The cause of eating disorders can be complex with multiple risk factors such as high conflict in the home, family history of dieting or obesity, critical comments from others, abuse, neglect and bullying.
Personal characteristics may play a part as well such as perfectionism, anxiety, low self-esteem, obesity and childhood obesity, early start of periods. Females are around nine times more likely to develop an eating disorder. If a parent has an eating disorder or other mental illness the chances may also increase.
What to look for
You can’t tell if someone has an eating disorder by looking at them as they may be underweight, overweight, fluctuating in weight or within the healthy weight range. You may notice changes in behaviour like avoiding meal times, anxiety around meal times and food, irritability, avoiding talking about body shape, weight or talk more about it, avoiding places where they have to show their body (PE, swimming), increased isolation, and much more.
What can you do?
Learn about eating disorders by attending a Mental Health First Aid course in your area, check out reachout.com, beyondblue, butterfly foundation or national eating disorders collaboration. Find out as much as you can by phoning these organisations and ask for advice.
Tell your friend what you have noticed and talk to them as a concerned friend. Ask them if they are struggling with their schoolwork, paying bills, relationships or family. Build trust. Listen respe3ctfully and don’t give advice or attempt to change their behaviour.
Use ‘I’ statements like:
“I know you are really tired at the moment and was wondering if stress might be keeping you awake at night.”
Instead of “You’re probably not sleeping because you are so stressed. You should try to relax before bed.”
“I’m worried when you get snappy with me. This is a change from 6 months ago and I would like to help us get back to how we were”
Instead of “You’ve changed. You used to be so patient with me and now you just seem to get snappy at me. Why can’t you be like you were 6 months ago?”
After you have discussed what you have noticed ask them if this seems like a fair observation and focus on their feelings not their eating, their body shape, weight or shape regardless of whether you think you are being positive or not. Ask them what it is like to feel this way.
Find out what services are in your area and call them. Once you know what is available ask your friend if they would consider talking to someone about it. They may just need to see a doctor and get some general advice which could be enough or the doctor may refer them on to a counsellor or psychologist. You could offer to go with them to provide support.
Early intervention is very important and the treatment provided will be developed based on the individual’s needs. Cognitive Behaviour Therapy, Interpersonal Therapy and Family Based Therapy may be used.
As your friend is recovering (perhaps with the help of a counsellor) just do normal stuff with them – movies, exercise, talk about the things you enjoy and focus on accomplishments not related to the eating disorder or disordered eating. Encourage them to read self-help books, learn relaxation techniques like yoga and meditation. Massage can be helpful as can Kinesiology and acupuncture. Dieticians can be helpful in meal planning and medication may be helpful in treating the eating disorder in combination with counselling. Acceptance and commitment therapy can be very useful as well.