The earlier that someone can receive professional support, the better the outcome will be.
The level of intervention that a person with an eating disorder needs depends on their ability to maintain a balanced physical state.
A balanced physical state is where the person is able to maintain their physical health at a level at which they can survive and live reasonably. This includes maintaining their natural weight. Obviously this is hard to determine. Examples of “living reasonably” would be the absence of feeling faint, dizzy, difficulty concentrating, heart palpitations, always feeling cold and shaky. See a doctor if you are concerned with any physical symptoms.
Sometimes an eating disorder is so powerful that it is impossible for the sufferer to make good choices for themselves. Decide whether they can control their own eating on this basis.
If they cannot maintain a balanced physical state, you (or someone) need to take charge of this for them as much as you are able.
If they can maintain a balanced physical state, support them to start challenging the eating disorder and the ways that it impacts on their life, but let them lead this process.
If they cannot maintain a balanced physical state themselves, what should I do?
Ideally the person should be encouraged to make as many choices and decisions as possible (with guidance and encouragement), however depending on their physical state, their age, whether they are living with you and whether you are able, some suggestions are:
- Take them to a professional mental health clinician or GP or go yourself
- Be aware of the symptoms of the eating disorder and know when to seek professional help
- Take control of their eating and exercising routine, but leave them in charge of the rest of their life as much as possible
- Spend quality time with them away from food issues
- Talk with them about the things you can do that will help
- Limit activity according to the amount of food they are eating or keeping down
- Find a way for them to eat – this will be unique to your family/friendship, they may need you to sit with them, or to have specific food (that is less scary to them) at specific times etc
- Do not give them options about whether they eat, but they may have options about what, when and how much, within the limits of safety.
- Do not enter long negotiations about food
- If they are vomiting, make sure they are with someone for at least half an hour after eating; reduce the opportunities for them to vomit or binge
- If they are vomiting or using laxatives challenge this and encourage them to cut down their use of them, with a doctor’s advice.
- Make sure there is food in the house that they like to eat