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If you suspect a friend or a family member has anorexia, bulimia, or binge eating disorder, don't wait until a severe weight problem or a serious medical problem proves you are right. There's plenty you can do before that happens:

• Act to get help. Speak to the person about your concern. Enlist assistance from family and friends. Talk to medical professionals, a social worker, or the school nurse or counselor if the person is a student. Call your local mental health association. A registered dietitian also can give you an expert perspective on eating disorders. See chapter 24, "Well Informed?" to locate a registered dietitian in your area.

As an aside: People with disordered eating may encourage disordered eating among others; today that problem has spread through the use of Web sites with private chat rooms.

For people with BED, a weight-loss diet alone may not be successful. Losing weight and keeping it off may be harder (for physical and emotional reasons) than for people without an eating disorder. Normal-weight people with binge eating disorder shouldn't be on a weight-loss diet.

The best treatment for disordered eating combines medical, psychological, and nutrition counseling. Participation in self-help groups for the patient, as well as group counseling for family members, are important parts of treatment.

  • Expect resistance. A person with anorexia usually doesn't believe that he or she needs assistance or is in any danger. Someone with bulimia or BED may acknowledge the problem but still refuse to seek help. But the faster he or she gets help, the greater the chances for recovery.
  • Prepare for long-term treatment. Recovery may take several months to several years. Symptoms and attitudes related to eating disorders rarely disappear quickly. Treatment includes helping people achieve an appropriate weight. Family support groups are particularly effective in helping relatives of people with disordered eating survive the long ordeal.

For more guidance, see "More Weighty Problems for Children—Fear of Weight Gain" and "Mainly for Girls... Pressure to Be Thin" in chapter 16.

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