Eating disorders: a guide for friends and family · Treatment for eating disorders While eating...

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Eating disorders: a guide for friends and family

Transcript of Eating disorders: a guide for friends and family · Treatment for eating disorders While eating...

Page 1: Eating disorders: a guide for friends and family · Treatment for eating disorders While eating disorders are serious illnesses, full recovery is possible. At Beat, we champion early

Eating disorders:a guide for

friends and family

Page 2: Eating disorders: a guide for friends and family · Treatment for eating disorders While eating disorders are serious illnesses, full recovery is possible. At Beat, we champion early

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Contents page

Introduction 3

What is an eating disorder? 4

Why do people get eating disorders? 5

Types of eating disorder 6 Bulimia 6 Anorexia 7 Binge eating disorder 8 OSFED/EDNOS 8

How can I approach someone I think has an eating disorder? 9

Treatment for eating disorders 12 Confidentiality 15

Supporting someone with an eating disorder 18 Lookingafterachild 21 Looking after a partner 22 Looking after a housemate 23 Looking after a friend 24 Lookingafteracolleague 25

Looking after yourself 26 Dealingwithasufferer’semotions 26 Telling others 28 Help and support groups 29 Taking time out 29

Next steps 30

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Introduction

Thisbookletisforanyonesupportingsomeonewithaneatingdisorder.Thismightbeafamilymember, a friend, a partner, a colleague. It covers typesofeatingdisorder,possiblecauses,howyoucan help, and treatment. It also gives guidance on takingcareofyourself.

This booklet is an overview, but we hope it will helpyouunderstandmoreabouteatingdisordersandprovideyouwithinformationthatwillhelpyoucareforyourlovedone.Youcanfindoutmoreonwww.b-eat.co.uk and through the resources listed in the Next Steps section.

Eatingdisorderscantakeovernotonlyasufferer’slifebutthelivesofthosearoundthem.Ifyou’recaring for someone with an eating disorder, whether full-time or through occasional support, itcanbedifficulttoknowhowtohelp,oreventopersuadethemtheyneedanddeservehelpinthefirstplace.

Butwiththerightsupportandtreatment,recoveryis possible. Encouraging a person to seek treatmentassoonastheirsymptomsappearisimportant;findingtreatmentearlywillgivethemthebestchanceoffullyrecoveringfromtheireating disorder.

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What is an eating disorder?

Eating disorders are serious mental illnesses that involve disordered eating behaviour. This mightmeanrestrictingfoodintake,eatingverylarge quantities of food at once, countering food eaten through purging or excessive exercise, or a combination of these behaviours. It is important, though, to remember that eating disorders are not about food. Instead, the eating behaviour might be acopingmechanismorawayforthesufferertofeel in control.

I thought, ‘If I can’t control what I eat, how can I control anything else in life?’

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Why do people get eating disorders?

Anyonecandevelopaneatingdisorder,regardlessof age, gender, or background. Research is still beingcarriedouttolearnwhypeopledevelopeatingdisorders,butevidencesuggestsit’sacombination of a biological predisposition towards the illness and a social or environmental “trigger”. This can be something life-changing, or something that to an outsider seems small – this does not invalidatetheperson’sillness.Stress,bereavement,difficultiesinanimportantrelationshipandculturalpressuresarejustsomeofthemanyfactorsthatmightplayaroleinsomeonedevelopinganeatingdisorder.

People with eating disorders do not choose to have themandcan’thelpbeingill.It’seasytolookforsomeonetoblame,whetherit’sthepersonwiththeeatingdisorder,someoneelse,orevenyourself.Butthisisn’tuseful–it’softenimpossibletosayforsurewhatcausedsomeone’seatingdisorder,buttherearethingsyoucandotohelpthemgetbetter.

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Types of eating disorder

It’scommontobelieveyoucan“see”aneatingdisorder.However,theyarementalillnessesandchangesinbehaviourandmoodwillprobablybenoticeable well before changes to appearance.

Eatingdisordersvaryfrompersontoperson–though there are some signs and traits associated with particular eating disorders, a person does not have to show all of them to be ill.

Somegeneralsignsthatmaybeassociatedwithalleating disorders include:

• Preoccupation with and/or secretive behaviour around food

• Self-consciousness when eating in front of others

• Low self-esteem

• Irritabilityandmoodswings

• Tiredness

• Social withdrawal

• Feelingsofshame,guilt,andanxiety

BulimiaBulimiainvolvescyclesofbingeingandpurging.This means the person will eat large amounts of food in one go and then engage in behaviour to compensate for the food eaten, such as making themselves sick, fasting, taking laxatives, or excessivelyexercising.Someotherpossiblesignsof bulimia include:

though there are some signs and traits associated with particular eating disorders, a person does not have to show all of them to be ill.

Somegeneralsignsthatmaybeassociatedwithalleating disorders include:

• Preoccupation with and/or secretive behaviour around food

• Self-consciousness when eating in front of others

• Low self-esteem

• Irritabilityandmoodswings

• Tiredness

• Social withdrawal

• Feelingsofshame,guilt,andanxiety

BulimiaBulimiainvolvescyclesofbingeingandpurging.This means the person will eat large amounts of food in one go and then engage in behaviour to compensate for the food eaten, such as making themselves sick, fasting, taking laxatives, or

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• Disappearing after meals

• A feeling of being out of control around food

• Soreskinonthebacksofhandsorfingersifused to induce vomiting

• Badbreathortoothdecayduetobeingsick

• Weightfluctuations

AnorexiaAnorexiausuallyinvolvesseverelyrestrictingfoodintake.Excessiveexerciseandbinge/purgecyclesmaybefactorsinsomeone’sanorexiatoo.Someother possible signs of anorexia include:

• Distorted perception of weight

• Preoccupation with and/or fear of gaining weight

• Obsessive behaviour such as counting calories

• Difficultyfocusing

• Wearingbaggyclothestohideweightloss

• Weight loss

• Disappearing after meals

• A feeling of being out of control around food

• Soreskinonthebacksofhandsorfingersifused to induce vomiting

• Badbreathortoothdecayduetobeingsick

• Weightfluctuations

AnorexiaAnorexiausuallyinvolvesseverelyrestrictingfoodintake.Excessiveexerciseandbinge/purgecyclesmaybefactorsinsomeone’sanorexiatoo.Someother possible signs of anorexia include:

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Binge eating disorder Binge eating disorder involves bingeing, i.e. eating large amounts of food at once, but not engaging in compensatorybehaviourassociatedwithbingeingin bulimia or anorexia. Binges are often planned in advance and carried out in secret. Some possible signs of binge eating disorder include:

• Spendinglotsofmoneyonfood

• Feeling out of control around food

• Eatingmorerapidlythanusual

• Eatingwhennothungry

• Weight gain

OSFED/EDNOS Sometimessomeone’ssymptomsdon’tfitallthe diagnostic criteria for anorexia, bulimia, or bingeeatingdisorder.Inthatcase,theymightbediagnosedwith“otherspecifiedfeedingoreatingdisorder”(OSFED)or,lesscommonlynowadays,“eatingdisordernototherwisespecified”(EDNOS).An OSFED or EDNOS diagnosis does not mean that the eating disorder is less serious. Signs of OSFED mightincludeanyofthosementionedabove.

Formoreinformationaboutspecifictypesofeatingdisorderandwhattolookforifyou’reworriedabout someone, visit www.b-eat.co.uk.

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How can I approach someone I think has an eating disorder?

Itcanbedifficulttoraisetheissue–youmayworryyou’llsaythewrongthing,thatit’snoneofyourbusiness,orthatyou’reinsultingtheperson.Remember eating disorders are serious mental illnessesandarenotthesufferer’sfault.Oftenpeoplewitheatingdisordersdenyordon’trealisethere’saproblem,butthatdoesn’tmeanthey’renotill.Eatingdisordersthriveonsecrecy,andcountlesspeoplewhoareinrecoveryagreethatbreaking the silence is the right thing to do, even iftheydidn’tfeelthatwayatthetime.The sooner the person can get treatment, the greater their chance of a full and sustained recovery.

Herearesomethingsyoucandowhentalkingtosomeoneyou’reworriedabout:

• Thinkaboutwhatyouwanttosayandmakesureyoufeelinformed.Readingthisbookletisagoodstart.Youcouldalsolookattheinformation on our website.

When my mum and partner expressed how worried they were… although part of me was annoyed and in denial, a huge part of me felt relieved.

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• Chooseaplacewhereyoubothfeelsafeandwon’tbedisturbed.Ifyou’reoneofseveralpeoplewhohavefeltconcerned,don’ttalktothepersontogetherastheymayfeelyou’reambushingthem.Decidewhotheyaremostlikelytoopenupto.

• Chooseatimewhenneitherofyoufeelsangryorupset.Avoidanytimejustbeforeoraftermeals.

• Havesomeinformationwithyouthatyoucanrefertoifyou’reableto.Youcouldshareitwiththem,orleaveitwiththemtolookatbythemselves.

• Trynottocentretheconversationaroundfoodand/orweight.Whileitmaybenecessarytobringthisuptoexplainwhyyou’reworried,thesemaybethingsthey’reparticularlysensitive about. At their roots, eating disorders are about what the person is feeling rather thanhowthey’retreatingfood.

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• Mentionthingsthathaveconcernedyou,buttrytoavoidlistingtoomanythingsastheymayfeelliketheyhavebeen“watched”.

• Trynottobackthemintoacorneroruselanguagethatcouldfeelaccusatory.“Iwonderedifyou’dliketotalkabouthowyou’refeeling”isagentlerapproachthan“Youneedtogethelp”,forexample.

• Theymaybeangryanddefensive.Trytoavoidgettingangryinresponse,anddon’tbedisheartenedorputoff.Reassurethemthatyou’llbetherewhenthey’reready,andthatyourconcernistheirwellbeing.

• Don’twaittoolongbeforeapproachingthemagain. It might feel even harder than the firstconversation,especiallyiftheydidn’treactwell,butifyou’restillworried,keepingquietaboutitwon’thelp.Remember,eatingdisordersthriveonsecrecy.

• Iftheyacknowledgethattheyneedhelp,encouragethemtoseekitasquicklyaspossible.OffertogowiththemtotheGPiftheywouldfindthathelpful.

• Iftheytellyouthere’snothingwrong,eveniftheyseemconvincing,keepaneyeonthemandkeepinmindthattheymaybeilleveniftheydon’trealiseit.Denialthatthere’saproblem is common – in the case of anorexia, it’sconsideredasymptomoftheillness.Youwereworriedforareason,sotrustyourjudgment.

• Ifyouneedsomesupportorhaveunansweredquestions,callBeat’sHelplineon08088010677.

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Treatment for eating disorders

While eating disorders are serious illnesses, full recoveryispossible.AtBeat,wechampionearlyintervention. Research shows that the sooner an eating disorder is treated, the less chance the behaviour and thoughts that cause it have to become ingrained, and the greater the chance of recovery.Whenwetalkaboutearlyintervention,wedon’tmeanthatsomeonewhohashadaneatingdisorderforalongtimecannotfullyrecover.However,aswithanyillness,wewouldalwaysencourage someone to seek treatment sooner rather than later. This is also true if a person relapses.

Therearemanydifferenttreatmentpathways.Therightoneforthepersonyousupportwilldependonlotsofdifferentthings,includinglevelofphysicalandpsychologicalrisk,whateatingdisordertheyarediagnosedwith,theirage,supportnetwork,andotherphysicalormentalillnessestheymighthave.Treatmentforeatingdisordersshouldaddresstheunderlyingpsychologicalcauses of the illness. It should of course treat

I agreed to see a GP if one of my parents came with me and, looking back, this was the beginning of the treatment that I so desperately needed.

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any physical problems too, helping the patient to develop healthy eating behaviours and maintain a healthy weight. But alongside this, they should be learning healthy ways to cope with the thoughts and feelings that cause the behaviour.

The path to recovery will likely begin with a visit to the GP. If they diagnose an eating disorder, they should refer the person to an eating disorders specialist.

Our GP leaflets, available on our website, are designed for people to take along to the GP appointment. Some other things you can do to help get a positive outcome include:

• Bring as much information as possible. People in England, Wales, and Northern Ireland should consult the NICE (National Institute of Clinical Excellence) guidelines for treatment at www.nice.org.uk. These guidelines are based on thorough research into what is effective. “Eating Disorders in Scotland – A Patient’s Guide” is available at www.healthcareimprovementscotland.org.

• Offer to go with the person for support. You could stay in the waiting room, or go in with them so you can prompt them if they need it.

• Book a double appointment, as a single appointment may not be enough time to discuss everything.

• Talk with the person beforehand about how they’re feeling and what they want to get out of the appointment. Suggest they write down

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theirsymptoms,behaviour,andanyquestionstheyhavefortheGPsotheydon’tforgetanythingtheywanttosay.

• Earliertreatmentisalwaysbetter,soit’simportant to support the person in pushing for referral to an eating disorders specialist.

• Thepersonyou’resupportingcanasktoseeanotherdoctoriftheydon’tgetthedesiredoutcome from the initial appointment.

Ifthepersonyou’resupportingcan’tgetareferralfromtheGP,thereareotheroptionsfortreatment.SearchourHelpfinderforindependentandprivatetreatment centres and practitioners, or see the Next Steps section at the end of this booklet.

Specialisttreatmentmayincludeappointmentswithaclinicalpsychologist,psychiatrist,counsellor,dietician, or a combination. Talking therapies, suchascognitivebehaviouraltherapy,arerecommended,astheseaddresstheunderlyingcauses.Medicationcanbeeffectiveintreatingsomesymptoms–forexample,certaintypesofantidepressantsmaybeprescribedforbulimia.

Most often, appointments will take place in outpatientfacilities,andtheirfrequencywilldepend on individual needs. Where someone needsmoresupervisionwiththeireating,itmaybenecessaryfortheirtreatmenttotakeplaceinadaypatientunit,meaningtheyarethereduringthedayandgohomeforthenight.Ifconstantsupervision is needed or there is major concern aboutphysicalcomplications,someonemaybeadmittedtoaninpatientfacility,wheretheystayovernightaswell.Forunder18s,theseservicesare

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likelytobeadministeredbyyourlocalChildrenandAdolescent Mental Health Service (CAHMS).

Inrareinstances,someonemightbeveryillbutnotwillingtoentertreatment.Inthiscase,compulsorytreatmentundertheMentalHealthActmaybenecessary.Youcanreadmoreinformationaboutthe Mental Health Act on the NHS choices website.

The Beat website has more information about differenttypesoftreatment.

Confidentiality Bylaw,thehealthcareteamkeepsdetailedinformationconfidential.Aslongasthey’redeemedcapable of making decisions about their treatment, childrenunder16areentitledtodecidehowinformationtheyprovideinconfidenceisused.

Peopleof16and17areentitledtothesameconfidentialityasadults.TheDepartmentofHealthrequiresabreachofconfidentialityonlywhereiftheyrefusetreatmentforalife-threateningillness.

I would have probably struggled to make the decision to go [for treatment] on my own.

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Eating disorders. Know the fi rst signs?

Awareness Campaign

It’simportanttobeabletospotthefirstsignsofaneatingdisordersothattheyoralovedonecangetthehelpandsupporttheyneedasquicklyaspossible.That’swhyBeathaslaunched a new campaign to make people aware of what to look out for.

Ifyou’venoticedanyofthesesignsinsomeoneyoucareabout,itdoesn’tnecessarilymeantheyhaveaneating

disorder.Butit’salwaysbesttotreateatingdisordersasearlyaspossible.

Ifyou’reworriedsomeoneyoucareabout is showing signs of an eating disorder–evenifthey’renotonourlist – please get in touch. We can give youtheanswersandsupportyouneedtohelpthemontheroadtorecovery.

Visit b-eat.co.uk/tips

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?

Kips Are they often tired or

struggling to concentrate?

Hips Do they have distorted beliefs

about their body size?

!

Nips Do they disappear to the

toilet after meals?

Skips Have they started exercising

excessively?

Lips Are they obsessive

about food?

Flips Is their behaviour

changing?

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However,respectforpatientconfidentialityshouldn’tmeanhealthcareprovidersdon’tlistentoorcommunicatewithyou.Youshouldexpecttobegivenenoughinformationbyhealthcareproviderstobeabletoprovideeffectivecare.Remember,anythingyouasacarerdiscloseshouldalsobetreatedconfidentially.

Supporting someone with an eating disorder

It’simportanttoencouragethepersonintotreatmentasquicklyaspossibletoensurethebestchanceofrecovery.Butbeyondthat,there’salotyoucandotosupportsomeonewithaneatingdisorder,nomatterwhatyourrelationshipwiththem.Rememberthateverypersonisdifferentandwillneeddifferentthings,butthiswillgiveyousomeideasaboutwhatyoucandotohelp.

Mealtimesarelikelytobeveryhardforthepersonyou’resupporting.Onthenextpagearesomewaysyoucanhelpthemout:

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• Ifyoulivewiththem,plantoeattogether.Arrangewiththemandanyoneelsewhowillbepresentwhattimeyou’llbeeating,whatyou’llbehaving,andportionsizes.

• Meals should be balanced, with a range of foods and sensible portions, taking into considerationthedietaryneedsofeveryoneelse at the table as well as the person with the eating disorder.

• Makesureyouhaveeverythingnecessaryforthe planned meal. Last-minute changes could cause the person to panic, and in the case of anorexia and other restrictive eating disorders, theymightlimittheirfoodintake.

• Shoppingtogethermayallowyoutointroducenewfoodsthatthey’rewillingtoeatinthecaseof restrictive eating disorders, and discourage themfrombuyingfoodtobingeonwherebingeing is a factor in their eating disorder.

Don’t give up – it’s hard, but keep going.

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• Keep conversation neutral, avoiding discussion of food or weight.

• Youcouldhavethetelevisionorradioontohelpdistractthemandtodrawattentionawayfrom them.

• Be aware that people with restrictive eating disordersmayneedtophysicallyadjusttoeatingmore,aswellasmentallyadjusting.Startslowlyandbewaryofpressuringthem.

• Youmayneedtoofferencouragementtohelpthem start eating, and further encouragement throughoutthemeal.Befirmbutacknowledgethatthisisabigeffortforthem.

• After a meal, suggest doing something together,likewatchingafilmorplayingagame,totaketheirmindoffpossiblecompensatorybehaviourssuchaspurgingorexercising,orofftheideaofbingeing.

Outsideofmealtimes,therearelotsofwaystosupportsomeoneandshowthemyouvaluethem.Youmightfindthattheireatingdisordercausesthem to withdraw, but keep inviting them to join in withgroupandfamilyactivities.Offercomplimentsthatdon’trelatetotheirphysicalappearance,andtrytofindthingstodowiththemthatdon’tinvolvefood.Don’tbetoocriticalofyourselfifyoudomakeamistake–youcan’talwaysaccountforthingsthepersonyou’resupportingmightfeelsensitiveabout,andyou’llbeawareforthefuture.

Whetheryoulivewiththepersonyou’resupportingor not, just being there for them and showing themyouunderstandthisisnottheirfaultandbelievetheyareworthyofsupportwillmakeabig

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difference.Andoncethey’reinrecovery,makesurethattheyfeelabletoapproachyouagainiftheyneedtointhefuture–fullrecoveryiscompletelypossible, but relapses are not uncommon.

Looking after a child • Remember,it’simportanttoaddressthe

thoughts and feelings causing an eating disorder, not just the behaviour. There are manydifferenttherapiesthatcandothis,andnosingletherapyisthebestchoiceinallcases.Dependingonhowyoungtheyare,youmayhavealotofsayovertheirtreatment,sorememberthatifyourchildisn’trespondingwelltooneformoftreatment,theymayrespond better to another.

• Be mindful of other children and how the eatingdisordermightbeaffectingthem.Theymayneedtheirownemotionalsupport.Ourleaflet,“CaringforSomeonewithanEatingDisorder(forunder18s)”maybeusefulforsiblings of the person with the eating disorder. It is available to download on our website.

• IfyourchildhasbeenreferredtoChildandAdolescent Mental Health Services (CAMHS) andturns16or18(dependingontheservice)theywillneedtomovetoAdultMentalHealthServices(AMHS).Thetransitionawayfromtheteamtheyandyouknowcanbedifficult,so talk to the CAMHS team about how the changecanbemadeassmoothlyaspossible.

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Looking after a partner • Ifyouhavechildren,trytoinvolvethemif

possible–whileyoumaywishtoshieldthem,childrenareperceptiveandmayrealisesomething is wrong. Explain the situation in age-appropriate terms, reassure them, and encouragethemtoaskquestions.Ifthey’reoldenough,youcouldalsoshowthemourleaflet“Caring for Someone with an Eating Disorder (forunder18s)”,availableonoursite.

• Remember eating disorders are isolating and secretiveillnessesbynature,andoftencausefeelings of low self-esteem and a distorted perceptionofbodysizeandshape.Yourpartnerprobablywillnotwanttobephysicallyoremotionallyintimatewhilethey’reill.Thisisnotthemrejectingyou,buttheeatingdisorderspeaking.Trytounderstandthingsfromtheirpointofview,butcommunicateyourfeelingstoo.

• Trytokeepdoingthingstogetherasacoupleandasafamily.

When I go through bad periods I do try to revert back to [my eating disorder], but my husband keeps me strong.

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Looking after a housemate • Ifyoudon’tfeelcomfortablespeakingtothem

aboutyourconcerns,youcouldtrytalkingtosomeonethey’recloserwith,suchasoneoftheir friends or relatives.

• Ifyou’rebothstudents,youruniversityorcollegemightbeabletohelp.Universityhallsoftenhaveresidenttutorsyoucouldtalkto.Manyuniversitieshaveanadviceservice,specificmentalhealthservice,andcounsellingteam, as well as a medical centre.

• Yourhousematemayknowtheyhave,orbeintreatmentfor,aneatingdisorderwhenyoumeet them. Moving, or having housemates they’vecometorelyonmoveout,canbeadifficulttransition,andanythingyoucandotohelpthemadjustwillbeuseful.Theyandthepeopletheypreviouslylivedwithmayhave come up with a plan for coping with mealtimes, so talk to them about whether there’saroleyoucantakeover.

• Ifthey’vemovedawayfromtheirregulardoctor,youcouldoffertogowiththemwhentheygotoseetheirnewone.

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Looking after a friend • Offerpracticalsupportsuchasaccompanying

themtoappointmentsandhelpingwithday-to-daytasks.Youcouldcoordinatethiswithother friends. If someone is supporting the person with the eating disorder full-time, this could help them, too.

• Involvetheminthesamethingsyouwouldhavedonebeforetheywereill,andmakesuretheyknowyou’retheretolistentoandsupportthem–eatingdisorderscanbeveryisolating,andyourfriendmaybeworriedaboutpeoplepullingawayfromthem.Ifthey’reundergoingtreatment,theymaybekeentokeepthingsasnormal as possible elsewhere in their life.

• Trytofindthingstodothatdon’tcentrearound food.

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Looking after a colleague • Ifyou’reworriedandyoudon’tfeelableto

talktoacolleagueyourself,speaktotheirlinemanageraboutyourconcerns.Youcandirecttheir line manager to this booklet or to the Beat websiteiftheydon’tknowmuchabouteatingdisorders.

• Whileyoumaynotbeclosewithacolleague,following the advice for how to approach someone with an eating disorder should still behelpful.Talktothemsomewherethatyouboth feel comfortable, and reassure them that theyaren’tintrouble.

• Itmaybethattheyarealreadyawareofandin treatment for their eating disorder, in which caseofferingtohelpwiththeirworkloadiftheyneedtotaketimeofftogoforappointmentscouldbeagoodwaytosupportthem.

• Youcanfindmoreresourcesonourwebsite–go to www.b-eat.co.uk/workplace.

[My employer] kindly asked what my availability was, and more importantly what I felt able to do.

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Looking after yourself

Taking care of someone with an eating disorder canbephysicallyandemotionallyexhausting.There’snoshameintakingtimeoutorseekingyourownsupportnetwork–youcan’ttakecareofsomeoneifyou’renotwellyourself.Belowaresomeissuesyoumightencounterandhowtodealwiththem,andsomewaystotakecareofyourownwellbeing.

Dealing with a sufferer’s emotions Eatingdisorderscanmakepeoplebehaveinwaysthatseemoutofcharacter.Theymaybecomewithdrawn,andyoumayneedtogotomoreeffortthanusualtomakethemfeelincludedandstopthemfromisolatingthemselves.Whileearlytreatmentisalwaysthebestoptionandwillgivethesuffererthebestchanceofgettingcompletelybetter, this can be upsetting and frightening, andtheymaytrytoresistit.Beforeandduringtreatment, emotional or aggressive outbursts and hurtfulcommentsorresponsestoyourattemptstohelparen’tuncommon,especiallywhenthepersonfeels challenged – remember this is not them but the eating disorder speaking. There are some thingsthatyoucankeepinmindtomakethesetimes more manageable and avoid escalating the situation.

• Itmightbebesttowalkawayandtalkonceeveryoneinvolvedhascalmeddown.Trytoresistanyurgetorespondtotheirangeroraggressionbygettingangryyourself.It’sreasonabletofeelfrustrated,buttrytoavoidexpressingthatinfrontofthesufferer.

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• Trynottofeeltooguiltyifyoudofindyourselfgettingangryatthem.Maketimewhenthingshavecalmeddowntoexplainyouremotionstothesufferer,andtrytoencouragethemtodothesame.Eachofyouclearlycommunicatingyourviewsandfeelingsmightmakeiteasiertoavoid the situation in the future.

• Rememberthat,muchasthepersonyou’resupportingisill,therearestillboundaries.Theydon’thavetherighttohurtotherpeople,evenifthey’refindingthingsdifficult.Whenthingsare calm, be clear with them about what is and isn’tacceptable.

• Talk to other people involved about how to handle situations where emotions are running high.It’sbesttocomeupwithaplanwhereyouworktogether,asconflictingapproachestodefusingasituationmaymakethingsworse.

With other people’s support, I finally realised the only way I could help my sister was to first take care of myself.

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Telling others Eating disorders and mental illnesses in general aresurroundedbystigmaandmisconceptions.Thismaymaketellingpeoplethatsomeoneclosetoyouissufferingmoredifficult.Dependingonyourrelationshiptothepersonyou’recaringfor,youmightfinditimpactsyourwork,studies,orsociallife. Having solid and dependable relationships withpeoplewhocansupportyouisimportant.

Youmaynotneedtoexplaintheexactnatureoftheillnesstopeople,especiallyifthey’renotgoingtocomeintocontactwiththesuffererthemselves.Whereyoudoneedtotalkabouttheeatingdisorderspecifically,theinformationinthisbookletoronourwebsitemayhelpthepersonyou’retalking to understand more about eating disorders.

Oncepeopleareawareofthesituation,youmightfindtheyhavequestionsaboutyourwellbeingandthatofthepersonwiththeeatingdisorder.Youcould ask someone else to keep people updated ifthisbecomesdifficultforyou.Iftherearepeoplewho want to help but whose close involvement is notappropriate,youcouldaskfortheirhelpwithday-to-daytasks.

Ifyou’rereceivingunwantedquestionsoroffersof help in dealing with the eating disorder, explainthatwhatyouneedfromthemistheirunderstanding and their continued friendship and support.

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Help and support groupsSupportgroupsletyoutalktoothersinsimilarsituations.Beatcurrentlyrunsanonlinesupportgroup for carers of people with eating disorders, andtheremaybeanin-personsupportgroupinyourarea.Visithelpfinder.b-eat.co.uktofindoutabout local support groups, and www.b-eat.co.uk/support-servicestofindoutwhatBeatcanofferyou.

Taking time outIfyou’recaringforsomeonefull-time,it’svitaltosetasidetimeforyourself.Thismaybesomewherethatfriendsandfamilycanhelp.Ifyou’resharingprimarycareresponsibilitieswithsomeoneelse,youcouldtakeitinturnstohavesometimeoff.Ifthere’snoonearoundtotakeoveryourrole,acarers’organisationsuchasCarersTrustmightbeabletohelp.YoucanseetheirdetailsintheNextStepssectionattheendofthisleaflet.

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Next Steps

We hope that you’ve found this booklet helpful, but we know that you’ll have a lot more questions and may need other resources. Here are some that you might find helpful:

Beat services • Visit www.b-eat.co.uk for information, message

boards, and online support groups.

• Search helpfinder.b-eat.co.uk for services in your area.

• Call the Adult Helpline on 0808 801 0677 or email [email protected].

• Call the Youthline on 0808 801 0711 or email [email protected].

Babble Online network for young carers. Visit babble.carers.org or email [email protected].

British Association for Counsellors and Psychotherapists Search for therapists in your area. Visit www.itsgoodtotalk.org.uk.

Carers Direct An NHS service for carers. Visit www.nhs.uk/carersdirect or call their helpline on 0300 123 1053.

Carers Trust A charity offering support to carers. Visit www.carers.org or email [email protected].

Carers UK A charity supporting carers. Visit www.carersuk.org or call their helpline on 0808 808 7777.

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Citizens Advice BureauFor enquiries about legal rights and responsibilities, benefi ts for carers, and fi nancial advice. Visit www.citizensadvice.org.uk.

GOV.UKContains information about support services, both your rights and those of the person you’re supporting, and more on the laws that may be relevant to you. Visit www.gov.uk.

MindInformation and support for anyone aff ected by mental health issues. Visit www.mind.org.uk or call 0300 123 3393.

National Institute for Health and Care ExcellenceThe NICE guidelines on the treatment the person you’re caring for is entitled to. Visit www.nice.org.uk.

NHS ChoicesInformation on eating disorders and other mental and physical health issues, diff erent treatment options, and local services. Visit www.nhs.uk.

RethinkInformation and support for anyone aff ected by mental health issues. Visit www.rethink.org or call 0300 5000 927.

Selfharm UKA charity supporting young people who are self-harming, which can sometimes occur alongside an eating disorder. Visit www.selfharm.co.uk.

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Beat is the UK’s eating disorder charity. We act as a champion, guide and friend for anyone aff ected by an eating disorder.

Online supportVisitwww.b-eat.co.uk for information about eating disorders, message boards and online support groups.

Use helpfinder.b-eat.co.uktofindservicesinyourarea.

beatED beating.eating.disorders

Help for adultsHelpline:

0808 801 0677

Email: [email protected]

Help for young people

Youthline: 0808 801 0711

Email: [email protected]

Beat, Wensum House,103PrinceofWalesRoad,Norwich,NR11DW

03001233355|www.b-eat.co.uk|[email protected]

Issuedate:February2017Reviewdate:February2020Version1.0

SourcesusedtocreatethisinformationareavailablebycontactingBeaton03001233355oremailinginfo@b-eat.co.uk.Wewelcomeyourfeedbackonourinformationresourcesandwhetheryoufoundthemhelpful. Email [email protected].

AcharityregisteredinEnglandandWales(801343)andScotland(SC039309).Companylimitedbyguaranteeno.2368495.