everybody's grand

‘Just eat more.’

‘Why are you doing this? Why won’t you eat? (followed by 200 more questions starting with why.)

‘You’re not trying hard enough.’

and my personal fave:

‘You obviously don’t take your problem seriously if you aren’t better by now.’

Yep, all of these things were said to me during my recovery. The first three came from the mouths of ‘professionals’ while the last one was from a former friend. I  don’t think you need to suffer from an eating disorder to know that these comments were not helpful. I was struggling with a mental illness. I didn’t choose to have it and I certainly did not try to keep it going but for quite a while, the battle between myself and the voice of the disorder was one that I could not win. Yet for some reason, people were speaking to me as if I could just flip a switch and get better, just like that. You wouldn’t ask a person with cancer to just ‘try harder’ would you?

At the time and for a long time, thinking about the people who made these comments made me angry, particularly as many of these people were being paid for their so-called expertise and advice. However, now that I look back on their approaches, I can understand them a bit more. Most of these people probably had my best interests at heart but when you have never had an eating disorder yourself, how the hell are you meant to understand one? To someone on the outside, controlling and restricting food and obsessing over calories, weight and exercise to such a degree that it makes you unwell and unhappy seems illogical. It appears to be a choice, even though it is not.

I have had a few friends say to me over the last few weeks that they never knew how to approach me on the issue and so, they said nothing at all. They said that they feel guilty about this. I have had others tell me that they know people going through an eating disorder but they ‘don’t know what to say’. They don’t want to upset them. My friends, don’t feel guilty or worry about saying the wrong things (or not saying them at all). Your silent support and the odd few drunken words of concern mean more than you know.

This post is aimed at those who do feel they want to approach somebody with an eating disorder but don’t know how to go about it. Now, I am as much a medical professional as Dr. Seuss (who was a legend by the way) but I feel that my own personal experience may be of use when it comes to this matter. This is going to be a long post so get the cup of tea and the comfy reclining chair ready! I know I have.

So, first thing’s first. How do you know if somebody has an eating disorder? Nowadays, there is a huge focus around healthy eating and working out and young people in particular seem to have caught the health  bug. I think that an awareness around healthy living and eating is fantastic and it is great to see people of all ages taking an interest in their well-being. If your friend, child or family member has adopted a “healthier diet” and an exercise routine, don’t immediately presume they are slipping into an eating disorder.  It is likely that they are not. However, there are a few things that may indicate a problem:

• Preoccupation with food: If the person is obsessively preparing foods in a particular way, reading nutrition labels on products and spending time reading about food, this could be a warning sign. There is no problem in having an interest in food and reading labels but when it takes up a large proportion of a person’s time, it is not healthy.
• Anxiety around certain foods: My mum has said to me a few times that she recalls the moment when she realised just how serious my problem was. It was a hot summer’s day and I was about 17. Mum went to the shop to buy food and returned with a strawberry milkshake for me. ‘Nice one!’, you say. ‘What a great surprise,’ you say. That is what a person sans eating disorder would think. For me, this milkshake was bloody terrifying. First of all, it was about the size of my head. Secondly, it was something I hadn’t planned and planning my daily food intake, as minimal as it was, was a big thing for me during the height of my eating disorder. And thirdly, something like a milkshake was a forbidden food for me. Everything I had read and heard said it was ‘unhealthy’ and ‘high in calories’ so I had to avoid it at all costs. (What I read and heard was bulls##t by the way. The only healthy diet is one that includes everything in moderation. It’s certainly not healthy to worry too much over certain foods). So anyway, though I felt that big ball of swelling anxiety in my empty tum, I didn’t let it show at first. I calmly refused it and said that I wasn’t hungry. When mum gently tried to encourage me that it would be good for me to have, well, all hell broke loose. I shouted, I screamed, I threw a tantrum and eventually, I cried. We were in our mobile home  at the time which is not very soundproof. I can only imagine what the neighbours thought!  After a long argument and plenty of protest, Mum eventually persuaded me to have that milkshake. She knew that it was the eating disorder fighting it. She knew that my body really needed the calories. I drank that god-damn milkshake, still crying mind you. And it was one  of the hardest things I ever had to do.                                                                   My little anecdote has a point. If a person is fearful of eating certain foods, it is not really normal. Unless you have a deadly allergy to something of course. It is ok to just not enjoy certain foods and that is fine. But I always liked strawberry milkshakes and mum knew that.
• Restricting food intake: This one is fairly self-explanatory. If the person suddenly starts eating less and less, keep an eye on them.
• Avoiding social occasions: Eating disorders are not simply a ‘diet gone wrong’. The reasons behind them are not all food and weight related and so, neither are the symptoms. However, controlling food and weight is used as a mechanism to cope with other problems and when the person with the ED use this, it can be terrifying. Of course, it can be hard to control your food intake when the cooking is out of your hands. With this in mind, a person with an eating disorder may make excuses to go out with friends or family, particularly if there is going to be food and drink involved. Other times, they might avoid social occasions because they feel ugly or worthless and don’t want to be seen. Anxiety is also a problem that I think many people with eating disorders can suffer from and this is fuelled by the lack of nutrients they are getting into their bodies. So, large social occasions can prove to be quite a big issue for somebody suffering. Finally, exercise and disordered eating often go hand in hand. A person with an eating disorder may pass on social occasions if it clashes with their planned workout. Which leads me on to my next point…
• Overexercise: There’s nothing wrong with hitting the gym or going for a jog in the fresh air. However, people with eating disorders are often perfectionists and so, they tend to take the exercise thing a step too far (Ho ho, great pun ;)). I walked 40 mins to the gym in the rain and hail so that I could go to an exercise class. I woke up at crazy o’clock to fit in workouts. I went for walks with my parents and got angry because they didn’t walk fast enough (Sorry guys!) I took up hobbies I didn’t enjoy just because they concerned exercise. Worst of all, I remember being sick with a dose and I still went to the gym. I went home halfway through as I felt like I was going to faint, lay down for a while, felt guilty and went back to continue where I left off. Head banging, nose blocked up, back aching. There’s nothing healthy about any of that behaviour. Exercise should be enjoyed and one should certainly not feel guilty for having a rest, especially when it is needed.
• Lack of interest in things you once enjoyed: Having an eating disorder is a full-time job. Seriously. If somebody paid me for the time and energy I put into it, I would currently be in Hawaii in a gold-plated jacuzzi asking my butler Maleko to get me another glass of prosecco. But alas, this is not that case.                                                         I I spent so much time reading about food and exercise, carefully preparing foods and weighing myself that I had little time for much else. It became my sole preoccupation. I lost interest in a lot of things that I once enjoyed. Reading, making things, watching movies, the list goes on. If food and exercise becomes a person’s only interest in life, then there is likely to be an issue there. This is perhaps one of the saddest parts of an eating disorder in my opinion. I struggled with it at quite a young age and this was when I should have been discovering what I enjoyed in life. Yet, for quite a while, I literally had no interest in anything. It actually was not until more recent years that I began to rediscover what I am interested in.
• Lying and being secretive: I don’t want to say that I lied a lot when I was suffering from an eating disorder. Sure, lies came out of my mouth but this was the eating disorder’s influence and I couldn’t help it. So, don’t blame me! The lies would only be used to get out of eating certain things so they could include: ‘I feel sick tonight so I don’t want dinner’, ‘I am allergic to X’, ‘I ate my lunch in school’, ‘I’m not hungry’ and ‘I don’t like that food. I never liked it.’
• Physical symptoms: These are probably the most noticeable and most discussed signs but they are not always present. A person with bulimia for example may not show any signs of weight loss at all. In fact, weight loss isn’t even necessary for somebody to have an eating disorder (disordered eating is a problem whether it causes weight loss or not) but obviously, it is a common feature. Other physical symptoms include: hair loss, extreme sensitivity to cold, dry and scaly skin, heart palpitations, headaches, digestion problems,  tooth decay, constipation and for the ladies, loss of period. Even more serious side effects are fainting, early osteoporosis, organ failure and even death.                                                                                                                          I always tried to blame any of my health problems on other things but it always came back to my eating disorder.
• Other unhealthy behaviour: This can include abusing laxatives, constantly weighing self, self-induced vomiting etc.

I guess I’ll throw in some advice from the professionals before I move on with the post. Back in February, I spoke with Dr. Terence Larkin who is a Consultant Psychiatrist involved in Eating Disorder Recovery at St. John of Gods Hospital. I asked him how somebody can distinguish between an eating disorder and a healthy change in lifestyle.

‘The danger of the information in the media nowadays is that families can overreact. I think parents have to be careful. Only if it seems that the person is becoming more obsessed should they be worried,’ he said.

Dr Larkin went on to say that most people try to lose a few pounds at some stage in their lives, adding that: ‘Most who try to lose weight give up after a while. For people with an eating disorder, it is never enough.’

Harriet Parsons from Bodywhys also chimed in by saying:

‘Signs include a marked change in personality. A person becoming low in themselves, becoming inward-looking, not engaging in their life in the same way. You may notice changes in eating behaviours such as skipping meals, not eating with the family, avoiding communal eating and maybe changes in weight.’

Finally, I spoke to Jacqueline Campion from the Marino Therapy Centre who said:

‘This is about value and worth. What I would recommend worried people to look at is where their loved ones put their value and worth. If there is a lot more going into the physical, that’s ten percent of the total self. If they’re saying “I can’t meet with a friend because I have to go to the gym”, that’s a major warning sign.’

So, if you have gotten this far in my post and are still worried about a loved one, keep on reading. I’ll try to explain what I feel is the best way to approach somebody and how to work with them during recovery rather than against them.

• DO NOT FOCUS ON FOOD AND WEIGHT!: I can’t stress this one enough. An eating disorder is not an extreme diet and it’s not solely about weight loss. It is a person’s way of coping with something difficult in their life, be it low self-esteem, stress, a traumatic event, whatever. Some people find that walks in the countryside help them with stress or difficulties. Others enjoy reading or taking a bath. People with eating disorders use control over food and weight as their crutch when they are struggling with something in life. So a good approach is gently asking somebody how they are feeling. Say that you are worried about them as they aren’t acting themselves. Ask them whether there is anything they want to talk about. You may not get a response at first but if not, try it again another time. Keep that line of communication open. The person will hopefully eventually open up. If you start by focusing on food and saying ‘you have lost a lot of weight’ or ‘you have to eat’ the person will only move closer to their eating disorder. I know this is probably the natural approach for those who are worried but trust me, it’s not the right one.
• Don’t place blame on the person: A person with an eating disorder does not choose to have it. Therefore, they can not choose to un-have it. Don’t tell them that they should be eating more or that they have to gain weight. Blame is helpful to nobody in recovery. Blame only causes a rift between you and your loved one. This is not meant to be a battle between you and them. Support your loved one and gain their trust so that it a case of the two of you vs. the eating disorder rather you vs. the person and their eating disorder.
• Don’t blame yourself: This can be a problem for parents in particular. It is not your fault that this person has developed an eating disorder. Again, blame is helpful to nobody. I can’t stress that enough.
• Try to encourage them to seek professional help: With any illness, it is always helpful to work alongside a person who has some experience in dealing with the issue. This is also helpful as the person will not have a personal connection with the sufferer so they will have a good objective viewpoint. If your loved one agrees to see someone, they might not click with the first doctor/ therapist they meet. I know I had to go through a lot of people before I found the ones who I could trust and work with. If the first attempt doesn’t help, move on and find somebody else. On this note, I think it is important for a person to have a rounded approach to recovery. Just seeing a dietician may help somebody to return to a healthier weight but it may not address the underlying issues that led to the eating disorder in the first place. The danger of this is that it will be easier for a person to relapse in future. Nutritional and psychological help are key.
• A bit of tough love goes a long way: While I did say to approach the person gently, the time may come when you have to be a little more firm. If a person’s health is truly at risk, you may have to take it upon yourself to bring them somewhere for help. This may cause the person to argue with you and become frustrated but try to remember that this is their eating disorder talking. Sometimes, when somebody is very ill, they do not know what is best for themselves. Tell them that ‘we are going to see this doctor’ but don’t make it appear to be a threat or battle. Walk by their side.
• Try to have patience: Don’t expect change to happen overnight. This is a long, long road of recovery and it really is a matter of baby steps. There will be a lot of setbacks. If a person has  acknowledged their problem and taken on the commitment to recover, it is important that you highlight every positive step they take, no matter how small they are. People with eating disorders tend to be perfectionists so telling them that they are not trying hard enough or that they are not moving fast enough will only make them think one thing: ‘I am not good enough at recovery.’ And if they feel that they aren’t good enough at recovery, there is a danger that they will turn back to what they know they are good at i.e. controlling food and weight.
• Expect setbacks: Everyone and I mean EVERYONE relapses at some stage in recovery. Don’t let this upset you or them. If your loved one falls, pick them back up and move forward.
• Distinguish between your loved one and the eating disorder: An eating disorder is an illness. Your loved one is still the same person. If they lash out at you or are not acting the way they once did, try not to get annoyed or upset with them. The power of the eating disorder is controlling their thoughts and actions but with a lot of time and work, it won’t be there forever.
• Have fun!: Experiencing and recovering from an eating disorder is a very tough and draining process. Life can seem a bit heavy at times. If your loved one has the time and energy, try to encourage them to do nice things that will take their mind off it, be it going on a trip, watching a movie, whatever. It is really important for them to find the joy in life again.
• Educate yourself: There is so much literature and support out there for people caring for those with an eating disorder. My blog is one of them 😉 Bodywhys also have online and in-person services, many of which are free. Also check your local library for books on the issue. It is important that you know what you are dealing with.
• Realise that full recovery is possible (and encourage your loved one that this is true too): For a long time, I didn’t want to get better. Not that I didn’t want to but I guess, I didn’t realise I had a problem. Once I did and started working on recovery, I wondered if things would ever improve. The future looked bleak and I often became disheartened by the whole thing. I was told by many ‘professionals’ that the eating disorder was something that I would always have and I just had to learn to live with it and manage it. I know I am not the only one with an ED who has been told this. This made me feel even more miserable! Why work so hard on getting better if you were still going to be half sick? I wasn’t born with my eating disorder. Nobody is. We can get better and while I still struggle with certain things, I have found less destructive ways to cope with the difficulties of life. We can all get to a stage where we accept ourselves, where we don’t have to fear the return of our eating disorder. I know this as I have met many people who have come out on the other side. I know this because I am not too far from crossing that finish line;)

Pheewwwww that was a long post! It is over a third the length of my college dissertation and took me over two hours to do so I hope it helps. As a mentioned, I am not a professional (though, I hope that one day I can be!) but hopefully my insight is valuable to some of you. Sometimes life experience is better than the textbook advice anyway. Feel free to fire any questions my way 🙂