Eating Disorder Talk

Sometimes, I get emails from readers who have a personal link to eating disorders. I’m not sure how each individual has come across the site, but each one has a different story, request or criticism. All are welcome, don’t misconstrue what I’m about to say, but sometimes, especially with my own particular history with recovery and treatment, I have a hard time answering the, “what should I do?” questions.

None the less, when I’ve received them, I do try to put a lot of thought into my response. And in these past couple of days of mayhem in my day-to-day activities, two mothers have given me the opportunity to provide my own opinions on their daughter’s struggles. One example was the email it received from Jenny*:

I am searching the web, I’m at a loss because I recently found out my 14 yr old suffers from bulimia, and has for over a year. And for the first time as a parent, I have no idea what to do or how to help her. It’s so hard and painful to watch her struggle with this knowing she wants to stop, but can’t.”

Jenny,

First and foremost, I think it’s important to discuss in depth with your daughter, her habits, how long it’s been going on and how she feels about it. In all honesty, a lot of us don’t want our eating disorder, but a lot of us also don’t want to be rid of it, either. I know that can be confusing, but if you think of an eating disorder in comparison to an addiction, it becomes a little more clear. Alcoholics don’t just drink because they need or want to, it is a part of them, an identity and well, saying goodbye to that often means saying hello and accepting a part of you that you may not like very much.

Very few true eating disorders are about weight - they’re usually a control mechanism of some sort. Or at the least, a coping method for things we cannot or in the past were not able to control. Talk to your daughter and find out, as best as you can while respecting her wishes, what kinds of feelings are really behind her lifestyle.

In my opinion, having an open, non-critical dialogue will lead to a wonder of opportunity for you to support her in her recovery attempt(s). Know this, recovery can be easy for some people, true, but in general as with that addictive behaviour I’ve earlier described, as eating disorder is always a part of you. Some people will recover and relapse many times and you need to know this, prepare for the possibility and let your daughter know that regardless, your love for her will not be affected.

My other suggestions include the following:

• take her to a doctor who has some experience and knowledge within the eating disorder field. Have her electrolytes, organ function and blood levels checked. Bulimic behaviour is extremely sapping of electrolytes, in prolonged conditions can lead to organ failure and constant binging and fasting routines can lead to big blood sugar issues. Trust me on that one.
• read a few books on the subject, educate yourself and try to figure out what her shoes feel like, before you try to help her. I don’t recommend the newest “parenting your child through EDs” books simply because I’ve never read them, but two authors I definitely recommend are Stephen Levenkron (which is actually fiction, but you’ll find it in the Eating Disorder section of your bookstore) and Peggy Claude-Pierre. Claude-Pierre ran a treatment facility here in British Columbia that was…unorthodox, but through her own daughters’ eating disorders and the patients she treated, I think that her commentary is great. I also recommend the newer book, “Gaining,” by Aimee Liu - it’s about life after recovery.
• Talk to your daughter about the possibility of treatment. Via cognitive therapy, the Maudsley Approach (which I’ve written about previously), psychiatry, whatever you have available to you.
• One thing I am all for in terms of recovery is family therapy and one-on-one therapy in conjunction with the use of antidepressants. This combination has so many positives: the family is involved in treatment and therefore not only kept ‘in the loop’ but also may have their own demons to slay and it’s a safe environment for kids to unmask those familial demons; the patient has the opportunity, again in a safe environment, to get out every little shred of emotional incapacitation, which can be a reason why some eating disorders surface - a lack of ventilation, for lack of better words; and antidepressants can treat any chemical imbalance that might have had an effect on your daughter’s psyche prior to engaging in bulimia.
• whatever you do, remember, though you might feel it’s your job and right and requirement to save her, this is one of the first times, you’ve got to let her save herself. You can be there every step of the way for her, constantly supporting and loving her despite and in spite of her efforts (or lack thereof) to recover. But if you handle it like it’s a task to be tackled without her emotions regarded, even simply because you feel you need to fix it for her, you may drive her in the other direction and lose whatever communication you two now share.

Best of luck, for the both of you.

Terra

* Not her real name.