Eating disorders - getting help

Eating disorders are complex conditions - and recovery can be just as complex. It's not as simple as encouraging someone with anorexia to gain weight or forcibly preventing someone with bulimia from vomiting. First, the person with the eating disorder has to accept that there is a problem, and want to make changes.

Experts stress that it's vital for parents and other supporters to try to understand the complicated thought process behind the disorder. Mary George from beat explains: "[On one hand] they are desperate to break free and determined to seek help. [On] the other, the prospect of living without the disorder fills them with terror. So, in a matter of minutes your child could flit from wanting help to rejecting it.

"Eating disorders can have such a powerful influence that they refer to their disorder having a 'voice'. The voice can be harsh, critical, demanding, persuasive and extremely persistent; it is very real and very frightening. And it is particularly loud when parents and healthcare professionals threaten it."

It's equally important to remember that your child did not choose to become unwell or intend to worry you so much. "Just be there for them," adds Mary. "If you can listen and support in a non-judgemental way your child will learn to trust both you and the support you are giving. You can't beat their eating disorder for them but you can provide them with the encouragement and support they need. Recovery is always possible," says beat. With the right treatment and the right support, disorders can be beaten and your child can be well again."

Getting help to beat eating disorders

The sooner someone gets help, the better their chances of a quick recovery, says beat. "Don't wait too long to offer support and help - act on the first sign of distress," adds Mary George. If you suspect something is wrong, talk to your child. Choose a good time - (avoid mealtimes and interruptions from others) - and stay calm. Try to 'voice concerns' rather than having an out-and-out confrontation. In fact, in your initial chat, you don't even need to mention eating disorders. Simply let your child know that you are worried about their physical and emotional health.

Whatever reaction you get - anger, disbelief, shock, amusement, denial, relief or even complete silence - you've made a start. You may need to accept that your child isn't ready to admit to a problem yet. But let them know they can come to you when they are ready. In the meantime, gather information and research. Make an appointment with your GP - even if your child refuses to attend with you or admit there is a problem. Your GP may be able to help your child recognise that they need help.

Make a note of your main concerns and specific questions you want to ask, beforehand. Any child under 14 should be accompanied by a parent when visiting the GP. But if they specifically want to be treated alone, that confidentiality has to be respected. A child reluctant to talk to a GP might confide in a practice nurse or health visitor. But the GP will need to become involved eventually. Following an examination (which can include questions, being weighed and blood tests), your GP can make a diagnosis and referral for treatment - usually as an out-patient, close to home, in age-appropriate facilities. However, if your child is very ill or has a very low weight, hospital treatment may be needed.

Tips to help you deal with your child's eating disorder

  • Don't offer bribes to encourage your child to eat or not binge. "Treats and shared activities are an important part of normal family life but they will not make your child's illness disappear," says beat’s Mary George. Teenagers will sense their parents’ desperation and play on it, but they cannot recover to order."
  • Keep normal family routines: for example, pocket money, hobbies, spending time together.
  • Try not to blame yourself for your child's disorder. Accept that you may never know what triggered it. Simply accept that your child has an illness and focus on recovery.
  • Work together as a family. Your child needs consistency and you need to prepare yourself for the fact that the eating disorder may lead them to lie about their behaviour or try to manipulate others.
  • There may be temper tantrums, accusations, resentment. Try to avoid falling into the 'good cop', bad cop scenario with your partner (one of you being lenient and the other strict).
  • Avoid unnecessary comments about food, appearance or weight. Ask open questions like: 'How are you feeling?' or 'How's your day been?' rather than closed, confrontational questions like: 'What did you eat for lunch?' or 'Have you just made yourself sick?'
  • Find out as much as you can about eating disorders. This will help you to understand your child’s behaviour, feelings and mood swings - and accept that there are certain aspects of the illness that will seem illogical and hard to understand. For example, your child may insist they are fat when, in fact, they are severely underweight. You do not have to agree with them - but try to accept that this is what they feel and believe.
  • Carry on eating normally as a family. It's important that your child sees you and the family enjoying food and normal helpings.
  • Keep including your child in family activities and social arrangements (even if they don't join in) and try to build up their self esteem.
  • Keep telling your child that you love them.

The four stages of recovery

"There is no quick fix that we know of, no magic wand, and no miracle cure," says beat's Mary George. "Recovering from an eating disorder is not like getting over a cold. You will have ups and down but these are part of the process." Experts have pinpointed four vital stages that sufferers need to work through.

Stages of recovery

Stage 1: Pre-contemplation: denying that there is a problem.

Stage 2: Contemplation: recognising the damage the eating disorder is doing but being daunted by the thought of change. They are literally in two minds about whether they want to recover or not.

Stage 3: Determination and action:  ready to accept help, and begin working towards recovery.

Stage 4: Maintenance: this is the most challenging stage of all as your child has to learn to manage life without their old coping strategy.

Recovery is a process, not an event. Moving from one stage to another can take a long time and your child may have to go through some or even all of these stages several times before recovering fully. "You cannot hurry or force your child through any of these stages," says Mary. "However, they do need to feel supported and strengthened by your love, encouragement and understanding."

One family's experience - Henrietta and Vanessa

Event organiser and mum of three Veronica Kamerling, 62, of Hook, Hampshire, runs beat’s London Carers' Group (which meets on the third Thursday of every month in Central London. For details on this and other groups log onto www.londoncarersgroup.org.uk). Veronica's two daughters, Henrietta, now 31, and Vanessa, 29 both dealt with from eating disorders. She says: "I remember, as if it was yesterday, that Christmas when Vanessa turned 14. She's always been slim, but I was shocked at how incredibly thin she'd become - almost overnight. With her loose-fitting school jumper on, it just hadn't been that obvious. I also hadn't spotted any noticeable change in her eating habits. We're a busy family and, with juggling work and family, we never got to eat together very often. I'd prepare meals for Vanessa, and her older brother and sister, as I was often working in the evening. 

"But when term finished, and she was back in her ordinary clothes, I was shocked at how skinny she was. When we went out for dinner, to celebrate my birthday, a few days before Christmas, I watched her like a hawk. Sure enough, she spent the evening picking at lettuce leaves and eating very little. When I spoke to her afterwards, she admitted immediately that she was ill. She'd been skipping lunch at school and hardly touching meals at home. After I rang my GP and asked for help, she was admitted to a paediatric unit. I now know this treatment is completely inappropriate as they have no idea how to cope with such a complex illness. 

"Finally, she was admitted to Rhodes Farm, in North London, a clinic which specialises in anorexia. Gaining weight is only half of the recovery. Vanessa also embarked on counselling sessions with a psychiatrist. An eating disorder is a way of a person presenting to the world that they are not happy. So you have to try and discover what lies behind it, what the real problem is - and this is where good treatment and aftercare is vital. Vanessa underwent three years of brilliant aftercare with a psychologist from the clinic - with weekly, then monthly sessions - and it was this which helped her get better. "Over time, she learned to manage her eating disorder and would know what to do whenever she felt she was starting to slip. 

"Henrietta's bulimia, diagnosed when she was 16, was twice as grim to deal with. In fact, to look at her you would never even have known she was ill. But after dealing with Vanessa I just knew something was wrong. It turns out she was a laxative abuser. She also suffered terrible bouts of depression and would hide herself up in her room for days. Again, it was a relief when she admitted she needed help. But recovery was a long, slow process. Three years after being diagnosed Henrietta tried to kill herself by taking a massive overdose of laxatives. Paramedics had to break down the door and doctors said she was incredibly lucky to have survived. Over time, she suffered endless health problems as a result of the disorder. A lot of her lovely thick hair fell out and has never fully grown back. 

"We tried lots of alternative and out-patient treatments. Eventually, she had two spells of treatment as an inpatient at a private clinic, combined with counselling on the NHS. It took 12 years for Henrietta to learn to manage her disorder. Even now, she still suffers health problems and she still gets more down periods than Vanessa. Thankfully, both girls are settled and happy, with good jobs and a wide circle of friends. Henrietta has even helped me give lectures and workshops on eating disorders to raise awareness. 

"During the course of recovery you may discover things you don't like but you have to be honest with yourself. I've discovered that the girls were affected enormously by my divorce. Also, because Vanessa was born with serious health problems which required four major operations over 20 years, Henrietta felt that she was pushed to one side - and I have to admit she was probably right. But I’m also convinced that there is a genetic predisposition to addictive behaviour in our family. 

"Eating disorders can quickly take an iron grip - so parents need to be pro-active and seek help as soon as they suspect there is something wrong. Ring your doctor, gather as much information as you can, join a support group, find out what help is available. Doing nothing is not an option. More than anything, it's vital that you remain positive. Yes, people do die from eating disorders but lots do recover and that’s what you need to focus on. The whole process was ghastly and I’m the first to admit that these past years have been a nightmare. But we've also learned a great deal and, as a result, we are incredibly close and devoted to each other."

Where to get help:

Call beat on 0870 770 3256 or log onto www.b-eat.co.uk. Leaflets and information are available to download.

Helpline for adults: 0845 634 1414 (Monday-Friday 10.30am-8.30pm, Saturdays 
1.00pm-4.30pm)
Email: help@b-eat.com

Help for young people: Youthline 0845 634 7650 (Monday-Friday 4.30pm to
10.30pm, Saturday 1pm to 4.30pm)
Email FYP@b-eat.co.uk or text 07786 201820

Suggested reading: Eating Disorders: Helping Your Child Recover, published by beat, £15
(www.b-eat.co.uk/Shop/Bookshop)


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