"Why can't she just snap out of it? I mean, just tell her to eat!"
I can't tell you how many times I've heard that phrase from well-meaning parents and family trying to help a loved one diagnosed with an eating disorder. Let's set the record straight:
1. You don't just wake up one day and decide to have an eating disorder.
2. Those who suffer cannot "snap out of it."
3. Eating disorders are the most deadly mental health issues for a reason—they are very difficult to treat.
It's likely you know someone who is struggling, even if you are not personally affected. About 1 in 10 individuals in the U.S. will deal with an eating disorder at some point in their lives. Body dissatisfaction (the most common warning sign) now affects nearly 95 percent of women and 85 percent of men. Up to 10 percent of females in the U.S. will suffer with an eating disorder at some point in their lives (compared to only 3 percent of males).
This week is National Eating Disorders Association Annual Awareness Week. This year's theme is "3 Minutes Can Save a Life." They mean that literally—the earlier a diagnosis is made, the better the prognosis. I've spent 20 years researching eating disorders and treatments. I myself have struggled with body dissatisfaction and eating disordered behaviors. My clients have struggled. My students have struggled. It has to stop.
An eating disorder is a coping mechanism that becomes an addiction. As this occurs, the brain chemistry of the person suffering is altered in a number of ways. This makes eating disorders, like addictions, very difficult to treat. Though no one factor will "make" you develop an eating disorder, there are many that can cause dangerous patterns.
Early warning signs include:
- Body dissatisfaction or preoccupation—with weight, shape, size, or specific areas of the body
- Obsessing over calorie intake and calories burned via exercise
- Yo-yo dieting
- Constant adherence to increasingly strict diets, regardless of weight
- Habitual trips to the bathroom immediately after eating to purge
- Secretly bingeing or hoarding large amounts of food
- Increasing consumption of laxatives, diuretics, or diet pills
- Exercising compulsively, often 2+ hours per day, despite fatigue or injury
- Using prescription stimulant medications or illicit drugs to suppress appetite or lose weight
- Withdrawal from friends and family, particularly following questions about eating habits or visible side effects of eating disordered behaviors
- Avoidance of meals or situations where food may be present
If you checked two or more of those early warning signs, go to NEDA's website and take their assessment. It might be time to seek help.
If it's not you, how do you confront a loved one?
- Be prepared. NEDA's website is a good place to start. They may get angry or deny it. Don't expect they will immediately admit they have a problem.
- Choose a caring environment.They need to feel most comfortable and safe—you both do. Don't approach the subject around mealtimes. Make sure you are both in a relatively good mood when you decide to talk. Leave enough time—the conversation shouldn't be rushed.
- Use the right language."I" statements ("I care about you" or "I'm worried about you") make it about you instead of about their "bad" behavior. Don't focus on the food; encourage them to express how they feel. This may be difficult as many individuals who suffer with eating disorders are uncomfortable talking about those emotions. Do not blame or threaten them, and avoid manipulative statements ("If you loved me...").
- Listen respectfully. Let them talk, let them feel heard—even if they're in denial.
- Encourage them to seek help. Have resources ready so that if they will accept help, they know where to go.
- Try not to act as a therapist. You might wish to chat with someone who specializes in eating disorders to know how best to handle your specific situation.
- Be patient. It may take more than one conversation. They may get angry and walk away. When they are ready to seek help, they will likely come to you because they know you care.
It's my hope that one day, I will be out of a job. But I realize that the prevention and treatment of eating disorders takes a village. Whether you suffer yourself or know a loved one who does, know that you do matter: You can help this important cause.