Refusal to eat certain foods or whole categories of foods (e. g. , “no carbs,” “no sugars”) Food-related rituals, such as excessive chewing, pushing food around on the plate, cutting it into smaller and smaller pieces Obsession with measuring food, such as constantly counting calories, weighing food, double- or triple-checking nutrition labels Refusal to eat out because it’s hard to measure calories
Obsession with food is a common side-effect of starvation. A landmark starvation study performed during WWII demonstrated that people who are starving fantasize about food. They will spend inordinate amounts of time thinking about it. They will often talk about it with others and to themselves. [6] X Trustworthy Source American Psychological Association Leading scientific and professional organization of licensed psychologists Go to source
“I’m just not hungry” “I’m on a diet/need to lose weight” “I don’t like any of the food available” “I’m sick " “I have food sensitivities” (A person who truly has food sensitivities will eat enough as long as they are given food that works with their sensitivities. )
People with anorexia may also wear large or baggy clothes to hide their true size. They may dress in layers, or wear pants and jackets even in the hottest weather. Part of this is to hide body size, and part of it is because people with anorexia often cannot regulate their body temperature effectively and are thus frequently cold. Don’t rule out overweight or obese people automatically. It is possible to be anorexic at a large size. Anorexia, restricted eating, and fast weight loss are very dangerous regardless of the person’s BMI, and you shouldn’t wait until they become underweight before getting them help. [9] X Research source [10] X Research source
For example, the person may exercise for many hours each week, even if they are not training for a particular sport or event. People with anorexia may also exercise even when they are fatigued, ill, or injured, because they feel compelled to “burn off” the food they have eaten. Exercise is a particularly common compensating behavior for guys with anorexia. The person may believe they are overweight, or may be unhappy with their body composition. They may be preoccupied with body-building or “toning. ” Distorted body image is common with anorexic people, too, who will often be unable to recognize how their body actually appears and will see themselves as “flabby” even if they are fit or underweight. [12] X Trustworthy Source National Eating Disorders Association Nonprofit organization dedicated to supporting individuals and communities affected by eating disorders Go to source [13] X Research source Strother, E. , Lemberg, R. , Stanford, S. C. , & Turberville, D. (2012). Eating Disorders in Men: Underdiagnosed, Undertreated, and Misunderstood. Eating Disorders, 20(5), 346-355. doi:10. 1080/10640266. 2012. 715512 People with anorexia who cannot exercise, or who have not exercised as much as they want to, will often appear fidgety, restless, or irritated.
Dramatic, rapid weight loss Unusual facial or body hair Increased sensitivity to cold Hair thinning or loss Dry, pale, yellowish skin Fatigue, dizziness, or fainting Brittle nails and hair Bluish fingers
People with anorexia may also experience irritability, listlessness, and trouble focusing or concentrating.
Physical self-confidence is also usually very low in people with anorexia. Although they may speak about getting to their “ideal weight,” it is impossible for them to attain that because of their distorted view of their body image. There will always be more weight to lose.
People with anorexia may spend time on “pro-Ana” websites, which are groups that promote and support anorexia as a “lifestyle choice. ” It is important to remember that anorexia is a life-threatening condition that can be successfully treated, not a healthy choice made by healthy people. People with anorexia may also post “thinspiration” messages on social media. These types of posts may include pictures of extremely underweight people or messages making fun of people who are a normal weight or overweight.
There is a difference between binge-eating/purging type anorexia and bulimia nervosa, another eating disorder. People suffering from bulimia nervosa do not always restrict calories when they aren’t binge-eating. People suffering from binge-eating/purging type anorexia will severely restrict calories when they are not binge-eating and purging. People suffering from bulimia nervosa will often binge-eat huge quantities of food before purging. People with binge-eating/purging type anorexia may consider much smaller quantities of food a “binge” that requires purging, such as a single cookie or small bag of chips.
Eat in secret Hide or throw away food Take diet pills or supplements Hide laxatives Lie about how much they exercise
Talking to Eating Disorders: Simple Ways to Support Someone with Anorexia, Bulimia, Binge Eating, or Body Image Issues, by Jeanne Albronda Heaton and Claudia J. Strauss, is a highly recommended resource. The National Eating Disorders Association is a non-profit organization that provides extensive resources for friends and families of those affected by eating disorders. The Alliance for Eating Disorders Awareness is a non-profit organization aimed at providing education and resources to heighten awareness of eating disorders and their impacts. The National Institute of Mental Health has a variety of excellent information and resources for individuals with eating disorders and their loved ones. [23] X Trustworthy Source National Institute of Mental Health Informational website from U. S. government focused on the understanding and treatment of mental illness. Go to source
Lack of menstruation in females Lethargy and exhaustion Inability to regulate body temperature Abnormally slow or irregular heartbeat (due to weakened heart muscles) Anemia Infertility Memory loss or disorientation Organ failure Brain damage
Avoid approaching the person if either of you is feeling angry, tired, stressed, or unusually emotional. This will make communicating your care for the person much more difficult. [28] X Research source
The person may become defensive. They may deny having a problem. They may accuse you of meddling in their life, or harshly judging them. You can reassure them that you care about them and would never judge, but don’t get defensive. For example, avoid saying things like “I’m just trying to help you” or “You need to listen to me. ” These statements will make the other person feel attacked and encourage them to stop listening to you. Instead, keep the focus on positive statements: “I’m concerned about you and I want you to know that I’m here for you” or “I am ready to talk whenever you feel ready. ” Give the other person room to make his/her own choices.
For example, avoid “you” statements, such as “You’re making me worried” or “You’ve got to stop this. ” Statements that play on the other person’s sense of shame or guilt are also unproductive. For example, avoid saying things like “Think about what you’re doing to your family” or “If you really cared about me you’d take care of yourself. ” People with anorexia may already feel an intense sense of shame about their behavior, and saying things like this could only make the disorder worse. Don’t threaten the person. For example, avoid statements such as “You will be grounded if you don’t eat better” or “I’ll tell everyone about your problem if you don’t agree to get help. ” These will cause significant distress and can make the eating disorder worse.
Don’t rush anyone through this type of conversation. It can take time to process feelings and thoughts. Reiterate that you do not judge or criticize your their feelings.
There are two screenings available through NEDA: one specifically for college students, and one for adults.
People with anorexia are often struggling to find control in their lives, so emphasizing that seeking therapy is an act of courage and control over one’s life may help them accept it. You can frame this as a medical issue, which may help. For example, if your loved one or someone you know had diabetes or cancer, you would encourage them to seek medical help. This is no different; you are simply asking them to seek professional help for an illness. NEDA has a “Find Treatment” feature available on their website. This feature can help you find a counselor or therapist who specializes in anorexia. Particularly if the person is a young person or teenager, family therapy may be helpful. Some studies suggest that family-based therapy is more effective for teens than individual therapy, because it can help address ineffective communication patterns within the family as well as offer ways for everyone to support the sufferer. [33] X Research source In some severe cases, inpatient treatment may be required. This is common when the person is so underweight that they are at a high risk of things such as organ failure. People who are psychologically unstable or suicidal may also require inpatient treatment. [34] X Trustworthy Source National Eating Disorders Association Nonprofit organization dedicated to supporting individuals and communities affected by eating disorders Go to source
NEDA has a list of support groups on their website. They also have a Parent, Family & Friends Network. The National Association of Anorexia Nervosa and Associated Disorders (ANAD) has a list of support groups by state. [35] X Research source Your physician may also be able to refer you to local support groups or other support resources. Seeking counseling is particularly important for parents of children with anorexia. It is important not to control a child’s eating behaviours or use bribes, but it’s hard to accept that when you see any child at risk. Therapy or a support group can help you learn ways to support and help a child without making their disorder worse.
Celebrate even small successes. For someone with anorexia, even eating what seems like a small quantity of food to you may represent a huge struggle for them. Don’t judge relapses. Ensure that your loved one gets adequate care, but don’t judge him/her for struggles or stumbles. Acknowledge the relapse, then focus on how to get back on track.
For example, the therapist may recommend that certain ways of communication or certain ways of handling conflict change. It can be hard to acknowledge that something you do or say could be affecting your loved one’s disorder. Remember: you didn’t cause the disorder, but you may be able to help your loved one recover from it by changing some things about your behavior. Healthy recovery is the ultimate goal.
For example, go out to the movies, go shopping, play games or sports. Treat the other person with kindness and care, but let them enjoy life in as normal a way as possible. Remember, people with eating disorders are not their disorder. They are people with needs, thoughts, and feelings.
Find support groups or other support activities for your loved one to join. Don’t force her or him to join them, but make the options available.
Past experiences and emotions may also trigger unhealthy behavior. Stressful or new experiences or situations may also act as triggers. Many people who suffer from anorexia are desperate to feel in control, and situations that make them feel uncertain may trigger the need to perform unhealthy eating behaviors.
Don’t try to “fix” your loved one’s problem. Recovery is as complex as the eating disorder. Trying to “fix” your loved one on your own may do more harm than good. Encourage him/her to see a mental health professional, instead.
Compliments are also unhelpful. Because the person is dealing with a distorted body image, s/he is unlikely to believe you. S/he may interpret even positive comments as judgment or manipulation. [38] X Trustworthy Source HelpGuide Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources. Go to source
Similarly, do not point out thin people and comment on their appearance, such as “Nobody wants to hug a bony person. ” You want your loved one to develop a healthy body image, not focus on fearing or diminishing one particular type of body. Instead, ask your loved one where those feelings are coming from. Ask what they think they would gain by being thin, or what they fear about feeling overweight.
Instead, offer your support with “I”-statements: “I realize this is a tough time for you” or “Eating differently can be hard, and I believe in you. ”
Acknowledge when one of you slips up, but don’t focus on it or beat yourself up for it. Instead, focus on what you can do going forward to avoid similar mistakes.
Understand that your loved one may initially be angry with you or even reject you for suggesting they need help. This is common. Just continue to be there for your loved one and let them know that you support and care for him/her.
