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The facts about eating disorders Indicators of eating disorders Ways of helping a family member overcome eating disorder The treatment options of eating disorders and professional help The recovery process of eating disorders Support for families Effective family communication Resources for families

Ways of helping a family member overcome eating disorder

When families first realize that a member has developed eating disorders many of them find it difficult to confront the person directly with her / his problems. This can be due to the fear that it will cause an outburst of anger, increase resistance to change, reinforce withdrawal of the person, or stop eating completely. Families need to understand that resistance in acknowledging one's problem is common and it is essential for the families to help the person become aware of her / his eating problems regardless of whether he / she is ready to deal with the condition.

The timing chosen for discussion of the eating problem between you and the involved person is critical. You should choose a moment of privacy free from distraction. It is important for you to show your genuine concern about the problem and your readiness to understand, support and help her / him. Your expression of concerns may be welcome if your timing is right and the person may be ready to acknowledge the problem. However your concerns could be ignored if she / he is not ready for a change and in such a situation you should help her / him to take responsibility for doing something constructive about the problem. You should let her / him know the problem will be discussed later when she / he is ready and you care about her / him though you cannot convince her / him to get help at the present moment. Action should be taken to help the person if the eating disorder develops into a more serious condition, such as severe weight loss or the development of significant physical problems, whether the person is ready to discuss it or not. Professional help should be sought.

Certain skills would be useful when you communicate with a family member with an eating disorder:

Choose a good time and a good place to talk
Try to relax
Use the right tone of voice and posture
Speak in a simple and clear language
Be caring and non-judgmental
Listen to his / her views, don't feel that you have to come up with solutions
Validate his / her feelings
Show respect for his / her feelings
Make empathic statements
Ask questions if you do not understand
Be open and honest about his / her feelings
Learn to feel comfortable expressing negative feelings
Avoid criticism
Avoid power struggles around eating
Avoid comments to do with physical appearance, weight and food which could trigger a dramatic outburst

Living with people with an eating disorder, families will face different day-to-day issues related to their eating behaviour and their mood swings. Please try out the following exercise to identify the appropriate actions for each of the issues. Please click on the options to indicate whether you would agree with the actions.

Helping a beloved family member to take control of eating disorders

Questions	Agree	Disagree
I should sacrifice my social activities and spend most of my time looking after the suffering family member.
Feedback comments It can be unhelpful for both you and your loved one to do this. The best thing you can do is try to normalise family life while caring for the person with an eating disorder. You should still maintain your social activities and enjoy yourself though the suffering family member feels unable to join. Feedback comments It is helpful to normalise family life, maintain your social activities and enjoy yourself though the suffering family member feels unable to join.
My family should adjust our meal times and choose the type of food to eat according to the preference of the family member affected by eating disorders .
Feedback comments This will be very unhelpful in the long run. Accommodating the eating disorder in this way not only disturbs family life but helps maintain the eating disorder. Your family can continue to eat the foods they enjoy and observe their regular mealtimes even though the person with the eating disorder may be unable to join in. Feedback comments It is helpful for your family to continue eating the foods they enjoy and observe their regular mealtimes even though the person with the eating disorder may be unable to join in.
I should keep a record of the food consumed by him/her or ask what she / he has taken as this will remind her / him about maintaining a healthy eating habit .
Feedback comments If the person with the eating disorder is over 18 it will be vital that she/ he takes responsibility for her/ his own recovery with support from family and carers. Generally monitoring her/ his every move and mouthful is unhelpful. During recovery it will be the responsibility of the individual suffering to monitor such things and check her/ his own progress. However families/ carers will need to monitor the eating disorder more generally and do their best to ensure their loved one seeks treatment whenever she/ he needs it. Feedback comments If the person with the eating disorder is over 18 it will be vital that she/ he takes responsibility for her/ his own recovery with support from family and carers. Generally monitoring her/ his every move and mouthful is unhelpful. During recovery it will be the responsibility of the individual suffering to monitor such things and check her/ his own progress. However families/ carers will need to monitor the eating disorder more generally and do their best to ensure their loved one seeks treatment whenever she/ he needs it.

Helping family members with an eating disorder to cope with mealtimes

Questions	Agree	Disagree
I would get angry when he / she refuses to eat .
Feedback comments It is unhealthful to get angry. Calm approach is the best thing taken by you when the suffering family member refuses to eat. However, she/ he can be reminded about the importance of trying to eat something. Feedback comments It is healthful to remain calm. Calm approach is the best thing taken by you when the suffering family member refuses to eat. However, she/ he can be reminded about the importance of trying to eat something.
Conversation during mealtime should focus on eating behaviour.
Feedback comments It is generally unhelpful to do this. Conversation during mealtimes should mainly focus on relaxing or distracting topics. However, if it is part of treatment family members/ carers may need to intermittently encourage or remind the individual to keep attempting to eat. Feedback comments This is generally helpful to avoid such conversation. Conversation during mealtimes should mainly focus on relaxing or distracting topics. However, if it is part of treatment family members/ carers may need to intermittently encourage or remind the individual to keep attempting to eat.
Most of the time I force him / her to eat verbally or physically.
Feedback comments It is wrong for you to agree with this action. Mealtimes could be a battle for people with an eating disorder. You should not force her / him to eat verbally or physically. It would be better to help her / him develop a responsibility for eating properly by overcoming the internal struggle. Feedback comments You are right to disagree with this action. Mealtimes could be a battle for people with an eating disorder. It is appropriate not to force her / him to eat verbally or physically. It would be better to help her / him develop a responsibility for eating properly by overcoming the internal struggle.

Helping your suffering family member to overcome fear

Questions	Agree	Disagree
I should cook large quantities of his / her favorite foods when she / he starts to eat more.
Feedback comments Generally this is not helpful. The person recovering from an eating disorder needs to learn to eat all food types. Large quantities of favorite foods can in some persons trigger binges. Feedback comments Generally this will be helpful not to cook large quantities of his/ her favorite foods. The person recovering from an eating disorder needs to learn to eat all food types. Large quantities of favorite foods can in some persons trigger binges.

Helping the suffering family member to cope with mood swings

Questions	Agree	Disagree
If my family member is upset and has lost control I should not leave him / her alone and should take control of the situation.
Feedback comments Unless your family member poses a risk to herself / himself or others generally this approach is not helpful. Give her/ him time alone to calm down and then afterwards approach her/ him to discuss what happened. Feedback comments Generally it will be helpful to leave the situation if it is out of control unless your family member poses a risk to herself / himself or others. Give her/ him time alone to calm down and then afterwards approach her/ him to discuss what happened.

Aware of the need for firmness and care

Questions	Agree	Disagree
I find it difficult to manage the irrational behaviours of suffering family members in a firm manner.
Feedback comments It is unhealthful to continue this. People with eating disorders could think and behave in an irrational manner at times. For the health benefit of your loved ones, you and your family should be aware of the need for firmness and care in dealing with irrational behavior. Feedback comments People with eating disorders could think and behave in an irrational manner at times. For the health benefit of your loved ones, you and your family should be aware of the need for firmness and care in dealing with irrational behaviour.

Responding to bulimic behaviours

Questions	Agree	Disagree
A bulimic person can be helped to reduce the temptation of bulimic behaviours by using the following strategies:
avoid cooking too much food
avoid buying large packets of snack foods
discourage bingeing at home
discourage the use of laxatives, diuretics or diet pills
require the person to replace the household food eaten during binges at her / his own expense
require the person to clean the bathroom and return it to its original state after vomiting
Feedback comments It would be right to agree with all the strategies as they are all effective to reduce the temptation for bulimic behaviours.

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