15/11/2012 07:10 GMT | Updated 14/01/2013 05:12 GMT

What to do if You Suspect a Friend or Family Member has an Eating Disorder

How do you know if you or a friend has an eating disorder; how and where do you obtain the best help and what should you do?

An eating disorder is a serious illness and of all psychiatric illnesses, it has the highest rate of mortality. If you are concerned that you, a friend or a family member is suffering from an eating disorder it is very important to take this seriously and obtain help as soon as possible. Without the proper treatment an eating disorder could be fatal.

It is important to know that you as a family member or loved one cannot cause an eating disorder. A person with an eating disorder develops this way of "coping" due to a physiological pre-disposition toward an eating disorder, which combined with environmental factors, family dynamics or trauma has resulted in the development of the eating disorder. In other words emotional wounds or difficulties in relationships provide reasons to use unhealthy eating behaviours, but families are not the cause of the disease.

If you have a family member/friend with an eating disorder, you are going to experience a range of emotions from helplessness and loneliness to anger, frustration and despair. You may even become preoccupied with your own or your family's eating behaviours and weight. It is very important to get help for yourself as well, as without proper support it will be difficult to provide the necessary support to your loved one.

How do you know if you or a friend has an eating disorder? There are three main types of eating disorder:

Bulimia: (binging and purging)

1. Binge eating: you may notice the disappearance of food, finding wrappers or containers indicating that large amounts of food have been consumed

2. Purging behaviours: frequent trips to the bathroom after meals, signs/smells of vomiting, finding laxative packages/ diuretic packages

3. Excessive exercise regimes despite weather, injuries or illness. Exercise is used as a means of burning off all calories consumed

4. Unusual swelling of the cheeks or jaw area

5. Calluses on the back of hands and knuckles from self-induced vomiting

6. Discolouration or staining of the teeth

7. Withdrawal from usual activities and friends, often to make space for rituals of binge and purge sessions

8. In general, behaviour and attitude which indicates that weight loss, dieting and control of food are becoming primary concerns

Anorexia: (restricting)

1. Dramatic weight loss

2. Preoccupation with weight, food, calories, fat grams, and dieting

3. Refusal to eat certain foods

4. Frequent comments about feeling "fat" or overweight, despite weight loss

5. Anxiety about gaining weight or being fat

6. Denial of hunger

7. Development of food rituals (eating food in certain order, excessive chewing, re-arranging food on a plate

8. Avoiding mealtimes and using excuses to avoid situations involving food

9. Excessive exercise despite weather, illness, fatigue or injuries

10. Withdrawal from friends and activities

11. In general, behaviour and attitude which indicates that weight loss, dieting and control of food are becoming primary concerns

Binge Eating Disorder (without purging)

1. Evidence of binge eating: disappearance of food, finding wrappers or containers indicating that large amounts of food have been consumed

2. Withdrawal from friends and activities

3. Dramatic weight gain or weight fluctuations

4. Eating large amounts of food when not physically hungry

5. Eating much more rapidly than normal

6. Eating until the point of feeling uncomfortably full

7. Often eating alone because of shame or embarrassment

8. Feelings of depression, disgust, or guilt after eating

What to do

Firstly it is important to remember that no matter how hard it is to watch someone slowly destroying themselves, you cannot save that person alone. You can encourage, support, and provide them with your unconditional love, but they need to save themselves, with the help of specialized professionals or treatment experts.

It would help to educate yourself about eating disorders by reading books, talking to professionals and recovered eating disorder sufferers, or anyone who can provide insight into this very serious illness. After helping your loved one find the appropriate treatment, you can offer love and support without focusing on the eating disorder behaviours.

Your loved one needs to know that you will not abandon them and that you will be there to talk whenever they need you. It is important to remember that eating disorders can be overcome. The recovery may be a long process which may even include relapse, but that with the right treatment and support the illness can be beaten.


In the first instance it is recommended that you go and see your GP. Doctors can assess your physical condition and refer you to available help. Your doctor may refer you to specialist professionals such as psychiatrists, psychologists, dieticians, nutritionists, and counsellors - it may not be possible to access this support via the NHS without seeing a doctor.

Be aware however that in the UK, to access help from the NHS for Anorexia treatment, you need a dangerously low BMI of 13 or below. Yet research shows early recognition and treatment will be easier, less traumatic and is more likely to be successful.

If your doctor is unable to provide help, other options do exist. Should you live in the Greater London area, there are several Day Care Centres which have well-earned reputations for a thorough, ethical approach. These Centres offer focused, flexible and effective day care at competitive rates and can assess and recommend treatment for children and adults with eating disorders and their families.

It is also recommended that you seek out support from one of the UK charities which help with eating disorders provides helplines, online support and a network of UK-wide self-help groups to help adults and young people in the UK overcome their eating disorders.

Facing and dealing successfully with a severe eating disorder is one of the most difficult and challenging things that many people face in their life.

Many anorexics do not even want to get well and normally it is because of a family intervention that they obtain help at all. Therefore it is important to find the treatment and support which works for you or your loved one; treatment which offers good family support program is very important to recovery.

Eating disorder conditions are multi-faceted and are frequently long-standing. Family dynamics and relationships typically play a major role in the development and continuation of eating disorders. For this and other reasons, the treatment of people suffering from these conditions needs to be thorough and detailed in order to be successful. Short treatment periods in general have less successful outcomes than do extended treatment periods and accordingly longer term residential treatment may be an option.

An option for longer term residential treatment care is Montrose Manor in Cape Town, South Africa, a world renowned eating disorder treatment centre with a proven track record.

Treatment at Montrose Manor is differentiated because it is less institutional than a standard primary in-patient facility making it the ideal setting for extended care. For adults over 18 years of age and a BMI of 16.5 and over, Montrose offers a programme that completes three phases of treatment. This typically involves a stay of three months at Montrose Manor. The initial phase is devoted to the stabilisation of disordered eating and is followed by phase two which addresses the underlying issues and emotions which surface once eating is stabilised. The final phase of treatment focuses specifically on beginning the reintegration process and ends with a handover to a specialist who will continue to work with the client upon their return home.

Helpful Links:

NHS Online

Eating disorder charity

Montrose Manor Treatment Centre ;