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.
Do’s and Don’ts for Friends and Family Members
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
Source: Adapted from Mirasol Eating Disorder Recovery Centers
What You Can Do and Shouldn’t Do
The first thing to keep in mind is that as an “outsider” (not suffering from an Eating Disorder yourself) there are many things you cannot do to help a family member or friend to get better. You cannot force an Anorexic to eat, keep a bulimic from purging, or make a Compulsive Overeater stop overeating. The first thing to realize once you have come to the awareness that your loved-one suffers from an Eating Disorder, is that you must not concentrate immediately on the food. All forms of Eating Disorders are emotionally based and the behaviors are only a symptom to emotional and stress related problems. As said many times on this site, disordered eating is an attempt to control, hide, stuff, avoid and forget emotional pain, stress and/or self-hate.
If you are the parent of a child under 18 you will have difficult decisions to make regarding their care. Regardless of pleas to “not make me,” and promises that the behavior will stop, you will have to stay very attuned to what is happening with your child and may have to force them to go to doctors and/or the hospital. Keep in mind how serious Eating Disorders are and that they can kill.
If your relationship with someone suffering from Anorexia, Bulimia or Compulsive Overeating is anything other than their parent, or if your child is over the age of 18 then you cannot force them to seek help. You can support and encourage your loved one, and gently express concern, and the best thing you can do is to learn to attentively listen.
In most cases it will be important for each sufferer to find a mode of recovery that will work for them. One-on-one therapy, support groups, clinics, in-patient or out-patient, art therapy, church groups, a combination of any, or none of the above but something completely different … there are many options out there. Share this website, help your friend or family member to gather information if they are open to your help. Be encouraging — there can be a lot of road blocks in searching for Eating Disorder recovery so be reassuring that recovery is possible! Be there to listen and communicate.
Things You Shouldn’t Say…
“Are you sick?”
“You look like you have AIDS”
Let’s remember that the person with an Eating Disorder ALREADY has a low self esteem. Why would you want to say these things to anyone, let alone someone with an Eating Disorder (and what if the person in question really was HIV positive, or suffering with AIDS)? There’s nothing wrong with approaching a close friend or family member you may be concerned about and saying “you’ve lost a lot of weight and I’m concerned about you” in a caring way, followed by “I’m here to listen if you want to talk,” but any comment that comes across as insulting or an attack will be heard defensively and unproductive for what your original intention may have been.
“Would you just eat already!”
“I don’t understand WHY you don’t just eat…”
“You better stay out of the *&%’ing bathroom!”
These are not words of love, but of control. Threatening an Anorexic or Bulimic with “take-over” is not a good idea if you’re trying to help. Let’s try to keep in mind too; like we said earlier, there is a lot of guilt attached to Eating Disorders, so laying it on thick with statements like these only perpetuates that. If you’re close enough, there’s nothing wrong with a gentle “Want to have some dinner with me?” or “Talk to me” after a meal, but lets keep the mind games to ourselves. With statements like these the person seeking to help is only trying to pacify his or her own guilt in not being able to help, and looking for a quick fix.
“Why are you doing this to me?”
“Would you look at what you’re doing to your boyfriend/husband/wife/kids…”
Again, with these types of questions you are only perpetuating guilt. You’re basically saying “why do you make everyone so miserable” and “why do you burden us with all this worry” which is nothing but selfish, and even if not meant selfishly, will only be perceived as a “don’t burden us with your problems” or “look at all the trouble you’re causing.” If you are close to someone with an eating disorder (and you might be if you’re reading this) take it as an opportunity for yourself to learn to communicate more clearly, and to be a more understanding individual. Those suffering with an Eating Disorders are not DOING anything to you, but are struggling tremendously themselves, inside. You need to keep this in mind when posing questions that are selfishly motivated or hurtful (even if unintentionally).
“Why are you doing this to yourself?”
“You have good things in your life, what’s the problem?”
Those with an Eating Disorder do not choose to do this to themselves. There is no conscious choice (in most cases) where a person suffering from an Eating Disorder would prefer that lifestyle as opposed to one filled with self-love and happiness. This is a coping mechanism, a means for dealing with depression, stress and self-hate that has been built up over many years. It is a reflection of how the person suffering feels about themselves inside. Wonderful husbands, kids, supportive friends have little influence (other than sometimes temporarily) in creating the true self-esteem required for permanent recovery, to cope with life positively, and to learn to believe that we deserve good things in life and happiness. These disorders are about the person suffering and how they feel about themselves.
For the Anorexic or Bulimic who exhibits any of the following signs it may be essential to encourage them into medical treatment, in-patient in a hospital, immediately: Dizziness, fatigue, black-outs, extreme temperature sensitivity, chest pains, tingling in hands or feet, blood in stools or vomit, stomach pains, incontinence or uncontrollable vomiting or diarrhea, and/or 25% or more weight loss of total average body weight in a short period of time.
There are many signs and symptoms as well as physical dangers. It is important to remember that the continued behaviors of Eating Disorders can lead to many physical problems, further emotional difficulties, and even death.
Keep in mind there isn’t a lot you can do overall, as an “outsider” to a close family member or friend suffering from an Eating Disorder. It is up to the individual suffering to decide they are ready to deal with the emotional issues in their life that have lead them to their Eating Disorder. They need to make a choice for recovery and to want to do the work to get there. There is no one in their lives that can make this choice for them; they must want to do it for themselves.
For advanced cases of Anorexia and Bulimia, the course of treatment will usually begin with stabilizing the patient’s health, and from there it is imperative that a course of therapy, both individual and/or group, take place. For cases in which the patient’s life it not in immediate danger, it is important they seek therapy, from an experienced therapist in the area of treating eating disorders, with or without group therapy. Unfortunately, more often than not, sufferers tend to reach life threatening situations before they seek help, even if then. And in some cases, once they’ve come out of immediate danger and left the hospital there is no follow up of treatment, so they only find themselves back in the hospital shortly after. This can continue for years and is destructive both emotionally and physically, but the final action to get better lies in the patient’s desire to get better. Often times they feel afraid to ask for help, or don’t feel there is a proper forum in which to ask. More often than not, the Eating Disorder sufferer does not feel they deserve help.
Source: Adapted from something-fishy.org
Help for Family and Friends
People can, and do, recover from eating disorders, but professional help is almost always required. Unfortunately, the longer symptoms are denied or ignored, the more difficult recovery will be. If you or someone you know suffers from a possible eating disorder, it’s important to seek help immediately. Family members and friends can also benefit from information and help.
You may find it difficult and stressful to approach someone you care about who has an eating disorder. You may wonder what to say, or be worried about what will happen as a result. These are legitimate fears. Rest assured, however, there are things you can do to offer support.
Be Patient
When you approach the individual for the first time, do not be surprised if they reject your expression of concern. They may even react with anger and denial. There is a lot of shame and pain that goes along with having an eating disorder. It’s also important not to rush the person, and instead recognize that it will take time for the person to make changes.
Be Knowledgeable
It’s important to understand that an eating disorder is a coping strategy that the individual uses to deal with deeper problems – problems may be too painful or difficult to deal with directly. Remember: Eating disorders are not simply about not eating or vanity! This website can provide you with additional information that is worth learning, information you may also want to offer to your family member or friend. Whether they act on it immediately or need more time to think is their decision to make.
Be Compassionate
Eating disorders are a complex problem, and food and weight issues are only the symptoms of a deeper problem. It’s important to understand that the person would prefer to have healthier coping mechanisms and is doing the best they can at the moment. Show compassion for the pain and confusion that the individual is experiencing.
Be Encouraging
Encourage the person to see themselves as more than their eating disorder. Do this by talking about other aspects of your lives, and of life more generally. Affirm their strengths and interests that are unrelated to food or physical appearance.
Be Non-Judgmental
It’s important to express your own needs in the relationship, without blaming or shaming the other person. Remember that the individual with the eating disorder will have to decide on when and how to get help, and what kind. Support them by validating the healthy changes that the person does makes, however small they may be.
Conversation Guide
•Focus on feelings and relationships, not on weight and food.
•Tell them you are concerned about their health, but respect their privacy. Eating disorders are often a cry for help, and the individual will appreciate knowing that you are concerned.
•Do not comment on how they look. The person is already too aware of their body. Even if you are trying to compliment them, comments about weight or appearance only reinforce their obsession with body image and weight.
•Try to be positive. Find neutral, comfortable places and times to discuss the issues. Try to focus on the main reasons you are concerned or in conflict. Try not to be negative.
For example:
Instead of saying, “Why are you doing this to me?”
Say, “This is difficult for both of us, so let’s try to discuss it.”
Instead of saying, “You could control/stop this if you wanted to.”
Say, “I know how hard it is for you. Let’s talk about how we can both find ways to make things better.”
•Find ways to keep calm, focused and respectful during difficult conversations.
•Set caring and reasonable limits. Be firm and consistent. For example, know how you will respond when the affected person wants to skip meals or eat alone, or when they get angry if someone eats their “special” food.
•Avoid power struggles about eating. Do not demand that they change. Do not criticize their eating habits. People with eating disorders are trying to be in control. They don’t feel in control of their life. Trying to trick or force them to eat can make things worse.
•Examine your own attitudes about food, weight, body image and body size. Think about the way you personally are affected by body-image pressures, and share these with the person.
•Make sure you do not convey any fat prejudice, or reinforce their desire to be thin. If they say they feel fat or want to lose weight, don’t say “You’re not fat.” Instead, suggest they explore their fears about being fat, and what they think they can achieve by being thin. Encourage them to reflect on how people are pressured to look a certain way, and how this makes us feel bad about ourselves.
•When the individual with an eating disorder is a child or minor, more direct action and guidance may be required. However, always respect the rights and feelings of the individual.
Take Care of Yourself
Seeing someone you love struggling with an eating disorder might make you feel very scared, angry, frustrated and helpless. However, be careful not to blame them. Try to understand that eating problems are a coping strategy for dealing with painful emotions or experiences. The person with an eating disorder may know that their condition is upsetting other people, but may not be able to change.
•Do not take on the role of a therapist. Do only what you feel capable of. Try to get some support for yourself. You need to take care of yourself while dealing with your friend/family member and might want to speak to a counselor or health professional.
•Make sure you continue to take care of you own physical, emotional and spiritual needs.
Remember that they can only get better at their own pace. You can be supportive and gently give them information. You can help them to see and consider alternatives. You cannot make them get better. Consult with professionals when a child is concerned.
Source: Adapted from: National Eating Disorder Information Centre
