How to help your friend, sister or daughter
Having to watch a close friend or a family member suffer from an eating disorder can be terrifying, frustrating but most of really hard to deal with because you simply do not know what to do. Psychiatrists, Psychologists, Doctors and all sorts of other gurus have spent years at University trying to understand the developmental reasons, the mechanisms, triggers, actions, thought patterns and sorts of other links associated with eating disorder sufferers. And the truth is, they are really hard to understand.
Please read the 'home' page as this will help identify the reasons as to why and how someone can develop anorexia or bulimia. And remember it is not a choice they have made.
I am going to talk in terms of your best friend to make things easier
- Get on top of things FAST. If your friend is becoming anxious around food, avoiding food, excessively exercising, has lost a lot of weight or has began to develop unusual habits - e.g frequent toilet trips after meals, Ask them whats going on. There's a good chance they will say nothing, but try and dig deeper. You may have to say you 'know' something is wrong and you just want them to tell you the truth. Denial can be a huge issue initially so don't say they are anorexic or bulimic - helping them acknowledge they have food issues will be the first step. Each day their obsession will worsen and food will become more and more fearful. Bad habits will become more and more ingrained as time goes on. Take a smoker for example - they've been smoking for a few months, it's easy to persuade them to give it up, but for someone who has smoked their whole life - they are dependant on nicotine, it's certainly possible for them to give it up but it will be a very hard and long road. So don't leave this talk too long.
- Treat them as a normal person. Keep in mind they are struggling but don't make them feel like a freak. Go to the movies, go shopping, talk to them as if you would talk to anyone else. When it comes to food - look out for them, but don't smother them or leave them in the dark. If you see that they are really down one particular day, offer and try and initiate an honest talk. But otherwise leave their eating disorder out of things, it doesn't need to be brought up every time you see them. How many people wear glasses because of poor vision - probably every second person. Do we need to bring up their eyesight every time we see them ? No.
- DO NOT EVER say they have put on weight, or 'YOU LOOK BETTER'. You could say this with the kindest intensions, but to them it translates to - You look fat, wow you have put on a lot of weight. Its almost habitual to comment on something when we see someone, so if you have to; compliment their hair, a particular piece of clothing or accessory. Even better, what about - It's so good to see you, It's been so long, I have so much to tell you.
- EAT together ! There is a good chance that your friend has lost sight of what normal eating is. Or they are becoming more and more afraid of eating around people. You are their friend, if they begin to get anxious around food let them know - it's ok, you can do this, it's just food, i'm here with you. I would eat in a corner in darkness at home. If I heard someone walk by I would go into panic mode and if my food wasn't perfect I would literally chuck a tantrum. Yet when I went to sushi with my girls I was much more relaxed. To them I was a little on edge and engaging in conversation whilst eating was very unnatural for me, but in comparison to how I acted when I was on my own I was much better. I also was my most adventurous with friends, dont get too excited - I'm talking swapping cucumber for lettuce, but it's the concept of letting go with regards to food, which is something anorexia does not let you do.
- Challenge them. They will never conquer their food fears without challenging them. Its the same concept with any fear. I'll give you a good example for me. I am naturally a very organised person, but I became ridiculously scheduled as my illness progressed. My eating times had to be correct within 14 minutes, my food plans were made 3 months in advance, weigh ins scheduled. I kept asking Bree to challenge me, but she saw how I reacted when food plans were altered or cancelled and to be honest she probably didn't want to go there - I don't blame her. So then she encouraged me to start being more flexible in terms of other scheduled things - meeting times, not planning catching up weeks in advance. Then I began to challenge myself in other aspects, such as my weigh ins and then eventually with my food.
- GOALS. My self help page will have a whole load of exercises, a lot of which will be goal orientated. But as friends, make a list together, the things you want to do before you die, the things you want to achieve in life. It will give you a good insight as to what you both want in life and probably cause a good laugh too - and no I don't want you to use these goals against them, but you can use them as motivation when they are down or don't seem to be making progress. Do they want a family ? - Someone with a child's size body and the insides of a starved orphan is not going to have very good chances having a baby are they - you don't say this ! You could though, remind them that having a family is going to be hard if they lose any more weight or they continue to binge and purge. Its most likely they will then go on to make some more personal goals later.
- Take them to the doctor, they may not realise how underweight and unwell they are. For some people it takes someone with authority to make them see the truth. A doctor will also be able to outline the medical risks associated with anorexia or bulimia. Once again they may be unaware as to how much damage they are actually doing to themselves. This is another one of those act fast things. My first admission when I was told I had less than 48 hours to live I didn't lift an eyelid. I didn't care, I was numb, 48 hours didn't scare me. Tell anyone else those exact words and they would have a fit. So make them aware of the risks while they can still rationally analyse the consequences.
- Perhaps your friend has reached the point where they are so dangerously underweight, weak and no encouragement with regards to food is making any difference. Hospital could well be the only option. When the body is in severe starvation mode, it will become very hard for them to make rational decisions, depression is most likely another issue and motivation is out the window. As a friend it's probably not your place to organise an admission, however you can mention that it may be time to let someone else help. Leave that to a family member or them to decide.
FOR CARERS - Parents and Partners
- Anorexia is all about CONTROL and bulimia is about loss of control and then an attempt in gaining control back by compensatory behaviours. Take control OUT of their hands. YOU are going to decide what is for dinner, YOU are going to cook for them. And do not let them dictate what you eat, when you eat. Be fair - they hate creamy sauces, dont make them carbonara. They like certain foods, let them have them often. And EAT TOGETHER. It is very likely that they will scrape things off or try and hide bits of food. Don't sit there watching them, but just be aware.
- Portions. I hope it hasn't got to the point where their stomach is so small a handful of vegetables literally FILLS the stomach to maximum capacity, but beware of what they are capable of. You cant expect a healthy human to eat a meal 3 x as big as what they are used to straight away, so don't expect that of them. But on the other hand, once they are capable of eating a somewhat reasonable amount - read below and LISTEN CAREFULLY !
- A teaspoon of rice is EQUALLY as horrifying as a small serving of rice. A piece of fish the size of a chicken nugget is EQUALLY as terrifying as a small fillet. See where I am going ? You can have argument after argument over how horrified they are at a food or a portion, but you would be having the exact same argument over a completely different size. So what are we going to do ? Give the control seeking anorexic a portion of rice to help them walk across the room or a small serving which will get them through the day. You're going to get an argument or tears either way.
- Challenge Challenge Challenge. You are their carer, you have a certain degree of control. They like 'their' mexican - no cheese, no avocado, no sauce, minuscule meat. Ok well they like mexican right ? Tell them were going out for mexican, or you're making mexican - PROPER mexican. They used to love ice cream ? Lets go out for ice cream. Don't fall into the trap of a low fat kids scoop. What did I say just before - that a low fat kids scoop is going to freak them out the exact same as normal serving of regular ice cream.
- Vomiting an issue? No showers after meals. Sit together after dinner, its most likely that work, school and other activities will get in the way during the day but after dinner be together. You don't have to talk, just go in the same room as each other and read a book, go on your laptop, let them do their homework. Initially they will argue about it being unfair, an invasion or privacy or whatever other excuse they have, but eventually it will no longer be an issue. You may actually find it's nice spending that half an hour or so together each day.
- Take a picture of them in minimal clothes. They can't see how sick they really are in the mirror. Sometimes a picture is more convincing or perhaps at that particular time they are completely blinded by their illness. Keep that picture for down the track when they are in a better place, when you show them then - they will be able to see what everyone could see.
I encourage both eating disorder sufferers and family and friends to join the I Will Find My Way facebook group. It will let you know when something new is added to this site. But most importantly it will be a support network for people living with an eating disorder who no longer want to live that way.