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As many of you in the health community know, this week (February 26-March 3rd) is National Eating Awareness Week in America, and this past week (February 20-26th) in Ireland. So, to do my part, today’s post is about the very serious mental illness’s that are eating disorders. “Count What Matters” is the theme this year for National Association of Anorexia Nervosa and Associated Disorders eating disorders awareness week. Recently I have also been working with Inspire Ireland’s mental health awareness website ReachOut.com (which by the way, they are totally awesome and you should check out their website!) Part of the information below is part of an informational worksheet that Reach Out and I are working on, which will be up in the near future on their website under “Help a Friend.”

What is an eating disorder?

The term eating disorder is used to describe a group of illnesses where a person has a distorted view of body shape and weight and extreme disturbances in eating behaviour. They can be seen as a way of coping with emotional distress, or as a symptom of underling issues. There are a number of eating disorders – Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder.

How do I help a friend with an eating disorder?

Seeing someone experiencing an eating disorder can be really hard. Helping someone who is not ready to change their behaviour may be difficult and the decision for them to get help is ultimately theirs. However, there are ways you can help support the person who has an Eating Disorder.

Talk to a professional

If you are worried about someone, you may want to speak with a person whom you trust about your concerns. This may be a family member, teacher, youth worker or a professional such as a counsellor or nutritionist.

Educate yourself

It’s a good idea to have a general knowledge of what eating disorders are and how they work. Remember, eating disorders are more than just trying to be thin. By learning more about the disorder and how it works, you can be better prepared to talk to your friend about it and understand what they are going through. By doing this, you may be able to better understand the reasons for the reactions you may receive. For example, denial and a belief that they are fat is one of the characteristics of eating disorders. It is not uncommon, therefore, for those who are experiencing an eating disorder to become angry and not want to talk or listen to you. Being informed may help you to deal better with their reactions.

Talk to them

Talk to your friend and let them know you are worried about them. Ask them what the experience is like for them. Sometimes, the person may not even be aware they have a problem and just think they are dieting. If you are concerned about their eating habits or use of laxatives, let them know! When talking to them, make sure the focus stays on feelings, and doesn’t wander back to talking about food. Also, if they aren’t already in treatment, encourage them to seek help. It may be hard for them to seek help, or even admit they have a problem. Just remind them that you are there for them. Remember that you are talking to them as their friend and not a therapist. Remember, they may come off as angry or defensive, but it’s not because they are upset with you personally. They’re going through a hard time and may not know how to handle it. For tips on how to talk to your friend, check out the worksheet at ReachOut.com on Tips for Communicating effectively with a friend.

Tips and information to keep in mind…

  • Eating disorders are not primarily about food
  • People can and do recover
  • Eating disorders can affect anyone
  • Eating disorders are characterised by a variety of disordered eating behaviours such as:
    • Self-starvation – by fasting and/or food restriction
    • Purging – by self-induced vomiting, over-exercising, or laxative abuse
    • Bingeing – by consuming quantities of food beyond what the body needs to satisfy hunger

An eating disorder can be very destructive, both physically and emotionally, and people can get trapped into a destructive cycle without knowing how to cope with or break it.
 An eating disorder is not just about food and weight, but also about a person’s sense of who they are.

What causes an eating disorder?

There is no single cause that can explain why a person develops an eating disorder.
It is usually a combination of factors (biological, psychological, familial and socio-cultural) that come together to create conditions in which an eating disorder is more likely to develop. The disorder often develops gradually as a response to an upset in a person’s life. This could be a traumatic event, a loss or major change in a person’s life, bullying, an overload of stress, and/or critical comments about weight or shape. Sometimes, it’s not obvious what the trigger may have been. 
A person with low self-worth or without a strong sense of identity may be more vulnerable.

People who develop eating disorders tend to be overly concerned with meeting the standards and expectations of others, and are super-sensitive to other peoples’ feelings.
This explains why eating disorders occur so often during adolescence when identity is an issue, the opinion of peers is so important, and parental expectations are resisted. Eating disorders do not start out as a conscious choice and are not a wilful form of ‘attention seeking’.
Understanding the emotional background of the eating disorder is crucial to developing an appropriate response and treatment approach.

The main types of Eating Disorders

Anorexia Nervosa

  • A person will make determined efforts to attain and maintain a body weight lower than the normal body weight for their age, sex and height
  • They will be preoccupied with thoughts of food and the need to lose weight
  • They may exercise excessively and may engage in purging behaviours
  • A person will make determined efforts to purge themselves of any food eaten, sometimes following a binge, and often following ‘normal’ food intake
  • They will engage in high-risk behaviours that can include fasting, excessive exercising, self-induced vomiting, and/or the misuse of laxatives, diuretics or other medications
  • They may maintain a body weight within the normal range of their age, sex and height. As a result, bulimia is often less obvious than anorexia and can go unnoticed for longer
  • A person will engage in repeated episodes of bingeing without purging
  • They will likely gain considerable amounts of weight over time
  • They find themselves trapped in a cycle of dieting, bingeing, self-recrimination and self-loathing

Bulimia Nervosa

  • A person will make determined efforts to purge themselves of any food eaten, sometimes following a binge, and often following ‘normal’ food intake
  • They will engage in high-risk behaviours that can include fasting, excessive exercising, self-induced vomiting, and/or the misuse of laxatives, diuretics or other medications
  • They may maintain a body weight within the normal range of their age, sex and height. As a result, bulimia is often less obvious than anorexia and can go unnoticed for longer

Binge Eating Disorder

  • A person will engage in repeated episodes of bingeing without purging
  • They will likely gain considerable amounts of weight over time
  • They find themselves trapped in a cycle of dieting, bingeing, self-recrimination and self-loathing

People can and do get better.

Further information can be found in the books listed on the Bodywhys booklist and from other websites for eating disorders and related issues. Similarily, in the United states, check out the National Eating Disorders Association. For even more information, check out the following links…

Nicole Paulie is a Counselling Psychologist, and co-author of “How to be Happy and Healthy – The seven natural elements of mental health.” She provides therapy in the Dublin city area. Contact us to learn more or to book an appointment.

Count What Matters – Helping a friend with an eating disorder
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