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Helping Eating disorders involve extreme disturbances in eating behaviors—following rigid diets, bingeing on food in secret, throwing up after meals, obsessively counting calories. It’s not easy to watch someone you care about damage their health—especially when the solution appears, at least on the outside, to be simple.

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But eating disorders are more complicated than just unhealthy dietary habits. At their core, they’re attempts to deal with emotional issues and involve distorted, self-critical attitudes about weight, food, and body image. It’s these negative thoughts and feelings that fuel the damaging behaviors.

People with eating disorders use food to deal with uncomfortable or painful emotions. Restricting food is used to feel in control. Overeating temporarily soothes sadness, anger, or loneliness. Purging is used to combat feelings of helplessness and self-loathing. Over time, people with an eating disorder lose the ability to see themselves objectively and obsessions over food and weight come to dominate everything else in their lives. Their road to recovery begins by identifying the underlying issues that drive their eating disorder and finding healthier ways to cope with emotional pain.

While you can’t force a person with an eating disorder to change, you can offer your support and encourage treatment. And that can make a huge difference to your loved one’s recovery.

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Types of eating disorders

The most common eating disorders are:

Anorexia – People with anorexia starve themselves out of an intense fear of becoming fat. Despite being underweight or even emaciated, they never believe they’re thin enough. In addition to restricting calories, people with anorexia may also control their weight with exercise, diet pills, or purging.

Bulimia – Bulimia involves a destructive cycle of bingeing and purging. Following an episode of out-of-control binge eating, people with bulimia take drastic steps to purge themselves of the extra calories. In order to avoid weight gain they vomit, exercise to excess, fast, or take laxatives.

Binge Eating Disorder – People with binge eating disorder compulsively overeat, rapidly consuming thousands of calories in a short period of time. Despite feelings of guilt and shame over these secret binges, they feel unable to control their behavior or stop eating even when uncomfortably full.

Warning signs of an eating disorder

Many people worry about their weight, what they eat, and how they look. This is especially true for teenagers and young adults, who face extra pressure to fit in and look attractive at a time when their bodies are changing. As a result, it can be challenging to tell the difference between an eating disorder and normal self-consciousness, weight concerns, or dieting. Further complicating matters, people with an eating disorder will often go to great lengths to hide the problem. However, there are warning signs you can watch for. And as eating disorders progress, the red flags become easier to spot.

Restricting food or dieting

  • Making excuses to avoid meals or situations involving food (e.g. they had a big meal earlier, aren’t hungry, or have an upset stomach)
  • Eating only tiny portions or specific low-calorie foods, and often banning entire categories of food such as carbs and dietary fat
  • Obsessively counting calories, reading food labels, and weighing portions
  • Developing restrictive food rituals such as eating foods in certain orders, rearranging food on a plate, excessive cutting or chewing.
  • Taking diet pills, prescription stimulants like Adderall or Ritalin, or even illegal drugs such as amphetamines (speed, crystal, etc.)

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How to talk to someone about their eating disorder

The decision to make a change is rarely an easy one for someone with an eating disorder. If the eating disorder has left them malnourished, it can distort the way they think—about their body, the world around them, even your motivations for trying to help. Bombarding them with dire warnings about the health consequences of their eating disorder or trying to bully them into eating normally probably won’t work. Eating disorders often fill an important role in the person’s life—a way to cope with unpleasant emotions—so the allure can be strong. Since you may be met with defensiveness or denial, you’ll need to tread carefully when broaching the subject.

Pick a good time. Choose a time when you can speak to the person in private without distractions or constraints. You don’t want to have to stop in the middle of the conversation because of other obligations! It’s also important to have the conversation at a time of emotional calm. Don’t try to have this conversation right after a blow up.

Explain why you’re concerned. Be careful to avoid lecturing or criticizing, as this will only make your loved one defensive. Instead, refer to specific situations and behaviors you’ve noticed, and why they worry you. Your goal at this point is not to offer solutions, but to express your concerns about the person’s health, how you much you love them, and your desire to help.

Be prepared for denial and resistance. There’s a good chance your loved one may deny having an eating disorder or become angry and defensive. If this happens, try to remain calm, focused, and respectful. Remember that this conversation likely feels very threatening to someone with an eating disorder. Don’t take it personally.

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