How to help anorexics and bulimics

Helping loved ones with eating disorders is a particularly difficult thing to do. But as eating disorders are so destructive, it's something that needs to be done without delay.

How to identify an eating disorder

The first thing you need to do if you suspect that someone you know, or love, is suffering from an eating disorder, is to make sure that this is really the case. Be on the lookout for the following signs and symptoms:


  • Refusal to eat.
  • Extreme loss of weight.
  • Distortion of body image. For example, the person insists that she is "fat" even if she is close to starvation.
  • Restless and hyperactive behaviour.
  • Excessive exercise. For example, insistence on doing exercise every day and for much longer than is advisable.
  • Hides food away.
  • Likes to prepare food for others and urge them to eat.


  • Bouts of gross overeating followed by self-induced vomiting.
  • Excessive use of laxatives and/or diuretics.
  • Some loss of weight.
  • Damaged tooth enamel caused by repeated exposure of enamel to stomach acid during vomiting.

Who are at risk?

The following types of people are at much greater risk of developing eating disorders than others:

  • The person with the obsessive personality, who tends to be meticulous, hardworking and who does well at school and/or sport.
  • The intelligent person who sets extremely high standards for herself.
  • Females are usually affected, but eating disorders can occur in males.
  • Young people, especially teenagers, but eating disorders can also occur in older individuals.
  • People with a tendency to anxiety and/or depression.
  • People with a very low self-esteem.
  • Previously overweight or even obese people.
  • Those from middle-class to affluent families where plenty of food is available.
  • Those who have family members that are overweight and/or obese.
  • People with an extreme concern with appearance.
  • The person may come from a severely dysfunctional family (for example, she feels lack of love by parents or envy of siblings).
  • The person who fears gaining weight, looking ugly or failing.

What should you do?

If you suspect that a member of your family, a friend or colleague is struggling with an eating disorder, you can try the following:

1. Initiate communication

People who suffer from eating disorders are very secretive about their condition and are clever at hiding their affliction. They make excuses and are evasive. Consequently, they're among the most difficult people in the world to talk to and to get to open up. Never confront them directly as this may cause them to clam up completely and refuse all help.

Try talking to them in a relaxed setting, which isn't threatening in any way. Talk about other aspects of this problem and not the actual disease. Talk about problems with communicating in families, brothers and sisters who are difficult to live with, parents who are too demanding or who don’t understand them. Hopefully, the anorexic or bulimic will open up a bit and get onto the topic of her eating disorder by herself. At this stage, you can suggest that she go for help.

Remember that it may take more than one session of friendly talks to get an anorexic or bulimic to be forthcoming about her real problem. Don’t rush things. It's after all the person who is suffering from the disease who has to take a decision to go for help.

Above all, don't be judgmental or prescriptive. These are total turn-offs and will do more harm than good.

2. Suggest solutions

Anorexics and bulimics need to be treated by a team of health professionals: a clinical psychologist, a dietician and/or a medical doctor and psychiatrist. Make sure you have the names and addresses of such experts available before you attempt to talk to her, so that you can give her the information immediately. If you don’t have this information at hand when she asks for it, you may lose a golden opportunity to set her on the road to recovery.

It may be a good idea to look up the names and addresses of these healthcare professionals and even to phone them to make sure that they treat eating disorders. Have all your facts available, but present them in a casual way, otherwise the patient will become suspicious.

3. Offer acceptance and support

Anorexics and bulimics are isolated in a world of pain and conflict. They need love, affection, acceptance and support. If you really care about them, you'll let them know that you're always there for them and that you don't judge them, no matter how difficult this may be.

If you're serious about wanting to help your child, friend or colleague, then be patient and understanding. The effort and frustration that you will experience is worth it.

(Dr IV van Heerden, DietDoc, updated May 2012)

Any questions? Ask DietDoc

Read more:

Telltale signs of anorexia
Destructive images of beauty
Dying to be thin
An obsession that could kill

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