How to Help Someone with an Eating Disorder

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You might have heard the term, but still, you may wonder. What is an eating disorder?

An eating disorder is a mental illness characterized by unhealthy or obsessive patterns around food. In the United States, about 30 million people deal with an eating disorder of some kind. Eating disorders come in many types and look different on everyone. Regardless of the individual, they tend to wreak havoc on a person’s life.

An eating disorder is a psychiatric concern for several reasons. Even though anyone can “attempt” to engage in the behaviors involved, like not eating, overeating, or also deliberately throwing up, these habits tend to be out of control. The unhealthy behaviors feel compulsive to sufferers, born out of deep-set negative attitudes, thoughts, and beliefs.

Eating disorders can be dangerous. In fact, statistics show that eating disorders have the highest mortality rate of all mental illness, according to the National Association of Anorexia Nervosa and Associated Disorders (ANAD). Because eating disorders feel harmless at first, especially to the person who is struggling with the condition, it can quickly snowball in severity. Before you know it, it’s full-blown, with a high risk of medical issues and related mental disorders. Furthermore, people with the condition tend to be secretive out of shame, denial, or low self-worth. Intervention, then, can’t be applied.

Causes of Eating Disorders

  • Genetics
  • Personality
  • Biology
  • Traumatic experiences
  • Lack of healthy coping mechanisms
  • Dieting behavior

Types of Eating Disorders

What all eating disorders have in common is patterns of abnormal attitudes and behavior around food, eating, and self-image. Eating disorders come in many forms, from those which are commonly known due to high media attention to those less heard of.

  • Anorexia nervosa
  • Bulimia nervosa
  • Binge eating disorder
  • Other (OSFED, orthorexia, etc.)

Anorexia

Anorexia nervosa is an eating disorder characterized by restricted food intake and very low body mass. Specifically, weight is defined as 15% less than the natural range at which a person’s body weight settles.

Many people with anorexia have a severe fear of gaining weight, and even if they seem very thin to the people around, they cannot see the same due to distorted perception of their own body. Sometimes they may exercise or purge as well. However, they generally are in a nutritional deficit. These behaviors eventually lead to many health problems:

  • Amenorrhea (irregular or nonexistent menstruation)
  • Malnutrition
  • Osteopenia
  • Depression & Anxiety
  • Constipation
  • Low blood pressure
  • Low body temperature
  • Muscle loss, hair loss
  • Cardiac muscle deterioration

If a person is engaging in anorexic behaviors but is not at low body weight, they would be diagnosed as atypical anorexia, a subcategory of Other Specified Feeding or Eating Disorder (OSFED).

Bulimia

Bulimia nervosa consists of periods of eating an abnormally large amount of food within a short period and purging it. Purging serves as compensatory behavior for the food out of fear of weight gain. However, purging does not always mean intentionally vomiting. Instead, it includes actions like over-exercising, fasting, or using laxatives.

About 1.5% of women in the United States deal with bulimia in their life. People with bulimia tend to have a pattern for impulsivity, which contributes to the nearly uncontrollable urge to binge eat. There is a high chance that people with bulimia may also struggle with substance abuse.

Bulimia nervosa is extremely dangerous in that it’s challenging to notice disordered behavior. Many people expect people with these diagnoses to have thin bodies. However, that is not always the case with bulimia. There are other signs indicative of bulimia nervosa:

  • Swollen cheeks or neck glands
  • Inflamed throat
  • Thin tooth enamel and decay
  • Kidney health problems (if using diuretics)
  • Dehydration and electrolyte imbalance
  • Gastrointestinal issues

Binge Eating Disorder

Binge eating without purging is called binge-eating disorder, or BED. People might not think of this is a disorder since it is more normalized to eat large amounts of food in social events or for enjoyment. What sets BED apart from a cheat day is the loss of control.

People with BED find it difficult to prevent the urge to binge. They devour large amounts of food, feeling dissociated during the process. Because many sufferers of BED feel shame about their behaviors, they binge-eat in secret. BED is quite common, with about 2.8 million Americans dealing with it. Health risks of BED include obesity, heart problems, diabetes, and mental disorders like depression.

Other Eating Disorders

OSFED is a class of eating disorders that cannot be definitively grouped into the different mentioned categories. Atypical anorexia is an example of OSFED, where a person engages in anorexic behaviors without a low weight. A person might be diagnosed with OSFED if they do a variety of disordered eating behaviors, like purging, binge-eating, or fasting, but with variable frequencies or in cycles.

Orthorexia Nervosa is another eating disorder in which a person becomes obsessive about the nutritional content and purity of food. The danger in orthorexia lies in extremely restrictive food choices to the point of dietary imbalances, limited social life, and low quality of life.

How Eating Disorders Affect Life

Eating disorders can have a tremendous impact on a person’s life. Many times, obsessive thinking and out-of-control compulsions to limit food, eat a lot of food, or over-exercise can make life very narrow. This disease is a mental illness. Thus, it can affect social lives, relationships, school or work, and in a worst-case scenario, prevent a person from functioning in everyday life.

How to Support Someone with an Eating Disorder

If you have a loved one with suffers from an eating disorder, it is easy to feel an urgency in trying to help. However, recovering from an eating disorder is not a straightforward process. Trying to jump in and force someone who isn’t ready can sometimes exacerbate things. That’s why a few steps are involved in becoming a sound support system for someone with an eating disorder.

Understand How Eating Disorders Work

Eating disorders are not due to a desire to lose weight or diet. The goal of an eating disorder is not to fit society’s body ideals. Rather, disordered eating behaviors have many complex underlying mechanisms. Eating disorders are due to genetics, personality, and environmental factors. For many, eating disorders serve as coping mechanisms for their low sense of self-worth, self-critical thoughts, or other mental conditions like depression and anxiety.

Before you bring up any concerns with someone who may have an eating disorder, make sure you do your research. After studying on how eating disorders occur and affect life, you will have more compassion and empathy for that person.

Talking to Someone with an Eating Disorder

Are you ready to gently face a loved one you suspect may have an eating disorder? First, know that you must approach this carefully. What you don’t want to do is assume you know what their issues are and warn about the possible health risks. You also don’t want to give ultimatums and shame them into eating “normally.”

What also won’t work is commenting on their body or appearance, unintentional guilt-tripping (“How could you do this to yourself?”), or judging them. These actions may cause someone with the condition to clam up, potentially exacerbating symptoms.

Speak to this person during a calm time. Focus on expressing concern without any judgment or assumptions. Let them know that you want to help in any way you can, even if it’s just listening. Be empathetic about their struggle, even if you don’t completely understand. Sometimes all a person needs is someone to talk to.

Reaction: What to Expect

Once confronted, a person with this condition may react defensively. This reception varies from individual to individual. So no matter how gentle you are, be ready for some adverse reaction about such a sensitive topic. But don’t take it personally. Many people with mental health conditions feel embarrassment about their behaviors, critical of themselves, or are in denial about their situation.

The person may not yet be ready to take a big step in recovery for many reasons. This situation can be compared to that of someone addicted to a substance. They use the food as a coping mechanism, so they can’t imagine life without it. While they understand the adverse effects it has on their life, they may not feel ready to “go sober” yet.

Be Aware of Available Resources

Several options exist to treat people with any eating disorder. The best choice usually depends on the individual’s severity, readiness, and physical and mental state.

Here are some available resources to look into:

  • First, go to a doctor to check the extent of physical damage and diagnose the person. A diagnosis helps in establishing a focused treatment plan.
  • Most treatment plans consist of a team. A doctor, nutritional, and mental health professionals work together to help in a person’s recovery.
  • The main concern initially is to discuss any serious medical issues, through nutritional counseling or weight gain/loss.
  • Other outpatient services include therapy (one-on-one, group, family) to learn better ways to cope.
  • Outside of a hospital or treatment center, people need an all-around support system of family and friends.

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Final Thoughts on Helping Someone with an Eating Disorder

Eating disorders are severe for both sufferers and loved ones. It makes sense to want to see people take care of themselves and get better. However, when it comes to helping someone with this diagnosis, the only thing you can do is offer support.

Even when someone with this mental health diagnosis wants to accept help, it does not end there. Recovery is a long process of unlearning negative thoughts and behavioral patterns. There is no quick cure. Just because someone has attained a healthy weight does not mean they are free from problems.

Unfortunately, an eating disorder is a chronic condition that many people successfully learn to manage. The job of a supportive person is to be there for them. Listen to them without judgment. Of course, be motivating without being forceful. And, most importantly, have patience.

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