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Anorexia/Eating Disorders/Does my friend have anorexia nervosa?? and if she does..what should i do??

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Expert: Jeanne Rust, PhD - 5/12/2011


Question

My friend
My friend is 14 years old. She is about 4'10' (really short for our age). Our friend 'group' has always had concerns, but very little because since she entered middle school she hasn't been eating that much. We thought that she might just not feel that she needed that much.
   But this year she started extreme competetive cheerleading and is always exercising. She dropped from 75 pounds to 70 (your probably thinking, "oh, its only five pounds" but she has no more fat to lose. 70 pounds at age 14. if you have kids...compare the weight). Heres the horrible thing...

she announced today that she was going on a diet until she loses 20 pounds.

That would put my friend's weight at 50 pounds.
I have a little sister who is too skinny for her age. she weighs 50 pounds. and she is 5. my best friend is trying to weigh the same as my 5 year old sister who is already underweight.

My friend at lunch will eat about half a banana, pick at a granola bar, and drink a bottle of chocolate milk. She was horrified that the fruit snacks had a total of 75 calories in the bag.

   My friends and I are pretty sure that she does have anorexia nervosa, but we want to be sure.

what should we do if she does??? is there someone at the mayo clinic in rochester mn that you know of that might be able to help us?? some sort of special program or group class thing??? we don't know what to do. please help us.

thanks you,
  kaitlyn

Answer

Jeanne Rust, PhD
Dear Kaitlyn,

I'm so glad that you wrote.  I also hope that someday your friend realizes how lucky she is to have your group -- a group that cares about her so much!

I will tell you that by her height and weight, she is anorexic.  And wanting to lose 20 pounds!  Not at all good!

Do you know her mom?  Do you guys live in Minnesota?  BTW, Mayo's does not have an eating disorder program.  But take a look at Mirasol's teen program.  It's very cool.

The most important thing, however, is for your group to have her know how much you love her, how worried you are about her, and how you would feel if she died!

If you go to www.mirasol.net and go to the place where I have the quizzes, you'll find a list of things for Families and Friends to do and not do.  I'm sending it to you as well.  See if you can talk to her mom or to a school counselor -- do this as a group.  Think about this as saving her life -- not as tattling or bullying -- this can truly save her life.

"Do's" and "Don'ts" for Friends and Family

DO:

remove yourself from the problem and allow the sufferer to make choices about her behavior unencumbered by power struggles and control battles
accept your limitations!
accept the other person's right to an independent life
allow each each household member to decide individually what he or she will or will not eat
be willing to negotiate household chores involving food
hold the eating-disordered person is responsible for her behavior whenever it affects others
ask!
DON'T:

take charge
purchase (or avoid purchasing) food solely to accommodate the eating-disordered person
force family members to eat or restrict what can be eaten
make mealtimes a battleground
monitor someone else's behavior for them (even if you are invited to)
be the "food police"
use money to control another person's eating behavior
anticipate someone else's needs
make eating out a battle of wills
play therapist
offer advice or opinions
comment about someone's weight and looks
Positive Strategies for Parents

The following "rules" are presented in the book Surviving an Eating Disorder: Perspectives & Strategies for Family & Friends. Siegel, M., Brisman, J. & Weinshel, M., 1997. New York, NY: Hamper Collins, which you can find in our collection of recommended books.

Rule #1: Accept your limitations. Encourage your loved one to get professional help.

Rule #2: Accept the other person's right to an independent life. Don't take charge.

Rule #3: Don't purchase (or avoid purchasing) food solely to accommodate the eating-disordered person.

Rule #4: Each household member decides individually what he or she will or will not eat. No one should be forced to eat anything or be restricted in what can be eaten.

Rule #5: Don't make mealtimes a battleground. Keep discussion about food issues to a minimum.

Rule #6: Be willing to negotiate household chores involving food.

Rule #7: The person with the eating disorder is responsible for their behavior whenever it affects others.

Rule #8: Do not monitor someone else's behavior for them (even if you are invited to).

Rule #9: Do not use money to control another person's eating behavior.

Rule #10: Do not anticipate someone else's needs.

Rule #11: Don't make eating out a battle of the wills.

Rule #12: Do not play therapist.

Rule #13: Do not comment about, someone's weight and looks.

Rule #14 Seek support for yourself.

How Parents Can Help

Parents can help their daughters by doing the following:

Do not treat this problem as just an academic issue, but rather recognize the emotional roots of anorexia and bulimia.
Be open to feedback from teachers, counselors and others who can help.
Educate yourself on the causes, impacts, and treatments of eating disorders through literature, books, seminars, and the Internet.
Talk to your daughter about what is underneath the disordered eating behavior; don't just focus on the eating patterns.
Recognize the need for proper assessment, dietary counseling, medical consultation and therapy treatments and options.
Get involved in a parent support group.
Talk about the issues and possible solutions to eating disorders with the whole family.
Don't be fooled by a daughter's attempts to minimize and ignore the real problem, be firm about the need for recovery while being sensitive to not forcing the issues.
Be a good role model around food, take care of yourself, don't blame yourself, and be patient.
Recognize that recovery takes time and do not place unrealistic demands for a quick fix of your daughter's eating disorder.
Additional Resources for Friends and Family

What can you do if you or someone you know is struggling with an eating disorder, body image issues, depression, and low self-esteem?

One of the first things to do is to take care of yourself either by finding a good therapist or a local support group. You can read the book, "Surviving an Eating Disorder: Strategies for Families and Friends" by Michele Siegel, PhD, Judith Brisman, PhD, and Margot Weinshel, MSW. This is an excellent book and will be a tremendous support in helping you learn appropriate ways of dealing with your loved one.

Warmly,
Jeanne Rust, PhD
CEO/Founder
Mirasol, Inc.
www.mirasol.net
www.edrecovery.com
http://www.facebook.aom/jeannerust
888-520-1700

Jeanne Rust, PhD

Expertise

I have been treating eating disorders for over 25 years and I have a doctorate in clinical psychology. I am an expert in anorexia, bulimia and binge eating disorders and in co-occurring disorders as well -- depression, anxiety, obsessive compulsive disorder, etc. I was the official eating disorder therapist for the University of Arizona athletic department and love working with girls and women of all ages! 12 years ago I started my own treatment centers in Arizona where we treat adolescents and adults. I love working with people and have been helping people online since 1994. My hearts go out to the people out there who are unable to find help, who aren't sure whether they need help, and who don't have much of an understanding of the terrible consequences, emotionally and physically, that go hand in hand with the eating disorder. I view eating disorders as coping mechanisms that people use when they are under stress. I believe that eating disorders most times have many similarities whether it is anorexia, bulimia, or binge eating. The good news is that people can heal from an eating disorder and learn to create the lives they would like to live.

Experience

I have 25 years of experience in treating eating disorders of all kinds. I also do consultations for people who are starting treatment centers.

Education/Credentials
Northwestern University -- BA Masters in Counseling Doctorate in Clinical Psychology -- Saybrook institute

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