, isn’t hungry, or has an upset stomach. The person may also claim to be disgusted by foods that used to be favorites.
When your loved one does eat, he or she may take tiny servings, eat only specific low-calorie foods, or obsessively count calories, read food labels, and weigh portions. In an effort to curb appetite, your friend or family member may also take diet pills, prescription stimulants like Adderall or Ritalin, or even illegal drugs such as speed.
Bingeing

Some people with eating disorders eat normally around others, only to binge in secret—usually late at night or in a private spot where they won’t be discovered or disturbed. Warning signs of bingeing include piles of empty food packages and wrappers, cupboards and refrigerators that have been cleaned out, and hidden stashes of high-calorie foods such as desserts and junk food.
Purging

People with eating disorders often go to extreme measures to work off calories from a binge or even a normal snack or meal. They may purge by throwing up, fasting, exercising vigorously, or using diuretics and laxatives.
Common warning signs of purging include disappearing right after a meal or making frequent trips to the bathroom. If your friend or family member is vomiting, he or she may run the water to muffle the sound and use mouthwash, breath mints, or perfume to disguise the smell.
Distorted body image and altered appearance

A loved one’s appearance can also offer clues to an underlying problem. Significant weight loss, rapid weight gain, and constantly fluctuating weight are all possible warning signs. A person with an eating disorder may also wear baggy clothes or multiple layers in an attempt to hide dramatic weight loss.
Other warning signs include a distorted self-image or an obsessive preoccupation with weight. A relative complains about being fat despite a dramatically shrinking frame, for example, or a friend spends hours in front of the mirror, inspecting and criticizing her body.
Common eating disorder warning signs

• Preoccupation with body or weight
• Obsession with calories, food, or nutrition
• Constant dieting, even when thin
• Rapid, unexplained weight loss or weight gain
• Taking laxatives or diet pills
• Compulsive exercising
• Making excuses to get out of eating
• Avoiding social situations that involve food
• Going to the bathroom right after meals
• Eating alone, at night, or in secret
• Hoarding high-calorie food

Helping a loved one with an eating disorder

If you notice the warning signs of an eating disorder in a friend or family member, you may be hesitant to say anything out of fear that you’re mistaken, you’ll say the wrong thing, or you’ll alienate the person. But although it’s undeniably difficult to bring up such a delicate subject, don’t let these worries keep you from voicing valid concerns. Eating disorders will only get worse without treatment, and the physical and emotional damage can be severe.
Talking to a friend or family member about your concerns

When approaching a loved one about an eating disorder, it’s important to communicate your concerns in a loving and non-confrontational way. Pick a time when you can speak to the person in private, then explain why you’re concerned. Be careful to avoid critical or accusatory statements, as this will only bring out your friend’s or family member’s defenses. Instead, focus on the specific behaviors that worry you.
Tips for Talking about an Eating Disorder

• Communicate your concerns. Share your memories of specific times when you felt concerned about the person’s eating or exercise behaviors. Explain that you think these things may indicate that there could be a problem that needs professional attention.
• Avoid conflicts or a battle of the wills. If the person refuses to acknowledge that there is a problem, or any reason for you to be concerned, restate your feelings and the reasons for them and leave yourself open and available as a supportive listener.
• Avoid placing shame, blame, or guilt on the person regarding their actions or attitudes. Do not use accusatory “you” statements like, “You just need to eat.” Or, “You are acting irresponsibly.” Instead, use “I” statements. For example: “I’m concerned about you because you refuse to eat breakfast or lunch.” Or, “It makes me afraid to hear you vomiting.”
• Avoid giving simple solutions. For example, "If you'd just stop, then everything would be fine!"

Source: Adapted from National Eating Disorders Association

Don’t give up if the person shuts you out at first or reacts in anger or denial. The eating disorder is your loved one’s way of dealing with emotions that are too painful to face directly. It may take some time before your friend or family member is even willing to admit to having a problem. Lecturing, getting upset, or issuing ultimatums won’t help the situation. Instead, make it clear that you care about the person’s health and happiness and you’ll continue to be there for him or her.
Seeking professional help

Aside from offering support, the most important thing you can do for a person with an eating disorder is to encourage treatment. The longer an eating disorder remains undiagnosed and untreated, the harder it is on the body and the more difficult to overcome, so urge your loved one to see a doctor right away.
A doctor can assess your loved one’s symptoms, provide an accurate diagnosis, and screen for medical problems that might be involved. The doctor can also determine whether there are any co-existing conditions that require treatment, such as depression, substance abuse, or an anxiety disorder.
If your friend or family member is hesitant to see a doctor, ask him or her to get a physical just to put your worries to rest. It may help if you offer to make the appointment or go along on the first visit.
Finding an eating disorder specialist

For treatment advice or referrals, click here or call the National Eating Disorders Association’s 24-hour information and referral helpline at 1-800-931-2237.

Treatments for eating disorders

There are many treatment options for eating disorders. The right approach for each individual depends on his or her specific symptoms, issues, and strengths, as well as the severity of the disorder. To be most effective, treatment for an eating disorder must address both the physical and psychological aspects of the problem. The goal is to treat any medical or nutritional needs, promote a healthy relationship with food, and teach constructive ways to cope with life and its challenges.
Often, a combination of therapy, nutritional counseling, and group support works best. In some cases, residential treatment or hospitalization may be necessary.

• Psychotherapy – Individual and group therapy can help your loved one explore the issues underlying the eating disorder, improve self-esteem, and learn healthy ways of responding to stress and emotional pain. Family therapy is also effective for dealing with the impact the eating disorder has on the entire family unit.
• Nutritional counseling – Dieticians or nutritionists are often involved in the treatment of eating disorders. They can help your loved one design meal plans, set dietary goals, and achieve a healthy weight. Nutritional counseling may also involve education about basic nutrition and the health consequences of eating disorders.
• Support groups – Attending an eating disorder support group can help your loved one feel less alone and ashamed. Run by peers rather than professionals, support groups provide a safe environment to share experiences, advice, encouragement, and coping strategies.
• Residential treatment –- Residential or hospital-based care may be required when there are severe physical or behavioral problems, such as a resistance to treatment, medical issues that require a doctor’s supervision, or continuing weight loss.

Hospitalization for an eating disorder may be necessary if your loved one is:

• Dangerously malnourished
• Severely depressed or suicidal
• Suffering from medical complications
• Getting worse despite treatment

Supporting a loved one’s recovery

Recovering from an eating disorder takes time. There are no quick fixes or miracle cures, so it’s important to have patience and compassion. Don’t put unnecessary pressure on your loved one by setting unrealistic goals or demanding progress on your own timetable. Provide hope and encouragement, praise each small step forward, and stay positive through struggles and setbacks.

Do’s and Don'ts for Friends and Family Members
Source: Adapted from Mirasol Eating Disorder Recovery Centers
DO:
Avoid power struggles over food Accept your limitations Accept the other person's right to an independent life Allow each household member to make his or her own food choices Hold the person responsible for behavior that affects others
DON’T:
Eat or avoid foods solely to accommodate the eating-disordered person Make mealtimes a battleground Monitor someone else's behavior for them (even if you are invited to) Be the "food police" Try to play therapist Comment about someone's weight and looks

• Set a good example. Make sure you’re a positive role model for healthy living and self-acceptance. Avoid dieting or making negative statements about your own body or your eating habits.
• Learn about eating disorders. Educate yourself about eating disorders and their treatment. The more you know, the better equipped you’ll be to help your loved one, avoid pitfalls, and cope with challenges.
• Listen without lecturing. Show that you care by truly listening to your loved one’s feelings and concerns. Resist the urge to criticize or offer advice. Simply let your friend or family member know that he or she is heard.
• Take care of yourself. Don’t become so preoccupied with your loved one’s eating disorder that you neglect your own needs. Make sure you have your own support, so you can provide it in turn. Whether that support comes from a trusted friend, a support group, or your own therapy sessions, what matters is that you have an outlet to talk about your feelings and to emotionally recharge. It’s also important to schedule time into your day for distressing, relaxing, and doing things you enjoy.

To Learn More: Related Helpguide Articles

Anorexia Nervosa: Signs, Symptoms, and Treatment Bulimia: Signs, Symptoms, and Treatment

Binge Eating Disorder: Signs, Symptoms, and Treatment Healthy Eating: Tips for a Healthy Diet

Related links for helping a person with an eating disorder

Helping a person with an eating disorder

What You Can Do – Discusses the things you can and can’t do to help a loved on with an eating disorder. Includes a list of things you shouldn’t say. (Something Fishy)
Approaching Someone You Care About – Tips for discussing your eating disorder concerns with a friend or family member and encouraging them to get help and treatment. (Something Fishy)
When You Want to Help a Friend or a Loved One – Learn what to say to a person with an eating disorder and important treatment steps to take. (Anorexia Nervosa and Related Eating Disorders, Inc.)
Advice for parents, family members, and friends

Eating Disorders – Article for parents on the causes, effects, warning signs, and treatment of eating disorders in kids and teenagers. (KidsHealth)
For Parents, Partners and other Family Members – Advice on what you can do to help a loved one and how to cope with the stress an eating disorder brings. (Anorexia Nervosa and Related Eating Disorders, Inc.)
Help for Friends & Family – Offers tips on how to approach a person with an eating disorder, what to say, and how to take care of yourself. (National Eating Disorder Information Centre)
Warning signs of eating disorders

Eating Disorders Warning Signs – Explore the red flags and warning signs of eating disorders, including food and exercise behaviors, feelings, and beliefs. (Anorexia Nervosa and Related Eating Disorders, Inc.)
Signs and Symptoms of an Eating Disorder – Extensive list of eating disorder warning signs, including those specific to anorexia, bulimia, and binge eating. (Mirasol)
Eating disorder treatment and recovery

Eating Disorders Survival Guide – Guide for patients and their families to finding appropriate and affordable treatment for eating disorders. (National Eating Disorders Association)
Treatment and Recovery – Overview of the eating disorder treatment process and the goals of recovery. (Anorexia Nervosa and Related Eating Disorders, Inc.)
What is Helping? Youth & Recovery (PDF) – Covers the stages of change that people go through when recovering from an eating disorder and progressing through treatment. (National Eating Disorder Information Centre)
Melinda Smith, M.A., and Suzanne Barston contributed to this article. Last modified on: 02/04/08.

[Chy]

Talk about having it all in one post! Excellent!

[pedagogue]

Wow!!

I may be "borrowing" that, as it is full of great info!