Understanding Eating Disorders Eating disorders are extremely complex psychological problems that are very closely associated with depression and low self-esteem. For a person with anorexia, bulimia, or binge eating disorder, the disorder serves a purpose in her/his life. Often, disordered eating is used as a means to mask other underlying issues, or to cope with personal problems that may be unrelated to their concerns about food and weight (i.e. trouble at school or work, relationship or family problems). For someone who feels very out of control, an eating disorder may seem like a viable means of gaining back some power or agency. In a culture that is obsessed with weight loss and idealizes thinness, it is not hard to imagine how certain psychologically vulnerable people may feel that losing weight is the answer to all of their problems. Unfortunately, the eating disorder will inevitably take over that person's life, dictating every minute detail of her/his day.

What To Do If you have reason to believe that a friend or family member is suffering with an eating disorder, it is important that you confront her/him and express your concern. Your ultimate goal should be to get that person to seek professional help. Because eating disorders are psychological problems with very real and damaging physical consequences, it is important that the sufferer receives the proper treatment, which includes both medical and psychological care. There are many qualified professionals who have experience working with these kinds of problems, and it is important that you find clinicians who have a knowledge of eating disorders. Not all doctors and therapists know enough about eating disorders to treat them effectively.

When you address the problem initially, you need to prepare yourself for all possible reactions. The person you are confronting may become upset, defensive, and/or angry. There is also a chance that s/he will be relieved that someone has offered to help. Either way, you need to stress the fact that you are bringing the issue up because you care about the person, and that you are genuinely concerned about her/his well-being. Be sensitive to the fact that s/he will probably be embarrassed or ashamed. People with eating disorders tend to isolate themselves and they become very good at hiding and denying their problems. Therefore, it is especially traumatic for them when someone openly acknowledges their "secret." Be firm but caring in your approach. Arm yourself with examples of things you have observed which have led you to believe that there is a problem. The more "evidence" you have, the harder it will be for that person to brush off the issue. For example, it is okay to say something like "I'm concerned because you seem to be preoccupied with your weight and I never see you eat anything," or "You always go to the bathroom right after meals and sometimes I can smell vomit in there."

Let her/him know that you want to help in whatever way that you can. Things that may seem very simple to you (i.e. finding referrals, making appointments, going to a doctor's office, etc.) are incredibly intimidating to a person with an eating disorder, so this is an area where friends and family members can make a big difference. Offer to do some of the groundwork for the person. Your assistance and support in the early stages of the treatment process will alleviate some of the stress and anxiety that your loved one will be experiencing.

Recognizing Your Limitations Ultimately, your friend or family member has to make the decision to help her/himself.* If s/he is unwilling to do this, there is very little that anyone else can do to force that person into treatment. The help s/he receives can only be as effective as s/he wants it to be. This certainly doesn't mean that you should stop trying to offer your support. Sometimes it takes awhile for people to realize that their problem has gotten out of control. It isn't helpful to get into an argument, though. If things start to go in that direction, take a step back and remain calm. Let your loved one know that you understand that you can't force her/him to do something s/he doesn't want to do, but that you are taking this situation very seriously and you will continue to urge her/him to seek professional help. People who have recovered from eating disorders say that they appreciated the fact that friends and family members kept trying to get through to them, even though they may have been saying the same things over and over again.

*We are referring to adults. If your friend or family member is under 18, parents or guardians will have more control of the situation. However, you may have the authority to force someone to get help, but this does not ensure that s/he will be willing to cooperate with the treatment process.

What to Expect From Recovery When your friend or family member has agreed to get treatment, it is only natural that you would want to see results. It is important to remember that recovery is a long-term process, and you may not notice a difference in behavior or attitude right away. You should be ready to deal with the person's emotional ups and downs. There will be good days and bad days, little victories and setbacks along the way. Because eating disorders are deeply rooted psychological problems, there is no "quick fix," and full recovery takes a lot of time and hard work. It is crucial that you continue to offer your support and encouragement all along the way. Ask her/him how things are going. If s/he is willing to discuss the treatment process with you, try to get some feedback about what is or is not being accomplished. If your loved one does not seem to be responding at all to therapy, try to get a sense of what might be wrong. Sometimes it takes a little while for a person to feel safe and comfortable in a therapeutic setting, but if there is a major personality conflict or some other issue with the therapist, you should suggest looking for another one. Try to make yourself available for your friend or family member. Let them know that you are there if they need someone to spend time with or talk to. The bottom line is that you should have realistic expectations. Your patience and compassion throughout this process are of the utmost importance.

Taking Care of Yourself It is easy to get wrapped up in your loved one's eating disorder. It's very common for friends and family members to feel overwhelmed by these situations, and to become frustrated, depressed or anxiety-ridden because of their concern for the sufferer. Eating disorders do not just affect the person who is suffering--they have a deep impact on everyone who cares about that person. Don't neglect your own needs. The more you push down your feelings, the more likely you are to end up expressing them at an inappropriate moment, when you may be especially angry or frustrated. AABA strongly encourages friends and family members to seek help for themselves. Whether through individual therapy, family therapy or a support group, it is important that you find a space where you can talk about what you are experiencing. AABA can help you find resources in your area.

Educating Yourself About Eating Disorders If you know someone who is suffering from an eating disorder, you should make an effort to educate yourself about these problems. The more you know, the better prepared you will be to help this person. Being knowledgeable about signs, symptoms, causes, and other issues related to eating disorders will give you a better sense of what to look for and what to expect.