Treatment Options

Helping Yourself

If you are concerned that someone you know may have an eating disorder, watch for the following warning signs:

• Abnormal food behaviors such as skipping meals, putting only tiny portions on their plate, unwillingness to eat in front of other people, eating in ritualistic ways (the same foods, the same times, or eating foods in the same order), and mixing strange food combinations. The individual may also chew mouthfuls of food but spit them out before swallowing.
• Social withdrawal - The individual tries to please everyone and withdraws when this is not possible.
• Feelings - The individual may have trouble talking about feelings, especially anger. She or he may become moody, irritable, cross, or touchy.
• Negative body image - The individual has frantic fears of weight gain and obesity, spends a great deal of time inspecting oneself in the mirror and usually finds a portion of the body to criticize. She or he wears baggy clothes, sometimes in layers, to hide the increasing thinness and to stay warm. Often the individual worries about clothing size and complains that she/he is fat even though others truthfully say this is not so.
• Thoughts and beliefs - The individual has lost the ability to think logically, evaluate reality objectively, concentrate, and correct undesirable consequences of choices and actions. The individual becomes irrational and denies that anything is wrong and is often envious of thin people.
• Exercise behaviors - The individual exercises excessively and compulsively.
• Disturbed sleep patterns - The individual has difficulty sleeping, falling asleep or spends too much time sleeping.

What can I do if I suspect an eating disorder?

First, understand that eating disorders are serious medical and psychological problems. They are not just a fad, a phase, or odd behavior. Eating disorders require that same level of treatment as any other serious disease, because they effectively cripple the mind and heart with body dissatisfaction, perfectionism, and the need for control. You will need the help of physicians, psychologists, and other mental health therapists who have been trained to work with these individuals. These individuals deserve and require professional evaluation, diagnosis, and treatment.

Recovery means much more than replacing dieting, binge eating, and purging with healthy eating. It means identifying the underlying reasons that have brought the individual to disordered eating and then resolving them. This process requires skill, sensitivity, and training of medical and mental health professionals.

Does that mean there is nothing you can do to help a loved one? No. There are many things you can do as a friend, a parent, a spouse, a partner, or a sibling for someone suffering from an eating disorder. Your primary focus should be to encourage the individual to discuss the problem with a physician or counselor. If, after an evaluation, ongoing treatment is advised, encourage the person to begin and continue treatment until the eating disorder is resolved. Typically, the biggest obstacle will be convincing the person to do this because at first she or he will deny there is a problem. She or he will fear weight gain, be ashamed, and not want to admit what is going on. The individual has used the eating disorder to protect, hide, comfort, and empower herself or himself. Arriving at a new and healthier perspective is the first challenge on the road to recovery and you can be there to help guide that person.

Where can I find help?

Finding a counselor, physician, and treatment team that you trust, and with whom you can work effectively, is an important part of the recovery process. Here are some tips to get you started.

• If you are in crisis, go to a hospital emergency room or call a crisis hotline. Find the number in the yellow pages under "Crisis Intervention."
• If you are not in crisis, ask your family doctor for an evaluation and referral. Don't let embarrassment stop you from telling the physician all the details.
• You can also ask people you trust, and who have been in your situation, for the names of physicians and counselors they found helpful.
• If you are a student, check with the school counseling center. Services may be low cost or free.
• If your income is limited, or if your insurance will not cover treatment for eating disorders, look for community service agencies in the "Counselors" section of the yellow pages. The organizations listed there may not provide formal eating disorders programs, but they do offer basic assistance to people who have few other options.

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Note: The above information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist, or other healthcare professional. It is not intended to diagnose a health condition, but it can be used as a guide to help you decide if you should seek professional treatment or to help you learn more about your condition once it has been diagnosed.