How do I help someone with an eating disorder?

[user1479630022]

How do I help my lovely SIL (F40)
she is such a wonderful, intelligent and thoughtful person and I feel so helpless.

it started about 3 years ago but she is very deep into it now. She classes herself as a vegan but her weight has plummeted. She claimed to me last night that she weighs around 38kg. She is stick thin.
she lives alone and works in a type of job that helps and advises other (mainly children). She runs/works out excessively, runs 12-15km most days. She is very vague about certain things now but after spending the evening with her last night I feel like her mental health has improved but when we mentioned her weight she clams up. She says it’s her now, and she is living with as best she can. She discharged herself from the ED clinic earlier this year as she felt it was damaging.

we feel so helpless but she is quite literally wasting away. We feel like any day we will get a phone call to say she has collapsed. It’s heart breaking to watch. She has allready pushed out so many other people in the family and lost lots of friends over this illness.

we can’t force her do anything that I know of. She’s an independent women with no partner or children.

does anyone know if there is anything we can do? We can’t just sit back and wait for her to die. Which by doing nothing feels like what we are doing

That sounds so difficult. My SIL also has an eating disorder and I'm at a loss as well.

Did anything trigger it any trauma perhaps? I'm sorry not to be able to help much but I understand how you feel

I had a dear friend with bulimia. She wouldn’t accept she had a problem. It’s like any addiction the sufferer has to recognise they have a problem and then want to get better. I remember her parents forcing her into inpatient care over and over. Nothing stuck until she became very ill and decided herself to get help. I think just being there for her no judgement is the best thing. It sounds like she knows you love her and care about her and in these situations that’s so important. I wish you the best ❤️

I learnt many years ago that you can't really do anything to help in this situation, other than being there as you would for any other friend or family member. You can't "fix" her, but you can do your own mental health a lot of damage if you try. This is a struggle that she has to find her own way of dealing with.

I'm sorry, it's really fucking difficult.

It is horrible having a close relative or friend suffering with this condition because there is nothing you can do until they recognise they need help and want to be helped. My sister went through years of anorexia, then bulimia and can still be a bit funny about food even though she is a normal weight. The only thing you could do is offer to pay for some counselling if she'd accept it. Avoid suggesting anything to do with weight, food or body image.

I'm surprised she was able to discharge herself from the ED clinic. Was she an inpatient? I think they often section people if their BMI is below 13. It's very hard for anorexics to accept how bad they are. It does become almost part of your personality, like a kind of shield.

But unfortunately it might be a case of accepting that she will only have treatment when forced by psychiatrists. If she does have a fall and ends up in hospital the psych team will definitely get involved and she may be sectioned.

Otherwise you can't force her to therapy or to eat. Just don't abandon her. And maybe don't talk to her about weight. Anorexics are very secretive and embarrassed and it just might not help to force her to talk.

I hope she's at least taking vitamins and minerals.

The sad thing is it's hard to find more general therapy that isn't through the ED service if you have anorexia. So if you won't go through that route the NHS often refuses other therapy services. Going private might be the best route if possible. Of course it has to come from her though.

Realistically you can’t do anything other than listen and be a safe space. There’s practical things in terms of helping her with the impact of being so small such as any heavy lifting or other physical things. EDs are so complex it’s very easy to say the wrong thing and there isn’t a great deal of ‘real’ information out there, I would even go as far as to say many treatments don’t work either and some of them (to me) are barbaric. Getting well is a very scary prospect generally and any pressure to do so will likely make her condition worse hence providing a safe space to talk things through if she feels comfortable to do so. It is very isolating. It might be helpful to encourage her to do things that give her pleasure or do them with her. She may not believe she has an issue yet as what she sees in the mirror may be different to what everyone else sees and forcing her to do so isn’t particularly helpful. She may gradually in her mind begin to realise that she can’t continue as is particularly because of the impact of being grossly underweight I’m sorry you and her family are having to witness this, I know how powerless you must feel and I also know what it’s like from her perspective as well. Any stressor can make her worse. There are a few very good YouTube lectures on this from professionals which may help you understand that this is a physiological and psychological illness and the brain works differently around food. The incidences of adults with anorexia is increasing who have not had these issues before and I imagine services across the country are stretched. If she is dizzy at any time I’d suggest electrolytes at least once a day, a blood pressure monitor might be helpful so she can track it herself so she choose not to drive, walk downstairs or run as she may be at risk of falls and broken bones. If she’s uncomfortable sitting or laying there are things that can help cushion the bones, same for the bath as well.

I would make contact with her GP surgery and register your concern, it sounds like she’s completely in the grip of anorexia and could die.

If they deem she is lacking capacity due to her staved state they could section her.

As someone who used to have a very unhealthy relationship with food I would say that I was basically unhappy and this was my outlet. It’s late in life for your SIL to develop an ED (if it is genuinely new). Has something changed for her recently?

Watching this. I have a close family member who abuses Mounjaro to a devastating extent, she doesn't live near me but I have seen recent photographs and she is very clearly seriously ill. I am worried for her life at that weight.

I did bring it up a few months ago, and said I understand how she feels because I've had an ED and have to always keep it in check. She confessed that when people say they're worried about her weight, or that she's dangerously thin, there is a small thrill in that (and I do remember this from my ED days.) Things are slightly different socially now too, because celebs are quite openly abusing WLIs, so it doesn't feel shameful or something to be hidden away.

Have look here https://mando.se/en/about-eating-disorders/treating-eating-disorders/ . The Mandometer method is totally different from the psychiatric approach