What to do? Please help?

by Jerzi
(United states)

QUESTION:

I have a friend and she wears belts around her waist to look smaller. Could that hurt her inside parts? I don't know what to do, she says she's in control but each extreme is leading to the next. Like no lunch, tons of working out. Can a person recover on their own? Do they have to be underweight to have an eating disorder? Are there stages of anorexia? Please help, thank you very much.;)

ANSWER:

I can't answer whether wearing belts tight around the waist could cause internal damage because I'm not a doctor. But what you're describing sounds like it could, eventually, lead to a full-blown eating disorder. Your friend seems to be exhibiting symptoms of eating disorders, either anorexia symptoms or bulimia signs, or possibly ednos.

That being said, neither you nor I can diagnose your friend with an eating disorder. Only a professional can do that. I think you are right to be concerned - because eating disorders symptoms do progress over time until they become a full blown eating disorder.

Different types of eating disorders start slowly. They start as a way to lose weight, or a way to control how much food you're eating. Over time, and it's different for everyone, eventually the symptoms take over. And so while it starts as your way of controlling something, eventually it (meaning the eating disorder) controls you (and by you, I don't mean you Jerzi ... I just mean someone who has the kinds of behaviors you are talking about here).

In terms of your question about whether you have to be underweight to have an eating disorder, the answer is absolutely not, you don't have to be underweight to have an eating disorder. That's what the diagnosis, ednos is for. EDNOS (Eating Disorder Not Otherwise Specified) is a diagnosis that is given when you don't fit all the criteria for Anorexia Nervosa or Bulimia Nervosa.

So for instance, if your friend is displaying anorexia symptoms like restricting (i.e. not eating lunch) and over exercising (in order to compensate for calories she does consume), but she still gets her period and she's not 85% below her normal body weight, then she could fit the diagnosis of EDNOS.


But remember, only a qualified doctor can diagnose her with an eating disorder!

In terms of your question about recovery - can people recover on their own? Yes, people can recover on their own. But in my experience, people recover more quickly and their symptoms are less severe the earlier they do get help. Because your friend seems to be in the early stages based on what you've said here, if she did realize she was headed for a full blown eating disorder, and if she was scared enough about the effects of eating disorders such as medical complications and the psychological effects of eating disorders, she might be able to turn it around before the eating disorder takes control.

I hope that helps you, Jerzi. The best thing you can do for your friend is support her, be understanding, and don't judge her. If you can find a way to involve adults (her parents would be a great place to start - or your own parents if you're not comfortable going to her parents), her chances of recovering more quickly will be much better.

But remember, you can't force someone to deal with their eating disorder. They have to make the decision to get help. Or, in a case such as you're describing with your friend, her parents have to make the decision to help her. Please also look at information on the Maudsley Method. I think this could be really helpful for your friend as long as you are able to get her parents involved.

Something you might want to think about is giving her parents the address to my site, and even point them to your question here. Maybe that will help them help their daughter.

If you have more questions, please feel free to post them here in the comments, or start a new eating disorder story with more questions. I edit everything before I publish it to the site, so I can follow up with more information if you have more questions.

Hang in there, Jerzi. Your friend is lucky to have you.