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Getting Help for Anorexia and Bulimia

Recognizing the problem in anorexia nervosa

In anorexia nervosa, family members are often the first to notice that something is wrong. Here is what you can do to get help for anorexia or bulimia.In anorexia nervosa, family members are often the first to notice that something is wrong. They notice that you are thin and continuing to lose weight. They become worried, and may be alarmed by your weight loss. You will probably continue to think that you are over-weight and will want to lose more weight. You may find yourself lying to other people about the amount you are eating, and the weight you are losing. If you have bulimia nervosa, you will probably feel guilty and ashamed of your behavior. You will try to hide it, even if it affects your work and makes it difficult to lead an active social life. People with bulimia often find that they finally admit to the problem when their life changes, perhaps a new relationship, or starting to live with other people. It can be a huge relief when this happens.

Getting the right help for anorexia

Your general practitioner can refer you to a counsellor, psychiatrist or psychologist who has experience with these problems. Some people choose private therapists, self-help groups or clinics, but it is still safest to let your GP know what is happening. You will need to have a regular physical health check.

Assessment

The psychiatrist or psychologist will first want to talk with you to find out when the problem started and how it developed. You will need to talk frankly about your life and feelings. You will be weighed and, depending on how much weight you've lost, you may need a physical examination and blood tests. With your permission, the psychiatrist will probably want to talk with your family, (and perhaps a friend), to see what light they can shed on the problem. However.. if you do not want other members of the family involved, even very young patients have a right to confidentiality. This may sometimes be appropriate because of abuse or stress in the family.

Self-help for anorexia and bulimia

  • Bulimia can sometimes be tackled using a self-help manual with occasional guidance from a therapist.
  • Anorexia usually needs more organized help from a clinic or therapist. It is still worth getting as much anorexia information as you can about the options so that you can make the best choices for yourself.
Things to do

In anorexia nervosa, family members are often the first to notice that something is wrong. Here is what you can do to get help for anorexia or bulimia.

Stick to regular mealtimes - breakfast, lunch and dinner. If your weight is too low, have morning, afternoon and night-time snacks.

  • If you can't manage this, try to think of one small step you could take towards a more healthy way of eating. For instance, you may be unable to eat breakfast. To start with, get into the routine of sitting at the table for a few minutes at breakfast time, and perhaps drink a glass of water. When you have got used to doing this, try having just a little to eat, even half a slice of toast - but do it every day.
  • Keep a diary of what you eat, when you eat it, and what your thoughts and feelings have been every day. You can use your diary to see if there seems to be any connection between how you feel, what you are thinking about, and how you eat
  • Try to be honest about what you are or are not eating, both with yourself and with other people.
  • Remind yourself that you don't have to be achieving things all the time- let yourself off the hook sometimes. Remind yourself that, if you lose more weight, you will feel more anxious and depressed.
  • Make two lists - one of what your eating disorder has given you, one of what you have lost by it. A self-help book can help you to do this.
  • Try to be kind to your body, don't punish it.
  • Make sure you know what a reasonable weight is for you, and that you understand why.
  • Read about stories of other people's experiences of recovery. You can find these in self-help books or on the internet.
  • Think about joining a self-help group. Your GP may be able to recommend one or you can contact the Eating Disorders Association (see overleaf).
Things NOT to do
  • Don't weigh yourself more than once a week.
  • Don't spend time checking your body and looking at yourself in the mirror. Nobody is perfect. The longer you look at yourself, the more likely you are to find something you don't like. Constant checking can make the most attractive person unhappy with the way they look.
  • Don't cut yourself off from family and friends. You may want to because they think you are too thin, but they can be a lifeline.

  • Avoid websites that encourage you to lose weight and stay at a very low body weight. They encourage you to damage your health, but won't do anything to help when you fall ill.

What if I don't have any help or don't change my eating habits?

Most people with a serious eating disorder will end up having some sort of eating disorder treatment, so it is not clear what will happen if nothing is done. However, it looks as though most people with an established eating disorder will continue with it. Some sufferers will die, but this is less likely if you do not vomit, use laxatives or drink alcohol.

Last Updated: 14 January 2014
Reviewed by Harry Croft, MD

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