Guidelines to Help a family member recover from an Eating Disorder
Home Appointments About Us Emergency/CrisisThere are no quick or easy solutions for recovery from an eating disorder. Therapists, physicians, and other “experts” have no magic that can cure your loved one. Be wary if someone offers guarantees or quick cures. If she is to recover, she will need to make some changes in her attitudes and behaviors. You cannot make them for her. You and the other members of the family may also need to make some changes to accommodate her growth. Hopefully, all of you will take advantage of professional help to make the rough spots a little smoother.
Allow yourself not to know all the answers about how to help the person you love. This does not make you any less of a parent, partner, or sibling. Admitting your lack of understanding of the problem demonstrates that you are human. There are resources for help with this problem. You do not have to be the expert.
If your child is younger than 18 (legal adulthood), get her into therapy immediately. Do not hesitate out of fear that she will hate you or become increasingly ill. If she is over 18, you need to admit that you have no control over her. She can choose to be helped, or not. You do, however, have control over how much you will let her take advantage of you. You do not have to continue living with behavior you find unacceptable. You do not have to provide her with opportunities to abuse your love and generosity. To protect yourself, you may have to set limits on the amenities you provide her which reinforce her eating behavior.
In any close relationship, you need to set limits on how much you can give of yourself. If you can do this, you not only model taking care of yourself, but remove some of the debt the person you love may feel she owes you. You need to set limits on how much you can do.
Once your child/spouse/sibling is in therapy, avoid getting involved in discussions or arguments over weight and food behaviors. If you become concerned about weight loss, dehydration, or other signs of medical jeopardy, call the therapist, physician, or both.
Cooperate with the therapist in devising and sticking to a plan that will encourage your loved one to become mature, self-loving and responsible.
If your child/spouse/sibling is food shopping or cooking for the family, realize that she may be using this nurturing role to deny her own need for food by feeding others.
LEARN TO TAKE CARE OF YOURSELF! Do not become a martyr. Do not sacrifice yourself for your loved one. You will accomplish nothing, and you will end up feeling exhausted and resentful. Do not let family life or your relationship revolve around the eating disorder. Make sure you and the other members of the family make time for satisfying activities and fun. Do not neglect fulfilling relationships. Do not spend all of your time with the person with the eating disorder; you will only encourage her to be more dependent on you. She needs to be making friends and contacts outside the family circle and your relationship.
Do not allow her to run the family. Her eating habits and food choices should not dominate your kitchen, your refrigerator, your meals, or your schedule. She should not be responsible for what the family eats, which restaurants you patronize, or where you go on outings and vacations. Remember, other family members are entitled to have input into these kinds of decisions.
Give your daughter/spouse/sister responsibility for the consequences of her words, actions, decisions, and behaviors. She needs to learn how to deal with disappointment, frustration, and anger. Do not protect her be giving her the power to avoid all situations she finds distressing. Give her the responsibility to replace what she has eaten on a binge or to clean the bathroom after she purges. This responsibility is aimed to help her deal with reality rather than punish her behavior. However, realize that in many instances the person with an eating disorder is not financially able to replace what she has eaten.
Verbally and physically express honest love and affection for her. Do not tie your caring to sermons about eating or demands to gain weight.
Admit you sometimes feel angry, frustrated, helpless, afraid, powerless, and enraged. Showing these emotions does not take away from your love for her. By sharing your feelings, you are providing the most direct permission for her to feel and express her feelings. Your feelings may be different from hers.
Participate in family therapy or a parent/spouse support group to work through these feelings and get support from others. Do not become isolated with your problem. Keeping it a secret does not necessarily help anyone.
Develop ways of sharing and socializing that do not involve food. This does not mean that you need to exclude socializing that centers around food. Develop dialogues with her about issues other than food, weight and diets. Discuss current affairs, feelings, the arts, sports or any other good topics.
Sometimes when discussing issues and feelings, you can hear things the way you want to. This also goes for the person with the eating disorder. Check to make sure that you are accurately hearing what is being said to you. It is equally important for you to make sure that you have been heard accurately.
Practice good sense. Do not go on diets. It is hard to explain why it is okay for you to diet but not for the person with the eating disorder. Take an honest look at your reasons for dieting and exercise. Are you giving you appearance priority over your health? Are these activities primarily for weight loss? It is hard for the individual with an eating disorder to try to change her thinking about weight loss and the importance of her appearance when significant others around her are reinforcing the importance of weight loss and thinness.
Recognize your daughter, sister, or partner for qualities that are independent of her appearance or achievements. Sharing with her what you appreciate about her or are attracted to can support her development of a sense of self that is secure, unique, and definitely less subject to the changing fancies of fads and fashion. Of course, such observations and sharing are helpful only when spontaneous and sincere.
Avoid power struggles with your loved one over gaining weight or stopping the bingeing and purging. She will always win. Avoid power struggles of any kind for the same reason.
Do not try to manipulate her with statements like “If you won’t change for your self do it for me (or us),” “You are ruining the whole family,” or “Why are you doing this to me?” She will feel guilty and responsible for the welfare of the rest of the family, something she most likely already feels. These feelings will not help her to change her behavior. You need to take care of your own welfare. Do not make her responsible for your happiness.
Avoid making requests such as, “What can I do to help you?” and “Help me to help you.” She does not know what she needs; if she did she would probably seek it.
Let her know that you are available to emotional and psychological support. You may even ask, “What kind of support could you use at this time?” or “How can I support you?” These questions are different from the questions, “Help me to help you” or “How can I help you?”
Do not ask, “Are you better?” This is a loaded question and pulls for the response, “Yes, of course,” Judge progress for yourself. For example: Is she more aware of her feelings? Is she thinking more realistically some of the time? If she being less critical of herself? Look for broader definitions of recovery than just changes in eating behavior or weight.
Realize you are trying to do what is right and best in an extremely difficult situation. Recovery takes time, patience, and professional help. Allow yourself to seek the resources you need during this time.
Adapted from the ANRED ALERT, by Dr. Jean Rubel.
Root, M. P., P. Fallon, and W. N. Friedrich (1986). Bulimia. New York, NY: W.W. Norton & Co.)