How do you deal with a loved one who has an eating disorder?

I think you can be there if he/she needs you while not enabling that behavior.

Eating disorders often times arise as a way for the person to take control of something in their lives. I’d imagine a person would have to deal with the deeper issues in their life if they want to stop the downward spiral.

Over eating, bulimia, anorexia? I guess is doesn’t really matter; any way, this is really tough. There’s probably little you can do yourself in the way of “healing” him/her. The best you may be able to do is encourage him/her to seek professional help.

@ubersiren in this particular case, Anorexia, to the point of being very pro-ana. It came as a shocker, which i guess most of these sort of things do. I’m guessing trying to convince them that it’s not a good practice is a bad idea?

Is this a minor? I a daughter or son? Niece, nephew, cousin?

If it is your child, I would call their doctor. My daughter has had bouts with this and we go immediately to the doctor. Usually, it means we’ll be going to counseling – someone that specializes in eating disorders, and really work with her, letting her know we are all here for her. We then allow her the space to work with her therapist.

You need to look for the triggers and punishment, yelling and bribes do not work, they will backfire and make things worse.

You can approach the person, but expect denial and fear. This person needs to have professional help, this doesn’t just go away.

@redsfan1324 – in regards to trying to convince them, they’ll never listen – not seriously. enough to make you be quiet about the subject; however, anorexia has a serious control issue – she’s not about to give that control up.

@cak it’s just a close friend. She is a minor. I mean, should I inform her parents? i assumed that this would just trigger of major issues, mainly of betrayal.

From the e.how site:

Find an appropriate time to talk to him/her (h/h from here on). Follow her cues and let her tell you as much or as little as she wants. Do not force h/h to tell you anything h/h is not ready to share.

Respect h/h and do not criticize, pass judgment or give advice unless h/h asks for it.

Listen with your heart and show h/h you truly care. Be genuine in your approach by first building a relationship of trust. If h/h confides in you, it is a sign of h/h awareness of the problem and h/h may want help.

Offer your moral support. Go with h/h to see a therapist or doctor if h/h is afraid to do so alone.

For a lot more tips and ideas, see this

@redsfan1324 – The thing is, this can be a life and death situation. She’s wrecking any number of her body’s systems, including just keeping her electrolyte balance in order. This can kill her.

I think you need to talk to her parents, but ask them to try to approach them and not mention you; however, you have to consider this is a serious issues. I’m sure her life is worth more than a few days, weeks or months of anger. Clearly, you care a lot. I’d want you in my corner.

I would say something. This isn’t anything to play around with.

You are an excellent friend.

Well first off you should bake a cake to celebrate the introduction of a new eating plan.

Tell her parents, or a guidance counselor at school. She needs more help than you can give her. Best of luck to both of you.

I agree that this is serious, and she needs help beyond what you can give her. I would talk with her and tell her that if she won’t talk with her parents, you will. If it were suicide-behavior, wouldn’t you do that?

You may lose her trust, and even lose her as a friend, but unless she gets help, the consequences may be dire, and you won’t be feeling good about knowing and not doing anything.

My sister has an eating disorder. I know from experience that you should be prepared for her to be angry at you, maybe even hate you for awhile. In the end, take a course of action that is in her best interest – which is getting her help. Make sure you have your facts straight, and inform the parents or whoever to what is going on.

Seek counsel from a professional.

Someone else asked a similar question: http://www.fluther.com/disc/41308/do-you-have-any-experience-either-personally-or-through-someone-else/

Well, I had an eating disorder for six years and this is my say on it.

Counseling, for me, does not work, and @cak, bouts? How does someone have bouts of an eating disorder? I mean, sometimes mine is dormant and I go through a couple of months where I’m okay with everything, but I’m still bulimic in those times. I still have thoughts about wanting to lose weight and I still come up with crazy diet plans in my head. She needs to STAY in therapy, dont take her out when everything looks like it’s fixed. I ended up having to go to an inpatient facility when I was sixteen(best choice of my life), but she may not be in that scenario if she’s still really young.

Anywhos, if she’s your friend, don’t go tell her mom. Her mom probably already knows, unless her mother is completely oblivious and doesn’t really care much about her child’s behavior (in which case, you should, actually, enlighten her, but don’t do one of those bullshit “everyone sit down to have this intervention because then she’ll start eating/stop throwing up” things). In middle school, a friend of mine told the school counselor that I wasn’t eating and that I had admitted to her about throwing up. They called my parents, and you know what happened? I denied that shit and told them that the girl who told the guidance counselor was full of shit and that we had “gotten in a fight earlier that week,” which was why she had told them (not true, just an excuse to not be forced to go to therapy).

So, honestly, I think as just a friend and not a family member, all you can do is not be an enabler. If she does decide to eat around you, don’t let her eat a box of donuts and a box of cereal and then nonchalantly go to the bathroom. If she’s bulimic, insist on going to the bathroom with her every time, and just make normal conversation while she’s in the bathroom stall (that sounds weird, but you can’t very well get away with throwing up, no matter how quietly, while you’re talking). Always always always remember that neither you nor anyone else can make her stop doing what shes doing, but you can do things that would prevent her from doing these things around you.

And before anyone “NUH UH GIRLFRIEND!“s me, i answered this way because this person is a friend, not a family member.

@timeand_distance – for lack of a better word, bouts. Today, more awake and clearly thinking, relapses. My sister was anorexic and bulimic – depending on the year and the current problem, at hand. 7yrs. My sister spent years starving herself and then binge eating, when she was really stressed. We all think that she might still do it, but no one can prove it. She’s turning 40, I just turned 38. This isn’t anything new to us – it’s been since she was 14.

Her best friend tipped us off to what was going on. She was thankful…several months down the road and so were we. She could have died.

@cak Ahhhhh okay. I get you. Hope you didn’t see my response as a shot at you or anything, I just know that telling parents of someone who’s not 18 about something like an eating disorder usually just ends in them working harder to keep it a secret.

@timeand_distance – No, not at all. I was tired and couldn’t think…words really were escaping me!

I don’t think every person, regardless of age is equipped to handle that truth and to tell someone else. I really don’t. My hope would be they could find someone that they could trust enough to talk to and that person could deliver the news. The girl that told my parents, tough as nails – she’s still a family friend.

It makes me so sad, so many of the people suffering from this are so shrouded in secret, that it’s hard for people to put it all together, until it has been going on for some time.

I’m glad to see you are recovering, but understand the battle. I wish you nothing but the best.

@timeand_distance If it’s dangerous for you to even think about these things, then please don’t answer this question. I was wondering what it was like to be in your head when you have all these thoughts about losing weight and you keep on coming up with diet plans. Also, what it’s like when people talk to you and try to get you to stop. In fact, how did therapy help?

It sounds like your mind gets into a trap, with endless circling thoughts, and the only way to make it stop is to give it satisfaction, and make it feel like you are attending to its demands.

I suppose learning about it must help learn some control over it. But it seems like there is a moment of choice, where you decide between continuing to see yourself as inadequate, and feeling you must gain control over that by, essentially, killing yourself slowly, and deciding to live. Is that choice a gradual thing, or does it happen suddenly?

I was just thinking that when you feel inadequate, it’s also pretty low self-esteem. Is it? And if so, is that environmentally caused low self-esteem (parents always telling you how you need to clean up your act and start doing this or that), or does it apparently come from nowhere?

I’m bipolar, so when I start thinking self-destructive thoughts, they can give me a drug or two, and stop these thoughts. Eventually I get pretty much better, and the thoughts of low self-esteem retreat into the background. But there are some thoughts I can’t allow myself to think, because I can start myself down, to where it’s out of control. This morning, on the radio, I heard about a mother whose son was going to die, and the medical establishment wanted to keep on trying to keep him alive, even though it meant more and more pain for him, and the end would be the same. She fought to get palliative care, but it was a new concept, and it took some doing. She said she didn’t want her son to suffer, and to have his suffering prolonged by the interventions. She just wanted to make the rest of his life as comfortable as possible.

Ok. What a long story to get to my point. When she spoke about the suffering, it was like being slammed with giant smothering bean bag. I remembered when I was suffering and I just couldn’t believe it would ever end, and death seemed preferable to that endless pain. At the same time, I was also distant from this feeling, and unable to imagine being in that state. I think maybe my brain has forgotten this in order to protect me, because when I think of it, as I am now, my chest gets heavy, and my brain feels slower, and I start feeling weepy. Not good.

Depression never goes away, like it sounds like eating disorders never go away. I always fear a return. I fear the helplessness of it. I fear being unable to see any way out of it. I fear the feeling of it being endless. It strikes me that bulimia might be similar. Although, if you don’t have drugs, how do you get out of it?

@daloon it’s just frustrating, really. i want to lose weight, and i know that if i cut back on my calories to under 1,000 a day or throw up I’m screwing myself, but at the same time i always feel like eating “healthy” is just too much. when people were trying to talk me into stopping, it was either annoying or a guilt trip. most people dont know what theyre talking about and assume that an eating disorder is mostly a choice, which is absolutely ridiculous.

i wouldn’t say that recovery is choice, but more of a state of affairs. you get to the point of recovery, you never wake up one day and tell yourself that you’re actually going to try and eat like a normal human and deal with your issues for real. i belong to an eating disorder forum, and nearly everyone who has started to recover did so because of a certain event, usually having to do with the mental part of the disorder (ie. suicide attempts, psychotic breaks, etc.), where they just kind of realized that they couldn’t handle an eating disorder any longer.

oh, about the nature vs. nurture about eating disorders: it’s different for everyone. my mother never called me fat when i was little, nor did anyone else in my family, but she was anorexic when for about 12 years when she was younger, so i think that might have had something to do with my having bulimia. other people, however, go through traumatic things (sexual abuse is a good example) that cause them to cope through an eating disorder.

i dont really know if that answered your questions, i got a little sidetracked. sorry.

@timeand_distance. Thank you. That was really interesting. A couple of comments.

I don’t know if there are meds that you can take that help you reign in your unrealistic thoughts. But it strikes me that there ought to be if there aren’t. When you say that many people with eating disorders start to recover after a strong event, it made me think of the issues that bipolar or schizophrenic people sometimes have with drug compliance. You have to really want to get better, or you won’t do the things that help you get better. Sometimes, the disease seems more beneficial than being healthy. For bipolar folk it’s the mania that is attractive. I wonder if people with eating disorders have something similar that is attracting them to the disorder?

On the nature vs nurture question, it seems like that is gradually becoming a false dichotomy. We have genes, and we have environment, and genes will be expressed differently depending on the environment. Two people with the same genes will end up in quite different places because they experience different stressors. One person may become bulimic because they have a genetic possibility for it, and they end up in really stressful stituations and they start trying to take control over themselves, since they can’t control their environment. Another person with the same genes may never get involved in the disorder, because they never run into such stress. And a third person may have a combination of genes that make it nearly impossible to avoid the problem, even if they have a stress-free environment.

@daloon i think it’s less about something being attractive than it is simply the fear of putting on weight during recovery.

I now have the answer on the nature vs. nurture issue—

I was at a presentation last night given by a genetic neurobiologist who is also a psychiatrist. I think he’s got a very good reputation in his field. He’s been looking at the genetic links to mental illness. They’ve discovered that a huge list of mental illnesses are related, including ADD, anorexia, anxiety, bipolar disorder, OCD, unipolar depression, schizophrenia and several others that I don’t remember, as well.

Bipolar disorder is related to at least 22 genes, and changes in specific alleles on those genes. By comparison, a congenital eye disease that results in blindness is related to just 5 genes. He had been looking at the sequence of one allele, and discovered that in people with a wide variety of mental illnesses, portions of that allele were transposed from the position they are in normal people.

This is interesting, because it suggests that a wide variety of mental illnesses may stem from similar genetic predispositions, and perhaps the expression of that predisposition is related to differing environmental conditions. That is purely speculative, since they still have little idea how this works. They do know that, for this particular allele, it changes the protein that regulates how sodium and potassium chains enter into nerve cells in the brain.

More and more, it appears that mental illness is primarily of organic origin. Once they figure out which genes are involved and which proteins they express, they’ll be able to design a diagnostic test first, and later on, drugs that are designed specifically to counteract the negative effects of the protein in our brains. He thinks this will happen in ten to twenty years.

Researchers believe that Anorexia (and presumably Bulimia as well) are the result of a genetic predisposition combined with some environmental stressor. Your thoughts, then, are not exactly your own. The fact that your mother had anorexia probably raised your risk of an eating disorder by 500% or so (compared to the overall population).

So, do they treat it with meds? Or do they expect you to do it all with therapy?

Just like any other mental disorder, both. I have a therapist as well as a psychiatrist.

That’s really interesting, though. I just woke up, so I don’t really have much else to say on the topic, but good to know. :)