Expert: Joanne - 1/29/2008

Question
I am actually researching this for my closest friend who lives in NZ. Her daughter (18yrs) who I have known since she was just 6yrs, has been diagnosed with bulimia, she had kidney stones b4 xmas and has blacked out at least once whilst driving! she has also had to have stomach pump due to excess alcohol during the xmas break. Anne is at her wits end with how to cope and how best to help Hannah. Hannah wants to come back to UK (they only left 3 yrs ago and Hannah did not want to go) I have offered for her to stay with me indefinitely. My 19 yr old daughter is Hannah's closest friend but Hannah has not as yet been able to tell her about all this, she has made several cloaked hints though in recent weeks on her bebo comments to Mikki. Mikki is also very worried for her friend and too wants to know how best we can help our beautiful young friend. Any help or advice would be so gratefully recieved. Our regards Gilli and Mikki.

Answer
Gilli and Mikki

I think that it is important for Hannah to tell you in her own time.  I think that Anne should maybe talk to her about your offer and has Hannah talk to you about it.  I don't want to suggest that you put conditions regarding her eating on her staying with you, but it may help to set some groud rules such as being honest with you, and that she continues treatment for her bulimia once she is across here.

Hopefully the bulimia has been in part a reaction to her move to NZ, and being back here in the UK will help.  However, there may be other issues there, and others that arise being away from family, or things not being as she remembers.  I think that is important that you are honest with her, and ask that she be with you.  Let her know that you are both there to support and listen to her if she is having any problems that she wants to talk about.

Try to avoid confrontations over meals and food.  It is not a good to have tension when sitting down to eat for anyone, never mind someone with an eating disorder.

It really is a matter of avoiding too many arguements over food and eating, and being there to listen and support her.  Hopefully she will receive counselling or something if she comes across here, so that should be helping her deal with the underlying emotions and issues that lead her to disordered eating patterns.

It may be worth setting down rules over alcohol consumption with Hannah and Mikki if she moves across, both of them so that it doesn't single Hannah out, and just to help avoid another situation like xmas.  Many people with eating disorders, especially bulimia, may abuse alcohol, and alcohol tends to have a greater effect on them if they are of a lower than normal weight.

If she moves across here with you, will she be attending school still, looking to go to college or uni, or work?  Depending on the state of her health, I definitely think that it would be a good thing for her to have a lot of her time occupied so that she doesn't have as much time to miss family or think about food and eating (however, even the busiest person will spend a lot of time focusing on eating if they have an eating disorder!).

Ask that she does as her Drs/counsellors want her to do, but be careful not to be too overbearing at risk of her pushing you all away.  I don't know what kind of treatment she will have been receiving and what may be available to her here, but some therapists will recommend some family therapy, etc.  If she is living here with you, you may be classed as her family for this, would you be willing to attend these therapy sessions with her if she is happy for you to be there?  Now not everyone receives therapy like this, and this may be all too soon for people to consider you as family, but quite often it is reckoned that therapy works better with input from those closest to her.

You need to talk to Anne and listen to what she has to say about the situation.  Find out what she has found to work, and if there is anything that she was asked to do by anyone to help with Hannah's recovery.

Maybe let Hannah know that initially this may just be a trial thing and that if there is a worsening of the eating disorder, she may have to return to her family to receive the support from them.  

I think that this may be a great thing for her, especially if she was so unahppy at moving originally, but my fear is that away from family, homesickness might set in and make things worse.

Visit www.something-fishy.org and look at the pages aimed to help friends and family and the advice there may help you.

I think that it is important that you think about whether or not you and your family will be able to deal with this.  Eating disorders can be very stressful for those people that care for someone with one.  If you both reckon that you can deal with this, then I think it could be a good idea, even just for a few months initially to see how things go, but you need to be aware of what you may be facing!

Please get back in touch if you want to ask anything else, or if your daughter, or even Hannah or Anne have any questions.

Love to you all
Joanne