What can I do to help someone who has bulimia?

The support of a spouse, parent, sibling, or friend is one of the most valuable tools a person with bulimia can have. If someone close to you has bulimia, you can face it together in many different ways, but remember that they are the one with the problem. Loved ones can research treatment options, read appropriate books, attend lectures, talk to experts, and lend a supportive ear, but only the bulimic herself can do the work.

Keep in mind that an eating disorder is a way to feel in control of one's life. Sometimes, what is intended to be helpful and considerate can be interpreted as controlling by the person with the disorder. Communicate that you are available to help, but that is not your job to patrol their behavior. You are there to support and encourage them in their struggle to get well, but only if that is what they want. 

An eating disorder is a protective device used to handle pain. If it was easy to give up, the person would have done so already. Someone who uses food as a coping mechanism needs understanding and compassion. The reality of bulimia may shock or disgust you, but separate the individual from her binge-purge behavior. She deserves love and appreciation for who she is apart from the bulimia, and compassion for the pain that has driven her to it. if a loved-one became disabled or ill, you would still be there for them—bulimia is disabling and life-threatening.

At the same time, do not be manipulated or lied to for the sake of binges. Do not "enable" the disorder by looking the other way or pretending that the problem is not serious. If you stock the refrigerator with food only to have it flushed down the toilet, be honest and assertive about your rights and needs. Bulimics should not be allowed to abuse your trust or pocketbook; having bulimia is not justification for treating loved ones poorly. Also, don't turn meals into battles—food is not the issue.

Parents of bulimics especially need to be aware of their limitations in helping their children. Often, the relationship is too close for objective evaluation. Let you daughter open up to you with her feelings, and if she does not make progress with your support within a short time, encourage professional therapy. It may also be appropriate for parents to seek out professional advice or a support group for help with their own feelings of frustration and helplessness.

Parents usually play a part in the development of their child's behavior, and in many instances, may have to face issues and make adjustments of their own. This is not to say that they are the cause of the eating disorder, but rather that they may have contributed to it in some way and need to acknowledge that. Parents may need to reevaluate their values, ways of communicating, family rules about food, ways of handling feelings, parenting roles, and the family's decision-making process. Guilt, anger, frustration, denial, and cynicism are all likely sentiments.

As hard as this all sounds, family therapy has proved to be one of the most successful methods of overcoming eating disorders. With better communications, increased self-knowledge and mutual acceptance of what has happened in the past, parents and children can focus on the important task of recovery in the present.

Reprinted from Bulimia: A Guide to Recovery (available at Gurze Books) by Lindsey Hall and Leigh Cohn.

For more information, Gurze Books has a wide variety of books about disordered eating and eating disorders.