Information for Family and Friends

How do I know if the person I care about has an eating disorder?

Often it can be difficult to tell. People with eating disorders can be secretive and defensive about it. An eating disorder is a coping mechanism which they have learned to use to help them deal with something else which is too painful, and often the thought of losing that coping mechanism is too terrible to consider, even though it may be causing them harm.
There are a few things you can look out for. Often, we're told to watch out for significant weight loss or gain. Although this is a side effect of some types of eating disorder, it is a myth that only the very under or overweight can have eating disorders. Sometimes people may appear perfectly healthy on the outside but still suffer from an eating disorder, so it is not always a factor to consider.

People with eating disorders may also suffer from depression and anxiety. Watch out for a change in mood.

  • Have they stopped going out with friends?

  • Do they hide in their room for long periods of time?

  • Have they stopped talking, particularly about themselves?

  • Do they have trouble sleeping?

  • Do they have routines which they have to stick to, and if these routines are broken, does it cause them distress?

There are also more practical things to consider, and it's easier if you live with the person to notice.

  • Have you noticed that they are cutting down on meals and portion sizes? And watch out for this one: huge bowls of plain vegetables do not count as meals!

  • Have you noticed any food mysteriously disappearing from the cupboards or the fridge?

  • Have you found any food or food wrappers stashed away secretively?

  • Have they developed a preoccupation with food and cooking?

  • Do they disappear to the bathroom immediately after meals?

  • Do they spend unusually long periods of time in the bathroom, during which you may be able to hear the tap running loudly?

There are physical aspects of eating disorders which may be easier to spot:

  • Hair loss

  • Dark circles under the eyes, a drained and tired look.

  • Dry flaky skin or breakouts

  • Brittle nails

  • Lack of energy and possibly fainting

  • Bad breath

  • Yellowing and/or damaged teeth

  • Sores on the knuckles

  • Unexplained and frequent bruising.

If you're noticing a few of these things, then it's likely that the person you care about has an eating disorder, although the chance may be that they do not realise it themselves yet, or are in denial.

What can I do to help?

If you haven't yet broached the subject with the person, this may seem like a daunting task. As previously mentioned, the person may be secretive and defensive about their problem, and with bringing it out in the open comes the possibilities of arguments, feelings of mistrust or resentment on behalf of the sufferer, or just flat out denial. But if you care deeply about the person, it is hard to ignore forever. And it is often worth risking the backlash, because there is often the possibility that your concern will plant a seed in their mind that all is not well, and that perhaps they should do something about it.

Things you should do include letting the person know that you care for them and are concerned about them. Listen to anything they have to say, even if it sounds nonsensical or illogical, and be non-judgemental about it. Try and suggest things they could do, or things you could do together which may help. Things like going to the doctors, calling a helpline, talking more about feelings and emotions. Learn about what they are going through. Speak to others with eating disorders, read books and articles.

Things which you should not do include commenting on weight or body image. This is more to do with how the person feels than how they look. Even if you think you are complimenting them, do not mention it. The mind of an eating disordered person is good at twisting words, even if they're said out of kindness. Do not belittle their problems or tell them to "just eat normally". Do not compare them to anyone else. Although it may be hard, try not to get angry. Stay as calm as possible.

More tips for things you should or shouldn't do or say can be found in this thread on our fourm: Do's and Do Not's.

It's important to look after you too!

If someone you love has an eating disorder, it is incredibly draining for you. It's awful to watch someone you care about doing such harm to themselves, and feeling so powerless to stop it. It's difficult when you know they are so sad and in pain but you can't do anything to take it away and make it better. You may feel like you've always got to be the strong one, the person they can always rely on. But the fact of the matter is, you're only human too. We only have so much we can give without losing some of our self in the process. Make sure you take time out to look after yourself. See other friends and do things you enjoy once in a while. Talk to others who are in the same situation as yourself. Perhaps even seek counselling, so you have support if things get too tough.

And remember that recovery has to come from them. You can't do it for them, but you can be there to help them along the way.

It's not always easy to spot

"So, you think you can spot if someone has an eating disorder?

Take walking around a supermarket. You can point out the severely skinny girl checking the calories on two different brands of lettuce, and the larger lady filling her trolley with cakes. You'd say that they had an eating disorder, albeit different ones, wouldn't you?

But eating disorders go deeper than that.

Any person you meet on your rounds of the store may have an eating disorder. For all you know, every employee in the shop may have issues with eating.

The nice man who sold you that feta cheese from the deli counter. He routinely smuggles quiches and chews them in the loos, but doesn't swallow them. He steals food purely to spit it back out again.
That sweet older lady with the white hair on the fish counter, she's thrown up ever meal she's eaten in the past three weeks. Can you see it?
The tall, thin bloke who reached for that tin of tomatoes from the top shelf for you- he compulsively eats a whole loaf of bread with Hartley's jam then punishes himself by living on a diet of apples for a week. But you'd be able to tell, wouldn't you?
How about that manager who you spoke to about the lack of poppadoms in the store- he's not happy until the exercise bike tells him that he's burned off every calorie he's eaten, every day, which he calculates strictly, even adding on some when he's unsure about something.
You're at the checkout. The smiling, chubby girl serving you, she can't possibly have an eating disorder, can she? Think again, she's been living on a diet of black coffee, diet coke and celery for the past week, but you can't tell, can you.
Oh, there's a problem with that pineapple. No barcode. The chubby, starving girl calls over an athletic looking man with blonde hair. He looks far too healthy to have an eating disorder, doesn't he? He looks like the kind of person who eats a healthy diet with a healthy amount of exercise. Yes, he does. But he's trying to recover from bulimia, yet he binges about once a week, thousands of calories worth, and pukes it all back up again.

And so...

You say goodbye to the athletic bulimic, goodbye to the starving chubby girl, but you're none the wiser, are you?

Just goes to show, eating disorders come in all shapes, sizes and professions."

Fran The Viera