Getting Help
By Abigail Natenshon
Author of When Your Child Has An Eating Disorder

  • Do you feel that you are unable to get control of your eating, that your body is not giving you reliable cues about what it needs, when it needs it, and in what quantities?
  • Do you feel depressed and concerned about how you look to others?
  • Do you tend to see yourself as fat even when you know you are thin?
  • Do you experience “fat” as being a feeling?
  • Do you feel afraid of food?
  • Do you feel fearful of becoming fat?
  • Do you sense that you become fatter with every bite you take?

When you have a problem, it is essential that you know how to recognize it and to reach out to others to get help?

Who can you go to? Do you have good friends who understand you and who really know how to listen? Can you express yourself clearly and with intention, sharing your problem with them and asking for what you need, be it advice or merely a “shoulder?”

Is this a problem that should be shared with your parents? Your parents are your caretakers and mentors, even beyond your childhood years. They are there to support you and to guide you if and when you begin to fall off course. Let them. They may need a little educating about you, about your needs and concerns, and about what healthy eating is, but this knowledge is easy enough to attain. When Your Child Has an Eating Disorder: A Step-by-Step Workbook for Parents and Other Caregivers Jossey Bass 1999, contains almost everything they, and you, will need to know about how to approach the problem, the solution, each other, and the health professionals that you may be working with.

Is this a problem that a health professional may need to handle with you?

  • There are several kinds of problems concerning food and eating that may need professional attention. Eating disorders are one of them. An eating disorder is not about food itself as much as it is about the misuse of food to resolve emotional problems.
    • Anorexia nervosa is the pathological need to restrict food for fear of becoming fat.
    • Bulimia nervosa is a condition marked by an out of control intake of food, followed by purging. Signs of bulimia are also seen in laxative, diuretic, and diet pill abuse as well as in excessive exercise.
    • Binge eating disorder or compulsive overeating is a condition that involves an excessive intake of food followed by feelings of guilt and/or depression, but no purging.
    • Eating disorders not otherwise specified is quirky eating that has taken on a compulsive quality, that sooths feelings of anxiety or depression. Signs of “sub clinical” disorders may be seen in the person’s not wanting to eat in front of others, hiding food, cutting it up into little pieces and moving it about the plate, chewing and spitting, eating according to set rituals, etc.

It is important to understand several things about eating disorders.

  • They are curable in the vast majority of cases when detected early and treated effectively. A very small percentage of people do not recover.
  • Eating disorders are the most lethal of all the mental disorders, having the capacity to compromise one’s life quality or even take a person’s life. You do not have to be ill for long to succumb to the ravages of these diseases. An eighteen-year-old bulimic girl died in her sleep from an electrolyte imbalance recently. She had been ill for only 13 months.
  • Most victims of eating disorders do not know that they are sick. They think they are eating “healthfully.” Remember that it is never healthy to restrict food.
  • It’s difficult to see an eating disorder in someone else. Even doctors may not notice an eating disorder during your physical exam. These diseases do not show up in laboratory tests (blood and urinalysis) till the very latter most stages.
  • Eating disorder recovery is the best investment a person can make in the rest of his or her life. Recovery makes kids feel as though they have their life back, their personality back, the meaning back in their existence. They invariably feel happy and grateful to have had this opportunity to learn to better solve life problems, cope with adversity and function in the world.

Finding the best professional help
Recognize that not every good health professional is equipped to treat your eating disorder. Because an eating disorder affects a person’s mind, emotions, nutrition, physical health, mood and family relationships, the professionals you work with should function together and collaboratively as part of a “team.” On this team there should be a psychotherapist who can see the individual as well as the family for family therapy, a medical doctor to monitor the patient’s health, a psychopharmacologist to administer medication, and a nutritionist to help get the patient back on track with eating.

Remember that therapy is a process about making changes. It should be fun and rewarding, even at the same time as it is hard work. It should not take long before you get a feeling about whether or not the therapy relationship is a good one and the work is beneficial. If you want to know more about what kind of things should happen in psychotherapy and in eating disorder recovery, review Chapters 4, 5, and 6 in When Your Child Has an Eating Disorder.

Remember to write to me if you get stuck or have any questions. Good luck!

Psychotherapist Abigail H. Natenshon has specialized in the treatment of eating disorders with individuals, families, and groups for the past 28 years. She is the author of When Your Child Has an Eating Disorder: A Step-by-Step Workbook for Parents and Other Caregivers, Jossey Bass Publishers, San Francisco, CA. October 1999. Based on hundreds of successful outcomes, this book shepherds concerned parents step-by-step through the processes of eating disorder recognition, confronting the child, finding the most effective treatment for patient and family, and evaluating and insuring a timely recovery. A guide to eating disorder prevention, this book is useful to parents, health professionals and school personnel alike in countering the pervasive epidemic of unhealthy eating and body image concerns, and destructive media and peer influences. Her work can be reviewed further at her web site at To order visit

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