1/3/18

Helping someone with an eating disorder



For many people, the New Year welcomes a great opportunity for change as it relates to health, wellness and diet. But among all of the chatter regarding weight loss, diet plans and fitness, at least 30 million people of all ages and genders are suffering from eating disorders in the US. Every 62 minutes, at least one person dies as a direct result from an eating disorder and eating disorders have the highest mortality rate of any mental illness.

For any individual who is currently struggling with an eating disorder, it can be very difficult to wake up on January 1st and simply stop the behaviors associated with a mental health condition. Beyond acceptance of a problem, seeking the appropriate care can be difficult. Denial, shame, misconceptions, money/insurance, stigma and fear can prevent someone from getting the necessary help/treatment needed.

If you know someone who may have an eating disorder, it can be very difficult to watch/see that person damage his/her health. Eating disorders are very complicated and often include negative, self-critical thoughts and feelings that fuel behaviors related to food, weight and body image. When an individual has an eating disorder, food is not seen as fuel or nourishment but it's used to deal with uncomfortable and painful emotions and thoughts.

At the beginning of the New Year with so many diet plans and health-seeking individuals, it can be very difficult to tell the difference between someone who has an eating disorder and someone who is dieting in an effort to lose weight or to improve health. There are a few warning signs to look out for and as the disorder progresses, the disorder is easier to identify in some individuals:

Restriction/dieting
  • Avoiding entire categories of food (ex. fat, carbs) or only eating low-calorie foods in small/tiny portions
  • Obsessively counting calories, reading labels and weighing food
  • Developing restrictive food rituals 
  • Taking diet pills and stimulants
  • Making excuses to avoid meals or situations that involve food
Bingeing
  • Unexplained disappearance of large amounts of food in short periods of time
  • Hoarding and hiding stashes of high calorie foods
  • Secrecy and isolation
  • Empty food packages and wrappers
Purging
  • Disappearing soon after a meal, making frequent trips to the bathroom
  • Showering, bathing or running water after eating to hide the sound of purging
  • Using excessive amounts of mouthwash, breath mints or perfume to disguise the smell of vomiting 
  • Taking laxatives, diuretics or enemas
  • Periods of fasting or compulsive exercise after eating
  • Complaining of sore throat, upset stomach, diarrhea or constipation
  • Discolored teeth
  • Swollen cheeks
Disordered body image
  • Extreme preoccupation with weight or body
  • Significant weight loss, rapid weight gain, constantly fluctuating weight
  • Frequent comments about feeling fat or overweight
  • Fear of gaining weight
  • Wearing baggy clothes or multiple layers in an attempt to hide weight
Orthorexia
  • Obsessive concern over the relationship between food and health
  • Increasing avoidance of foods because of food allergies without medical advice
  • Drastic reduction in foods/food groups
  • Irrational concerns over food preparation techniques
  • Strict rules and beliefs about food 
  • Anxiety, depression, mood swings and panic attacks relating to food
  • Feeling guilt when deviating from strict diet guidelines 
  • Feelings of satisfaction, esteem or fulfillment from eating healthy 
  • Increase amount of time spent thinking about food 

If you are concerned about a friend or family member who may have an eating disorder, it's important to not let your worries of saying the wrong thing stop you from voicing your concerns.

Here are a few tips for talking to someone about an eating disorder:

  1. Don't lecture or criticize. Instead, discuss specific situations and behaviors that you have noticed and why you are worried. You are not there to offer solutions or to counsel but to express your concerns about his/her health, how much you care about him/her and your desire to help.
  2. Be prepared for denial, resistance and anger. Remain calm, patient, supportive and respectful.
  3. Don't force someone into treatment. The decision to change must come from within. Make it clear that you care and that you will be available as a listener and for help.
  4. Avoid commenting on appearance, body and weight. This includes in person and on social media, which can make it tough to truly know if a person is struggling behind the happy-looking social media posts. For someone who is overly focused on his/her body, he/she may be looking for body image approval with a strong drive for acceptance or may be twisting positive comments into negative thoughts about body and weight. 
  5. Don't shame, blame or give simple solutions like "just eat". Eating disorders are complex problems and the right treatment depends on specific symptoms and issues and the severity of the disorder. Treatment with a team of professionals, who specializes in eating disorders, will address, diagnosis and treat the physical and the psychological aspects of the problem.
  6. Eating disorders don't have a look. An eating disorder is a mental illness and you can not determine a person's level of suffering based on appearance or weight. The individual is not choosing to behave a certain way but every individual deserves treatment and help.
  7. Stop the fat talk, diet advice and food talk. For a person who has an eating disorder, they likely already spend a large amount of time thinking about food and body image. Engage in more meaningful conversations beyond food and weight.
  8. Educate yourself about eating disorders so you have a basic understanding of the physical, emotional and psychological effects. Be knowledgeable about resources and sources for help. Encourage your friend/family member to call the free NEDA (National Eating Disorder Association) Helpline at 1-800-931-2237. Mon-Thurs 9am-9pm EST and Friday 9am-5pm EST.
  9. Set limits for yourself and decide what you are and are not willing to do for this person. You can only do so much. Be sure to take care of yourself throughout the process.
  10. The recovery from an eating disorder is a long-term, strenuous, exhausting process, lasting months if not years. While the road to recovery is not an easy one, it's the path worth traveling as it will improve health and quality of life and will finally put an end to the suffering that was keeping someone from living a quality life.