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© 2006 Dilys Morgan
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Eating Disorders - weight loss and weight gain.  Not being able to control your food intake....or taking extreme measures to control it may sound, at first glance, very different.  But often, people who have problems with fluctuating weight usually have much in common.  And being both underweight and overweight have huge health implications.  Those who are underweight, actively controlling the amount they eat to the point of starvation - anorexics - or eating fairly normally but then bringing most of it back up again - bulimics -  are usually deeply unhappy people who have found no other outlet for all the bad emotions that invade them.  Somehow, being in charge of their weight empowers them, gives them a sense of relief and enables them to survive the bad times.   Those who overeat are in a pretty similar position:  often desperately unhappy and able to get some comfort and satisfaction only through food.  So - although poles apart in many respects, both under-eating and over-eating are symptoms of a similar syndrome....disordered eating.  In other words using food for reasons other than the reason it was invented - to satisfy hunger and keep us alive.

What to do about friend with Eating Problems?

Dear Dilys,

I've just discovered my best friend has an eating disorder.  She's been acting strange for a long time but I caught her being sick in the loo the other day straight after lunch at school.  She doesn't want to talk about it though and I don't know how to bring it up without upsetting her.  So how do I deal with her from now on?

Nelly

Dear Nelly,

Your friend most probably won't want to talk to anyone about the eating disorder as such.  Anyone who has problems like this is likely to want to keep them to themselves.  Sometimes having such an eating disorder is the only way young people find to cope with the stresses and strains in their lives.  They can often become quite attached to this disorder and view it as an essentially private thing.   It sounds like you've already picked up on your friend's reluctance to talk, so you sound like a good sensitive friend to have.  Your friend must be feeling deeply unhappy inside to want to harm herself in this way.  Starving themselves, or eating and then bringing the food up again, are pretty extreme measures that people only take as a last resort.  So I guess there are plenty of things going on in your friend's life which are making her so unhappy and depressed.  And your best way in, to try and find a way to help her, is likely to watch out for any moment when she looks like she might be ready to talk.  And then, not even to mention the eating, but simply to focus on her bad feelings.  Ask her what's wrong, what is making her so unhappy.  Or ask her to tell you what she's feeling deep inside and then be prepared to listen to whatever she has to say.  Don't judge or criticise her, just listen.  Good empathic listening is what somebody  in this situation needs, and that ( in summary !) means acknowledging what she says with comments like:  I see, or OK, or simply Yes or Mmmm.   The more you can keep quiet and listen, the more likely she is to talk.  And sometimes summarising what she's just said could be helpful....as in:  so it sounds like you feel so-and-so...?;  or clarifying what she really means as in:  'so are you saying you feel such and such...?  All of which will help her examine her own feelings more closely so that she too learns more about what she's feeling....which is what she needs really if she's going to sort any of this out.  You'd be surprised but sometimes even really unhappy people don't fully understand what's going on for them or what they're truly feeling and why.  But you can'tbe expected to support your friend entirely on your own and you probably need to encourage her to get help from a professional, such as a school counsellor...or find a counsellor outside school.  Counselling should really help your friend sort out what's going on for her, understand why she feels so bad and help her find strategies to feel better.

Dilys

Abusive Partner has brought back my Eating Disorder

Dear Jayney,

This sounds as if might boil down to a tough choice between your health and your partner. It seems a pity that this relationship, which gave you such a lift at the start, has deteriorated so badly to cause you to slip back into your old habits. At the moment it certainly doesn?t sound as if your partner is doing you any good. Only you know how bad you?re feeling and how quickly you might slip back into your eating disorder. If you feel this is a real risk then you probably need to seek some outside help as soon as you can.

Many people with eating disorders suffer from low self-esteem and are all too easily put back into a situation where they doubt themselves, dislike themselves and can find nothing good about themselves. It sounds as if being in love initially helped lift you out of all that and for the first time in ages gave you good reason to feel good about yourself.

But the trouble is that these feelings of low self-worth are awfully easy to rekindle. And it sounds as if your partner may be the kind of person who gets off on making others feel bad. That?s a pretty fatal combination. In his case it could be a kind of power trip whereby he needs to make others feel small, and stupid in order to feel superior. If this is what he?s doing then it could be desperately damaging to someone like you.

Find a counsellor or therapist to talk to about this as soon as possible. Together you could work out what aspects of your relationship are currently pulling you down and why it is that you allow your partner to get away with treating you badly. A counsellor would help boost your self-esteem so that you would begin to feel you no longer had to put up with this kind of treatment and then you might be able to get the relationship on to a more equal footing and one which didn?t stir up all the old bad feelings that led you to your eating disorder in the first place.

What you really need in your life is the kind of man who can be consistently supportive, give your confidence a boost, remind you how much you?re valued when you?re feeling low, and reinforce on a daily basis how much you matter, and how important you are.

If your present partner can?t do that then ? sadly - he?s possibly not the best prospect as a life partner for you.

Dilys

Health implications of my weight

Dear Kathy,

I do sympathise for I know how hard it is to battle with weight?and how it seems to get harder and harder as the years go by. But you?re wise to be concerned about your health and be looking to the future.

The trouble is, as you?ve pointed out, you understand the basic principles of taking more exercise, eating less and cutting out all those things that are bad for you. It?s just the doing of it that feels so hard.

It seems that you comfort eat and I guess your little treats feel like something to look forward to. The good news is that you?ve recognised this - that you eat for emotional reasons when you?re upset or stressed or bored. It certainly can?t be easy being at home all the time, surrounded by temptation. But the very fact that you know you eat to make yourself feel better gives you plenty to work on.

Two ideas come to mind. The first is to try and find other ways to reward or treat yourself rather than using food all the time. It is possible to retrain ourselves so that we begin to value other treats as much as food. So that instead of putting something in your mouth to make yourself feel better, you plan something else ? like buying a glossy magazine or going for a hairdo ? that will cheer you up and won?t pile on the pounds.

The other idea is distraction. It works for people who suffer from anorexia and bulimia so I see no reason why it shouldn?t work for you. The trick is, whenever you feel yourself wanting to eat in order to feel better, you distract yourself with something like a long chatty phone call to a friend, or a walk or shopping trip. Anything, indeed, that takes your mind off your rumbling tummy for a while so that the initial urge has time to pass.

It seems a pity to deny yourself swimming just because of your size. Try to overcome your embarrassment by going with a friend. Having support should bolster your confidence and mean you?re less likely to chicken out at the last minute!

And if none of this works for you, try some counselling. It can work wonders in boosting morale and confidence and can help you learn how to manage your emotions without using food.

Dilys

Putting weight on.    Eating Disorder  - or Disordered Eating?

Dear Miriam,

Families often steer clear of these sensitive areas for fear of touching on some supremely sensitive point and unearthing a can of worms. Sometimes the things that are hardest to hear are those that we really know to be true and it sounds as if you?ve realised that by broaching the subject with your daughter you?re likely to be rubbing salt into an already open wound. However?..by not mentioning anything about your worries for your daughter?s health and well-being, you?re not being at all honest with her. Instead you seem to prefer to protect her from hurt by avoiding the subject while suffering in silence as you see the weight pile on.

Ask yourself what would be your attitude if your daughter had a different kind of eating disorder, anorexia say, and was starving herself? Is it likely that you could sit quietly by and watch her fade away? I doubt it. If you could see that she was not eating and the weight was gradually falling off, I guess your parental instinct would kick in, in time to prevent her going too far.

Over-eating is simply a different form of eating disorder. Your daughter is slowly and surely killing herself. The next step is likely to be diabetes and we all know what a strain obesity can put on the heart. Spelt out like that, does that make it any easier to see how some gentle intervention might be just what?s required?

When dealing with parents of teenagers with eating disorders, I always suggest that it?s likely to be better to be honest than pussy-foot around the issue. As long as people ?turn a blind eye?, the sufferer can convince herself that nothing?s wrong. Right now your daughter could be forgiven for taking your silence as a signal that you?re not worried, that all?s well, and view it as approval and permission to carry on.

But if you were to be honest and tell her how much her ballooning weight was worrying you, she?d learn that you really do care about her health and well-being?and be shaken back into reality.

But be tentative and careful. Don?t judge, but try, instead to steer her towards the kind of help, like counselling, which could help her explore why it is she over-eats. Your daughter?s confidence and self-esteem are likely to be pretty low, so boost them as much as you can. She?ll need lots of moral support to conquer this and probably practical help as well like an offer to accompany her on a walk every day, or some baby-sitting while she takes an exercise classes.

Good Luck.

Dilys

 Grand-daughter disappearing to the loo after every meal

Dear Pat,

This is a dilemma for you. As you say, doing nothing is not really an option for it would be terrible to leave your grand-daughter alone in her suffering if she has some kind of eating disorder. But dealing with your prickly daughter-in-law also presents problems.

The best course would probably be to try to get close enough to your grand-daughter to find out what feels wrong in her life. Contrary to popular opinion, people don?t develop eating disorders in order to get thin. Starving yourself, controlling what you eat, or throwing up anything you do eat it are all demonstrations that something is deeply wrong. The behaviours become an expression of the problem. Your grand-daughter must be feeling very unhappy to resort to such behaviours. It may sound simplistic to say that she may be trying to get rid of her bad feelings by vomiting them up, but it may not be very far from the truth.

It also gives her something in her own life that she can control. So could it be that in other areas she feels not in control?

What you say about your daughter-in-law could be significant. If she is prickly with everybody, not just you, and has a tendency to be demanding yet hard to please, then it could be that your grand-daughter is sick and tired of being nagged, got at and of being made to feel wrong all the time.

These are difficult things for you to affect but the best way to start would be to try to understand your grand-daughter?s feelings. Ask her how she is, if she?d like to talk, whether something?s up, what?s troubling her?.?

The trouble is that your grand-daughter has probably got into the habit some time ago of burying her bad feelings so it could be hard work encouraging them to the surface again.

If she won?t talk to you, or if you don?t believe you?re getting anywhere, find her someone outside the family to confide in. It may feel difficult for you going behind your daughter-in-law?s back. You may like to confide in your son at least. But you could take the initiative and organise some counselling for your grand-daughter, which could, if necessary be kept secret from her mother.

This isn?t ideal for it?s clearly healthier for families to be able to communicate about such serious issues. And for your grand-daughter to get better, she?s probably going to have to learn to be open and honest with her loved ones. But it?s vital that your grand-daughter gets some help ? sooner rather than later ? so secret counselling is probably better than none at all.

Dilys

 Swimming doesn't have to be embarrassing for anyone wanting to lose weight

Dear Helen,

Thank you so much for writing. Your letter is full of useful advice and information for anyone else who?s struggling to lose weight at the moment.

It?s so totally understandable that anyone who?s over-weight should feel self-conscious. And the whole idea of swimming, which exposes so much more flesh than many other activities, must be just about the most daunting thing to contemplate. So it?s really good to read the experience of someone like you who overcame her fears, anxieties and even sickness - and found that in the end she didn?t really need to be self-conscious at all! As you discovered, everyone around you was much more interested in themselves and their own enjoyment to spare a glance in your direction. So the key thing here is obviously to work really hard on focusing on becoming healthy again for yourself?and not letting your suspicions about other people?s attitudes or views or opinions bother you.

This is a really good example of how we can be held back in life by worries about what might happen, and, in particular, by worrying about what other people may think of us. And all too often our greatest fears prove groundless once we?re brave enough to confront them. But it takes huge guts and courage to do this. You conquered your demons by going swimming and it?s really worked out for you.

Let?s hope Kathy feels inspired by your experience. It won?t be easy, as it wasn?t for you, but if she could only summon up enough confidence in order to try swimming again, I?m sure she?d have the same good experience as you.

Dilys