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Altered appearance, Anorexia, Anxiety, Binge Eating Disorder, Body size, Bulimia, Depression, Diet pills, Distorted body image, Eating Disorders, Emotional pain, Extreme dieting, Fasting, Helplessness, Loneliness, Low Self-Esteem, Powerlessness, Purging, Restrict food, Self-loathing, Shame, Starvation, stress, Underweight
All of us have been there, especially women. Women look in the mirror and we think “I need to lose weight” or “I look fat” or “I need to go on a diet”. We compare ourselves to others and wish we could look more like someone who is younger, skinnier, prettier, or has a better body than we do. Self esteem issues are a normal part of life and self acceptance comes as we get older and mature. However, for some people, self esteem issues go beyond normal and require professional help.
What is an Eating Disorder?
Many people think that an eating disorder is about food or weight. It is not. It is a person’s attempt to deal with emotional and stress related issues.
Eating disorders are extreme eating behaviors. Examples of these behaviors would be: a person following a rigid diet, binging on food in secret, throwing up after meals, and obsessively counting calories. Eating disorders are way more complicated than just unhealthy dietary habits. At their core, they involve distorted, self-critical attitudes about food, weight, and body image. It’s these negative thoughts and feelings that fuel these damaging behaviors.
People with eating disorders use food to deal with uncomfortable or painful emotions. Restricting food is used to feel in control. Overeating is done to soothe sadness, anger, or loneliness. Purging is used to combat feelings of helplessness and self-loathing. Over time, people with eating disorders lose the ability to see themselves objectively and their obsessions with food and weight dominate over everything in their life.
Myths About Eating Disorders
Myth #1: You have to be underweight to have an eating disorder. People with eating disorders come in all shapes and sizes and most people with eating disorders are average weight or overweight.
Myth #2: Only teenage girls and young women are affected by eating disorders. While eating disorders are most common in young women in their teens and early twenties, they are found in men and women of all ages.
Myth #3: People with eating disorders are vain. It’s not vanity that drives people with eating disorders to follow extreme diets and obsess over their bodies, but rather an attempt to deal with feelings of shame, anxiety, and powerlessness.
Myth #4: Eating disorders aren’t really that dangerous. All eating disorders can lead to irreversible and even life-threatening health problems, such as heart disease, bone loss, stunted growth, infertility, and kidney damage.
Types of Eating Disorders
The most common eating disorders are anorexia, bulimia, and binge eating disorder.
Here is an explanation of each one:
Anorexia – People who have this disorder starve themselves out of an intense fear of becoming fat. Despite being underweight or even emaciated, they never believe they’re thin enough. In addition to restricting calories, they may control their weight with exercise, diet pills, or purging.
Bulimia – This involves a destructive cycle of bingeing and purging. Following an episode of out-of-control binge eating, people will purge themselves of the extra calories. In order to avoid weight gain, they vomit, exercise, fast, or take laxatives.
Binge Eating Disorder – People who have this disorder compulsively overeat and rapidly consume thousands of calories in a short period of time. They are unable to stop eating even when they are uncomfortably full.
Warning Signs of Eating Disorders:
In the early stages it may be difficult to tell the difference between an eating disorder and normal self-consciousness, weight concerns, or dieting. As eating disorders progress, the red flags become easier to spot. A person with an eating disorder will often go to great lengths to hide the problem, so it’s important to know the warning signs, which are:
- Restricting food or dieting behaviors.
This is the most obvious one. The person may frequently skip meals or make excuses to avoid eating (i.e. they had a big meal earlier, they aren’t hungry, they have an upset stomach). The person may claim to be disgusted by foods that used to be their favorites. Or if they do eat, they take tiny servings, eat only specific low-calorie foods, obsessively count calories, read food labels, and weigh portions. In an effort to curb appetite, they may also take diet pills, prescription stimulants like Adderall or Ritalin, or even illegal drugs such as speed.
- Bingeing.
Some people who have eating disorders will eat normally around others, only to binge in secret (usually late at night or in a private spot where they won’t be caught or disturbed). Warning signs of bingeing include piles of empty food packages and wrappers, cupboards and refrigerators that have been cleaned out, and hidden stashes of high-calorie foods such as desserts and junk food.
- Purging.
The person will purge by throwing up, fasting, exercising vigorously, or using diuretics and laxatives. Common warning signs of purging include disappearing right after a meal or making frequent trips to the bathroom. If they are vomiting they may run the water to muffle the sound and use mouthwash, breath mints, or perfume to disguise the smell.
- Altered appearance and a distorted body image.
A person’s appearance can offer clues to an underlying problem. Significant weight loss, rapid weight gain, and constantly fluctuating weight are all possible warning signs. An altered appearance would be where the person wears baggy clothes or multiple layers in an attempt to hide dramatic weight loss.
A person may have a distorted body image where they are obsessively preoccupied with their weight and complain about being fat despite having a shrinking frame or they may spend hours in front of a mirror inspecting and criticizing their body.
How To Help
If you notice warning signs, you may feel hesitant to say anything. You may fear that you’re wrong or that you’ll say something to make things worse. Although it’s difficult to bring it up, don’t let your fear hold you back. Often times people who have eating disorders are afraid to ask for help and struggle like you, to find a way to start the conversation. Others have such low self-esteem that they simply don’t feel that they deserve any help. Eating disorders will only get worse without treatment and the emotional and physical damage can be severe. The sooner the person gets help, the better their chance of recovery.
Tips In Starting The Conversation
- It’s important to communicate your concerns in a loving and non-confrontational way. It will be received much better.
- Pick a time when you can speak to the person alone.
- Try to be positive and respectful of their feelings. Avoid critical or accusatory statements.
- Focus on feelings and relationships, not on food and weight. Share with them times when you felt concerned about the person’s eating behavior. Explain that you think these things may indicate that there could be a problem that needs professional help.
- Do not comment on how they look. The person is already too aware of their body. Comments about weight or appearance only reinforce their obsession with body image and weight.
- Make sure you don’t convey any fat prejudice or reinforce their desire to be thin. If they say they feel fat or want to lose weight, don’t say “You’re not fat”. Instead, suggest to them that they might want to take a look at their fears about being fat and what they think they can achieve by being thin.
- Avoid power struggles about eating. Do not demand they change. Do not criticize their eating habits. People with eating disorders are trying to be in control because they don’t feel in control of their life. Trying to trick or force them to eat will only make things worse.
- Avoid placing shame, blame, or guilt on the person regarding their actions or attitudes. Do not use accusatory “you” statements like, “You just need to eat”. Or, “You are acting irresponsibly”. Instead, use “I” statements. For example: “I’m concerned about you because you refuse to eat breakfast or lunch”.
- Avoid giving simple solutions. For example, “If you’d just stop, then everything would be fine!”
They may deny it. They may be angry and defensive. That’s ok. It’s important that you don’t give up! It may take them time to open up to you and admit that they have a problem. You can’t force it. They have to decide to want to get better. What you can do is offer to be supportive to them by showing them love and compassion. They will be grateful that someone cares.
Tips for After The Conversation
You’ve had the conversation and your loved one has confided in you that they have a problem. So now what? Aside from offering support to them, the most important thing you can do for them is to encourage treatment. The longer an eating disorder remains undiagnosed and untreated, the harder it is on the body and the more difficult to overcome, so urge them to see a doctor right away.
A doctor can assess their symptoms, provide an accurate diagnosis, and screen for medical problems that might be involved. The doctor can also determine if there are co-existing conditions that require treatment such as depression, substance abuse, or if they have an anxiety disorder.
If your friend or family member is hesitant to see a doctor, ask them to just get a physical to put your worries to rest. You could offer to set up the initial appointment for them or go with them to be supportive.
Children and Eating Disorders
Many times when kids are confronted if they have an eating disorder they will get defensive and angry. Kids who have eating disorders tend to pull away from friends and keep to themselves, avoiding social events that involve eating food. If you suspect your child has an eating disorder but they deny anything is wrong, make an appointment with their pediatrician or family doctor. Also ask a school counselor, religious leader, or trusted friend to help. Often kids find it easier to admit that they have a problem to someone outside of their immediate family. A doctor will determine if there are any serious health problems. If your child is referred to an Eating Disorder Specialist, they are used to dealing with children who refuse to admit that they have a problem and know how to make them feel comfortable talking about their issues.
Tips for Parents
It can be difficult to find out that your child is struggling with an eating disorder. Here are some tips on how to get your child the help they need:
- Examine your own attitudes about food, weight, body image, and body size. Think about the way you personally are affected by body-image pressures, and share these with your child.
- Avoid threats, scare tactics, angry outbursts, and put-downs. Remember that an eating disorder is often a symptom of extreme stress and an attempt to manage emotional pain. Negative communication will only make it worse.
- Set consistent limits for your child. For example, know how you will respond when your child wants to skip meals or eat alone, or when they get angry if someone eats their “special” food.
- Remain firm. Regardless of them telling you that you are not going to “make them eat” or promising to stop the destructive behaviors, you will have to stay attuned to what is happening with your child and you may have to force them to go to the doctor or hospital.
- Do whatever you can to promote self-esteem in your child through intellectual, athletic, and social endeavors. A well-rounded sense of self and solid self-esteem are perhaps the best antidotes to disordered eating.
- Encourage your child to find healthy ways to manage unpleasant feelings such as stress, anxiety, depression, loneliness, or self-hatred.
- Remember it’s not your fault. Parents often feel they must take on the responsibility for the eating disorder, which is something they truly have no control over. Once you accept it is not your fault, you can take action that is not clouded by what you “should” or “could” have done.
How are Eating Disorders Treated?
There are many treatment options for eating disorders. The right approach for each person depends on their symptoms, issues, strengths, and the severity of the disorder. To be most effective, treatment for an eating disorder must address both the physical and psychological aspects of the problem. The goal is to treat any medical or nutritional needs, promote a healthy relationship with food, and teach constructive ways to cope with life and its challenges.
Often, a combination of therapy, nutritional counseling, and group support works best. In some cases, residential treatment or hospitalization may be necessary. Here is brief explanation of each type of treatment used:
Therapy
Individual and group therapy can help your loved one explore the issues underlying the eating disorder, improve self-esteem, and learn healthy ways of responding to stress and emotional pain. It is very important to find a Therapist who is specifically trained for eating disorders. Family therapy is also effective for dealing with the impact the eating disorder has on the entire family unit.
Nutritional Counseling
Dieticians and Nutritionists are often involved in the treatment of eating disorders. They can help your loved one design meal plans, set dietary goals, and achieve a healthy weight. Nutritional counseling may also involve education about basic nutrition and the health consequences of eating disorders.
Support Groups
Attending an eating disorder support group can help your loved one feel less alone and ashamed. Run by peers, rather than professionals, support groups provide a safe environment to share experiences, offer and receive advice, encouragement, and coping strategies.
Residential Treatment
Residential or hospital-based care may be required when there are severe physical or behavioral problems, such as a resistance to treatment, medical issues that require a doctor’s supervision, or continuing weight loss.
When is Hospitalization Necessary?
The person is:
-Dangerously malnourished;
-Severely depressed or suicidal;
-Suffering from medical complications;
-Getting worse despite treatment.
Recovery
Recovering from an eating disorder takes time. There are no quick fixes or miracle cures, so it’s important to have patience and compassion for your loved one. Don’t put unnecessary pressure on them by setting unrealistic goals or demanding progress on your own timetable. Provide love and encouragement, praise each step they make forward, and be supportive to them with struggles and setbacks.
If you or a loved one is struggling with an eating disorder and need to talk to someone, we are here to help. Please call us today at (810) 299-1472 to set up an appointment with one of our Therapists.
Sources:
Helpguide.org. Helping Someone with an Eating Disorder, Advice for Parents, Family Members, and Friends. Retrieved 2016, from http://www.helpguide.org: http://www.helpguide.org/articles/eating-disorders/helping-someone-with-an-eating-disorder.htm