Site Map
Eating DisordersMood DisordersAnxiety DisordersTrauma & AssaultRelationshipsSubstance AbuseOther Issues
Abby Penson, Phd Helping Someone Image


To schedule an appointment or for more information, please contact
Dr. Penson at 323-580-3383 or by email
Helping Someone
Eating Disorders >> Helping Someone With An Eating Disorder

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.. 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.

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.

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.
  • 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.
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.

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.

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.

  • 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
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.

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
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.
  • 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.
Do’s and Don’ts for Friends and Family Members
  • 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

    Melinda Smith, M.A., and Suzanne Barston contributed to this article. Last modified on 2/4/08.

    Reprinted with permission from http://www.helpguide.org/. C 2008 Helpguide.org. All rights reserved.

    You can find the original article at :

    SOURCE: www.helpguide.org

    Helpguide.org: Mental Health, Healthy Lifestyles, and Aging Issues

    Licensed Clinical Psychologist - PSY21602  |  Disclaimer
    copywrite 2006 abbypenson.com
    All Rights Reserved