In our first episode, we met Gemma, a teenager who is struggling with an eating disorder. But she doesn’t know that yet. She believes she is just dieting and eating healthier; she hasn’t realised that she has been spending more and more time thinking about food, that she has become preoccupied with what her mum is cooking for dinner, and that she has started to carefully investigate the calorie and fat content on food packaging. This is what people do when they are on a diet, right? Parents often blame themselves for not seeing the signs sooner, but the truth is that the initial ED behaviours are easy to hide, and they escalate silently - but surely. However, parents do find out, and when they do, it is usually a game changer. Slowly, Gemma’s family started to notice the increase in food rules (no carbs on week days; no eating after 5pm), and an unusual interest in the amount of oil her mum was using to prepare the family meals. Her parents noticed that Gemma would disappear to the bathroom immediately after dinner, and, come to think about it, it had been quite a while since she had any friends over, or left the house to meet up with them. They saw her portion sizes decreasing and an unprecedent tension during mealtimes. Some nights Gemma would pick a fight with one family member or another, and storm off upstairs for the rest of the evening. Her dad had caught her doing sit ups in her bedroom at 11pm a couple of days in a row because the weather was quite wet and she couldn’t go out for a run. Gemma’s parents tried talk to her a few times, but she would come across as incredibly stubborn, righteous and dishonest. She was shutting her parents off and they couldn’t see that deep down, Gemma was actually trying desperately to cope. The solution to manage difficulties had now become part of the problem she was trying to cope with. Eating caused Gemma a huge sense of guilt, and she felt she didn’t deserve to eat or to enjoy food; she was scared that eating potatoes would turn her into a balloon and everybody at school would make fun of how fat she looked – it would be such a failure to gain weight after all this effort to lose it. Gemma would only accept going to school if she was on empty stomach, and she started to weigh her food, just to be sure she was eating the right amount. She also started to weigh herself twice a day, again just to make sure nothing was changing and she had full control of her body. Inevitably, her parents became very worried and didn’t know how to communicate with their daughter anymore. Not only would she shut down any conversation, but there was always the chance that she would storm off to her room and not get back down for dinner. At that stage, they couldn’t afford that, so they would agree to pretty much anything in order for her to complete her dinner, or some days, at least half of it. They felt like there was no way out and they were seeing their daughter shrinking away without knowing how to help. Especially because she didn’t want any help. She wanted to be left alone!! It is not uncommon for the whole family to get reorganised around the problem. As they try to adjust to the new situation, the illness becomes central to the family life; routines, decision-making, and responses to conflicts change to accommodate the needs of the ill person. As you can imagine, eating disorders put tremendous demands on the family’s coping abilities. As a result, they can get caught up in unhelpful patterns of interactions, which can inadvertently enable the eating disorder further. As Gemma’s parents tried desperately to help her get better, they would often focus their conversations and attention on food and weight, without realising that the more they talked about calories, the less they addressed what was buried deep inside Gemma. While mum took on the caring role, dad started to spend more time with the other children; they also chose to cancel their holiday trip so that they would try and tackle the problem. Some days, mum would drive for 45 minutes to get that special type of non-fat, non-dairy, non-sugar yogurt from one particular trendy organic food shop because that was the only thing Gemma would accept for breakfast. And just like that, everyone was stuck and feeling like hostages of the situation. Stay tuned for the next chapter, when I will talk a bit more about how Gemma and her family start receiving professional support, as well as the role of the family as part of the recovery process. Are you struggling with an eating disorder, or is it someone you love? Get in touch for a free consultation today.
