Identifying and supporting someone with an eating disorder

Mental health experts offer guidance on providing emotional support to someone struggling with an eating disorder.

Unhealthy weight loss

Eating disorders are often associated with emotional challenges, identity issues, trauma, or external pressures. For some individuals, food serves as a way to exert control when their lives feel chaotic. So, if you suspect that someone close to you has an eating disorder, it’s important to know how to approach the situation and who to contact for assistance.

“From an emotional perspective, an eating disorder often reflects underlying issues related to identity, emotional coping, family dynamics, trauma, or other personal challenges,” says Johan Erasmus, a senior clinical psychologist at Mediclinic Denmar Mental Health Services in Pretoria. “An individual may seek comfort or try to cope by controlling food or food intake. This all-consuming disorder leads to an intense focus and awareness of food and eating.”  

Signs of an eating disorder

Eating disorders can take over an individual’s life, affecting more than just their eating habits and exercise. There is often a constant struggle to avoid or control food intake while trying to hide what they eat from others. “It is an ongoing mental process that affects how you make decisions and plan activities and interactions,” says Karlien Erasmus, a counselling psychologist consulting at Mediclinic Kloof.

“People suffering from eating disorders often dread social situations and may find it easier to isolate themselves rather than having to say no to food and explain themselves to others. They may fear being caught out, and dress, act, and speak in ways that convince others they’re fine. But mentally they may not be present, distracted by their own thoughts and struggles.”

Someone with an eating disorder may struggle to maintain social relations, Karlien adds. Work performance may also decline, and underlying conditions like depression or anxiety could worsen.

“Psychotherapy is invaluable to help identify the root of the problem and address the underlying conflicts and causes,” she says. “Clients with eating disorders are often referred to a clinical dietitian because they need multidisciplinary support and treatment. In addition to facing emotional and behavioural challenges, they may need to reassess their understanding of and relationship with food. A dietitian can help them make positive changes and follow a healthy eating plan.”

The dangers of rapid weight loss

In addition to the physical dangers of rapid weight loss, such as nutrient deficiencies, loss of lean muscle, electrolyte imbalances, gallstones, general weakness, and hormonal imbalances, there is also an increased risk of emotional problems.

Sonia Raudszuz, a clinical dietitian who works alongside Johan Erasmus in a multidisciplinary obesity team, warns that the rise of "diet culture", especially through fad diets, has contributed to unhealthy weight-loss practices. These often promote an unhealthy obsession with weight and food, which can trigger eating disorders.

Recognising the warning signs of diet culture can help people develop a healthier relationship with food. For example, a fad diet that encourages cutting out entire food groups or promises quick weight loss (like losing more than 1kg of fat per week) is a clear sign of unhealthy eating habits.

A positive, patient mindset

The support of family and friends is invaluable on the journey to a healthier lifestyle, says Johan. “Family and friends often find it hard to cope with the lengthy recovery process from an eating disorder. They may feel frustrated by relapses and even lose hope, struggling to find the right words to help challenge negative thoughts. However, improving relationships can greatly support the recovery journey.”

Demonstrating a healthy relationship with food can be helpful, he adds. “Preparing and sharing meals together should focus on enjoying each other’s company rather than just the food itself. Family and close friends must remember that there may be relapses. If someone with an eating disorder loses hope, it can lead to more despondency and damage to their confidence, self-trust and self-image. Be on the lookout for manipulation but be kind, caring and genuine by being present and emotionally available.”

To find a clinical psychologist near you, go to www.mediclinic.co.za