If you are concerned that a member of your family has an eating disorder, research the best ways to approach them to discuss your concerns. Understanding the signs and symptoms of eating disorders will help you to prepare. Remember that you are not alone, and that help and support is available before and after you approach your family member.
If you think that a loved one might have an eating disorder, it can be difficult to know when to approach them to discuss your concerns. You might even wonder if your suspicions are correct.
But you will never know if your family member has an eating disorder, if they don’t acknowledge that they might have a problem, and are therefore reluctant to see a healthcare professional to diagnose the eating disorder. It is important to remember that getting an early diagnosis and treatment is the best way to get people on the road to a complete recovery.
You are not alone. Help and support is available before and after you have approached your family member. Eating Disorders Victoria has a specific Family Support Service (as well as support for siblings and friends) to help you to express your feelings, get suggestions on strategies to help, and to find out what types of support services are available. The Butterfly Foundation also offers support for family members and other people affected by eating disorders.
Understand the symptoms of eating disorders
It can be difficult to know if your loved one has an eating disorder, because the signs and symptoms can be difficult to detect. These include:
- feelings of shame, guilt and disgust about their eating behaviours
- unusual eating and exercising behaviours that are hidden from friends and family
- denial that they have disordered eating patterns or an eating disorder
- inability to ask for help from friends and family.
It is important that you understand the signs and symptoms of eating disorders, so you know what to look out for and you are prepared. You have the potential to be a great support to your family member if they are diagnosed with an eating disorder.
Physical symptoms of eating disorders
Although the physical signs will vary depending on the type of eating disorder, symptoms include:
- loss or gain of body weight or weight fluctuations
- cold, mottled (spotted or blotchy) hands and feet due to poor blood flow, even in warm weather
- fatigue and fainting without a reason (such as an illness)
- signs of damage from frequent vomiting such as swelling around the cheeks and jaw, damaged teeth and bad breath.
Psychological symptoms of eating disorders
Although some psychological signs can be hidden, others might be more obvious. Psychological signs and symptoms can include:
- preoccupation or obsession with eating, dieting, exercise or body image
- sensitivity to comments about eating, dieting, exercise or body image
- feelings of shame, guilt and disgust, especially after eating
- a distorted body image or extreme dissatisfaction with body shape – people can think they are fat even when they have a healthy body weight
- low self-esteem, depression, anxiety or irritability.
Behavioural symptoms of eating disorders
Behavioural signs and symptoms will vary depending on the type of eating disorder but can include:
- unexplained disappearance of food – hiding of binge eating episodes
- secretive behaviour around food – hiding uneaten food or saying they have eaten when they haven’t
- behaviour that is antisocial and withdrawn
- eating alone and avoiding other people at meal times
- chewing and spitting out of food
- frequent trips to the bathroom after eating
- dieting behaviour – obsessive dieting, counting kilojoules, avoiding certain food groups
- intense fear of gaining weight or ongoing behaviour that does not enable weight gain
- use of laxatives, enemas, diuretics or appetite suppressants
- spending large amounts of money on food
- self-harming behaviour, use of substances and suicide attempts.
Helping someone with a potential eating disorder
Your family member’s behaviour and symptoms may also affect you. You might be feeling a range of emotions, such as grief, sadness, anger, neglect and stress. Getting support and help with your emotions is also important. Eating Disorders Victoria has a psychology service where you can speak to someone about how you are feeling and being affected by your family member’s behaviour and symptoms.
When you first approach a family member about their potential eating disorder, they might react negatively or they might not want to speak with you at all. The person might feel threatened that you have noticed their behaviours or discovered their situation, and they might need time to respond. You can be persistent without nagging. Remember that ignoring the problem will not make it go away.
While the first step might be to get your family member to acknowledge they might have a potential eating disorder, the next step is to go to a doctor for a diagnosis. Eating disorders cover a range of conditions and some people might not fit neatly into one category. This makes it important for people who might have an eating disorder to see their doctor as soon as possible. Other healthcare professionals can also recognise eating disorders, but they will not be able to give a physical check-up.
To diagnose an eating disorder, your doctor will need to do a full physical check-up, take blood tests, and ask questions about your health, including your emotional health and wellbeing, medical history and lifestyle to see if you have the symptoms and behaviours of the condition such as those listed above.
The doctor will also have to make sure that any symptoms do not relate to another reason, such as an undiagnosed physical illness or another mental health condition.
Family and carers can play an important role in the process of diagnosis, particularly as physical check ups and blood tests alone may not necessarily indicate a diagnosis of an eating disorder.
Family and carers may be in a position to identify some of the other psychological and behavioural signs and symptoms that the person may not necessarily talk about with their doctor. This may include commonly co-occurring anxiety, depression or obsessive compulsive behaviours.
Things to do when approaching your family member
When preparing for and speaking with your family member, some of the things you can do include:
- informing yourself about eating disorders
- informing yourself about the help they might need and the support services available
- being prepared for a negative response
- thinking about what you are going to say or seeking help from a support service for advice on what to say
- choosing a safe place and a time when you are both calm
- telling your loved one that you are raising your concerns because you care for them
- letting them know you are worried they might have an eating disorder
- focusing on their feelings and your feelings
- focusing on the wider range of behaviours and feelings that you are worried about and that they might be opening to talking about and seeking help for (for example, that you are worried they are sad and withdrawn), rather than putting all of the focus on their eating and body weight.
Things to avoid when approaching your family member
The types of things you should avoid include:
- making comments about body weight, appearance or food
- giving a list of people who are also concerned
- demanding change or berating your family member
- tricking or forcing them to eat
- using statements that label, blame or are judgemental.
Mental health first aid for eating disorders
There might come a time when you fear for the safety of your family member and you might need to use mental health first aid for your family member’s situation.
Mental Health First Aid (MHFA) Australia has an action plan that includes:
- Approaching, assessing and assisting with any crisis
- Listening non-judgementally
- Giving support and information
- Encouraging appropriate professional help
- Encouraging other supports.
The signs of a crisis or emergency include:
- a medical emergency – thinking that seems disordered, disorientation, vomiting several times a day, fainting, collapsing, chest pains, difficulty breathing, irregular heartbeat, slow heart rate of less than 50 beats per minute or a low body mass index (lower than 16)
- suicidal thoughts or behaviours
- non-suicidal self-injury (self-harm).
- calling an ambulance
- taking your family member to the emergency department of a hospital
- getting advice from a healthcare professional such as your doctor
- calling the Eating Disorders Helpline or the Butterfly Foundation National Support Line.
Where to get help
- Your doctor
- Community health centre
- Mental health centre
- In an emergency, always call triple zero (000)
- Lifeline Tel. 13 11 14
- Kids Helpline Tel. 1800 55 1800
- Eating Disorders Victoria Helpline Tel. 1300 550 236 – support from Monday to Friday 9 am to 5 pm
- Butterfly Foundation’s National Support Line Tel. 1800 ED HOPE (1800 33 4673) – support from Monday to Friday 9 am to 5 pm (except public holidays)
Things to remember
- You will never know if your family member has an eating disorder, if they don’t acknowledge there may be a problem and allow a healthcare professional to give a diagnosis.
- You are not alone. Help and support is available before and after you have discussed your concerns with your family member.
- It is important that you understand the signs and symptoms of eating disorders so you know what to look out for and you can prepare.
- Research how you can best approach someone with a potential eating disorder and strategies you should avoid.
- If you think your family member is in physical danger or at risk of harming themselves, then you might need to take direct action such as calling an ambulance.
- You have the potential to be a great support to your family member if they are diagnosed with an eating disorder.
You might also be interested in:
- Anorexia nervosa.
- Binge eating disorder.
- Bulimia nervosa.
- Eating disorders.
- Eating disorders - adolescents.
- Eating disorders not otherwise specified (EDNOS).
Want to know more?
Go to More information for support groups, related links and references.
This page has been produced in consultation with and approved by:
(Logo links to further information)
Eating Disorders Foundation of Victoria; Eating Disorders Victoria (EDV)
Fact sheet currently being reviewed.
Last reviewed: October 2012
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