Ask Dr Nicki: Helping Someone with an Eating Disorder

Once a week I present this feature called, "Ask Dr. Nicki" featuring a question that either a) I generate myself from commonly asked questions, or b) a question that somebody submits to me. I really hope that each and every one of you gets something from my advice!

Dear Dr Nicki,

I've noticed some things about my sister that lead me to believe she has an eating disorder. I tried to bring it up to her, but she just brushed it off. But she continues to look too thin, and make mentions of how fat she is, and I’ve noticed her severe lack of energy. 

I don’t know how to get through to her without pushing her away, but this is getting serious. How do I help her when she can’t even see there’s a problem? Help!

Dr Nicki Says:


Dear Concerned Sister-

It's difficult, of course, to see a beloved suffering and feel powerless to reach them! Naturally you're concerned about pushing her away with your recognition's. 

This, however, is the time to decide what true love mandates. 

Is it loving to back away from intimate, authentic conversation because it may upset the apple cart? 

As you can guess, I'd say no! 

Does backing away from conflict signal real caring? 

Again, no! 

Still, this is a challenging problem because even if you're willing to go where angels fear to tread you're likely to be continuously met with denial. That doesn't mean back off entirely though. 

So what to do?

There are a couple avenues to walk - none particularly fun or certain to bring great results:

a) You can say to her something on the order of: 

"I know you're going to reject what I'm saying however I've done some research and what I know about anorexia is that it potentially has severe physical ramifications, including such awful things as sterility and brain damage, to say nothing about a weakened immune system plus less energetic resources to move healthily through a day and a life! This names but a few potential outcomes. Plus, to get as thin as you are (and including your body dysmorphia = visual distortion) it's probable you're doing other disastrous get-thin things like bulimia which comes with its own set of problems. All-in-all I'm really worried about your health and well-being. Of course, it's your body so it's your decision but I'm only saying I'm here to listen if you want to talk about any of this!"

b) Do an intervention, which means gathering other aware people together and tell her en masse what you see and experience with her and get her to counseling of some kind (great to have a facilitator present at these events if possible - an expert in the field of eating disorders. There's plenty around!).

No matter what you need to talk to someone else about your feelings with regard to sis. Unfortunately, we live in a world that promotes and supports emaciation as a beauty standard. 

Ugh. 

This makes your confronting job ever more difficult. Still, your writing this question to me tells me you know something must be done.

Anorexia is truly dangerous on many levels. I again suggest that confronting is important no matter what the outcome. 

She won't "believe" you but perhaps it will plant a seed.

Lovingly, Dr. Nicki 


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