I am 1 of 11 million victims. The majority of us do not want help. We think we are healthy and doing fine. How does not wanting to gain weight put my life at risk? That should be helping me live a longer, healthier, happier life. But for us, it's a different story. We go to the extreme to do anything we can to lose weight. We can't help it. In our eyes, we are fat and ugly. We are actually pathologically terrified of gaining weight and being fat. Along with this fear comes refusing to eat sometimes, binge eating at others, having poor self esteem, fainting regularly, compulsive exercising and taking laxatives or diet pills.
I suffer from anorexia nervosa. This is a very serious, psychological disease. But I am not like the majority of my fellow victims. I know I have a problem. I don't want to feel this way or do those things anymore. I know they are harmful and could eventually kill me. Luckily, like many other diseases, there is cute. I need help to become healthy again. But I can not do it on my own. I need a support system, a friend. How can you be that friend to a victim of anorexia nervosa?
It might first be important to realize who can be a friend. The answer is anyone can be a friend: family, siblings, significant others, teachers, coachers, doctors, co-workers, bosses. It is not one person’s responsibility to take action. It can be any of the above.
There are many things that involve being a good friend, but first, you need to understand what anorexia is: It is an eating disorder. It is psychological. It involves a fear of food and gaining weight. It requires treatment. Individuals who develop anorexia will go to extremes to get to a dangerously low body weight. They become obsessed with seeing the numbers on the scale drop.
Anorexia is most common in girls and women specifically between the ages of 13 and 25. It is commonly thought that anorexia and eating disorders only happen in women. But this is not true! From the 8 million of people that suffer from eating disorders in the United States, it is estimated that 10% of those people are men. The number is probably much higher than that, but since men are typically thought to be strong and brave many victims do not get the treatment they need. Also, they could be embarrassed because anorexia, bulimia, and other eating disorders are usually attributed to women. The fact is that the number of men with eating disorders is increasing.
There are certain factors that will make a man more susceptible to developing an eating disorder. They include being overweight as a child, being involved in sorts that require thinness, cultural expectations among some homosexuals, and professions such as modeling or acting. The same as with women, unsuccessful dieting is a primary trigger to developing an eating disorder. Unfortunately, treatment is less available for men. But, the same organizations, hotlines, and websites can help men also. Just as with women, recovery is a long process. It might even be longer in men because of the availability of treatment and the shame to admit the problem.
There are two types of anorexia. The first type, a restricting type, loses weight through restricting calories. These individuals follow drastic diets, fast and excessive exercise. But it might be difficult to tell the difference from dieting and being anorexic. There are certain signs to look for if you are concerned that your friend might be developing a problem. The second type, a purging type, gets rid of the calories they have consumed through throwing up or using laxatives.
If you suspect your friend might have a problem, the first thing to do would be to talk in private with that friend. Don't accuse them or embarrass them. By being accusatory, you will just upset your friend and turn them away from you. Make it obvious that you care a lot about them and are just worried, but you are there to be supportive. Listen to everything they have to say. There is a good chance they will deny having a problem. This is normal. Victims of eating disorders are very private about their feelings and do not easily share. Just remember to be patient.
If your friend will not admit that she has a problem, that makes helping much more difficult. Anorexics feel in control and successful when they become thin. They do not want to lose that sense of control by admitting their disorder. When friends continuing to admit their problem and your concerns increase, you should talk to your parents or their parents. Something needs to be done before it gets worse. By doing this, you might feel like you are betraying your friend, but you are only doing it because you care for them.
For friends that will willingly accept help, offering to go with them to see a doctor, dietician, or counselor would be the next best thing to do. Also, it would be helpful to do your own research and look into the different kinds of eating disorders. This can only make you more supportive and understanding towards your friend. You also might find organizations, websites, or hotlines that would be helpful for your friend. Your own behavior is going to have to change when you are around your friend also. There are certain behaviors that could make healing very difficult.
It might be difficult to tell whether or not your friend is dieting or has a more serious problem. There are certain characteristics to look for that follow under dieting. They are: 1. Losing weight is thought of as a way to improve your appearance as well as your health. 2. Self esteem is not only based on body image and weight. There are a lot of other factors. 3. Dieting will help to control weight. And 4. Losing weight, but in a wealthy way. These signs are not something to worry. Things to worry about are when you friend feels like this: 1. Losing weight will make you happy. 2. Self esteem is entirely based on how thin you are. 3. Losing weight will help control emotions and therefore life. And 4. Health is not an issue when it comes to being thin. Being skinny is the only concern.
As you can see, there is a big difference between dieting and having an eating disorder. It is not uncommon for a disorder to start out with dieting. Sometimes dieting just does not give individuals the results they want fast enough. Maybe a person is exercising and trying to eat healthy just to lose just a few pounds. Once they start to lose the weight, they become obsessed. It is all they can think about until they ultimately stop eating altogether.
Not eating makes anorexics feel like they are in control. They might not be able to control many other things going on in their lives, but self starvation is completely in their power. It also might be a way to cope with their emotions such as anger, embarrassment, stress, or pain. The only problem with not eating and using this coping method is that it does not last very long. They only way anorexics know how to get the feel good about themselves again is by losing more weight. It is a vicious cycle that they ultimately lose control over. Many people also become anorexic because their needs are not being met. They do not know how to deal with the struggles and stresses in their daily lives. But instead of asking for help and voicing their needs, anorexics show it though abusing their body. Don't let one of your friends struggle alone. They might not be able to use their words, but just know their desire for help may lie in their thoughts. Anorexics deciding to abuse their bodies might be more than a distorted body image. It could be a cry for help. Don't let that go by unnoticed.
As anorexia progresses, signs and symptoms become much more obvious. They can be divided into three different groups: eating behaviors, body image signs, and purging symptoms. Eating and food behavior signs and symptoms include: dieting despite being thin, follows a severely restricted diet, eats only certain low-calorie foods, obsession with calories, fat grams, and nutrition, pretends to eat or lying about eating, preoccupied with food, and strange or secretive food rituals. Appearance and body image signs and symptoms include: dramatic weight loss, feeling fat, despite being underweight, fixation on body image, harshly critical of appearance, and denies being too thin. Purging signs and symptoms include:using diet pills, laxatives, or diuretics, throwing up after eating, and compulsive exercising. All of these signs are tell-tale signals that your friend is struggling with a problem.
The chances are that your friend will try to hide their condition. They become embarrassed and do not want people to know. Because of this, warning signs might be difficult to spot especially in the beginning. As anorexia continues, the symptoms and signs start to become obvious. You will be able to tell for sure what is going on and you should take action. It is also important to realize that even if someone you know becomes anorexic, they can still be ok. It is very treatable, so do not give up on them.
When realizing that your friend has a problem and especially when your friend is trying to get better, there are certain behaviors that you will have to change in order to be a supportive friend. Do not talk about food, weight, diets, or body shape in front of them. This means yours, your friends, or anyone else’s. This is going to be hard, but try not to be to involved, paranoid and watchful of your friends eating habits, food portions, and choices. It is ok to pay some attention to it. But your friend needs to be able to feel like they are in control of those things especially when they are on the road to recovery. If you are constantly watching and saying something to them, your friend will just get annoyed and frustrated. Never make statements like "If you'd just eat, you'll get better." or "If you'd just stop working out so much, you'll get better." This will make matters worse. Bring out your friend's strengths. Tell them how good they are at the piano or at painting. Never bring out their flaws. Try to not pay to much attention to how your friend physically looks. Not doing these changes could actually cause your friend to get worse which nobody wants to happen.
If their disorder is not treated, then there are many dangerous health risks that can occur. Women with anorexia nervosa will have lack of or an abnormal menstrual flow. This can cause infertility in the future. They can experience erosion of the tooth’s enamel and an increased incidence of cavities. 50% of all anorexics will suffer from bone thinning or otherwise known as osteoporosis. They can sometimes develop kidney infections and kidney failure, which if not treated can be fatal. In the younger person with anorexia nervosa, growth may be slowed and cause short stature. Studies have shown that 10% to 15% will die of complications arising from anorexia nervosa. Anorexics have a slower and sometimes abnormal heart rate, low body temperature, electrolyte imbalances, and lower blood pressure. They also experience a lot of dizziness, fainting, and headaches as well as constipation and abdominal pain.
Like any other disease, anorexia nervosa requires treatment. Like any other treatment, it can be very successful. But anorexia is not like most diseases. Chemotherapy, radiation, antibiotics, shots, or drugs have no effect when it comes to this psychological eating disorder. They should just be left at the door. This kind of disease requires special treatment.
Anorexia is a physical and emotional condition, and even though its effects can be severe and harmful, with sufficient help, it is one hundred percent treatable. This disorder greatly affects not only your body, but also your mind. That means treatment needs to involve both your body and your mind. The best way to approach helping someone is with through a team: medical doctors, mental health professionals, and dieticians. Those people will all be part of an anorexics support system, but equally important is family and friends. That is where you come in. You need to be there for you friend in their time of need. Having the support and participation of people that love them and are close to them can make a big difference. One of anorexics biggest problem is a lowered self esteem. Knowing that people love them and care about their well being can give these victims something to work towards. No one wants to be alone. That's why it is so important to be a friend to someone in this position. Whether or not they come out and say they need you, they do!
There are many people out there that are willing to and want to help victims of anorexia. Friends and family can do a lot for someone suffering from eating disorders. They can offer love and an amazing support system which does so much. But they can not personally relate to the victim. They will never know exactly what they are experiencing unless they too develop anorexia. Sometimes anorexics want to talk to someone who knows what they are feeling and why they feel the way they do. That is why being in a group counseling group can be very helpful.In the same way, family and friends might need advice on how to behave or go about the situation in the best way possible. They might need someone to talk to and share their experiences with. That is why organizations, hotlines, and websites that are great. They offer an outlet for everyone, and there are many available. Unfortunately, treatment is less available for men. But, the same organizations, hotlines, and websites can help men also. Just as with women, recovery is a long process. It might even be longer in men because of the availability of treatment and the shame to admit the problem.
I feel that most of the time eating disorders such as anorexia nervosa can be avoided. Even if they do begin, I think that they should be able to resolved or at least caught much quicker. Anorexics should never get to the point where they are emaciated. No one is completely alone in this world and the fact that people let their family, friends, or even acquaintances get to that point is absurd. That is one thing I really regret about my own experience. My friend’s mom, my friends, and I should have done something much sooner. Maybe her illness would not have gotten to the point it did.
Anorexia is a very serious illness. People die from it every year, and it is not just a few people. Eating disorders have the highest mortality rate of any other mental illness. A study by the National Association of Anorexia Nervosa and Associated Disorders reported that 5 – 10% of anorexics die within 10 years after contracting the disease; 18-20% of anorexics will be dead after 20 years and only 30 – 40% ever fully recovers. The mortality rate associated with anorexia nervosa is 12 times higher than the death rate of ALL causes of death for females 15 – 24 years old. And the numbers are only increasing.
I know it is much easier to say that we are going to help those we know suffering from an eating disorder, then to actually do it. And, I know this from my own experience. But something has to be done, and we have to try. Being a friend can be the difference between life and death for a suffering anorexic.
You should be thinking to yourself "why should I listen to this persons advice." I know it's hard to listen and trust people who talk about things they have never experienced. Well, I am not one of those people.
The girl in the picture above has been my best friend since we were in kindergarten. It has been 16 years. We have been through so much together; some great, unforgettable times, and some not so great. Amongst the not so great times was when my very best friend, a girl I basically consider a sister, became sick with mono over Christmas break of our junior year of high school. She was really sick for a few weeks- tired all the time and not being able to eat because her throat was so swollen. Not only was she sick, her parents were going through a divorce. She had so much stress and pressure on her.
During this time, she lost a significant amount of weight. My friend is tall and has always been thin. When she lost all the weight, she was extremely skinny. People noticed, but they also knew she had been so sick so everyone just assumed she would gain it back. My friend did not want this to happen. She liked the weight she had lost. It made her feel good and in control. A couple of my other friends and I noticed her lunches had changed. They were not longer gushers, peanut butter and honey sandwiches, and chips. They were yogurt and granola with some grapes. After everytime she ate, she would go to the bathroom right afterwards and come out with a runny nose. She also started to exercise all the time.
We knew something was wrong. We were not sure what to do at first so we tried to talk to her mom about it. Tennis season was also starting at this time. Her and I were doubles partners all through out high school, and our tennis coach was also an emergency room doctor. When we confronted her mom about it, she said, "Me and Dr. Merril (our tennis coach) already know what has been going on. We don't want to do anything about it though until tennis season is over. It's your guys senior year, and we want it to be a good one." My friends and I could not believe it. My friends health was much more important to me then having a good tennis season. We continued to keep an eye on her, but things were progressively getting worse, and she was getting so thin. She was missing a lot of school, and she was not playing well in tennis. She almost fainted in one match.
We tried to talk with her about it, but she would continuously deny it. One thing I regret about the whole situation was not confronting her when we first suspected something. We waited way to long. After a while, her mom finally did something. She took her to a doctor, a nutritionist, and enrolled her in a peer support group. She had never had a regular menstruation cycle, but when she got sick, she just never got it. When she went to the doctor, he said that she could possibly not have kids. I don’t think that she will ever be able to. He also told her that her bone density was very low for a girl of 18. She started to take bone density pills, and she still takes them today. The nutritionist told her how to eat healthy and planned out her meals. My friend would attend the peer support group two times a week in which she talked with other girls in her situation. I think this was most helpful for her. She was embarrassed to talk about her disorder in front of us, but with people who knew what she was going through, she felt comfortable. My friend was able to talk about all her feelings that she had kept inside for so long.
My friend did get better and healthy again, but it was not easy. Even today, she struggles. There is always the chance that something will trigger it again, and I worry about this all the time. I don’t ever want to see her like she was that year she was really struggling with anorexia. It was hard on all the people that care about her, but I can’t imagine how hard it was for her personally.
Being a friend to someone who is experiencing this is challenging and many times, you question yourself, what do I do, how can I help? Many times, there is not a whole lot you can do. You just have to be there for them, remind them how much you care. But most importantly, constantly remind your friend that you just want them to be better and healthy. Ask them regularly how they are doing or if there is anything you can do to help. A lot of the times just being there is exactly what they need.