I’m caring for someone with an eating disorder

Eating disorders are mental health conditions marked by an obsession with food, body weight and/or body image. They can affect anyone but are more prevalent among young women.

Types of eating disorder

Anorexia nervosa is a condition where someone tries to keep their weight as low as possible through limiting food intake, exercising too much or both.

Bulimia nervosa is a condition where someone can lose control and eat a lot in a very short period (binging) and are then deliberately sick or take laxatives to get rid of food. Someone with bulimia may also restrict food for periods of time and/or carry out too much exercise.

Binge eating disorder is when a person loses control overeating and eats lots of food until they feel uncomfortably full and feel guilty, upset, and ashamed.

Other specified feeding or eating disorder is when someone’s symptoms do not match those of anorexia, bulimia, or binge eating, but it does not mean it is a less serious condition.

Signs and Symptoms to Look For

• Dramatic weight loss
• Not being honest about the amount of food eaten or how much they weight
• Exercising obsessively or too much
• Cutting food into small sizes and taking a long time to eat
• Avoiding eating with others
• Going to the bathroom a lot after eating or looking flushed on returning
• Eating a lot of food very quickly
• Wearing loose and baggy clothes to hide weight loss
• Low mood and depression
• Aggression and violence, could happen pre, post and during meals especially when eating is being challenged
• Develop regression, where the person may behave in a childlike manner rather than in an age-appropriate way

How you can help

The first step in approaching someone with an eating disorder is to educate yourself. Eating disorders are often misunderstood. It is helpful to have some knowledge of eating disorders prior to approaching someone. This will help ensure that some of the common myths and misinterpretations are not projected on the individual living with the eating disorder. It can also be helpful to understand the theory behind the stages of change and to know that people can move between these different stages, across different subjects, in a non-linear way.

The Stages of Change are:

Pre-Contemplation:  Not yet acknowledging that there is a problem behaviour that needs to be changed

Contemplation: Acknowledging that there is a problem but not yet ready or sure of wanting to make a change

Preparation/Determination: Getting ready to change

Action: Changing behaviour

Maintenance: Maintaining the behaviour change

Relapse: Returning to older behaviours and abandoning the new changes

Being aware of these different stages of readiness to change may alter your approach and help you understand where the individuals living with an eating disorder are at. This is key to sustaining motivation to change when the individual is ready.

What you need to do

Someone with an eating disorder can be secretive and defensive about their eating and weight. They may deny having any problems or illness. Let them know that you are worried about them and encourage them to go to the doctors. Other things that may help:

• Remember you are not to blame
• Reassure the person you care for that they are not to blame either
• Remember this is a distressing illness for the person you care for
• Avoid discussing weight, shape, food, and diets in front of the person
• Ask the person what you can do to help, maybe setting mealtimes, putting boundaries in place following mealtimes, having space and time to talk
• Remember things change and people can recover with help
• Try not to collude with the person, so avoid cooking separate meals, eating in different places in the house or cleaning up vomit
• Find out as much as you can about eating disorder
• Ask the person how they are feeling rather than assuming

Looking after yourself

It can feel overwhelming when you are caring for someone with an eating disorder. It affects everyone in the family but not always in the same way. It is important for you to take care of yourself, this might include seeking guidance and emotional support from a therapist or a support group.

Caregiver Tips

Someone living with an eating disorder has the best chance for recovery when they are surrounded by people who are loving and supportive.

• Be aware of your own issues with food, exercise, and body
• Recognize that love based on weight, food, or eating leads the individual to feel manipulated and controlled
• Become a team with them against the eating disorder (make sure you’re not enabling the illness with certain actions)
• Remember that the individual with an eating disorder is doing the best they can

Additional Resources

• Connect with National Initiative for Eating Disorder (NIED) or call 1-866-633-4220 for more resources and support
• Download the caregiver brochure from NIED
• Download the Safety Crisis Readiness Caregivers Tool from NIED
• Connect with ConnexOntario or call 1-866-532-2600 for free and confidential health services for people experiencing problems with mental health, gambling, alcohol, or drugs.
• Connect with other caregivers in our online support group

Not sure where to start? Call our 24/7 helpline 1-833-416-2273 (CARE) or talk to us in our live chat to find resources in your community.

*Sources

https://carers.org/downloads/help-and-advice-section/eating-disorders-information-for-carers.pdf