An Eating Disorder - What Happens Now?
When you realize that someone you love may be struggling
with anorexia nervosa, bulimia nervosa or binge eating disorder,
naturally you want to know more about it. And because you care,
you also want to understand what they are experiencing
so that you can be as supportive as you
can throughout their recovery.
You may already know that anorexia, bulimia and BED are complex
and confusing illnesses. Now that you
are past the initial shock of discovery, you may be experiencing feelings
of anxiety, guilt, anger, and frustration–all understandable
reactions. Seeing a loved one suffer from
an eating disorder is very frightening and difficult. We
know it's not easy.
What happens now? First, understand that the illness did
not develop overnight, and that recovery
will not happen overnight. Second, know that there is reason to
have hope. With dedication to treatment, recovery is attainable.
Today We Know Much More
When singer Karen Carpenter died
of anorexia, it was at a time when many doctors lacked
the awareness and education needed to diagnose and treat
victims of eating disorders. Today we know much more about
these illnesses–what causes them, how to recognize the
symptoms earlier, and the steps required for recovery.
Even though you may find it difficult to understand, your
loved one finds security in their eating
disorder. To its victims, the illness is a powerful and
misguided coping mechanism. But with treatment, enough
time, and lots of love, you can look forward
with hope to a day when your loved one will likely be
able to break the stranglehold of this illness.
You can play a critically important role in the recovery
process. Your knowledge-based appropriate
actions and support can be a tremendous source of strength
and comfort to your loved one.
Ten Ways You Can Help
Learn
about eating disorders
To begin, you can help your loved one by getting
your own emotions under better control. Educate yourself
about anorexia, bulimia and BED and you will almost certainly
feel less anxiety and fear. Sometimes the unknown frightens
us the most.
Your local hospital, library, mental health organization,
and eating disorder specialists are good sources of information.
You can also review our resources area
of this section.
Learn
about treatment for eating disorders
Learn about different modalities of treatment:
medical care, medication, therapy and
counseling, and dietary counseling. Learn about levels
of care and different programs: inpatient
care, residential care, partial hospitalization, and
outpatient care. Sometimes intensive
or inpatient care becomes necessary.
Be a smart consumer. Identify those professionals who
work with eating disorders. Ask pointed
questions such as what are the credentials of those who
will be working with your loved one?
Whenever possible, visit facilities and treatment programs
which are under consideration.
Seek
professional help
Don't try to deal with this problem alone.
Consider this: Of all psychiatric disorders,
anorexia and bulimia have the highest mortality rate.
On the other hand, early intervention
improves the chances of recovery.
When dealing with an adolescent or with someone who is
in acute medical danger, be prepared
to exercise responsibility and authority. Their life
may depend on it. In such circumstances,
you may not be able to convince them they need treatment,
and therefore you may need to act for their safety and
well being.
Find out what needs to be done, and discuss options with
eating disorder specialists and family
members. Do all you can to stabilize your loved one's
medical condition and prepare them for
appropriate treatment options.
Even with full recovery, the longer the illness runs,
the more serious its permanent effects
are. Conditions caused by the eating disorder (such as
osteoporosis, ovarian failure, brain
damage, endocrine abnormalities, and a weakened heart) can
diminish quality of life long after the eating disorder
is under control. Seek help as quickly
as possible.
Good therapeutic intervention will help them in understanding
the problem and dealing with the reasons
their eating disorder exists.
Help
your loved one recognize the problem
Those suffering from an eating disorder cannot
begin changing their beliefs and behaviors
until they admit they are struggling. When you gently
confront your loved one about your observations
and concerns, be prepared for strong reactions.
They will be embarrassed, will likely deny anything is
wrong, and will be terrified of losing
the perceived sense of control they believe the illness
gives them. They may withdraw out of fear or lash out
in anger.
Be compassionate yet firm in your resolve. Be prepared
for resistance. Your loved one may question
the need for treatment, claim they can do it on their own
or try to instill guilt by claiming you don't care about
them. You will probably be rebuffed
many times as you encourage your loved one admit to and to
take responsibility for their eating disorder and related
difficulties.
The knowledge you have gained from reading and discussing
the problem with professionals will
help you persist in loving and appropriate ways.
Have
meaningful communication
Since eating disorders are rooted in emotional
struggles, solutions are found in emotional
healing.
In your attempts to help, do not oversimplify by saying "just
eat". This will only alienate the person
you are trying to help. Instead, try to see the world through
their eyes. Listen to your heart and follow those impressions.
In moments of frustration and anger,
don't let your emotion control what you say and do. Express
your own thoughts and feelings-- especially your loving
concern, your desire to help, and your
good intentions. Feel free to admit to some of your own
frailties, weaknesses, and short-comings. This gives
your loved one permission to do likewise.
Try your best not to shame your loved one into eating.
One of the hardest things to do is not
personalize your loved one's eating disorder (i.e., "if she
loved me she would eat"). If it were that simple most
sufferers would eat on their own again.
They are out of control and don't understand what's happening to
them. Nor do they know how to help themselves out of
the self-defeating behaviors.
Try to be objective, calm, and caring. Avoid fixing blame
or guilt. Be sensitive, but be firm.
Share your observations and concerns in a direct manner
with kindness and respect. And when
you are at a loss for words, a hug can express many loving thoughts
and feelings.
Those with eating disorders often feel ashamed, discouraged,
fearful and hopeless. These feelings
don't need fuel, but correction through unconditional
love and encouragement.
The reality of an eating disorder is that the underlying
issues are about pain, emotional suffering,
and self-conflict –- not food. Helping your loved one
to discover these emotions or to begin to talk honestly
about their pain is a very important
step toward help and recovery.
There is hope for recovery -– something worth encouraging.
Find it and do some coaching. After
listening, acknowledging, empathizing, and validating feelings,
move on to encouragement, hope and positive possibilities.
Always remember to respect the privacy of those you are
trying to help. Do not discuss their
issues with others unless they have given you permission to
do so or unless sharing is necessary in keeping a loved
one safe from harm.
Interact
in ways that do not center on the eating disorder
Express your love consistently, not just when
they are doing well with food or with
gaining weight. Identify other ways of expressing your
approval and affection that have nothing
to do with weight or with the foods being eaten or
rejected.
Even if they act as if 90% of their life is the eating
disorder, treat them as a person --
not as a behavior or an illness.
Never refer to your loved one as "the anorexic" or "the
bulimic".
Try not to be drawn into arguments, threats, bribes,
guilt, or blame concerning weight, eating,
and food. Just give a consistent "broken record" response
affirming your love, concern, and hope.
Unless there is endangerment to live, do not shield them
from the natural consequences of their
eating disorder. For example, don't finance the binge episodes
of a loved one. Sometimes the pain from the consequences
of engaging in the eating disorder can
become a cornerstone of the motivation to let go of
it.
Develop
a support network
Find people you can talk with openly about
your feelings and experiences, your
fears and frustrations, and your plan of action. Contact
local mental health professionals to
learn if there are support groups in your area for friends
and family of people with eating disorders. Participation
in such a group may be very helpful.
Talking with people whose family members have recovered from
an eating disorder can bring hope and encouragement to
you during difficult or discouraging
times.
Be
a good role model
Be a good example with food and when discussing
food or weight-related issues. This
may call for changes in your attitudes, eating habits,
and activities. Consulting with a dietitian
and a therapist may help you determine necessary changes
in your own attitudes and behaviors around food and weight.
First, remember you can set an example without lecturing
or making a production of it. Start
by eating a well-balanced diet with a variety of foods.
Exercise moderately. Accept your own
weight, shape, and your right to participate in activities
such as swimming and dancing or any activity you might
enjoy but have not allowed yourself
to participate in due to body dissatisfaction. Do not
make negative comments about your own or others' bodies.
Don't
blame yourself
There is no single cause for an individual's
eating disorder. Eating disorders are
complex illnesses. The eating disorder is not your fault.
Whatever your mistakes or weaknesses
as a parent, spouse, or friend, you did not create this eating
disorder. We all have weaknesses. We all have been less
than perfect or ideal in our roles and
relationships. Yet, most of us have made good efforts
to do our best based on our abilities
and knowledge.
Take ownership for your weaknesses and frailties and
make genuine efforts to change and improve.
More importantly, take stock of your talents, gifts, and
resources, and get to work providing love, support, and
open invitations for your loved one
to come into a safe relationship with you as they are
ready. Don't let your guilt, insecurity,
or fear get in the way of being actively involved
in your loved one's life.
Take
care of yourself and be patient
If you are exhausted emotionally or physically,
you will not be able to provide the
emotional support your loved one needs the way you would
like to. Those with eating disorders
often do not know how to get their needs met and often do
not know how to take good care of themselves. If you
take good care of yourself, you will
have more energy in your efforts to help them, and you
will be teaching by example something
your loved one needs to learn. Set aside time to care for
your own social and emotional needs.
There are no quick or easy cures for eating disorders,
so pace yourself. Be patient with yourself
and with your loved one as he or she recovers. Often it
will seem they are taking five steps forward, then three
backward. But there is hope and recovery
is attainable. Don't ever give up!