An eating disorder is far more than just fussy eating or trying to maintain a certain body shape. Eating disorders such as bulimia or anorexia nervosa are serious psychological disorders which manifest themselves as an obsessive or peculiar attitude towards food and body weight and image. These attitudes can become so extreme that they lead to behaviour which puts the sufferers health, or even life, at great risk.

This extreme behaviour often involves starving oneself  (in the case of anorexia) or ‘binging and purging’ – eating so much food that it causes vomiting (bulimia) – in order to reduce weight. Other sufferers may ‘comfort eat’ – overeating when depressed or under stress, which can lead to rapid weight gain. People with eating disorders often have very low self-esteem, and see themselves as ugly or undesirable. They attempt to change their appearance through their dietary habits, but these habits turn into patterns of obsessive behaviour that the sufferer cannot control.

People with eating disorders  are almost always in denial of their problem, and can see nothing wrong with their behaviour. Meanwhile, they are putting their bodies under enormous stress which eventually lead to serious health complications if left unchecked. So how do we recognise when a loved one is affected by an eating disorder, and how do we persuade them to see this for themselves?

Eating disorders are incredibly difficult to diagnose in the early stages. There are several different types, and they affect individual sufferers’ behaviour in varying ways. People with eating disorders also become very good at hiding their behaviour, in much the same way as addicts, so that even those closest to them may not initially realise there is a problem.

There are several subtle signs that a person’s behaviour may be more than just a healthy attempt to lose or gain weight. If you have any concerns at all about someone you know, these are the signals you should be looking out for:

• A preoccupation with weight and/or appearance, often to the point of obsession
• Dieting when already slim, or overeating when already overweight
• Fluctuations in weight or rapid weight loss/gain
• Making excuses to avoid meals
• Frequent trips to the bathroom (particularly after or even during meals)
• Taking diet pills or laxatives unnecessarily
• Hidden stashes of food or empty food containers
• An overly zealous exercise regime
• Periods of fasting
• Excessive vomiting

Sufferers will go to great lengths to hide the effects of their eating disorder. If someone is losing a lot of weight they may try to disguise this by wearing many layers of clothes, even in hot weather. Binge eaters may hide stashes of food which they can feast on when no one is around. If someone you know is behaving in this way then it’s obvious they have some kind of problem. But the first step to helping them is getting them to admit this to themselves, and this is not easy.

If you are worried about a friend or family member who is displaying signs of an eating disorder, talk to them about it. Don’t go in ‘all guns blazing’ as this is bound to lead them to take more drastic steps to hide their behaviour. Approach them discreetly, talk to them in a private place, and choose your words carefully.

Avoid focusing on the negative aspects of their behaviour and instead advise them of your concerns for their physical and mental well-being. Remain calm – any distress, anger on other extreme emotion on your part is likely to cause an extreme reaction. Eating disorders are psychological and often triggered by stress, anxiety or trauma. Adding to this stress will just be fuel to the fire and may push your friend’s behaviour to even further extremes.

Don’t be surprised if the person you are talking to denies any problem, gets angry, or ‘shuts down’. Admitting you have a serious psychological problem is not easy, and many people with eating disorders are in complete denial that there is anything untoward about their behaviour. If they do react in this way, simply let them know that you are there for them if they want to talk at any time.

Your friend may give you perfectly valid reasons for the way they have been behaving. People with eating disorders can be very good at ‘covering up’ what they are doing and often have a very convincing answer for everything. Again, the best thing to do is to reassure them that, if they do ever want to face up to any problems they may have, you’ll be there to help.

If you or someone you know does recognise that they have an eating disorder and wants help to tackle the problem, there is plenty out there. The first option you try may not be successful. Different treatments work better for different people, and the important thing is not to give up. Eventually you will find a treatment for eating disorders that is effective.

One option for treatment is nutritional counselling. Nutritional counsellors are experts in how to eat a healthy balanced diet. Many of us aren’t well educated when it comes to a healthy and balanced diet, and this ignorance often leads to the unhealthy dietary behaviours associated with eating disorders. Nutritional counselling empowers a person by giving them the knowledge to eat well while maintain a healthy body weight.

Therapy can often help with eating disorders, which are often triggered by anxiety or low self-esteem. Dealing with the causes of these problems can help a person deal with their eating behaviour in a healthier and less destructive way.

There are support groups available for eating disorders. People with eating disorders often feel like ‘aliens’, even amongst friends and family, and that no one else understands what they are going through. Talking to a group of people who have been through a similar experience can really help. Fellow sufferers are able to give advice and guidance on the ways they got through the problem, and the support the individuals in these groups offer each other is an invaluable part of the recovery process.

In the most extreme cases of anorexia, bulimia or binge eating, close professional care may be required. Extreme eating disorder sufferers lose any realistic sense of the damage they are causing to their bodies, and are unable to break the pattern of destructive behaviour. If not placed under constant care, the results of this behaviour could prove fatal.

People suffering from eating disorders need the love and support of their friends and family if they are going to get through their problem. If you do suspect that someone you care for may suffer from an eating disorder, make sure they know you are there to help, not to judge, and when they are ready to face their demons they will know they can turn to you for support.