|Guidelines for Others When a Loved One is in Treatment
Aside from the suggestions for approaching and talking to a person with an eating disorder, there are additional considerations listed below for parents or significant others who live with and/or love someone who is in treatment for an eating disorder. Remember that each case is unique and warrants special individualized attention. The guidelines listed should be discussed and followed with the assistance of professional help.
Be Patient. There Are No Quick Solutions. Eating disorder treatment is lengthy and full recovery usually takes several years. Even if you are aware of this you may still be inclined to think that your loved one should be doing it faster and more progress should be made. Long-term thinking is necessary.
Avoid Power Struggles. As much as possible find alternatives to power struggles, especially when it comes to eating and to weight. Don't make mealtimes or eating a battle of the wills. Don't try to force or restrict eating. If your child is an adolescent you may be able to help in this area but do this with professional assistance from an eating disorder expert. Leave these issues up to the therapist or other treating professional unless your involvement is discussed and requested.
Avoid Blaming Or Demanding. Don't try to find causes or someone to blame for the eating disorder and don't plead or demand that your loved one stop. Neither of these will help; they will only serve to oversimplify the situation and will cause even more shame and guilt. It is easy for your loved one to feel responsible for your or anyone else's feelings. You can help prevent this by avoiding blame or making demands.
Don't Ask Your Loved One How You Can Help. Ask A Professional. Your loved one will not know how you can help and may feel worse if you ask. A professional is in a better position to give you advice.
Deal With Feelings Of All Family Members. The family members are often the forgotten victims, especially other children. They need to talk about their feelings. It doesn't help to keep feelings bottled up inside, therefore it is useful for all family members to express themselves in journals, letters, or verbally as a way of getting their feelings out and communicating.
Show Affection And Appreciation Verbally And Physically. A little unconditional love goes a long way. There are many ways to show affection and support besides talking, for example hugging a lot or spending special time together.
Do Not Comment About Weight And Looks. Avoid making appearance a big focus. Don't comment about other people's looks. Physical appearance has become too important in our society and especially in the eating disordered person's life. It is best to stay away from the topic of weight altogether. It is a trap to answer questions like, "Do I look fat?" If you say no, you won't be believed and if you say yes or even hesitate for a moment, your reaction will be an excuse to engage in eating disorder behavior. Telling someone with anorexia they look emaciated is a mistake because chances are he/she wants to hear that. Telling someone with bulimia she looks good on a particular day may reinforce her binge/purge behaviors if she believes these behaviors are responsible for the compliment.
Do Not Use Bribes, Rewards, Or Punishments To Control Your Loved One's Eating Behavior. Bribing, if it works at all, is only temporary and postpones the person learning to deal with internal means of controlling her behaviors.
Don't Go Unreasonably Out Of Your Way To Purchase Or Prepare Special Foods. It is fine to help out by buying foods your loved one likes and feels safe eating,... to a point. Don't drive all the way to the frozen yogurt store because that is all the person will eat. Don't be pushed into any special treatment by the threat that, "I won't eat unless....." If a person refuses to eat unless very strict circumstances are adhered to then they may ultimately need inpatient treatment. Giving in to their every whim will only postpone the inevitable.
Do Not Monitor Someone Else's Behavior For Them, Even When Asked. Do not become the food or bathroom police. Often loved ones will ask you to stop them if you see them eating too much or tell them when you see they have gained too much weight. They may seek your praise for the amount of food they are eating. Monitoring behaviors may work for a short time but often ends up backfiring in the end. With adolescents, parents may work with a professional who helps them be an active part of the treatment and the monitoring.
Don't Allow Your Loved One To Dominate The Rest Of The Family's Eating Patterns. While nurturing others, individuals with eating disorders deny their own need of food. As much as possible the family's normal eating patterns should be maintained unless they also are in need of altering. Don't let the person with the eating disorder shop, cook for, or feed the family unless she/he also eats the items bought, prepared, and served.
Accept Your Limitations. Accepting your feelings and your limitations means learning to set rules or say "No" in a caring and reasonable but firm and consistent manner. For example, you may have to discuss cleaning the bathroom, limiting the amount of food your loved one goes through, or charging him /her for binged food. You may have to tell your loved one that you can't always be there when she/he needs to talk and that calling you at work is not acceptable. You may want to establish rules that laxatives or ipecac syrup aren't allowed in the house. If the illness progresses you may have to add many more rules and re-evaluate your own limitations. Do not get over-involved and try to become a substitute for professional care. Eating disorders are very complicated and difficult to treat; getting professional help is necessary.