One of the most common features of eating disorders is a lack of self-awareness that prevents people from recognizing that they are in trouble; indeed, many are openly protective of their disorder. Keep this in mind when you think about helping a loved one in your life and approaching them with your concerns.
Recovery means much more than replacing dieting, binge eating, and/or purging with intuitive eating. Stabilizing medical issues and normalizing eating are often the essential first steps in eating disorder treatment. Recovery also means identifying the dynamics, emotions, thoughts, and behaviors that underlie disordered behaviors and working to resolve them. The process requires a level of skill, sensitivity, and experience that only trained medical and mental health professionals can provide.
Does this mean there is nothing you can do to help? Not at all. There is so much parents, caregivers, family, or friends can do in collaboration with the treatment team.
Defining What ‘Help’ Means
For teens and adolescents, it is essential for parents to play an active role in normalizing eating patterns. However, a parent is not a trained clinician. A parent may need to encourage and remind their loved one to openly and honestly discuss their struggles in sessions with their physician, dietician, psychiatrist, and/or therapist. If ongoing treatment is advised, you can also support the person by helping them research their treatment options, accompanying them to an assessment, actively listening to them without judgment, validating their emotions, and encouraging them to follow through with the experts’ recommendations.
Recognizing The Signs of an Eating Disorder
An eating disorder is a psychiatric condition in which there is a persistent disturbance of eating or eating related behaviors that often results in medical, psychological, and social impairment. The most common eating disorders are binge-eating disorder, bulimia, anorexia, and other specified feeding or eating disorder (OSFED).
People with Binge-eating disorder engage in binge eating episodes. They eat large amounts of food in a discrete period of time, often feeling out of control and past feeling full. Those struggling with binge-eating disorder often experience a great deal of shame with their behaviors and unlike bulimia, they do not compensate for the food intake.
Individuals with Bulimia Nervosa engage in cycles of binge eating and purging behaviors to compensate for binge eating episodes. The purging associated with bulimia may take many forms including self-induced vomiting, excessive use of laxatives or diuretics, or compulsive exercising.
Those who struggle with Anorexia Nervosa or Atypical Anorexia Nervosa purposefully restrict their intake, which leads to significant weight loss and/or a significantly low body weight in the context of age, developmental trajectory, and physical health. These individuals have an intense fear of gaining weight and high levels of body dissatisfaction regardless of weight, shape, or body size. Those with AN binge/purge type also engage in binge eating episodes and/or purging.
Finally, Other Specified Feeding or Eating Disorder (OSFED) is a diagnosis given to those who do not meet the strict diagnostic criteria for AN, BN, or BED, but report behaviors and symptoms severe enough to cause impairment across various domains.
Resources for Educating Yourself
Before discussing your concerns with your loved one, it’s a good idea to educate yourself on eating disorders. There is more information than ever before and not only will this knowledge empower you to better understand what your loved one is going through, but it will also demonstrate to them that you care about them and want them to get better.
More resources can be found here: https://renfrewcenter.com/best-learning-resources-for-eating-disorders-and-recovery/
Tips for Overcoming Barriers
One of the greatest obstacles can be waiting for your loved one to admit they have a problem. At first, there may be denial. They may be ashamed or embarrassed of their symptoms. Patients often tell us that their eating disorder is controlling them and that they have lost the ability to make the decision to stop using eating disorder behaviors.
The following are some suggestions to help you talk to someone who is fortunate enough to access treatment resources, but has mixed feelings about accepting help for an eating disorder:
- Be kind. Talk to the person when you are calm rather than frustrated or emotional. Keep in mind that the person with an eating disorder may feel especially sensitive to real or perceived criticism, irritation, or rejection.
- Be non-judgmental. Don’t talk about appearance or weight. Instead, talk about mental health, relationships and mood.
- Be realistic. Realize that change will be difficult without motivation and support. You can help them identify the positive reasons for changing and some of the negative consequences of staying the same.
- Be helpful. Provide information.
- Be supportive and caring. Be a good listener and don’t give advice unless you are asked to do so. Be compassionate because they might not immediately want or appreciate your support.
- Be patient. Continue to suggest professional help. Don’t pester, but don’t give up either. If you notice you’re becoming tense or uncomfortable, take a break and create a plan with them to continue the discussion at a later time.
- Talk about the many physical, emotional, and social advantages of life in recovery.
- Validate that recovery is hard work but emphasize that it’s possible and many people have achieved it.
What NOT to Do
Despite the best of intentions, there are actions and approaches that often hurt more than help. Here are a few things to avoid:
- Never nag, plead, beg, bribe, force, threaten, or manipulate. These approaches don’t work and can potentially damage your relationship.
- Avoid power struggles. Eating disorders are irrational disorders and will likely not improve by arguing or debating with logic. Express your own concerns and feelings without expecting them to agree with you.
- Never criticize or shame. Most people with eating disorders already feel ashamed and guilty. You may make it harder for them to open up to you about the eating disorder or other struggles in the future.
- Don’t ignore or minimize the problem and its warning signs.
- Don’t try to control. Your task is to help them come to their own realization that some things must change.
- Don’t get involved in endless conversations about weight, food, and calories. These discussions are usually unproductive. Help them identify the consequences of their choices and the benefits of change.
- Don’t let the eating disorder always decide when, what, and where you will eat. Eat together and try to keep to a normal meal schedule. Constantly adapting to the demands of the eating disorder may keep them from recognizing that something is seriously wrong.
When to Call an Eating Disorder Professional
It is critical to understand that eating disorders are not just fads, phases, lifestyle choices, or trivial eccentricities. They are extremely serious disorders that have one of the highest mortality rates in the DSM-V. Patients with eating disorders deserve and require professional assessment, diagnosis, and treatment.
Eating disorders can be devastating to the mind, body and spirit. People with eating disorders typically struggle with intense emotional experiences, anxiety, depression, and poor body image. No matter how much you may care for a person, you cannot fix those things. Your support can help tremendously, but your loved one also deserves treatment by expert physicians, therapists, and dieticians, as well as the support found among a community of recovering peers.