When Your Loved One Has an Eating Disorder
Repost from 01/31/18
Perhaps you’ve been worried about your loved one for a while, or maybe you only recently started to wonder if they are struggling with something. Regardless, if you think that your loved one is struggling with an eating disorder there are a few things that you should know to be able to be the best support as they start their journey towards finding treatment and hopefully eventually engaging fully in recovery.
What do you need to know?
Signs and Symptoms
Eating disorders do not only have an effect on a person’s relationship with food, though a change in someone’s relationship with food may be the most obvious or first thing you notice. In general, you may notice that your loved one much more preoccupied with food, nutrition information, and weight. He may cut out entire categories of foods, or refuse to eat specific foods that he used to enjoy. Your loved one may consistently cook for others without eating, or provide frequent excuses for not eating. This includes denying their hunger as well as becoming more anxious around eating with other people or eating in public. You may also notice that she has developed some rituals or patterns around food like eating much slower or faster, eating foods in a certain order, using excess condiments, or other behaviors around food that you’ve never seen her use before.
Because disordered eating has an effect on how people nourish themselves, you may also see physical changes, or hear your loved one complain about physical symptoms. You may notice that your loved one has dramatic weight loss or gain. She may begin to complain of gastrointestinal upset like constipation, pain, bloating, or diarrhea. You may begin to see dry skin and/or nails or thinning nails. Malnutrition or other eating disorder behaviors can also cause dental issues, so your loved one may have more cavities, discolored teeth, or increased sensitivity. They may complain of dizziness or being cold all of the time. Impaired immune function may leave your loved one more vulnerable to getting colds or other illnesses. If your loved one struggles with self-induced vomiting, you may also notice cuts or calluses across their knuckles. All of these may lead to more serious medical conditions which should be evaluated by a medical professional.
People who struggle with eating disorders often struggle with their relationship with themselves as well as their relationships with other people. As far as their connection with themselves, you may notice that your loved one frequently makes comments about feeling fat or about weight loss. He may act intensely afraid of weight gain or of maintaining a weight that seems safe for his height and age. He may have a distorted relationship with his body shape and size. Your loved one may begin to wear excess layers or loose fitting clothing to stay warm or to hide weight loss. In their interpersonal relationships you may notice that she has withdrawn from her friends, family, or typical activities. She may avoid social interactions or decreased emotional expression. Your loved one may struggle with spontaneity in social situations, or try to maintain control over social situations more than she used to.
How serious is this, really?
If you believe your loved one has an eating disorder, you need to know that an eating disorder is a serious illness. This is not an extreme diet, or a fad that will go away on its own. Eating disorders are an illness that occurs in the brain, and they need to be treated like any illness that has affected any other organ in the body. Regardless of the diagnosis, eating disorders are potentially lethal. They are the deadliest group of mental illnesses. This is likely because they affect a person’s physical health as well as mental, and an individual who struggles with an ED is just as likely to pass away from physical complications as they are to complete suicide.
Often, when people begin to seek treatment for an eating disorder they say they’ll start meeting with a therapist or admit into a program once they’re on break for the semester, or after they’ve graduated, or once they’ve crossed a specific milestone at a job. As with any serious and potentially fatal illness, it’s important to seek treatment as early as possible. Better outcomes are associated with earlier intervention.
In addition to seeking treatment as early as possible, it’s important to know that you should not try to “treat” your loved one without the help of professionals. Even if you are worried about your adolescent child and have chosen to pursue Family Based Treatment which places parents at the head of a treatment team, you still need the support and guidance of professionals to provide care for your loved one. See my previous post about the general makeup of an eating disorder treatment team for an idea of the types of people who may help you and your loved one on their recovery journey.
What Should I Do Now?
If you concerned about your loved one, it’s worth approaching her with care and concern. Use “I” statements to let them know how you are feeling and what you are seeing. Rather than saying, “You’ve stopped eating, and that’s worrisome”, try saying “I’ve notice that you’re not eating as much, and I feel concerned for you.” Ask opened ended questions, and don’t place blame. It’s typical for people who struggle with disordered eating to have limited insight into their illness or to actively engage in denial prior to seeking treatment. If this happens, it’s important that you do your best to maintain an empathetic connection with your loved one rather than getting angry and judgmental with him.
When your loved one is open to treatment, you can be a support as they pursue care, and once they connect with a program or a treatment team you can be involved if they will allow that. I like to think that nobody recovers from an eating disorder on their own, and that means support people are essential in recovery.
Resources
Finally, know that it’s important to take care of you throughout this process. Being a support for a loved one struggling with an eating disorder is really challenging, and can be exhausting. You can’t pour from an empty cup, so it’s important to make sure that you are finding ways to restore your own well-being throughout this process. That may include finding your own therapist or support group or finding the time to engage in self-care. You can also utilize the resources below.
NEDA Helpline: This line is run by the National Eating Disorder association, and can be utilized both by people who believe they may be struggling with an eating disorder and those who want to help their loved ones. Learn more about the helpline here
F.E.A.S.T: Families Empowered and Supporting Treatment of Eating Disorders is an international organization created by parents of children with eating disorders specifically to support families as they go through the challenging process of recovery. You can find more information about F.E.A.S.T. at their website.
MEDA Parent and Family Support Services: If you live in the Boston area, The Multi-Service Eating Disorder Association can provide support for the friends and family of loved ones. They offer individual coaching sessions, support groups for loved ones, as well as additional guidance to supports for families and friends.
Renfrew Center of Massachusetts: If you live in the Boston area, The Renfrew Center offers a Support Persons Community Group for those who have loved ones with an eating disorder. Learn more about the group here. (Disclosure: I am also employed by The Renfrew Center in addition to my private practice)