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HealthInfo Canterbury

Family & friends' FAQs about eating disorders

How do I approach someone who has an eating disorder?

An eating disorder is an illness that affects a person's thinking and behaviour – it isn't consciously difficult behaviour to gain attention or control others. So you should approach a person with an eating disorder with concern and compassion.

Eating disorders, like other illnesses, can make other people feel awkward or afraid. It's always appropriate to try to understand what's happening to the person suffering from an eating disorder and to offer to be involved in helping towards recovery.

Pretending that nothing is wrong or ignoring behaviours that promote the eating disorder are unlikely to help.

How much you become involved in helping a person who has an eating disorder depends upon your relationship with them. Obviously if they're a family member you're likely to be deeply concerned and involved in helping them recover. In other situations, asking "what would I want this person to do to help me if the situation was reversed?" is a useful guide.

If you're worried about a colleague, ask yourself "Would I ask about this person's health if they had a serious physical illness, such as cancer?" If the answer is yes, then approach them about the problem. If their illness creates a managerial or performance issue you should discuss this frankly and ask for a medical opinion if this is appropriate.

Is it safe to let my child exercise?

First, you should get a health professional such as a GP or a dietitian to confirm that your child is underweight. Then agree on a plan to restore their body weight to normal. This should be guided by a health professional, never by a coach or instructor.

Once you know there are no medical reasons why your child is underweight, you'll need to adjust their energy balance. This will mean extra food to compensate for any exercise or sport they do. If a child (or indeed an adult) is underweight and isn't recovering to a healthy weight, exercise or sport isn't appropriate until they start gaining weight.

Some sports are notorious for encouraging girls to maintain body weights far below their healthy range. You can't rely on those involved in these sports to act in your child's best overall interests. Any concerns you have about your child's health, including their weight, should be managed by independent health professionals such as GPs and dietitians.

The GP said not to worry, what should I do?

It's very easy to underestimate how bad an eating disorder is, especially if you only have a snapshot of a person. Families will often have a deeper awareness of what's going on. You must be prepared to watch and review the situation over time and to tell the GP what's happening. You might need to visit the GP more than once to point out changes in eating, exercise patterns, behaviour, and weight.

If you're worried about your child having an eating disorder, ask your GP to review the situation after some time and to compare physical measurements such as weight, height, and blood tests. However, a child or teen who only eats a very small range of food, and may have ARFID, may still be a normal weight and height, even though they aren't getting enough nutrients to be healthy.

If you're still concerned, ask your GP to refer your child for a second opinion or to a specialised eating disorders service.

What if someone with an eating disorder doesn't want help?

It's normal for someone with an eating disorder to appear to not want help, refuse offers of help, and even not see why they need treatment.

Sometimes a part of them does want help, but is afraid of treatment or recovery and especially of giving up control to others. They may mistrust the motives of others, including health professionals. They'll need reassurance that others understand their dilemma but are concerned about them. This can be very difficult for those who love and care about them. You may feel anger, frustration, or despair, which can make it even harder to relate to the person.

Often supporting someone with an eating disorder means repeatedly challenging or confronting them, and that can strain the relationship. But this may be what they need to become healthy again.

When a person with an eating disorder appears physically unwell, is eating such a limited range of food that their health suffers, is losing weight rapidly, or has almost completely stopped eating and drinking, it's important to seek advice from a health professional. The earlier they get treatment, the better the outcome will be.

In the short term, it may be necessary to treat them in hospital against their will, using the Mental Health Act.

Written by the South Island Eating Disorders Service, Canterbury DHB. Adapted by HealthInfo clinical advisers. Last reviewed December 2017.

See also:

Children of parents with a mental illness or addiction


Page reference: 76411

Review key: HIEDI-73561