How to help anorexics and bulimics

How to identify eating disorders
The first thing you need to do if you suspect that someone you know, or love, is suffering from an eating disorder, is to make quite sure that this is really the case. The following signs and symptoms are characteristic of individuals suffering from anorexia and/or bulimia:

Anorexia

• Refusal to eat
• Extreme loss of weight
• Distortion of body image - the patient insists that she is “fat” even if she is close to starvation
• Restless and hyperactive behaviour
• Excessive exercise - insistence on doing exercise every day and for much longer than is advisable
• Hides food away
• Likes to prepare food for others and urge them to eat

Bulimia

• Bouts of gross overeating followed by self-induced vomiting
• Excessive use of laxatives and/or diuretics
• Some loss of weight
• Damaged tooth enamel caused by repeated exposure of enamel to stomach acid during vomiting

At risk population
The following types of people are at much greater risk of developing eating disorders than others:

• Obsessive personality, tends to be meticulous, hard working, does well at school and/or sport
• Usually very intelligent and sets extremely high standards for herself
• Usually female, but Eating Disorders can occur in males
• Young people, especially teenagers, but can also occur in older individuals
• Tendency to anxiety and/or depression
• Very low self-esteem
• Possibly previously overweight or even obese
• Living in middle-class to affluent families where plenty of food is available
• Some members of family may be overweight and/or obese
• Extreme concern with appearance
• May live in a severely dysfunctional family (e.g. feels lack of love by parents, envy of siblings)
• Fear of gaining weight, looking ugly, failing

What should you do?
If you suspect that a member of your family, a friend or colleague, is struggling with an eating disorder, then you can try the following:

• Initiate communication
  People who suffer from eating disorders are very secretive about their condition and clever at hiding their affliction. They make excuses and are evasive. Consequently they are among the most difficult people in the world to talk to and to get to open up. Never confront them directly as this may cause them to clam up completely and refuse all help.

  Try talking to them in a relaxed setting, which is not threatening in any way. Talk about other aspects of this problem and not the actual disease, e.g. talk about problems with communicating in families, brothers and sisters who are difficult to live with, parents who are too demanding or who don’t understand teenagers. Hopefully the anorexic or bulimic will open up a bit and get onto the topic of her eating disorder by herself. At this stage you can suggest that she go for help.

  Remember that it may take more than one session of friendly talks to get an anorexic or bulimic to be forthcoming about her real problem. Don’t rush things. It is after all the person who is suffering from the disease who has to take a decision to go for help.

  Above all do not be judgmental or prescriptive. These are total turn-offs and will do more harm than good.

• Suggest solutions
  Anorexics and bulimics need to be treated by a team of health professionals: a clinical psychologist, a dietician and/or a medical doctor/psychiatrist. Make sure that you have the names and addresses of such experts available before you attempt to talk to her, so that you can give the patient the information immediately. If you don’t have this information at hand if, and when she asks for it, you may lose a golden opportunity to set her on the road to recovery. It may be a good idea to look up the names and addresses of these healthcare professionals and even to phone them to make sure that they treat eating disorders. Have all your facts available, but present them in a casual way, otherwise the patient will become suspicious.
• Offer acceptance and support
  Anorexics and bulimics are isolated in a world of pain and conflict. They need love, affection, acceptance and support. If you really care about them, you will let them know that you are always there for them and that you do not judge them, no matter how difficult this may be.

  If you are serious about wanting to help your child or friend or colleague, then be patient and understanding. The effort and frustration that you will experience is worth it, if you can help these lost souls to rid themselves of the scourge of anorexia or bulimia, and you may even save their lives.

  - (Dr I.V. van Heerden, DietDoc)