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          Family Strategies for Coping with an Eating Disorder

          May 12, 2010

          Jennifer suffers from anorexia and bulimia and weighs a fragile 90 pounds, up from her lowest weight of 78 pounds. Her parents, Sue and Allan, and little sister, Abby, say they don’t recognize Jennifer anymore, and her eating disorder is destroying their family. Dr. Phil goes over tips for coping with a family member who has an eating disorder.

          Don’t live by eating disorder rules. Jennifer dictates her family’s mealtimes. She hoards food in her room, gets mad if anyone eats her food, binges and purges the family’s groceries, and no one eats until after she’s done. Her family lets her do whatever she wants in order to avoid an angry confrontation. “You are being run by the disease. You run on her schedule,” Dr. Phil tells the family. “It’s the ultimate emotional extortion: ‘I am going to die if you don’t do what I want you to do.'” Dr. Phil says their sacrifices are not helping Jennifer. Instead, it’s tearing their family apart.

          Don’t neglect other relationships.
          Jennifer’s family members find themselves staying at home to avoid stares from strangers or being embarrassed by her behavior. “You have two other children, you have each other, you have friends, you have your church, you have your community,” Dr. Phil says. “You can’t shut down the rest of your world because of this, because then you’re pulled in to this epicenter of this disease.”

          Create a family support system.
          Require the loved one to get professional help and seek family counseling as well. “You need help as individuals and as a family. You’re in over your head. It’s like you get a little kitchen fire. The next thing you know, the cabinets are on fire, the drapes are on fire, it’s jumped to the den. There’s a point at which you need to call the fire department,” Dr. Phil tells Jennifer’s family. “You’ve got to require Jennifer to get professional help, and if she won’t, then she’s got to go somewhere else. But to just sit there and watch her die is not an option.”

          Be patient and expect denial and hostility.
          “This is a chronic disease; this isn’t just somebody who won’t eat. This has gotten to an involuntary state for her. You need to expect denial, you need to expect hostility. You need to expect that she will throw a fit, and yell and scream,” Dr. Phil says.

          Don't blame.
          "You can't get caught up in blame here. This isn't your fault. You guys don't own this," Dr. Phil says.

          Don't obsess on food.
          Watch comments, negative or positive, about what your loved one eats or how much she eats. A person with an eating disorder is acutely aware of what goes in his or her body. Reminding him or her will only make it worse.

          Avoid commenting on weight or appearance.
          Don't play the game. If your loved one asks, 'Do I look fat today?' do not answer. Dr. Phil says he would respond with "I'm not going to play that game with you. That is an obsessive need for reassurance from me to feed your disease, and I'm not going to play that game." Even positive comments about your loved one looking healthy could be skewed in her mind and make her feel fat.

          Educate yourself about eating disorders.
          Eating disorders can be misunderstood. Find books on how to support a loved one with an eating disorder, what to say and what not to say. Find support groups and counselors who can help the entire family with strategies for a healthy environment.

          Model healthy focus on appropriate self-esteem.
          "There is so much more that Jennifer is than her body image. Wasn't this a delightful young woman? She was everything that Abby is," Dr. Phil reminds Jennifer's family.

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