>> Helping Someone With An Eating
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
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
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
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
All eating disorders can lead to irreversible and
even life-threatening health problems, such as heart
disease, bone loss, stunted growth, infertility, and
TYPES OF EATING DISORDER
The most common eating disorders are anorexia, bulimia,
and binge eating disorder.
SIGNS OF EATING DISORDERS
- 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
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
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
A LOVED ONE WITH AN EATING DISORDER
- Preoccupation with body or weight
- Obsession with calories, food, or nutrition
- Constant dieting, even when thin
- Rapid, unexplained weight loss or weight
- Taking laxatives or diet pills
- Compulsive exercising
- Making excuses to get out of eating
- Avoiding social situations that involve
- 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
- 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
- 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
- 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.
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
Often, a combination of therapy, nutritional counseling,
and group support works best. In some cases, residential
treatment or hospitalization may be necessary.
Hospitalization for an eating disorder may
be necessary if your loved one is:
- 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
- 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
A LOVED ONE’S RECOVERY
- 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
- 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.
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
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
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.
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