advice on eating disorders...

[blackfox]

OK, I am somewhat hesistant to do this - but I am in need of some advice.

You all on this forum have proven during my time as a member here to be widely diverse and knowledgeable of opinion, so I ask humbly for some assistance.

I recently moved back to Texas and reunited with perhaps my closest friend, a girl I have known for about seven years. Through considerable effort on both of our parts, we truly love each other enough that there are no longer any secrets kept between us. That is the good news.

The bad news is that over some wine the other night, she told me that she is really struggling with Bulemia and asked me for help. She has been bulemic off-and-on since she was 15 (she is now 24). I am forbidden from involving her parents, and reluctantly respect those wishes.

She is to a point where she really wants to change, which I feel is a necessary starting point - and she is realistic about the struggle which lays ahead. She is to the point where she cannot eat in front of people because she is embarrased that she will have to excuse herself to vomit.

While I understand the disorder abstractly, and somewhat understand what led her down this path ( a beautiful, non-encouraging mother - and she being slightly plump) - I am really out of my element. She seems to think that this is all her fault, as it was her initial choice to engage in this behavior, something which I vehemently disagree with, although I do applaud the general willingness to take appropriate responsibility.

So I ask you fine forum members for advice on how to proceed - as I am the only other person who explicitly knows, and don't know how to proceed.

She has a host of other health-related problems, possibly due to poor nutrition and is prone to mood swings and crippling anxiety, which all may be related to this underlying problem, so I want to tread carefully.

As assets, however, we have been through alot together, and have a very strong relationship as well as a great understanding of each other.

My first thought for her would be some kind of Psychotherapy - although she has had bad experiences with merely having pills thrown at her as a solution.

I know this will be a long, ardous process, and will never be something she will be completely over. I love this person enough, however, to be patient and put forth the effort to help her along the way.

What I ask if for constructive steps on how to proceed, on what I am up against, and what realistically to expect.

I really appreciate it.

Please feel free to ask for clarifications and/or further questions.
Thankyou.

 

[iEdd]

Hey, I understand this is a tough time, but you might need more help than we can give. Do her parents not know about it at all? As hard as it is, it probably wouldn't hurt for them to know.

 

[superbovine]

First, off this going to cost money. The first thing I would do is ask if she has health insurance. If she start going through the doctors offered on the insurance plan. You need to do some research on the doctors, and you probably find what you are looking for. If she doesn't I'd take to her primary doctor and get her checked out and ask for a referral, or just get online and do research for facilities in the area. Hell even the phonebook will probably be of some help.

 

[mymemory]

Well, I have no clue about bulimia itself but those kinds of problems (my two cents) are a pattern like any other.

I had a friend who suffered from that until she went to a psicologists and she told her something (I do not remember waht) that made her change her mind in seconsd, my friend wanted to be pretty and she stoped eating for that reason.

Then... bulimia will let to other diseases OR it may be the result of some other things so is a package of issues of course and she has to dig a bit in her mind in teh early days of her desicion.

On the other hand... every thing that you practive in your life good or bad creates 2 things: 1 endorphines, that mean that the body feel pleasure for that and if you want to change the abit your body will feel sick for a while trying to keep in the same path. 2. Behaviours, if you feel in certain way you will create an environment to support that same way, way of doing things and thoughts about yourself. Everything is in the mind and is good she wants to make the change and the change can be done it just takes time and determination, she just created the elements that support her bulimia in her mind and body so, steps by steps or "one island at a time".

There is a lot of information in the internet, do every search, find out your information with what you feel related. A psicologist can help you so far but ther will be this "something" that will make her change her mind and it can come from any source.

For example... I had this terrible situation with Iliana my ex gf. We broke up 5 months ago and I just couldn't let her go (this is a pater that you can use as a analogy for your case). So, I went out with a girl and the more I was facusing in this new girl the more Iliana was in my head, I got laid with this girl and my body was completly on Iliana. 2 Weeks later I went to a Karate class and my mind again totally about "I wish Iliana was here to enjoy this". It was so sick... what happened I realized the next day? my body created endorphines based on the depresion created towards Iliana and every time I was breaking the pattern it was pushing harder but once I realized that I gained so much control over what I was doing. I do think about her but my level of energy went up so high that everybody is telling the difference and I am not depress any more.

So, work out the situation with optimism, do not let your body rule you, your body is doing what nature told him to do... to fallow a pattern. Change that pattern, bring her out to eat something in public but just a bit and if she feels bad is ok but do it again and again until the mind realize there is nothing wrong with that and the feelings dissapear gradually. That would be my sugestion and she may fall again in to it but if she felt better just for a few minutes then that is the way to go. It is going to take time but persistance will do.

That is it. Good luck and do your home work searching in the internet for it.

 

[blackfox]

I am not looking for things to be miraculously solved by you humble forum members, but I figured more imput wouldn't hurt.

I am already researching doctors as we speak - yes she has insurance (thank god). I just want to try and appear organized.

As for the parents involvment - it is complicated - as her mom seems to be part of the problem and she idolizes her dad, who she said visibly aged the last time this problem was confronted ( 5 years ago ). I am not sure she is ready for their involvement - too much anguish - perhaps later. I have considered involving mine, but only as a last resort (they really like her).

thanks again. Sorry for such a serious thread.

 

[leekohler]

It would also help to discuss any underlying causes with her. Did a boyfriend or relative call her fat? Does she feel inadequate in some way?, etc. Talk to her about why she feels the need to do this. Start there.

 

[blackfox]

It would also help to discuss any underlying causes with her. Did a boyfriend or relative call her fat? Does she feel inadequate in some way?, etc. Talk to her about why she feels the need to do this. Start there.

Done that. To an extent. Though we are very close, I am not a professional therapist and feel it potentially unwise to enter such waters for the chance of causing further problems unwittingly.

I know most of what I would think are the causes, but even if I was 100% correct in my assesment (doubtful), I am not skilled in the ways of aiding her in repairing this damage. While I desperately want to help, I know my limitations.

 

[leekohler]

Done that. To an extent. Though we are very close, I am not a professional therapist and feel it potentially unwise to enter such waters for the chance of causing further problems unwittingly.

I know most of what I would think are the causes, but even if I was 100% correct in my assesment (doubtful), I am not skilled in the ways of aiding her in repairing this damage. While I desperately want to help, I know my limitations.

In other words, you feel uncomfortable bringing up certain situations or subjects for fear they might push her away?

 

[748s]

it's a serious illness.
she needs a good doctor who will do more than just prescribe medication.
pills don't fix it.
you say you are researching doctors.
i would start asking for help from womens health services in your area.
they take the illness more seriously than a lot of other health professionals. they will know of reputable specialists in bulemia/anorexia.
what can you both expect? ups and downs like any other journey to recovery.
she wants help. you want to help. thats a great start.
just don't forget it's an illness and people recover from it.

 

[Deepdale]

... I know most of what I would think are the causes, but even if I was 100% correct in my assesment (doubtful), I am not skilled in the ways of aiding her in repairing this damage. While I desperately want to help, I know my limitations.

She is fortunate to have you in her life for desperately needed support since bulimia is an extremely serious problem that requires both medical and psychological assistance. As you may also be aware, there can be serious long-term physical damage sustained, with some being life threatening (like cardiac arrhythmias).

The reason one cannot be overly effective within the confines of such a forum is because the condition is one that demands the expertise of those with extensive training. Knowing the existence of her struggle is one thing and while it is admirable to respect another's wishes, it is imperative to be proactive without further delay.

Having feelings for her places you in the unenviable position of having to incur anger, but there can not be effective control over that disorder until comprehensive intervention programs are commenced. Without deep exploration of all underlying contributory factors (family relationships, image dysfunction, lack of confidence and self-esteem, possible abuse in her background), her chances of regaining proper control over her life will be diminished. I wish you both well as assistance is sought.

www.raderprograms.com/bulimia.aspx
www.raderprograms.com/medcomp.aspx

 

[EricNau]

She'll need professional help. Best bet would be to check into a program for eating disorders. The best thing you can do is support her. Don't try and handle this by yourself, Eating disorders can be very dangerous, and often very hard to overcome.

 

[ibook30]

She'll need professional help. Best bet would be to check into a program for eating disorders. The best thing you can do is support her. Don't try and handle this by yourself, Eating disorders can be very dangerous, and often very hard to overcome.

Words of wisdom.
I spent a year with a young lady working through some of the same problems. It is very difficult for anyone involved. I would urge you not to attempt to "solve" her problem. She is best working with a professional and will only work through it by herself.

Your support will help- and it is a credit to you that she confided in you. I wish her well- and hope you enjoy being in Texas!

 

[velocityg4]

I may be wrong but you would probably get better help by having her go to a good psychologist rather than a psychiatrist. Mainly because the psychologist is not licensed to prescribe medication. Therefore they actually have to do verbal therapy. There are good psychiatrist out there who don't consider pills to be the holy grail of psychiatry, but the search for a psychiatrist whom is not a pill pusher will be long and expensive.

Also what does her insurance cover. Most health insurance plans only cover seven to twelve psychiatric visits.

 

[Blue Velvet]

All good advice so far but to add just a point about medication.

Sometimes in these types of circumstances and other crippling neuroses, supervised medication can be a valuable tool to stabilise and create a 'breathing space' where the deeper psychological roots of this problem can then be explored.

It's not a cure but acts as a temporary palliative to break a vicious circle which may be rapidly leading to a point of no return.

It is obvious that you have a great deal of affection for this individual and it must be tearing you apart to see her like this — I wish you the very best of luck.

 

[EricNau]

I'd like to point out - medications don't solve everything. It seems to be everyones first thought that there must be a magic pill that can solve this problem, but chances are there isn't.
There are doctors that specialize in Eating disorders, her best bet is to see one of those, where they can properly decide what is best.
Sure a psychologist/psychiatrist can be help in the mental process, but you should not rely on them completely. For example, if the eating disorder was caused by a family problem, the psychologist/psychiatrist may be able to help with that, but that will most likely not solve the eating disorder, just the thing that caused it.

 

[EricNau]

I may be wrong but you would probably get better help by having her go to a good psychologist rather than a psychiatrist. Mainly because the psychologist is not licensed to prescribe medication. Therefore they actually have to do verbal therapy. There are good psychiatrist out there who don't consider pills to be the holy grail of psychiatry, but the search for a psychiatrist whom is not a pill pusher will be long and expensive.

Also what does her insurance cover. Most health insurance plans only cover seven to twelve psychiatric visits.

Eating disorders are more than just a mental illnesses because they can be life threatening. I'm thinking I read somewhere that health insurance will usually cover eating disorder related costs.

 

[blackfox]

Thankyou for some excellent responses. I really appreciate it.

I am leaning towards looking into therapists, psychologists - but I will first ask questions at a woman's health services - and proceed accordingly.

I will NOT be trying to handle this myself.

I merely wish to facilitiate her getting the help she wants and needs, and to be there in the ways I need to be.

As a generally healthy person (mentally and physically), I have not had too much experience with Doctors of any stripe, and find the search for the appropriate one rather daunting.

Medication is certainly not out of the question, but might play a supportive role similiar to what BV described, though ultimately it is up to her. We will see.

Thanks for the kind words.

ibook30, since you seem to imply you have direct experience with this kind of issue, perhaps you may be able to assit me further in some way. Feel free to PM me if you's like, though only if you feel you have something constructive to add and feel comfortable doing so.

 

[Clix Pix]

In most cases of eating disorders, it is important to have a treatment team: internist (overall physical status), psychiatrist (for prescribing appropriate psychotropic meds), psychotherapist (for one-on-one "talk" therapy) and a nutritionist (registered dietitian who will assist with developing a healthy meal plan and in working with food phobias or other food-related issues). In many communities there is also the option of attending either a free support group or a for-fee therapy group.

In some situations the patient needs more help than he/she can get in once-weekly therapy sessions, and this is when specific eating disorder treatment facilities come in. Many offer not only inpatient care but also partial hospitalization ("day treatment") and an Intensive Outpatient (IOP) program as well.

It definitely sounds as though your girlfriend needs some help; shame and embarrassment about the illness are often part and parcel of it. Many bulimics do eventually reach out for help when they realize they can no longer tolerate living this way. Eating disorders are deadly because they are psychiatric disorders with many physiological manifestations.

Keep us posted as you explore the various options open to her and as you help her find the help she deserves.

OTB