In order to help someone with an eating disorder, you need to have spotted the signs, understand something of the nature of eating disorders and why someone develops one.
Anorexia nervosa, bulimia nervosa and binge eating disorder are the three main eating disorders. There is still a lot of stigma, judgement and misunderstanding about them, particularly that they are about dieting and vanity or greed or lack of control.
Eating disorders affect all ages and genders. They are essentially coping strategies, helping the person feel more in control of life. Stress, relationship difficulties, gender issues, bereavement, bullying and all forms of abuse are triggers. They are caused by a complex interplay of genetic, social and neurological factors.
Anorexia is easier to notice because food avoidance and sustained weight loss is evident. Binge-eating disorder is evident by weight gain, but there are little signs to see for bulimia nervosa because for those struggling (where self-induced vomiting is the key symptom), weight stays in normal limits. Secrecy and guilt prevent someone from coming forward, so if you notice tell-tale signs in the staff toilets, or see someone going there frequently, then do not confront them. Consider placing helpline information leaflets there. For all eating disorders, tact, understanding and a thoughtful approach are necessary.
Decide who is best to have a discreet and private conversation with the employee to see how they are coping generally. Someone close to them who has their trust is best, however, it will take time for them to open up. Where the person’s health is clearly at risk, for example, having difficulty concentrating, feeling faint at work, complaining of chest pains, then someone senior needs to be involved. Eating disorders have the highest mortality of all mental health conditions, so it is important employees receive on-going medical monitoring, therapy and dietetic advice and support.
Jane Smith is chief executive officer at Anorexia and Bulimia Care (ABC)