Opinion piece

Mental Health: When a girl has an eating disorder

It is extremely challenging for friends and family members to watch a loved one caught in the trap of obsessive behaviours that surround eating disorders. There may be an obsession with exercise, weight or with the calorie count or fat content of foods. There may be guilt about food eaten, or the victim may set up a competition within herself to eat less than the day before.

When people become concerned and comment about how little is being eaten, or how much weight is being lost, this is interpreted as success. The young woman feels that her attempts to control diet and weight are working, because others are noticing. Being described as too skinny is music to her ears. All the while, though, she most often will deny that there is an eating disorder, saying that she’s just not hungry.

After a while those wanting to help become angry and frustrated, because they know there is a problem, but they are being blocked from talking about it. Parents will sometimes begin to monitor what is eaten or try to force their daughter to eat. This increases her anxiety and guilt about eating. She now must redouble her efforts to lose weight and to compensate for whatever she was forced to eat. This might begin the cycle of bulimia, where she will eat, but throw up immediately afterwards. Or she might double her exercise time in order to burn more calories.

As she goes deeper into the disorder, and continues to lose weight, loved ones begin to panic. They strengthen their efforts to intervene, and the more they do, the more the girl resists. A vicious cycle is underway.

There are no pat answers as to how to handle this situation. If the child is young, parental control may be the answer to stopping the problem before it gets worse. A visit to the doctor to validate the seriousness of the situation may be all it takes. If the girl is older, the most one can do is to tell her directly that you are concerned about an eating disorder. You may ask that she go with you to the doctor or a psychologist to discuss your concern, after which you will leave the issue to her and the doctor. There are also groups for people with eating disorders.

However, she may resist all help, because the bottom line is that getting well means eating properly and gaining a few pounds. That thought terrifies her. Until she is ready to acknowledge the problem, everyone who cares feels totally helpless. You can tell her that you are there to support her, and whenever she is ready to deal with the problem you will help in any way that you can.

If the problem gets out of control, she will end up with the doctor anyway, or even in hospital. Continue to let her know she is loved. Do not judge her. Do not pressure her. Tell her that it is hard to watch her like this, and that you do not want to make it worse. Ask what you can do to help.

If she does not want your help, you must honour that. You just do not get into a power struggle with someone with an eating disorder. If it starts to drive you crazy, you must get help and support for yourself, so you can cope with one of the most difficult situations a parent can face.

Gwen Randall-Young is an Alberta author and award-winning psychologist.

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