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MY SPECIALTIES:
EATING DISORDERS
Introduction
Anorexia Nervosa
Bulimia Nervosa
Binge Eating
Disordered Eating
Body Image
Obesity & Weight Management
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Nash
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How to Help a Friend or Loved One Who Has an Eating or Exercise Disorder
When a friend or loved one needs treatment for an eating disorder:
- Plan to talk to the person you suspect has an eating or exercise problem. Decide if
this should be a one-to-one conversation, or if someone else (a parent, sibling, spouse,
or friend) should be part of the conversation.
- Pick a good time to talk. Allow for privacy and the opportunity to talk without
interruption. Avoid talking when you are angry, upset, or hurt. Consider writing down
ahead of time what you want to say.
- Be empathic and understanding; remember it is often hard for someone with an eating
or exercise disorder to ask for or accept help.
- Explain what behaviors you have observed that lead you to suspect a problem. Be
direct and frank but gentle. Avoid arguing or getting into a power struggle. Don't get
distracted by side issues.
- Communicate your feelings using "I" statements, as in "I'm worried about your health"
or "I'm getting angry about the missing food."
- Remember that even though the eating or exercise disordered person may be miserable,
he or she may also be ashamed or afraid to admit there is a problem, or the behavior may
be giving them the illusion of being in control of their lives or circumstances. Be a
good listener, but be firm about the need for seeking help. Agree that recovery is often
difficult, but emphasize that people have done it.
- Be prepared to make suggestions for taking action. Obtain information on treatment
options and resources, including the names of qualified therapists, that the eating
disordered person might consider. Offer to accompany the person to the first treatment
session.
- Anticipate a variety of possible reactions on the part of the person being confronted.
These may include relief that someone is aware of the problem and readiness to accept
your help, or defensiveness and denial.
- Remember that if your friend or loved one is an adult, he or she has the right to
refuse treatment, even if they admit there is a problem. It may be necessary to continue
talking to the person about your concerns. Continue to be a caring and supportive friend
while encouraging the person to seek professional treatment.
- If the eating disordered person is your minor child, don't let tears, tantrums,
or refusals stop you in getting him or her help. Be kind and gentle, yet unwavering in
your insistence that the child get treatment. Start by calling your physician or a mental
health professional and request a referral to a specialist trained to treat eating disorders.
- If the eating disordered person is a friend who is younger than 18, tell a trusted
adult-parent, teacher, coach, pastor-about your concern.
When the friend or loved one is in denial about having a problem:
- Seek the advice of a professional about confronting the loved one and communicating
the seriousness of what you are observing.
- With the advice and support of a professional, consider a group intervention-the
goal of which is to break through the denial. Enlist the help of several people who are
significant to your loved one. Together plan how to confront the person with the eating
problem with information and evidence to support your concerns. Rehearse your intervention
carefully.
- Before the confrontation, investigate possibilities for a plan of action so that
during the intervention you can make referrals for appropriate treatment or to other
resources.
- Anticipate reactions and problems that might arise during the confrontation. For
example, the loved one may react with anger and become defensive.
- If the situation is an emergency-the person with the eating disorder is talking
about suicide or is no longer going to school or work-seek immediate help. If suicide
seems imminent, call the police or take the person to the nearest emergency room. Call
a professional and request help if the person with the eating disorder is no longer
functioning socially or occupationally or appears dangerously thin.
When a loved one is already in treatment:
- Be patient. Eating disorder treatment may take from one to five years.
- Avoid power struggles, especially around the eating or exercise behavior.
Don't give advice unless asked. Don't expect the person to follow your advice,
even when it has been solicited.
- Avoid blaming yourself or others for the eating disorder.
- Avoid demanding or pleading that the person stop his or her disordered eating behaviors.
- Seek the advice of a professional on how you can help.
- Remember that others in the family may have feelings and reactions to the
loved one's eating disorder. Help other members of the family, especially siblings,
to express their feelings and concerns. Discourage others from confronting or providing
advice to the person with an eating or exercise disorder.
- Show the eating disordered person more unconditional love; try hugging more or
spending special time together-without talking about your concerns for them.
- Avoid commenting on appearance or weight, even if your loved one solicits your
input with questions or comments such as, "How do I look?" or "I'm so fat." Say nothing
or reply something like, "I don't have an opinion."
- Avoid using bribes, rewards, or punishments to control your loved one's eating or
exercise behavior. Don't compliment, criticize, blame, cajole, plead, or make promises
in hopes of getting him or her to change.
- Don't go out of your way or make special concessions on food preparation or
purchases that support the continuance of the eating disorder (for example, buying her
diet pills), even if the loved one threatens or pleads with you.
- Don't monitor the eating disordered person's behavior, even when asked. Avoid
becoming the food or bathroom police person. Don't pry; respect the other's privacy.
- Maintain as much as possible the family's normal eating patterns as long as they
are healthy eating patterns. Don't allow the eating disordered person to shop, cook for,
or feed the family unless he or she participates in the meal.
- Set limits and maintain your boundaries. Establish clear rules about such things
as who will pay for binged food or excess food consumed, who will clean the bathroom,
or who will clear away food that has been chewed and spit out into bags. Learn to say
"no" in a caring and reasonable but firm and consistent manner. Don't ignore stolen food
and evidence of purging; ask the person to take responsibility.
- Get help for yourself as necessary. Expect to experience a range of emotions from
helplessness and anger to despair. You may need someone to talk to, and this could be
a friend or a therapist.
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