Expert: Joanne - 2/10/2006

Question
Hi Holly,
        Hope u can help. A very good friend of mine has been buimic for many years, I have tried to be a pillar of support for her neither lecturing nor encouraging her in her ED, I didn't feel that is was my duty as she does recieve professional help. Anyway recently she has been in and out of hospital suffering from kidney stones and has recently had a major operation to remove them. I was woundering wether they are related to her bulimia? I feel that it has got to the point that she may be putting her health in serious jeapordy and she is complete denial, and whilst tryin to be understanding I am finding it hard to bite my toungue out of pure worry for her. Please advise if kidney stones are related to bulimia (she denied ED to doc's in the hospital) and how to best support my friend at this time.
Many thanks.

Answer
Causes of Kidney Stones:
- a family history of kidney stones,
- being aged between 20 and 40,
- taking certain medicines such as diuretics (water tablets), antacids and thyroid medications,
- having only one kidney,
- eating a diet high in protein but very low in fibre,
- becoming dehydrated by not drinking enough fluids or living or working in a hot place,
- having poor mobility (eg, being confined to bed),
- having an ileostomy, eg, for Crohn's disease.

Quite often bulimics will abuse diuretics and laxatives which could probably cause these.  But bulimics tend to become quite dehydrated at times due to purging, so it is possible that it could be a factor too, as could eating the wrong kind of foods.  However, it is hard to directly relate one to the other, but I do know that kidney stones are quite common in anorexics, so may be possible in bulimics too.  It is also common to get kidney stones again within a matter of years after having them once!

The minute she started purging she put her health in danger.  It is good to hear that she is receiving professional help - but in what form?  If she is in treatment, why did she feel the need to keep it hidden from the Drs?

I think that the best way usually to support someone in this situation would be to just be there to listen to them when they are ready to talk, but I think that your friend may need a reality check.  Maybe just voice your concerns to her, and find out about what kind of treatment she is receiving.  The fact that she is so far in denial suggests that if she is in treatment, she is in it all for the wrong reasons.  I think that you just need to let her know how much she is scaring you.

Come back if you need anything else!

Wishing you and your friend all the best
Hugs Holly