How to Help Anorexic Friends or Family

The eating disorder anorexia nervosa is a serious mental and physical condition that's one of the most common chronic illnesses in adolescence. The disease has a higher mortality rate than all other causes of death for females 15-24 years old. Additionally, although the majority of people who suffer from anorexia are female, 10-15% are male.^{[1]XResearch source} If you are worried that someone you know has anorexia, act quickly to help them avoid serious consequences such as heart and kidney problems, or even death.^{[2]XTrustworthy SourceNational Health Service (UK)Public healthcare system of the UKGo to source} There are many different treatment options they can explore to improve their chances of recovery.

Part 1

Part 1 of 3:

Helping Them Take Steps to Recovery

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Have them see a doctor about diagnosis and treatment. Untreated anorexia nervosa can become a serious health issue, potentially causing kidney problems, heart problems, and even death, but spotting signs early on can help reduce the risk of such issues developing. If they exhibit the following symptoms, ask them to see their primary care physician as soon as possible. If you are their parent, take them to see the doctor.^{[3]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source}
- Eating very little and avoiding fatty foods.
- Severe weight loss and dangerously low weight.
- Fear of gaining weight.
- In females, loss of periods.
- Thinning of hair.
- In males, body dissatisfaction and obsession with building a muscular physique.
- Body image distortion, where the body is seen as larger or smaller than it actually is.
- Weighing oneself excessively, also known as checking.
2
Be aware of the difference between healthy and unhealthy body types. Obviously, there's nothing wrong with being in good shape. Regular exercise and healthy eating can result in being fit. There are differences, however, between healthy, fit bodies and unhealthy bodies.
- In males, unhealthy bodies may be 15% lower in body fat than is normal for his age, height, and activity level. He may lift weights compulsively and be obsessed with toning his muscles. He may also take anabolic steroids in order to gain muscle mass.^{[4]XResearch source}
- In females, unhealthy bodies may have a consistently low weight, such as a 17.5 or less on the Body Mass Index, which she can calculate by clicking here. She may diet excessively and spend a lot of time on scales and in front of the mirror.^{[5]XTrustworthy SourceHelpGuideNonprofit organization dedicated to providing free, evidence-based mental health and wellness resources.Go to source}
3
Talk to them about triggers. A trigger is a person, place, or thing that causes them to turn toward anorexic behaviors to cope. They can gain control over how they react in these situations by learning to identify what triggers them, such as:^{[6]XTrustworthy SourceMental Health FoundationUK charity working towards good mental health for all.Go to source}
- Interacting with someone who is judgmental of their body.
- Specific foods that are difficult for them to eat or think about.
4
Help them set reasonable goals. Goals that are reasonable and realistic will help them make progress in their recovery. These are goals that can be achieved within a specific time-frame without causing problems in other areas of their life.^{[7]XTrustworthy SourceHelpGuideNonprofit organization dedicated to providing free, evidence-based mental health and wellness resources.Go to source}
- If they have trouble eating a typical amount of food three times a day, ask them to try once a day. After they have mastered this smaller step, they can continue to the bigger goal. This will help them feel accomplished and work at a realistic pace, so that they don't overwhelm themselves.
5
Recommend that they keep a recovery journal. Journaling about their struggle with anorexia can help them express themselves in a positive way. Although writing a journal is no replacement for a supportive community or professional help, it can be a powerful tool for them to share their feelings and reflect on what is happening in their life.
- Have them try the Five-Minute Sprint approach by Kathleen Adams, founder of The Center for Journal Therapy. Give them these instructions: set a timer for five minutes, pick a topic that's been on your mind, and write. You don't need to put a lot of thought into this writing exercise; try to let your thoughts flow onto the page. Now read this draft back to yourself, and whenever something stands out to you, write: "Reading, I notice or feel _________." This will help them begin to process their emotions around these issues. It's a good idea to do this exercise with them to show solidarity.
6
Learn about intuitive eating together. Intuitive eating is a nutritional system designed by dietitian Evelyn Tribole and nutrition therapist Elyse Resch. It can help them learn to listen to their body's needs and develop a healthier relationship with food. Show them you care by learning about this system together. Intuitive eating can help them:
- Listen to when their body is hungry or full.
- Find ways of solving their emotional difficulties without using food.
- Learn how to take pleasure in eating.
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Part 2

Part 2 of 3:

Talking to Them About Professional Help

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Discuss in-patient treatment. Anorexia is a condition that can threaten both their emotional and physical health. Because the condition involves different areas, discuss in-patient treatment options with them, such as a dedicated eating disorder facility. These sites will be able to address all of the problems anorexia brings up, so that their body and mind are both taken care of.
- This is especially important if they are severely underweight or malnourished. Doctors at these facilities can help them maintain their body's health, while psychologists can address the mental part of the condition.
2
Help them find a good therapist. Therapy can help them deal with the emotional difficulties underlying anorexia. A good therapist will help them change the way they feel about their body and food.
- Cognitive behavioral therapy. CBT is the most researched method of therapy for eating disorders.^{[8]XResearch source} It can help them change their thoughts and behavior so that they don't fall into the same old irrational beliefs about their weight and food.
- Interpersonal therapy. IPT focuses on improving the relationships in their life so that the symptoms of anorexia will go away on their own, as their social sphere becomes healthier and more supportive.
- Search for a therapist by clicking here.
3
Recommend getting help for additional problems like depression and anxiety. Research shows that people who have an eating disorder are more likely to have depression and anxiety as well. These complex issues can make recovery more difficult, so it's a good idea for them to seek out help for any other major difficulties they are having as well, such as obsessive-compulsive disorder or depression.^{[9]XTrustworthy SourceHelpGuideNonprofit organization dedicated to providing free, evidence-based mental health and wellness resources.Go to source}
- Obsessive-compulsive disorder is the most common anxiety disorder that shows up at the same time as eating disorders. If they mention having repeating thoughts about things they can't control, like germs or intruders in their home, they may want to ask their doctor about OCD.
- Depression can lead to eating disorders and also be caused by them. If they seem to have persistent sad moods, constant tiredness, or difficulty feeling any pleasure, have them ask their doctor about major depression.
4
Suggest a registered dietitian. People with anorexia frequently have deficiencies in nutrition. Contacting a registered dietitian will help them get their body back in balance. A dietitian can assist with gaining weight as well as replenishing whatever their body may be lacking, such as electrolytes. Research suggests that it may actually be necessary to address food and weight concerns before recovery can take place.^{[10]XResearch source}
- Look for a dietitian who specializes in eating disorders. You can find one local to them by clicking here.
There are no medications specifically for eating disorders, but things like anti-depressants or medication for anxiety can be helpful in treating the psychological symptoms of anorexia, which is often a necessary step in recovering from the disorder.^{[11]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source} If you are their parent, you can ask the doctor directly. If you are a friend or sibling, you may want to talk with them about it first.
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Part 3

Part 3 of 3:

Providing a Supportive Environment

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Educate yourself and other friends or family about anorexia. The first step is to cultivate awareness around their disorder so that you and other people will understand what they are going through. You can ask a doctor or view a resource like the National Eating Disorders Association's toolkit for parents.
- Click here for the toolkit.
2
Encourage them to ask for support. There are most likely things you and others can do, or not do, to help them recover from anorexia. Let them know that you are there for them whenever they need help. Research shows that recovery from an eating disorder has a lot to do with how connected the person feels to other people.^{[12]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source} The kind of supportive care they get from friends and family is essential to their well-being, so do your best to let them know that you care and are willing to help in any way possible.
- For example, if their doctor or dietitian puts them on a specific diet, ask if they want help managing this new routine.
3
Participate in therapy with them. One promising method of treatment for anorexia is family therapy, which involves other members of their family undergoing therapy with them. This kind of therapy enlists their family members as allies to help them recover from the condition. Some research actually suggests that family therapy is more effective than individual therapy.^{[13]XResearch source}
- The therapist will teach you and other family members how to be supportive and increase their chances for recovery. He may even observe your family eating together in order to make suggestions for healthy ways to encourage a better relationship with food.^{[14]XTrustworthy SourceAmerican Psychological AssociationLeading scientific and professional organization of licensed psychologistsGo to source}
If they are still living with parents, it's a good idea for them to have at least three meals with them each week. Research shows that people who have regular meals with family are less likely to have an eating disorder. This time together can be a healthy way of getting them back on track, especially if combined with family therapy, so that their family members know how to best support them while they are struggling with food issues.
Isolation is one of the worst things they can experience if they are already struggling with anorexia. It may seem like a good idea to hide away from the world while they try to manage their weight, but isolating themselves will only make the situation worse. Talk to them about letting their friends and family into their life so that they can be there for them. Relying on the people who care about them and want to see them recover is a key to success.
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Tips

When you talk to them, focus on their feelings and relationships. This will help you avoid bringing up feelings of shame about their relationship with food or their weight.^{[15]XTrustworthy SourceHelpGuideNonprofit organization dedicated to providing free, evidence-based mental health and wellness resources.Go to source}
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Promote their self-esteem. Stay positive when you interact. Focus on what you appreciate about them.^{[16]XTrustworthy SourceHelpGuideNonprofit organization dedicated to providing free, evidence-based mental health and wellness resources.Go to source}
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Warnings

Don't blame yourself if you're a parent. Eating disorders are complex. You didn't cause anything. If you feel like you made mistakes that contributed to their condition, try to apologize and act differently.
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Respect their boundaries. Be available, but don't pry or act in an overbearing way. Boundary violations such as food policing can contribute to an eating disorder.
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