Advice for family and freinds
Family and friends often worry that someone they care about may have an eating disorder. It may be that the friend or relative has lost a considerable amount of weight or worries about her weight constantly. She may appear overly interested in food or furtive about her eating habits.
The descriptions of anorexia nervosa and bulimia nervosa included earlier in this book contain lists of particular signs and symptoms of the illnesses. Some of these will be obvious, such as a very low weight, whereas others may be entirely hidden, for instance secret binges or vomiting.
You may have noticed other signs that are much less specific. Some of these are listed in the box. Remember, though, that none of these features is present just in eating disorders. The presence of one or even all of them is not enough to determine that someone definitely has an eating disorder. However, if some of these are clearly present and causing you concern, then it may be time to think about sharing your concerns with the person involved.
BROACHING THE SUBJECT
There is no way to be sure that someone has an eating disorder unless the person confides her thoughts and worries. To turn a suspicion into something more definite, it is necessary to talk. But do not jump to conclusions, and do not panic.
Choosing the right moment to bring up the subject is important. However, having chosen the moment you should share your worries in a direct manner. This is better than beating about the bush. It may be a hot topic but it needs to be approached with a cool head and a warm manner. Pushing too hard for answers may make the patient more defensive.
Parents can sometimes feel that home has become a battleground, with food as a powerful weapon. They can feel guilty and responsible for what is happening to their child. This is not a useful starting point for tackling the problems of eating disorders.
Someone with an eating disorder may be relieved to share her trouble, although she may not. Eating disorders are often a private form of suffering, and that person may be wary of talking for all sorts of reasons. Eating disorders in general and anorexia nervosa in particular may give the person a tenuous but valued sense of personal control. Letting someone know all about it may seem to threaten this control in a frightening way.
The very person who is worried may be involved in some of the issues that are caught up in the problem. The sufferer might find it difficult to broach the topic and be open about her feelings; open discussion of everything is not, however, necessary. To get things started, the sufferer must come to feel safe enough to take the risk of confiding some of her fears. Often the best person to hear the full story may be someone once removed from the sufferer’s immediate family. This may be a teacher, friend or some other trusted person. If she has an eating disorder, the family doctor would be an appropriate first port of call in the search for help.
PUTTING UP WALLS
The person with the condition may not admit the problem, or she may not want help even if she will acknowledge that she has a problem. The whole thing may be too fraught with fears and mixed feelings. One way of coping with mixed feelings is to get into an argument, where both parties find themselves expressing their views in more and more extreme terms. This usually gets nowhere.
In situations like these, it is usually best to back off and let everyone cool down rather than allow it to develop into a fight. Things are rarely so extreme that a few days will make matters worse. Someone cannot be forced to overcome fears and to trust another person. Trying too hard to make this happen cannot help.
It may be difficult for the worried parent, partner or friend to give space to the person about whom they are worried. Going behind that person’s back to seek help is not a good idea. It may be helpful to talk to a relevant professional, such as the family doctor, about their own dilemma. Likewise, self-help organisations such as the Eating Disorders Association offer valuable support and advice to relatives and friends of people with eating disorders.
BEING IN CONTROL
Everyone, even children to a degree, has the right to be in control of their own lives. Fears about control seem to be central to eating disorders.
It is therefore not surprising that real conflicts can arise when a fearful sufferer and a worried parent or friend confront the issue of what to do next. Personal autonomy includes the possibility of making one’s own mistakes.
In most circumstances the sufferer eventually comes to feel that more is to be lost by staying where she is than by risking change. She may have to come to this decision in her own time. Only in very extreme circumstances, where the person’s life is in danger, is it justifiable to coerce someone into any form of treatment. And such circumstances are rare.
Perhaps it is best to recall the overall message of this book. Eating disorders are a serious matter, but they are not a reason to panic.
