How do you help someone with anorexia who doesn't want it?

jnchorn

Hello there. I went back home this past weekend for a family wedding. While I was there I saw my best friend for the first time in 18 months, and she scared the heck out of me. When I saw her 18 months ago, she was too thin and barely eating. I had talked to her about making sure to get at least 1200 calories, plenty of water, eating your exercise calories etc. She brushed it off but I had to try.

Well, fast forward 18 months and she is much much worse. She has dropped 40-50 pounds since I last saw her. She has lost a lot of hair, her skin is hanging and she just plain looks terrible. She works out like a fiend. She does 6 miles a day of running/joggin, zumba and elliptical just to name a few. In the 2 days I spent with her, she had only one 2 in. X 2 in. piece of lettuce and some water.

Her sister asked me to talk to her about the problem. My best friend, Joy, has been talked to by her Dad, her co-workers and her friends and noone can seem to get her to talk about the problem. I tried to make plans with over the weekend and she backed out of them. I told her I would come by her house and see her or even go to work and see her so she didnt have to drive anywhere. She got angry with me and told me to stop pestering her. So I was not able to talk to her like I had intended. Her family doesn't know what they can do medically to get her help or legally. How do you get help for her when she doesn't see a problem? I don't think her body can take much more of this. I really appreciate any advice you can offer!

:flowerforyou:
Charity

icimani

I have no experience with anorexia - either myself or any friends. But here are some thoughts - take what makes sense and discard the rest!

- no one is going to be able to talk her into anything until she decides on her own - much like an addict has to help themselves.

- this is coming just after I read the post about "why didn't you TELL me I was fat?!" Maybe she needs some tough love - like someone telling her in no uncertain term how bad she looks. Not "skinny" because that's probably what she's going for, but BAD.

- it's my understanding that some of the psychology behind anorexia is that it's about control - like controlling their weight is the only thing they feel they can control. She needs more help than just a healthy diet; she needs professional therapy to understand her thinking about food and how she looks.

nothingwithoutHim

Bump. This is a very important issue.

_Elemenopee_

You cannot help someone who doesn't want help. You can only be there for them and be persistent (without being pushy). After all, it is their life, not yours.

I hope she sees what is happening and gets help, before it's too late.. :flowerforyou:

rabbit__food

You cannot help someone who doesn't want help. You can only be there for them and be persistent (without being pushy). After all, it is their life, not yours.

I hope she sees what is happening and gets help, before it's too late.. :flowerforyou:

^^Agreed 100% I had a friend in high school in the same situation. Nothing anyone said or did helped until she finally realized it was unhealthy.

ChristyRunStarr

Simply put-you can't. As much as you want to help her you won't be able to because she won't listen until she's ready. Same thing with her parents and any forced help (impatient, ER, ect.). All you can do is be there for her as a friend and hope she turns around. I know it's tough but I've been on both sides and sadly you just have to hope she wants to get help

knightreader

you can't.

perhaps tell her that when she is ready to make a change, you will be there to help her. until then, unfortunately, there isn't anything you can do.

AlsDonkBoxSquat

You cannot help someone who doesn't want help. You can only be there for them and be persistent (without being pushy). After all, it is their life, not yours.

I hope she sees what is happening and gets help, before it's too late.. :flowerforyou:

Basically this. It's like any other thing that a person uses to self medicate, they just have to want to stop and want to get the help they need to get better. Intervention with a therapist? Simply talking to her about what she should be doing in and telling her how wrong everyone thinks her decisions are just won't help. Her family needs to consult with a specialist, this isn't an issue of diet, it's an issue of psychology.

phiddy23

This might be controversial but I actually disagree, I think she should be put into hospital / rehab / something like that. It's what you would do for a drug addict and there is a lot of similarity between the two situations. Yes it is her life but she is slowly killing herself - it's an illness. I think if anything bad were to happen to her you might regret not doing the above. It might work, it might not, but either way it's better than doing nothing.

macybean

Her family needs to get her to an ER for a psych eval. She can be held against her will for 72 hours if she is deemed a danger to herself, which if what your describing is true, she is. They can also call 911 if she won't go willingly, as this is a psychological emergency. This may seem harsh, but it may be the only way to help her. Trying to reason with someone who has such a distorted view of herself is useless. Trying to use tough love is useless. Waiting until her heart stops is not a good choice either. Best of luck to her and her family, this is not an easy thing to do.

GamerGurl729

Tough love for now is the best thing you can give her. Don't sugarcoat what you tell her, but make sure she knows that what you're telling her is coming from a place of love and respect. If she blows you off, keep pestering her until she makes time for you. Get her family to do the same. If she keeps hearing the same things from those who truly love her, it may make a difference.

Sometimes there is the option of having someone committed; anorexia is considered a mental illness. But you really don't want to go that route unless it's absolutely necessary. If she gets so bad that her health is compromised and she has to seek emergency treatment, they may commit her anyway. I truly hope that it never gets to this point.

It's a delicate situation, and I'm by no means an expert. You did ask though, so there's my $.02. I wish both of you the best of luck. And I hope she realizes what she's doing before it's too late and the damage can't be undone

firstsip

Well, I've had experience with anorexia, and though I can't speak for everyone with EDs, a few things come to my mind.

1. You CAN'T legally or medically do anything for an adult. If she is an adult, unfortunately, you can't go complaining to her dad or a doctor.

2. Yes, what Icimani said is spot on. EDs are generally about control--binge eating is the lack of it, anorexia is the extreme opposite of that, etc. What else is she dealing with in her life right now? I can almost guarantee she's not starving herself solely for looks. Sure, body dysmorphia is a HUGE part of EDs like bulimia and anorexia, but it is, ultimately, about control. How's her personal life, work, etc.? Knowing more about that will reveal more about why she's going on this path.

3. Things you can or cannot do:
a.) When people commented on how skinny I was, it was absolutely validating: it made me feel good. It made me feel progress. It made me feel like, "I can get skinnier, and the comments will still come." It almost didn't matter if the comments were positive or negative (ex: "You're so skinny!" vs. "You look like a bag of bones!"); just being commented on validated how my control was working--I was getting results from restricting my eating and overexercising.

b.) Though I always say that once you have an ED, you always have an ED (i've dealt with triggers, minor relapses, etc. on this site since January)... but when I was just starting to recover from the worst times, a support system helped me, in a way that you may or may not do, and people may or may not agree with. I had friends say, "Okay, well I won't eat lunch if you don't" or "I'm not going to eat until I see you eat." This can drive people to purge after this scenario, but this scenario also put me very outside of my personal demons. I couldn't bear to let people around me starve, be unhappy, etc. So I started eating with them. It eventually tuned into me eating without them, and here I am (I'm trying to lose weight now, fyi, from a purely medical issue way after my very worst ED days).

Closing thoughts? Urge therapy, get a group of people that can be very consistent with how they handle the situation (ex: eating with her, watching what she eats, distracting her, agreeing to say or not say certain things like "You look so skinny!" etc.).

As for her sequestering herself and breaking plans with you: don't call and say, 'I'll drive! Don't worry!' Show up. If she breaks plans, say, "Sorry, I'm already on my way." Don't give her outs to withdraw from people more into her world.

2hobbit1

Guide for friends and family
http://www.helpguide.org/mental/eating_disorder_self_help.htm
http://www.nationaleatingdisorders.org/information-resources/family-and-friends.php
http://www.nationaleatingdisorders.org/uploads/file/toolkits/NEDA-Toolkit-Parents_03-10-09.pdf

Legal issues/rights
http://www.bulimia.com/client/client_pages/newsletteredt7.cfm

macybean

You CAN'T legally or medically do anything for an adult. If she is an adult, unfortunately, you can't go complaining to her dad or a doctor.

Yes, you can. It's called an emergency hold and is reserved for circumstances like this. It's a last resort for someone that is in danger of self harm due to mental illness. No, you can't make her change, but if she never even gets in the door to therapy she has zero chance of recovery. Waiting until her heart stops from malnutrition would be wrong. Think Terry Schiavo.

2hobbit1 gives great resources/links.

jnchorn

I had to tell her things straight. I didn't sugar coat them at all. I wanted to do face to face but she wouldnt let me. I told her I love her very much but what she is doing is killing her. I didn't tell her to eat more or exercise less. It's too late for that in my opinion. I think just adding more food isn't going to help since it has downgraded to a psychological issue. I feel pretty helpless. I just hope someone can reach her before it's too late.

ErinBeth7

I have no experience with anorexia - either myself or any friends. But here are some thoughts - take what makes sense and discard the rest!

- no one is going to be able to talk her into anything until she decides on her own - much like an addict has to help themselves.

- this is coming just after I read the post about "why didn't you TELL me I was fat?!" Maybe she needs some tough love - like someone telling her in no uncertain term how bad she looks. Not "skinny" because that's probably what she's going for, but BAD.

- it's my understanding that some of the psychology behind anorexia is that it's about control - like controlling their weight is the only thing they feel they can control. She needs more help than just a healthy diet; she needs professional therapy to understand her thinking about food and how she looks.

I'd have to agree with all of this. I'm no expert nor do I have any license to give advice so I won't.

misfitswayoflife

I have had lots of experience with anorexia, (Not myself but friends) You can't help if they don't want help.
Never comment on their weight flucuations, whetehr telling them they are skinny/bony etc
All you can do is be there to listen until they want help. It can be frustrating because Anorexia is so dangerous. But if they don't want to fix it, forcing help will be worse.

belgerian

The same as any other mental/emotional disease get help yourself you are powerlessness. I wish you the best of luck Maybe find a CODA meeting somewhere (Codependants Anonymous).

firstsip

You CAN'T legally or medically do anything for an adult. If she is an adult, unfortunately, you can't go complaining to her dad or a doctor.

Yes, you can. It's called an emergency hold and is reserved for circumstances like this. It's a last resort for someone that is in danger of self harm due to mental illness. No, you can't make her change, but if she never even gets in the door to therapy she has zero chance of recovery. Waiting until her heart stops from malnutrition would be wrong. Think Terry Schiavo.

2hobbit1 gives great resources/links.

Though you're in scrubs in your avatar, I'm not sure what state you live in or if you've seen this firsthand. An emergency hold is reserved for, like you said, danger of self harm due to mental illness... involving immediate harm. Eating disorders are infamously hard to do this with; the majority of emergency holds are for threats of suicide, possession of drugs/weapons, etc. These "holds" are used for patients with eating disorders AFTER they have been admitted into a hospital because of illness having to do with it (see: heart attack, electrolyte imbalance, etc.), not before. You say "waiting until her heart stops would be wrong," but the issue here isn't morality but what can be done legally for an adult.

amyrockefeller

I can't believe some of the dark-aged mentality on this site. How does one change if they are an addict or anorexic? They need external help like I did. You can want to change all you like but it doesn't work for everyone. Not everyone has a strong constitution or is emotionally or mentally well. If you see a friend dying of anorexia or drug addiction and do nothing, shame on all of you!!!

glin23

I can't believe some of the dark-aged mentality on this site. How does one change if they are an addict or anorexic? They need external help like I did. You can want to change all you like but it doesn't work for everyone. Not everyone has a strong constitution or is emotionally or mentally well. If you see a friend dying of anorexia or drug addiction and do nothing, shame on all of you!!!

I don't think anybody wouldn't want to help a friend with anorexia, but the truth is legally they would be limited s to what they could actually do. There's a difference.