Significant Others Family and Friends are Victims of Eating Disorders Too

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GUIDELINES FOR OTHERS WHEN A LOVED ONE IS IN TREATMENT

Aside from the above suggestions for approaching and talking to a person with an eating disorder, there are additional considerations listed below for parents or significant others who live with and/or love someone who is in treatment for an eating disorder. Remember, each case is unique and warrants special individualized attention. The guidelines listed should be discussed and followed with the assistance of professional help.

BE PATIENT—THERE ARE NO QUICK SOLUTIONS

Recovery from an eating disorder takes a long time. Even if you are aware of this, you may still be inclined to think that your loved one should be improving faster and that more progress should be made. Long-term thinking and endless patience are necessary. Research suggests that recovery from anorexia and bulimia takes approximately four-and-a-half to six-and-a-half years (Strober 1997).

AVOID POWER STRUGGLES

As much as possible, find alternatives to power struggles, especially when it comes to eating and to weight. Don't make mealtimes or eating a battle of wills. Don't try to force or restrict eating. Leave these issues up to the therapist, dietitian, or other treating professional unless your involvement is discussed, requested, and worked out with help from a therapist or other helping professional.

AVOID BLAMING OR DEMANDING

Don't try to find causes or someone to blame for the eating disorder, and don't plead or demand that your loved one stop her behaviors. Neither of these will help; they will only serve to oversimplify the situation and will cause even more shame and guilt. It is easy for your loved one to feel responsible for your or anyone else's feelings. You can help prevent this by avoiding blame or making demands.

DON'T ASK YOUR LOVED ONE HOW YOU CAN HELP— ASK A PROFESSIONAL

Your loved one will not know how you can help and may feel worse if you ask. A professional is in a better position to give you advice.

DEAL WITH FEELINGS OF ALL FAMILY MEMBERS

Family members are often the forgotten victimss, especially other children. They need to talk about their feelings. It doesn't help to keep feelings bottled up inside; therefore, it is useful for all family members to express themselves in journals, letters, or verbally as a way of getting their feelings out and communicating.

SHOW AFFECTION AND APPRECIATION VERBALLY AND PHYSICALLY

A little unconditional love goes a long way. There are many ways to show affection and support besides talking—for example, hugging a lot or spending special time together. Consider writing letters or just little notes to your loved one, even if you live together. This is a good way to express encouragement, concern, and support without expecting a response or putting the person on the spot.

DO NOT COMMENT ABOUT WEIGHT AND LOOKS

Avoid making appearance a focus. Don't comment about your loved one's or other people's looks. Physical appearance has become too important in our society and especially in the eating disordered person's life. It is best to stay away from the topic of weight altogether. It is a trap to answer questions like "Do I look fat?"

If you say no, you won't be believed, and if you say yes or even hesitate for a moment, your reaction may be used as an excuse to engage in eating disorder behavior. Telling someone with anorexia that she looks too thin is a mistake because chances are that this is what she wants to hear. Telling a bulimic she looks good on a particular day may reinforce her binge-purge behaviors if she believes that they are responsible for the compliment.

DO NOT USE BRIBES, REWARDS, OR PUNISHMENTS TO CONTROL YOUR LOVED ONE'S EATING BEHAVIOR

Bribing, if it works at all, is only temporary and postpones the person's dealing with internal means of controlling her behaviors.

DON'T GO UNREASONABLY OUT OF YOUR WAY TO PURCHASE OR PREPARE SPECIAL FOODS

It is fine to help out by buying foods your loved one likes and feels safe eating—to a point. Don't drive all the way to the frozen yogurt store because that is all the individual will eat. Don't be pushed into any action by the threat, "I won't eat unless . . . " If a person refuses to eat unless very strict circumstances are adhered to, they may ultimately need inpatient treatment. Giving in to every whim will only postpone the inevitable.

DO NOT MONITOR SOMEONE ELSE'S BEHAVIOR FOR HER, EVEN WHEN ASKED

Do not become the food or bathroom police. Often loved ones will ask you to stop them if you see them eating too much or tell them when you see they have gained too much weight. They may seek your praise for the amount of food they are eating. Monitoring your loved one's behaviors may work for a short time but always ends up backfiring in the end. Get professional help and do not become a monitor until such time as the professional requests otherwise.

DON'T ALLOW YOUR LOVED ONE TO DOMINATE THE REST OF THE FAMILY'S EATING PATTERNS

While nurturing others, individuals with eating disorders often will deny their own needs for food. As much as possible, the family's normal eating patterns should be maintained unless they also are in need of altering. Don't let the person with the eating disorder shop, cook for, or feed the family unless she also eats the items bought, prepared, and served.

ACCEPT YOUR LIMITATIONS

Accepting your feelings and your limitations means learning to set rules or say "No" in a caring and reasonable but firm and consistent manner. For example, you may have to discuss cleaning the bathroom, limiting the amount of food your loved one goes through, or charging her for binged food. You may have to tell your loved one that you can't always be there when she needs to talk and that calling you at work is not acceptable. You may want to establish certain rules—for example, that laxatives or ipecac syrup aren't allowed in the house. If the illness progresses, you may have to add many more rules and reevaluate your own limitations. Do not get overinvolved and try to become a substitute for professional care. Eating disorders are very complicated and difficult to treat; getting professional help is necessary.

GETTING HELP AND SUPPORT FOR YOURSELF

If you care about someone who has an eating disorder, it can be painful, frustrating, and confusing. You need knowledge, guidance, and support in dealing with the situation. The more knowledge you have about the causes of eating disorders and what to expect in regard to treatment, the easier it will be for you. Check the resource section in the back of this book for reading material and other resource suggestions.

You are going to experience a range of emotions: from helplessness and anger to despair. You may find yourself losing control of your feelings and actions. You may even become preoccupied with your own and other family members' eating and weight. It is important to get help for yourself.

You need to talk about your own feelings as well as getting guidance in how to deal with your loved one. Good friends are important, but a therapist or support group may also be necessary. There are support groups and therapy groups you can attend that include your loved one and groups for parents and significant others only. These groups are hard to find, and it may be worth your while to start a support group yourself and let local hospital programs, therapists, and doctors know about it. You will find information about support groups in the resource section. An individual therapist may also be important, so you can discuss in detail your particular situation, your feelings, and your specific needs.

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Whether your significant other or loved one with the eating disorder gets help, let her know that you are getting help for yourself. This may help your loved one take the situation more seriously, but, even if it does not, you must take care of yourself. If you do not stay healthy and strong, you will not be able to help someone else. Remember the instructions on an airline flight to first put on your own oxygen mask, then to put one on your child? With your own "oxygen mask" on, you can safely explore, pursue, and participate in helping and supporting those you care about and love.

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