Watching loved ones struggle is a difficult experience. We might feel sad, helpless, guilty, or even frustrated that we can’t help them out of their suffering.
This is especially true for those who know someone dealing with an eating disorder. Not only do these illnesses take a toll on a person’s physical health, but their mental health too. In their lifetime, 9% of Americans will suffer from an eating disorder — this is equal to about 28.8 million people. That’s a lot of individuals who need support and people by their side who can be a pillar during their difficult journey.
Maybe you know someone who’s dealing with an eating disorder and you want to help them, but you don’t know how. Here, we’re going to share some types of eating disorders, how you can recognize symptoms in a loved one, and some practical tips on how to help them.
What is an eating disorder?
According to the American Psychiatric Association, “Eating disorders are behavioral conditions characterized by severe and persistent disturbance in eating behaviors and associated distressing thoughts and emotions.” Here are a few of the most common eating disorders and their symptoms.
Bulimia
Bulimia nervosa is an eating disorder and mental health condition whereby an individual goes through periods of eating a lot of food in a short amount of time (binging), and then making themselves sick or taking laxatives — sometimes they might do both — so that they don’t gain weight. Not only will they binge on so-called “bad” foods, but they’ll also eat low-calorie or “safe” foods to manage their weight. Another way that they try to control their weight is by taking part in compulsive, and sometimes vigorous, exercise.
Individuals dealing with bulimia tend to have a fear of putting on weight and can be very critical about their weight and body shape. Because they often binge and purge the food they’ve eaten in secret, they may experience feelings of anxiety and shame due to their behavior.
While up to 3% of females will suffer from bulimia nervosa in their lifetime, approximately 1% of males will experience this mental health condition, too.
There are many health risks linked to bulimia due to a person not getting enough nutrients through lack of food, vomiting too much, and the overuse of laxatives. Some of these problems are:
- Dehydration, which can lead to kidney failure
- Dental problems from the stomach acid due to persistent vomiting
- Irregular or absent periods
- Digestive issues
- Anxiety and depression
- Heart problems
Anorexia
Anorexia nervosa is another eating disorder and mental health condition where an individual tries to keep their body weight as low as possible by not eating, or exercising too much—or both. Those dealing with anorexia often have a distorted image of their bodies and believe that they’re overweight, even when they’re underweight. They also might be fearful of weight gain.
People with anorexia will try to manage their weight by missing meals, avoiding food, and generally trying to eat as little as possible. Some of their symptoms might include having an unusually low Body Mass Index (BMI) for an adult, muscle weakness and wasting, cold intolerance and severe constipation, bloating, and fullness after meals.
In their lifetime, up to 4% of females and 0.3% of males will suffer from anorexia nervosa, and the number of adolescents with anorexia is increasing.
As with bulimia, there are many health risks linked to anorexia due to malnutrition. Some of these medical complications are:
- Problems with muscles and bones
- Heart problems
- Absence of period in a female
- Decreased testosterone in males
- Kidney problems
- Gastrointestinal problems
Other specified feeding or eating disorders (OSFED)
For those suffering from disordered eating symptoms that don’t match the criteria for anorexia or bulimia, they’d be diagnosed with Other Specified Feeding or Eating Disorders (OSFED).
Examples of OFSED can include:
- Atypical anorexia: Where a person has all the symptoms of anorexia but their weight remains “normal”
- Bulimia nervosa (of low frequency and/or limited duration): Where a person has all the symptoms of bulimia, but the binge/purge cycles are less frequent and don’t continue for as long as a doctor would expect
- Binge eating disorder (of low frequency and/or limited duration): Where a person has all the symptoms of binge eating disorder, but the binges are less frequent and don’t continue for as long as a doctor would expect
- Purging disorder: Where someone makes themselves sick or uses laxatives to control their weight, but doesn’t do this as part of a binge/purge cycle.
- Night eating syndrome: Where someone continues to eat at night, either after waking up or by eating a lot after their evening meal
Elizabeth Delullo, a licensed professional counselor with Grow Therapy, offers the following as some symptoms of disordered eating: “They may be hiding food, eating late at night, eating in secret, having multiple helpings, skipping eating even when they’re hungry, categorizing foods as good and bad, excessive restriction, and eating just because it’s there — these are just a few.”
Even though someone with OFSED has a slightly different combination of symptoms to a person with one of the other common eating disorders, it’s no less serious and still comes with many, if not all, of the health risks associated with anorexia, bulimia, etc.
How to recognize disordered eating in a loved one
There are a number of warning signs that someone has an eating disorder. Here are some to look out for:
Signs and symptoms
Some of the signs that someone has an eating disorder are:
- Dramatic weight loss
- Eating in a ritualized or compulsive way
- Visiting the bathroom frequently after eating
- Exercising more than usual
- Decreased concentration
- Secretive eating
- Feelings of depression or anxiety
- They’re significantly withdrawing or isolating
- They often feel cold, tired, dizzy, or faint
- Frequent headaches
- Dry skin and/or skin sores
- Hair is falling out or is brittle
- Brittle nails
- Disturbed sleep
- Constipation
- Frequent urination (especially if they’re filling up on liquids to avoid eating)
Julia Preamplume, another of Grow Therapy’s licensed professional counselors, adds that there are other things we can look out for in people with an eating disorder: “Listen to how the person talks about food: do they speak about it in a negative or judgmental way? Notice how they speak about their body, such as frequently criticizing aspects of their appearance. Some other concerning signs are a strong focus on their weight and size, preoccupation with calories and other food macros, avoidance of social events that involve food, and frequent dieting.”
How to talk to someone you think is struggling
If you think someone you know is struggling with an eating disorder, it might be a good idea to talk to them. However, it’s important to be considerate when doing so, especially if the person concerned doesn’t realize they have an eating disorder.
Our Grow Therapy licensed counselors offer some dos and don’ts when it comes to having that difficult conversation.
Do
- Try speaking to them during a time when they aren’t actively engaging in disordered behavior.
- Approach them in a way that doesn’t lead to blame or anger.
- Express to them that you’ve noticed they are struggling and are concerned for them.
- Try to use “I” statements.
- Emphasize that you realize this is an awkward conversation, but it seems like they’re struggling, and you want them to get help because you care about them.
- Offer to help them connect with a knowledgeable mental health professional.
- Understand that your loved one may have a negative reaction, and that it’s not personal.
Don’t
- Say “just eat normally”, or, “eat three meals a day”, or, “why don’t you just stop?”
- Say that you think they have an eating disorder because your role isn’t to diagnose them — it’s to lead them to help.
- Make comments about their body, even if it seems complimentary.
- Comment on their food or eating habits, as that could lead them to feel more self-conscious.
- Be discouraged if they say they don’t have an eating disorder, but instead say they have another problem, such as a break-up, family issues, etc. Encourage them to go to therapy, and hopefully, it’ll eventually come out there. The most important thing is to get the person to go to therapy.
Christy Barongan, one of Grow Therapy’s licensed professional counselors, says, “These conversations often don’t go well, and the person [with an eating disorder] may hold a grudge or hide things from the person who tried to help. But sometimes it helps later on when the person concerned is ready to acknowledge that they have a problem, and it may be an important first step into getting them help.”
Get help for an eating disorder
Tips to help
It’s not easy having a loved one who’s going through something so difficult, especially if they don’t realize that they have a problem or are finding it hard to stop their disordered behavior. By doing small things, you may have a significant impact — here are some tips.
Include them
People with eating disorders tend to have low self-esteem, so do your best to include them in conversations, events, and activities to make them feel valued — it might be a good idea to arrange things that don’t involve food.
Make them feel good about themselves and try to build them up when you can.
Be gentle and patient with them
You can’t force someone to change their behavior. The more pressure you apply, the more they may withdraw from you. Just let them know that you’re there for them, without conditions.
Preamplume adds, “It’s so challenging watching someone you care about suffer in this way. For adults, it’s important to respect a person’s autonomy and not coerce them into seeking eating disorder treatment options. Let them know that there is help available if they change their mind, and you can help them get connected with the right professionals when they are ready.”
Don’t focus on their weight or appearance
Saying things like “you look well” might sound harmless, but it’s still reinforcing a focus on someone’s appearance — and their own body image is already a problem that they’re dealing with. Try not to comment on their weight and appearance in any way.
Keep mealtimes stress-free
Just like commenting on their appearance might make them feel self-conscious, so might commenting on their food choices. Let them eat in the way they feel able to at that time.
Help them find reliable information and avoid bad sources
There’s a lot of harmful information out there, such as pro-anorexia (or pro-ana) websites that not only don’t see disordered eating as a mental health condition, but also encourage people to take part in anorexic or bulimic behaviors.
While it’s very difficult to police what someone else does with their own time and devices, try to steer your loved one in the right direction by offering them reliable, factual information and online support.
If appropriate, you could even send them stories from other people who are either thinking about starting eating disorder recovery or who are in recovery and want to share their story with others.
Refer to the eating disorder as a third person
It might make the problem easier to talk about if you both talk about it in the third person — referring to it as something that’s not part of your loved one.
Encourage them to seek help, and go alongside
If they decide to seek professional help but feel nervous, offer to go with them so that they feel less alone. They may also feel more comfortable in a support group, where other group members are sharing similar feelings and experiences.
Key takeaways
Due to the complicated nature of eating disorders, it can take months or even years to recover from them. Not only do sufferers need to make a physical recovery, but also behavioral and psychological recoveries too.
A strong support system from family members and friends can be instrumental in helping those dealing with the disorders on their healing journey, along with medication — if needed — and regular therapy.
Grow Therapy is home to many excellent, qualified therapists who specialize in eating disorders. Simply filter by the specialty you’re looking for and your insurance type to find the right therapist for you or your loved ones.