How to Discuss Eating Disorders

In my last blog post, we looked at the signs of an eating disorder. This week I am going to discuss what you can do if you believe that a friend has an eating disorder.

A few points to remember:

• in 86% of people who have eating disorders, the disorder has been established by the age of 20 for adolescents, anorexia is the third most common chronic illness
• a quarter of college-aged women employ binging & purging as a method of weight management
• more than 1/2 of teenage girls about 1/3 of teenage boys use unhealthy weight control behaviors including: fasting and skipping meals, smoking cigarettes, vomiting, and taking laxatives.

Eating disorders are a real and prevalent concern among adolescents and emerging adults and we should be aware and vigilant. When you observe the kinds of behaviors that indicate an eating disorder, it can be extremely difficult to have a frank conversation, even with a very close friend. So what should you do if you observe an eating disorder in someone you care about?

How you can help

• A good first step, it so try to bring the topic up with your friend in private. Explain what you have observed and why you are concerned. Try to listen and be supportive in the most non-judgemental manner possible.
• If your friend is willing to discuss the eating disorder, discuss ways that they can become healthy again. Avoid blame-based statements such as, “you could get well if you’d only eat” or “all you have to do to start getting better is work out less”. Try to engage them by finding out how you can help and be supportive.
• Learn about eating disorders. There are lots of online sources from reputable organizations such as NEDA (National eating Disorders Association)  and (NIMH) National Institute of Mental Health. The more you know, the better equipped you will be to share what you know with your friend as you determine that they are ready to hear.
• Don’t hover over your friend or monitor every bite of food they eat. Eating disorders are complicated and if you become too overbearing, your friend may simply pull away.
• Remember that “fixing” your friend is not your job! Know your own limitations. At some point it may become necessary to get parents or a professional involved. You can call a hotline or talk with a counselor about next steps.
• Try to get your friend to join a support group or speak with a professional, you may even go as far as to offer to accompany them.

Eating disorders are very challenging for everyone involved. It is hard to discuss them and even harder to watch someone you care for struggle with one. If you are in this situation, be as supportive as possible while also being aware that you may need to get a professional to help your friend.

Sincerely,

Dr. Eileen Wynne

References

http://kidshealth.org/teen/food_fitness/problems/friend_eating_disorder.html

http://www.helpguide.org/articles/eating-disorders/helping-someone-with-an-eating-disorder.htm

http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/

Signs of an Eating Disorder

In the United States, it is estimated that between 24-30 million teens and adults have eating disorders. Women and girls tend to have eating disorders more frequently than men and boys, but in recent years, the number of males with eating disorders has increased to about 10-15% of the overall number of individuals with eating disorders. Living in a culture that is pretty much obsessed with image, in which magazines and online sources crop and airbrush models and celebrities to perfection, can have an impact on how people see themselves. This can be particularly damaging to emerging adults who are in the process of refining who they are as autonomous individuals. It is between the ages of 12-25 that eating disorders are most common. It can be difficult not to feel hyper-conscious of your body when society is telling you that to be happy and successful, you must look a certain way, it is almost impossible to escape the pressure to look perfect.

While being fit and taking care of the body is very important for good health, sometimes a person can take it too far and become obsessed with how they look, deriving feelings of success and self-worth from appearance. The need for control over the body can lead to anxiety and depression. In fact, about half of people who have an eating disorder also meet the criteria for depression. Eating disorders can be very dangerous, leading to increasing feelings of anxiety and, in extreme cases, death. Of all mental illness, eating disorders have the highest mortality rate.  Eating disorders are especially tricky to deal with because they are not actually about weight or food intake. They tend to be a way of dealing with emotional issues, stress, and anxiety. It may seem like a problem that is easy to fix, but it is more challenging to deal with an eating disorder than you may think, as the root cause is emotional. People with eating disorders tend to use their relationship with food to cope with uncomfortable or painful emotions.

What types of eating disorders are common?

An eating disorder can manifest in many ways. Basically, it is a distorted attitude about food, weight, and body image. You may observe a series of more and more extreme and restrictive diets and obsessive calorie counting. In cases where one eats less and less, becoming more thin and rigid about eating rules, you may suspect anorexia. In other cases, eating disorders can take the form of binge eating followed by the use of vomiting, laxatives, compulsive exercise, or fasting to counteract the effects of the binge. While individuals with this type of cycle, which is called bulimia, often stay about the same weight, the behaviors can be extremely detrimental to the body. Finally, binge eating disorder is an eating disorder in which people compulsively overeat, consuming large numbers of calories, followed by feelings of intense guilt and shame.  

Is it an eating disorder?

If you think the behaviors that you are observing in someone you care about may be an eating disorder, here are a few things to check for. The following list may help you to recognize the clear signs and red flags of an eating disorder. 

Someone with an eating disorder may do the following:

• Exercise all the time, even when they are already exhausted.
• “Compensate” for overeating or drinking too much by exercising, using laxatives, or fasting.
• Seem obsessed with calories, weight, and food intake.
• Avoid gatherings where friends are eating.
• Wear clothing that hides their shape.
• Visit the bathroom after eating or is heard vomiting.
• Buy laxatives often.
• Describe themselves as fat in spite of obvious weight loss.
• Focus and obsess about body parts they don’t like.
• Be competitive with others about minimal food intake.
• Gain weight  without ever eating in front of people.

If you observe several of these signs, you may want to consider discussing them with your friend. Be aware that people with eating disorders can be very uncomfortable talking about them.  Your support and encouraging your friend to seek treatment can make all the difference. Read my next blog post for advice on the steps to take if you suspect that a friend may have an eating disorder. 

Sincerely,

Dr. Eileen Wynne

References

http://kidshealth.org/teen/food_fitness/problems/friend_eating_disorder.html

http://www.helpguide.org/articles/eating-disorders/helping-someone-with-an-eating-disorder.htm

http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/