Is an eating disorder destroying your family?

By Liz Paul, Psychotherapist & Counsellor

Jenny (not her real name) is an all-too-common sufferer of anorexia nervosa. Although smart and social, Jenny is weighed down by what she calls her ‘passenger’ – that is, her illness.

It’s an insidious condition which overwhelms her personality, her natural happiness and her ambition – it has literally ruined the past two years of her life. And that’s really sad.

As is the fact that Jenny’s whole family has been almost destroyed by Jenny’s illness.

Her mother feels guilty as she’s convinced it must be something she has done to create this terrible illness. She wonders constantly was it something she said, was it her own focus on dieting, and so she is constantly asking herself what she could have done differently.

Her father is confused – he can’t understand why his daughter would be doing this to herself. He feels helpless and afraid. He feels she is slipping away from him and he feels powerless to stop this from happening. He feels inadequate as he is the father and should be able to ‘save his little girl’, but nothing he does seems to work.

Her sister is worried about Jenny’s health but also very resentful. She’s angry with Jenny for all the time her parents have to spend with her and how the whole family has to look after Jenny. Everything revolves around Jenny, from meal times, to family discussions, to holidays, to leisure choices. Everybody’s focus is on Jenny, and the sister feels she is not an important member of the family and that she is being abandoned by her parents. She feels alone and without a voice, and deep down she suspects that Jenny just wants attention.

This terrible illness has the whole family in despair.

Jenny needs individual therapy to help guide her through this insidious disease. And each member of her family also needs therapy to help them cope with the fallout from Jenny’s condition.

It will be a long journey, but family counselling will re-open many channels of communication within this family that have been long lost due to Jenny’s dark passenger – the new family member known by all as ‘Ed’ (eating disorder).

What is an eating disorder?

Increased media exposure to the notion that ‘beauty’ means ‘thin’ has heralded an increase in body image issues and eating disorders. The idea that being ‘thin’ will deliver the happiness and contentment that so many young people are missing in their lives drives the attainment of unrealistic ideas of beauty.

In general, eating disorders describe a range of problems associated with eating, food and body image, and can be linked to low self-esteem and an attempt to deal with underlying psychological issues through practicing an unhealthy relationship with food.

More young people (male and female) are coming through the therapy doors to seek the support they need to help them on the journey to recovery.

How to recognise an eating disorder in your family

The most serious eating disorder is anorexia nervosa, which is characterised by dangerously low body weight and can be life threatening. Bulimia nervosa is usually not so frequently life-threatening, but can have serious medical complications. This condition is characterised by binge eating and subsequent behaviours to compensate for the binge. Others suffer from other equally unhealthy patterns of eating, known as Eating Disorders Not Otherwise Specified (EDNOS).

I’ve outlined some of the common warning signs of eating disorders, though please note that not all of these symptoms are necessarily indicative of an eating disorder and that some sufferers may not display all of these signs.

Physical warning signs:
· Rapid weight loss or frequent weight changes
· Loss or disturbance of menstruation in girls and women and decreased libido in men
· Feeling tired and not sleeping well
· Lethargy, dizzyness or low energy
· Damage due to vomiting including swelling around the cheeks or jaw, calluses on knuckles, damage to teeth, bad breath
· Feeling cold most of the time.

Psychological warning signs:
· Preoccupation with eating, food, body shape and weight
· Feeling anxious or irritable around meal times
· Rigid thoughts about food being ‘good’ or ‘bad’
· A distorted body image
· Using food as a source of comfort (e.g. eating as a way to deal with boredom, stress or depression)
· Using food as self-punishment (e.g. refusing to eat due to depression, stress or other emotional reasons).

Behavioural warning signs:
· Fasting, counting calories/kilojoules, avoiding food groups such as fats and carbohydrates
· Avoiding meals with other people
· Evidence of binge eating (e.g. disappearance and/or hoarding of food)
· Frequent trips to the bathroom during or shortly after meals
· Vomiting or using laxatives, enemas, appetite suppressants or diuretics
· Changes in clothing style (e.g. wearing baggy clothes)
· Compulsive or excessive exercising (e.g. continuing to exercise when sick, and experiencing distress if exercise is not possible)
· Changes in food preferences (e.g. claiming to dislike foods previously enjoyed, or replacing meals with fluids)
· Eating very slowly, cutting food into very small pieces, insisting that meals are served at exactly the same time every day
· Extreme sensitivity to comments about body shape, weight, eating and exercise habits
· Secretive behaviour around food (e.g. saying they have eaten when they haven’t, hiding uneaten food in their rooms).

What can be done to help the sufferer of an eating disorder?

Many people with eating disorders feel isolated. They often feel cut off from sources of support as the disease encourages their behaviours to hide their illness.

So it is very important for the sufferer to find someone to support them. This may be a friend, family member or professional. The more support people in their lives the better. Support groups for individuals and their families can be a wonderful place to connect to others who are also suffering.

Sufferers need to feel they can trust their support person, and they need to feel validated and understood to help repair their self esteem. The process is a long physical and psychological journey.

A large part of this process is for the sufferer to learn to ‘be kind’ to themselves. Those who suffer eating disorders are typically very self critical, they set unrealistic goals for themselves, and are usually perfectionistic high achievers. They are their own hardest critic.

Recovery involves the development of new meaning and purpose in the sufferer’s life as they move beyond the effects of the eating disorder.

For the sufferer, it is a deeply personal and unique process of changing attitudes, values, feelings, goals, behaviours and skills. But the sufferer will eventually learn how to meaningfully engage again with family and friends, whilst learning to accept and love themselves.

The sufferer needs to find ‘hope’, they need to know full recovery is possible. The sooner support is found for the sufferer the better results will be for his/her recovery.

Liz Paul

Psychotherapist & Counsellor
Sydney Individuals and Couples Counselling
Think Ahead Centre

Suite 5D, 5 Dee Why Parade
Dee Why NSW 2099

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Ph: 0422 306 679

liz@sydneyindividualsandcouplescounselling.com