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Helping Someone with an Eating Disorder: Signs and Treatment
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Helping Someone with an Eating Disorder
Advice for Parents, Family Members, and Friends
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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
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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
s, 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
Eating Disorder Treatment & Recovery:
Help for Anorexia and Bulimia
Anorexia
Nervosa: Signs, Symptoms, Causes, Effects, and Treatment
Bulimia
Nervosa: Signs, Symptoms, Treatment, and Help
Binge
Eating Disorder: Symptoms, Causes, Treatment, and Help
Stress Management: Skills
to Reduce, Prevent, and Cope with Stress
Healthy
Weight Loss Your Way : What you Need to Know for a successful Personal
Plan
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.
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