If you think a loved one may be suffering from an eating disorder, it is worth intervening as soon as possible. Many suffering from such disorders may be reluctant to seek help or even talk about it, so it’s vital that an intervention takes place. In the early stages of an eating disorder, intervention and prevention from progression can be a life saver. The behaviors that result from a disorder can be life threatening. The risk of suicide in those with eating disorders is much higher than the average for the rest of the population.

Why is it important to intervene?

Suicide is one of the most common causes of death among individuals with an eating disorder[1]. Instances of non-suicidal self-injurious (NSSI) behavior also occur frequently in this group. People suffering from an eating disorder, like Anorexia Nervosa (AN) or Bulimia Nervosa (BN) should be carefully evaluated by a clinical professional and treated promptly and appropriately.

A review published in 2006 by Franko and Keel found that the rates of suicide among sufferers of anorexia were high, much higher than those with bulimia. On the other hand, sufferers of bulimia were found to engage in self-injurious behaviors, like bingeing or purging, at a higher rate than sufferers of anorexia. The rate of NSSI in people with BN was found to be 25-35% of those studied, compared with 3-20% in people with AN[2].

Intervention is important if you believe a loved one or someone you know is experiencing this illness, as the risk of suicide is high.

‘Research on treatments for eating disorders, as well as most mental health problems in general, indicates that early identification and treatment improves the speed of recovery, reduces symptoms to a greater extent and improves the likelihood of staying free of the illness.[3]’

How will I know?

An eating disorder intervention may be necessary if you notice the following signs or symptoms in a loved one. Remember that if your loved one displays one or more of these symptoms, that doesn’t necessarily mean that they are suffering from a disorder, but let these signs and symptoms act as an indicator of the potential need for intervention.

Weight

• The person has lost a substantial amount of weight.
• The person has been expressing concern about the shape and/or weight of his/her body.
• The person may regularly express a desire to lose weight or change how he/she looks.
• The person might talk a lot about clean eating or different diets.

Exercise

• The person may increase the frequency or intensity of his/her exercise routines but not meet that increase with an increased calorie intake.
• If there is some reason the person is unable to exercise, he/she may become anxious or irritable.

Meal Prep

• The person may become very interested in cooking, but may not even eat the meals he/she has cooked.
• The person may make their own meals, outside of the meals the family is eating.

Obsessive Control

• The person may become noticeably upset when they don’t have control over an eating situation, like if plans for dinner have changed or a restaurant does not serve the food they want.

Abnormal Behavior with Food

• The person frequently use the bathroom right after a meal.
• He/she won’t eat in front of people.
• The person is ritualistic with food – playing with it, cutting into unnecessarily small pieces.
• The person may be secretive about their intake of food or say that he/she has eaten when that is not the case.
• The person is vomiting and/or using laxatives on a regular basis.

Mood Fluctuation

• The person is showing more signs of depression, anxiety, irritability, or fatigue than usual. (Though depression and anxiety are common, they are also very often comorbid with eating disorders, so stay alert.)

Energy Spikes/Drops

• The person’s energy seems unusually low in all areas of life – he/she is lethargic, and doesn’t seem to enjoy doing activities that he/she normally would.
• Alternatively, the person may have unusually high energy, meticulously pushing him/herself beyond necessity[4].

If you believe, or even just have a feeling, that your loved one has an eating disorder, try not to panic. One of the best things you can do for him or her is to stay calm, and do not regularly pressure them to talk about something they do not want to talk about. If the person wants to talk about it with you, he/she will. If not, applying pressure will likely worsen the situation to the point where he or she feels like you are not someone with whom they can talk freely.

This is not to say that you shouldn’t express your concerns. It is important to do so,but do so lovingly and with patience. It can be painfully worrying to witness a loved one suffering from such an illness, but unless you are a health professional yourself, your ability to help is limited. What you can do is be there as a source of love and support as much as you can. Let them know you love them and that your concern is coming from a place of love.

For your own peace of mind and to be best equipped to best deal with this situation, talk to a health professional about what’s going on, such as a physician, a paediatrician, or a therapist. Seek out and gather advice from professionals on how to approach this situation with gentleness and tact. The earlier you do this the better, as early intervention can prevent a lot of psychological and physiological damage.

Sources:

1. Costa, M. and Melnik, T. (2016). Effectiveness of psychosocial interventions in eating disorders: an overview of Cochrane systematic reviews. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4943360/ [Accessed 3 Feb. 2020].
2. Franko DL, Keel PK. Suicidality in eating disorders: occurrence, correlates, and clinical implications. Clin Psychol Rev. 2006
3. Lock, Agras, Bryson, & Kraemer, 2005; Loeb et al., 2007; Russell, George, Dare, & Eisler, 1987; Treasure & Russell, 2011
4. Kay, J. (2016). 7 Signs Your Friend or Loved One Might Be Struggling With an Eating Disorder. [Blog] National Eating Disorders Association. Available at: https://www.nationaleatingdisorders.org/blog/7-signs-your-friend-or-loved-one-might-be-struggling-eating-disorder [Accessed 3 Feb. 2020].