Eating disorders are a serious problem that affects more people than you might think. Anorexia nervosa, also known simply as "anorexia", most often affects adolescents and young women, although it can affect adult men and women; a recent study found that 25% of people suffering from anorexia are men. This disorder is characterized by severe limitation of ingested food, reduced body weight, intense fears about weight gain, and impaired vision of one's body. It is often a response to complex social and personal problems. Anorexia is a serious disease and can cause devastating damage to the body; has one of the highest death rates of any other mental health problem. If you think a friend or loved one is suffering from this problem, read on to learn how to help them.
Steps
Part 1 of 5: Observe the Habits of the Person
Step 1. Check your eating habits
People with anorexia have a conflicting relationship with food. One of the driving forces behind this disease is an intense fear of gaining weight - anorexics limit their food intake in an exaggerated way, which means that they even go hungry to avoid gaining weight. However, the simple fact of not eating is not the only sign of anorexia. There are other potential warning signs, including:
- Refusal to eat certain foods or entire categories of foods (for example, "no carbohydrates", "no sugars");
- Diet-related rituals, such as chewing excessively, continually moving food around the plate, cutting it into smaller and smaller pieces;
- Obsessively dosing portions, always counting calories, weighing foods, checking the nutrition labels on packages two or three times;
- I refuse to eat in restaurants because it is difficult to measure calories.
Step 2. Pay attention to whether the person seems obsessed with food
Even if they eat a little, anorexics are often obsessed with food. They can read many cooking magazines morbidly, collect recipes or watch cooking shows. They can often talk about food, even if these conversations are more often than not negative (for example: "I can't believe everyone eats pizza despite it being so bad").
The obsession with food is a very common side effect of hunger. A study on chronic hunger during World War II showed that people who suffer terribly from hunger fantasize about food. They spend an infinite amount of time thinking about it, and often talk about it with others and with themselves
Step 3. See if the person has a habit of finding excuses to avoid eating
For example, if she is invited to a party where there will be food, she may say that she has already had dinner. Other typical excuses to avoid food can be:
- I'm not hungry;
- I am on a diet / need to lose weight;
- I don't like any food there;
- I do not feel well;
- I have "food intolerances" (a person who really suffers from intolerances eats normally as long as he has available foods that do not cause him problems).
Step 4. See if the person seems underweight, but keep talking about the diet
If he looks very thin to you but says he still needs to lose weight, he probably has a disturbed view of his body. Keep in mind that a characteristic of anorexia is precisely a "distorted perception of the body", in which the person continues to consider himself overweight when in reality he is not at all. Anorexics often deny that they are underweight and do not listen to anyone who points this out.
- People with this disorder also tend to wear loose fitting clothing to hide their true size. They can dress in layers or wear long pants and jackets even on the hottest days. This behavior is partly due to the desire to hide body size, but partly due to the fact that anorexics are hardly able to regulate their body temperature effectively and are often cold.
- Do not rule out overweight or obese people a priori; it is possible to be anorexic while having a robust constitution. Anorexia, excessively restrictive diets and too rapid weight loss are very dangerous, regardless of the body mass of the person in question. You don't have to wait for him to get underweight to take action.
Step 5. Observe his training habits
Anorexics can compensate for the food they eat by exercising, often excessive and usually very rigorously.
- For example, your friend may be exercising for many hours each week, even if he's not preparing for a particular sport or event. People with this disorder can exercise even when they are very tired, sick or injured, because they feel compelled to "burn" the calories they have eaten.
- Exercise is a fairly common compensatory behavior, especially in anorexic men. People think they are overweight or may feel uncomfortable with their body; may be particularly concerned with building muscle mass or getting a "toned" physique. The distorted perception of the body is also common in men, who are often unable to recognize their physique as it actually looks and feel "flabby", even if they are fit or underweight.
- Anorexics who cannot exercise or who do not exercise as much as they would like often appear restless, agitated, or irritated.
Step 6. Observe its appearance, bearing in mind that it is not always indicative
Anorexia causes a number of physical symptoms, but you can't say for sure that a person suffers from this disorder just by looking at their appearance. A combination of the symptoms listed below and the disturbed behaviors is a clear sign that the person has an eating problem. Not everyone has these symptoms, but anorexics usually show more than one:
- Dramatic and rapid weight loss;
- Unusual presence of facial or body hair in women
- Increased sensitivity to cold;
- Hair thinning or loss
- Yellowish, dry, pale skin
- Feeling tired, dizzy or faint
- Brittle nails and hair
- Bluish fingers.
Part 2 of 5: Consider the Emotional State of the Person
Step 1. Observe the person's mood
Mood swings can be very common among anorexics, because hormones are often out of balance due to the starving body. Concurrent with eating disorders, anxiety and depression frequently occur.
People with anorexia may also experience irritability, apathy, and problems with attention or concentration
Step 2. Pay attention to the subject's self-esteem
Anorexics are often perfectionists, they can be bright and ambitious, they often do very well in school and at work they achieve above average results. However, they easily suffer from low self-esteem and complain about not being "good enough" or not being able to do "anything good".
They also usually have very low self-esteem as regards their body. Even if they talk about wanting to reach the "ideal weight", it is impossible for them to be able to achieve it due to the distorted image they have of their physique: they will always have more weight to lose
Step 3. Notice if the person is talking about guilt or shame
Sufferers of this disease easily feel a lot of shame after eating; in fact, it tends to interpret eating as a sign of weakness or a loss of self-control. If your loved one also often expresses a sense of guilt or shame about food or body size, this could be a warning sign.
Step 4. Check if the person has become shy
This is also a typical feature of anorexics, who begin to distance themselves from their friends and usual activities. They can also start spending more and more time online.
- They often spend a lot of time on various "pro-ana" websites, which are groups that promote and support anorexia as a "life choice". It is important to remember that anorexia is a life-threatening disorder that can be successfully treated, it is not a healthy choice made by healthy people.
- They can also post "thinspiration" messages on social media. The term derives from "thin" (thin) and "inspiration" (inspiration) and indicates the phenomenon that has taken hold on the web and on social networks in which users are urged to "thinness at all costs". These types of messages can include images of extremely underweight people and making fun of people who are of normal weight or are overweight.
Step 5. Check if the person spends a lot of time in the bathroom after eating
There are two types of anorexia nervosa: the binge-eating type and the limitation type. The latter is the most common one, with which anorexics are most familiar, although binge-eating is also quite common. The form of binge eating anorexia involves self-inducing vomiting or using laxatives, enemas or diuretics after eating.
- Know that there is a difference between the binge-eating type of anorexia and bulimia nervosa, another eating disorder. People suffering from bulimia nervosa do not always limit calories when they are not binging, while, in the case of binge-eating anorexia, they severely limit calories when they are not experiencing a binge eating phase.
- People with bulimia nervosa often overeat huge quantities of food before expelling it. People with binge-eating anorexia, on the other hand, may consider eating much smaller portions of a "binge" (but which must then be eliminated), for example a single dessert or a small bag of chips.
Step 6. Determine if the person is very private about their habits
Anorexics may be ashamed of their disease, or are convinced that others cannot "understand" their eating behaviors and that they want to prevent them from implementing them. They also often try to hide their eating habits from others to avoid judgments or interference. For example, they can:
- Eat in secret;
- Hide or throw away food;
- Take diet pills or supplements
- Hide laxatives;
- Lying about how much they train.
Part 3 of 5: Offer Support
Step 1. Get information on eating disorders
It can be easy to judge people who have an eating disorder, and it can be difficult to understand why someone you love is behaving this way, not at all healthy with their body. Learning about what causes eating disorders and what sick people feel will help you approach your loved one with empathy and attention.
- Look for books or online sites that tell the biographies of those who have overcome this disease. You can also find blogs and numerous pages on the internet. It won't be difficult for you.
- The Italian Association for Eating and Weight Disorders (AIDAP) is an autonomous non-profit association that provides ample resources for the friends and families of those affected by eating disorders. ABA, Bulimia Anorexia Association, is another reality and a point of reference for those who have to deal directly or indirectly with these eating disorders. The Istituto Superiore della Sanità, in its EpiCentro portal, provides a variety of great information and resources for people with eating disorders and their loved ones.
Step 2. Understand the real risks of anorexia
This disease literally starves the body and can lead to serious health problems. In women between the ages of 15 and 24, anorexia nervosa causes 12 times more deaths than any other cause and, up to 20% of cases, causes premature death. It also generates a variety of health problems, including:
- Disappearance of menstruation in women;
- Lethargy and fatigue;
- Inability to regulate body temperature
- An abnormally irregular or slow heartbeat (due to weakened heart muscles)
- Anemia;
- Infertility;
- Loss of memory and disorientation
- Insufficiency of some organs;
- Brain damage.
Step 3. Find an appropriate time to talk privately with your loved one
Eating disorders are often a reaction to more complex personal and social problems. There may also be genetic factors that affect the disorder. Talking about a condition like this with other people can be terribly embarrassing or uncomfortable. Make sure you approach your friend in a safe and private environment.
Do not approach the person if either of you is angry, tired, stressed, or unusually emotional, as dialogue would be much more difficult in this case
Step 4. Use the "I" often when you want to convey your feelings to him
By speaking in the first person and saying the word "I" you can help your friend feel less attacked or attacked. Set up the discussion as securely as possible so your friend can be in control of the situation. For example, you can say something like, "I've noticed some things lately that worry me. Since I care about you, can we talk about it?"
- Know that your friend may be on the defensive, denying that he has a problem. He may also accuse you of meddling in his life or that you are judging him unfairly. At this point you can reassure him by telling him that you care about him and that you will never judge him, but don't get defensive.
- For example, avoid saying, "I'm just trying to help you" or "You need to listen to me." These statements would make him feel attacked and cause him to stop listening to you.
- Instead, stay focused on positive affirmations: "I love you and I want you to know I'm here for you", or "I'm available to talk whenever you feel ready." Give them the opportunity to make their own choices.
Step 5. Avoid using incriminating and accusatory language
If you speak in the first person, using phrases with "I", you will avoid falling into this mistake. However, it is very important not to speak to him in a judgmental or accusatory tone. Exaggeration, "guilt," threats, or accusations do not help the other person understand your true intentions.
- For example, avoid using "you" phrases such as "You are worrying me" or "You have to stop this."
- Claims that play on the other person's sense of guilt or shame are also unproductive. For example, don't say phrases like, "Think about what you're doing to your family" or "If you really cared about me, you'd take care of yourself." Anorexics already feel an intense sense of shame about their behavior, and saying things like this only makes them worse.
- Don't even think about threatening the person. For example, avoid statements such as "You will be punished if you don't eat better" or "I'll tell everyone about your problem if you refuse to get help." Such phrases can cause significant discomfort and make the eating disorder worse.
Step 6. Encourage your friend to share his feelings with you
It is also important to find time for him to confide in you his state of mind and his feelings. Conversations that are one-sided and that only converge on you are hardly effective.
- Don't rush him during this conversation. It may take some time for them to process feelings and thoughts.
- Remind him that you are not judging him and that you are not criticizing his feelings.
Step 7. Offer your friend to take an online screening test
AIDAP has an online screening tool that is free and anonymous. Asking him to take this test can be a "soft" way to encourage him to recognize his problem.
The AIDAP test is called EAT-26 and you can run it directly from the online page, getting the result immediately
Step 8. Make your loved one aware of the need for professional help
Make them understand your concern productively. Note that anorexia is a serious but highly treatable disorder if handled professionally. Convince him that seeing a therapist or psychologist for help is not a sign of failure or weakness - nor does it mean that he is "insane."
- Anorexics often struggle to manage and control their lives, so make it even more evident to your friend that going to a therapist is an act of courage and demonstrates control over your life; doing so can help him accept treatment.
- It may help to frame this disorder as a medical problem. For example, if your friend has had diabetes or cancer, he has surely turned to medical centers. This case is no different; you are simply asking him to seek professional help in dealing with an illness.
- Do an online search to find possible treatments, or ask your doctor to refer you to a professional or therapist who specializes in anorexia.
- Family therapy can be particularly useful if the anorexic is young or adolescent. Some studies have found that family therapy is more effective during the teenage years than individual therapy because it can help address ineffective communication patterns within the group, as well as offering all members ways to help. and support the sick.
- In some severe cases, hospital treatment may be required. This is essential when the person is so underweight that they are at high risk of problems such as organ failure. In addition, hospital treatment may also be necessary if the patient suffers from mental instability or has suicidal tendencies.
Step 9. Seek support for yourself
It can be difficult to manage and see a loved one struggling with an eating disorder. It can be even more difficult if you refuse to acknowledge that you have a problem, which is all too common in those with eating disorders. Seek help from a therapist or support group to help you stay emotionally strong.
- Search online or go to your nearest clinic to find support groups.
- Sometimes even the parish or the community can be of help and support for family members. Contact the closest reality that you think is best suited to your specific situation.
- If necessary, your family doctor can also point you to help groups or other resources that can help you.
- Finding a therapist or psychologist is particularly important for parents of anorexic children, not so much to control or manage the child's eating behaviors, but rather to be able to accept the fact that the child is at risk, which is very difficult for some parents. Therapy or a support group can help to find support and help for the child without aggravating their condition.
Part 4 of 5: Helping the Person Through the Recovery Path
Step 1. Value the feelings, struggles and successes of your loved one
When treated, about 60% of people with eating disorders recover. However, it can take years before you see a full recovery. Some people can always suffer from feelings of discomfort with their body or still have the urge to fast or overeat, even if they manage to avoid harmful behaviors. Support your loved one on this journey.
- Celebrate small successes too. For an anorexic, eating even what seems like a small amount of food to you can be a huge strain.
- Don't judge about possible fallout. Make sure your friend gets proper care, but don't judge him in his struggle or if he "stumbles" along the way. Acknowledge and accept the relapses and invite him to focus to "get back on track".
Step 2. Be flexible and adaptable
In some cases, particularly when the anorexic is young, the treatment may involve changes in the daily lives of friends and relatives. Be prepared for the possibility of having to make changes that are necessary for her to heal.
- For example, the therapist may recommend that you change certain ways of communicating or managing conflict.
- It can be difficult to recognize that your actions or words may be affecting a loved one's disorder. Remember: you are not the cause of her problem, but you can help her heal by changing some of your behaviors. The ultimate goal is to recover in a healthy way.
Step 3. Focus on fun and positivity
It can be easy to slip into a "supportive" attitude that can suffocate the anorexic. Remember that a person struggling with anorexia already spends a large part of his time thinking about food, weight and body image; don't let disturbance be the only topic of conversation you focus on.
- For example, go to the cinema, go shopping, play games or play sports. Treat the sick person with kindness and concern, but allow them to enjoy life in the most normal way possible.
- Remember that anorexics "have" eating disorders, not "they are" their disorder. They are people with needs, thoughts and feelings.
Step 4. Remind your friend that he is not alone
Those who struggle with eating disorders can feel terribly isolated. You don't have to stifle him with attention, but letting him know that you are there and available to talk to him or be of support can help him in his recovery process.
Find support groups or other support activities that your loved one can join. You don't have to force her to join at all costs, but present her with the options available
Step 5. Help the anorexic to manage the triggering factors
There may be some people, situations or things that "trigger" your illness. For example, being close to him with an ice cream can be an impossible temptation, going out to eat in bars can cause him anxiety about food. Try to support him as much as possible. It may take some time to understand what are the elements that aggravate the disorder and could prove to be a surprise even for the patient.
- Sometimes past experiences and emotions can also trigger unhealthy behavior.
- In addition, new or stressful experiences or situations can trigger the problem. Many people with anorexia are desperate to be in control of their lives, and situations that make them feel insecure may trigger the need to maintain certain eating behaviors.
Part 5 of 5: Avoid Aggravating the Problem
Step 1. Do not try to control the anorexic's behavior
Don't force him to eat at all costs. Do not try to bribe him by promising him a reward in exchange for a meal and do not threaten him to force him to behave in a certain way. Sometimes, anorexia is the answer to an inability to control one's life. If you set up a power struggle or prevent him from having control over himself, you can only make the problem worse.
Don't try to "solve" his problem. The recovery process is as complex as the disorder itself. If you try to "fix" it on your own you could do more harm than good. Instead, encourage your child to see a mental health professional
Step 2. Avoid judging the patient's behavior and appearance
Anorexia often involves a great sense of embarrassment and shame on the part of the subject. Even if you do it with the best of intentions, commenting on his appearance, eating habits, weight, and so on can trigger feelings of shame and disgust in him.
Compliments are also useless. Since the sufferer has a distorted image of their body, they hardly believe what you say and may interpret your positive comments as judgments or attempts at manipulation
Step 3. Don't assume "fat is beautiful" attitudes and don't try to show him that he is "skin and bones"
A normal body weight can be different for each person. If your loved one comments that he feels "fat", it is important not to reply with phrases such as "You are not fat". This would only reinforce his unhealthy idea that "fat" is something inherently negative that must be feared and avoided.
- Likewise, don't target thin people by commenting on their appearance by saying things like, "Nobody wants to hug a skinny person." You need to get your friend to develop a healthy body image, not focus on dreading or belittling a particular body type.
- Instead, ask him where his feelings and ideas come from. Ask him what he thinks he's getting from being thin or what he's afraid of feeling overweight.
Step 4. Avoid simplifying the problem
Anorexia and other eating disorders are very complex and often occur in conjunction with other diseases, such as anxiety and depression. Confrontation with peers or colleagues and media pressure can play an important role, as can family and social situations. Saying phrases such as "If you only ate more, things would be better" means not taking into account the complexity of the problem that the anorexic is facing.
Instead, always offer your support by speaking in the first person, as described above. Try saying things like, "I realize this is a hard time for you", or "Eating differently can be hard for you and I believe you."
Step 5. Avoid perfectionistic tendencies
The desire to be "perfect" is a common trigger of anorexia. However, striving for perfection is an unhealthy way of thinking, hindering the ability to adapt and be flexible, which is crucial to success in life. This attitude prompts you and others to try to reach an unreal, impossible and elusive standard model. Never expect perfection from either your loved one or yourself. Recovering from an eating disorder can take a long time, and both of you will have moments where you will act in a way that you will later regret.
Recognize when one of you "slips", but don't focus on that aspect and don't punish yourself for that. Instead, focus on what you can do in the future to avoid similar mistakes
Step 6. Don't promise to "keep it a secret"
You may be tempted to agree to keep your friend's problem a secret to gain their trust. However, you must not favor his behavior in any way. Anorexia can cause early death in 20% of sufferers, so it's important to encourage them to get help.
Know that he may initially be very angry with you or even reject your advice to get help; this is very common. The important thing is to continue to be available and present anyway and let him know that you can support and take care of him
Advice
- Be aware that there is a difference between a healthy diet and exercise routine and an eating disorder. Those who pay attention to their diet and exercise regularly can be perfectly healthy. If your friend seems obsessed with food and / or training, particularly if he also seems anxious or vague and misleading in this regard, then it could be a cause for concern.
- Never assume that a person is anorexic just because they are very thin. At the same time, however, don't think that someone isn't anorexic just because they're not very thin. You cannot tell if a person has this disorder just by looking at their build.
- Don't make fun of someone you think might be suffering from anorexia. Anorexics are often lonely, unhappy and in pain. They can be anxious, depressed or even have suicidal thoughts and shouldn't be criticized - it would only make things worse.
- Do not force an anorexic to eat unless under close medical supervision. He may be very ill and even if he feels physically well from the food he has eaten, the calories he consumes may push him to intensify fasting and exercise, thus aggravating the health problem.
- Keep in mind that if a person suffers from anorexia, it is no one's fault. You don't have to be afraid to admit the problem and you don't have to judge who is affected.
- If you think you or someone you know may be anorexic, talk to a trusted person. Talk to a teacher, counselor, religious figure, or parent. Seek professional help. Help is possible, but you can't get it if you don't face the problem with courage and talk about it.
