Worried about my anorexic sister. Help. :(

iKapuniai

My sister is 17 years old. She's been overweight her ENTIRE life, up until about a year ago when she decided "Hey, I'm going to starve myself and see how that goes." She started at around 330, and she's now around 120-130 if I had to guess, but aside from her excess skin, she is skin and bone. Her shoulders, collar bones, spine, hip bones and ribs are all very pronounced. She said she was eating between 500-800 calories per day, and that hasn't changed even once she reached her goal weight. I'd be surprised if she was eating up to 800 calories actually.

She was recently professionally diagnosed with anorexia. She also suffers from severe depression and possibly bi-polar... her moods change from one extreme to the next at the drop of a hat, it's ridiculous. The only thing that keeps her calm and happy is marijuana, but that is not solving any issues. It'll help her eat, but then she'll feel so guilty and gross about it later that she cries and cuts herself. She cuts her arms, her legs, her feet and her stomach. She does it to relieve the emotional pain I guess.

The other day she ate two chips... TWO (2) standard ruffles chips... and went straight to the bathroom to purge. She said she couldn't, and that made her feel gross. She said she could "literally feel it turning in to fat" inside of her. She says that if she could, she'd cut her fat off... but she has no fat, it's all excess skin, and I've tried a thousand times to explain that to her. Regardless, the things she says sometimes really scare me.

I'm very ignorant on the subject of eating disorders... except for my own, I overeat to deal with my pain, but I can change that. My sister, on the other hand... she says that's the absolute only thing in her control, and she needs people to let her have at least that. Her controlling what she eats (or doesn't eat). Anyhow, I've researched a bit on anorexia and I understand that it has more to do with mental and emotional issues rather than the food and weight. I get that. But she's been going to therapy for years for her depression, and it doesn't seem to be helping. Not in the least bit.

My sister doesn't work. She dropped out of high school in her second year. She hasn't even gotten her GED yet. She's so scatterbrained and emotionally/mentally f*cked up that she can barely think. She cannot make decisions on her own, she's EXTREMELY indecisive. She has no motivation, no ambition, nor the energy to do anything. If she could, she'd stay in her room and smoke weed all day long because it makes her happy and confident and makes her forget about her problems, but as soon as she comes down from the high, she's back to being depressed, suicidal and weight conscious.

Anyhow... I apologize for the long post, but I thought I'd get as much info out as I could.

I'm not looking for "answers", I know that she needs to want to help herself, which she doesn't... she said she'd rather just die. Which kills me to hear. She says she's worthless, that she's a burden, that she doesn't deserve for anyone to care for her, because no one cares anyway, etc. I worry so much.

I'm just wanting to see if maybe anyone else has personal experience dealing with this sort of thing... maybe you've been through it, or someone you know has been through it? What did you do? How did you help yourself or the other person? What can you do to help them, if they don't want help? Anything helps.

Thank you all.

greentart

First off, I'm sorry that you're both having to deal with this. I found these sites to be really insightful: http://www.helpguide.org/mental/eating_disorder_self_help.htm
http://www.anad.org/eating-disorders-get-help/how-to-help-a-friend/

I don't have any personal experience with anorexia, but I just wanted to say that I hope the both of you the best in the world.

Amanda4change

I'm not sure if your here in the US or if you have legal custody of your sister, which my advice is going to be based on. From what you've said your sister needs intensive intervention this is NOT something you are going to be able to fix for her. If you are her guardian I would contact her primary care doctor and request a meeting without your sister being present (obviously if your parents are her guardians they need to do this). Explain to the doctor your concerns and what options are available. Then make an appointment with the doctor for her. The one advantage that you have is at 17 she's a minor and her parent or guardian can place her in an inpatient treatment center with out her consent easier than one can when she's an adult. Good luck

MyOwnSunshine

Your sister needs inpatient treatment -- physically and psychiatrically.

Call your Primary Care Provider and ask how to go about filing a family-generated legal petition to have her undergo a mandatory psychiatric evaluation. Family members can do this, provided there is evidence of self-harm, and self-cutting would qualify.

Kalikel

Everything you listed is very common among anorexics. They don't all have all of it, but none of it is one bit surprising.

800 calories a day, on a regular basis, is pretty high for anorexics. The ones who eat that much don't end up hospitalized all the time, if ever. It is doubtful that she lost all that weight on 800 calories a day.

She will not be able to think clearly until she's been eating well for months. One of the biggest problems of treating anorexics is that their brains need a loooong time to bounce back. Some girls have said it took six months, but it's usually around two or three. Of course, since their brains are wonky, getting them to eat properly for two or three months is nearly impossible. It really is a Catch 22.

Inpatient treatment for months can cost about what a house costs and insurance companies don't always pick up any significant amount. Unless someone has the cash to pay for it, she will have to be convinced to participate in her own treatment. If you can't convince her, don't blame yourself. It's not that you suck or that she doesn't love you; it's her wonky brain.

She needs a therapist who specializes in eating disorders and she needs to eat.

She wants to eat. She doesn't like living that way. None of them do. One the flip side, she doesn't want eat. If she could pull herself out, she would.

About the only thing that gets them to eat is wanting the tube out of their nose. It's annoying and uncomfortable, plus their hands are often tied down so they can't pull it out. They hate that, so they begrudgingly eat.

Force-feeding them will rescue them from the jaws of death, but if they don't eat on their own at home...sometimes I wonder if there's even a point to feeding them, but hope springs eternal.

Anorexia doesn't just affect the girls, it affects everyone who loves them. You should seek therapy. You'll get good advice there.

Just remember - her refusal to eat is NEVER your fault.

I will say a prayer for your sister and for you.

sarajenivieve

500-800 sounds like the ABC diet its really common with anerexics in my blog on my page i have 2 that deal with these issues

iKapuniai

Thank you all very very much for your replies and kind words.

I took her to an appointment today with a behavior health specialist and unfortunately I couldn't be there during the initial interview with my sister, but my mother and I were pulled in afterwards to express our concerns and learn about some things the therapist talked about with my sister. Apparently my sister absolutely refuses to go into treatment. Her exact words are "There will be girls there that's skinnier than me. That's going to make me not want to eat, and I'll want to kill myself even more than I do now." To that I said "I care about you too damn much to not take advantage of any help that's being offered."

The course of action they have in mind for now is not in-patient unfortunately, as I don't know if the insurance will cover it, or if it's what she needs. But there's a program where it's 5 days per week about 6-7 hours per day and they focus on many things: confidence, meditation, cognitive therapy, emotions, crafty/creative/artsy like projects, etc. So... we'll have to go with that for now, and if they feel she might benefit from in-patient treatment, that's something we'll explore later on when we get a referral.

But there's still the worry that she'll be okay during the program, but once she comes home in the evening and weekends, everything will be the same. Nothing will change. So I really don't know how much it'll help her, but at this point I'm pretty desperate to help her.

Anyhow... thank you all very much for your feedback, I really appreciate it.

vegkitten

800 calories a day, on a regular basis, is pretty high for anorexics. The ones who eat that much don't end up hospitalized all the time, if ever. It is doubtful that she lost all that weight on 800 calories a day.

Uh, how do you define what is "high" for anorexics? 800 is still pretty low espicially going on for a long period time. At my lowest weights, I was eating up to 900 calories a day. And I was pretty damn sick.

Kalikel

Watch to see if she starts throwing up or exercising a lot at night. If you notice it, don't badger her, but let the therapist know.

I hope the therapy works. Crossing my fingers for you all!!

People do get better!

vegkitten

She can only get better if she wants to get better. And it's way beyond just food. She can go to an IP or OP program, eat well, gain a good amount of weight, but can turn around because the mindset never went away. I've been struggling with an eating disorder for 13 years, and my weight goes from the low 90s to the high 160s and all over the place. She will need a lot of help long term. And a lot of support and unconditional love. She will have bad days where she doesn't want to get better (if she does decide recovery) and will fall into old habits. Be there for her.

AliceDark

You're clearly a very loving big sister! Be kind to yourself, because this is going to be rough for you, too.

This site has a ton of good information on EDs: http://www.youreatopia.com/ Your sister may or may not be ready for any of the information, but you may find it helpful.

momblobnomore

I struggled with ed as a teenager and the only things that really helped were anti depressants therapy and my mom and boyfriend begging me to eat until I gave in. Really honestly though I never changed until I got pregnant with my son and forced myself to eat for him... I know that's not very helpful just my experience with it. You are a good big sister and clearly doing all you can... hopefully she will come around.

MyOwnSunshine

Intensive outpatient therapy is good. Ultimately, you and your family have done your part in getting her to treatment. Now, she will ultimately decide whether treatment is successful. Many times, multiple attempts at treatment are unsuccessful, but it is important to encourage her to keep trying. Hopefully, she will eventually be in a place where she can fully embrace treatment and get better. You can love her and support her, but you can't force her to change.

FatFreeFrolicking

She honestly needs an inpatient program. She clearly needs 24/7 supervision/monitoring.

If she continues to make comments/threats about killing herself, call the police and have them send an ambulance. She will then be forced to go and will be admitted into a psych unit under suicide watch. From there, she will most likely be referred to an inpatient facility.

Outpatient programs are great but she refuses to get help. Because outpatient programs require actually leaving the house and getting yourself there, it doesn't sound like that's what's going to work for her.

Unfortunately, you and your family can do everything in your power to encourage her to get help, but she won't change until she wants to/is ready to.

Some_Watery_Tart

She sounds like my mom. My mom is bipolar and suffers from a variety of EDs. I grew up in a very screwed up household as a result.

The best thing I ever did was get some therapy for myself. So that is my suggestion for you. You need to work through your own feelings and learn to cope with a family member in this condition. It is incredibly hard to watch, and you feel so pathetically helpless, but at the same time you want desperately to do something--anything--to help this person. A professional who specializes in helping family members of mentally ill people can help you work through this.

My mom is still sick. But I no longer take her sickness upon myself.