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How To Help A Bulimic

Dear Sugar,
I think that my cousin's wife is bulimic. She leaves the table (out or at home) between each course during meals and claims that she has a small bladder. She is tall, beautiful and very, very skinny; frail-like skinny. She also eats at least twice as much as everyone else.

Her hair is thinning and her teeth are kind of bumpy and yellowish. The signs are all there, but I don't want to accuse her of something just yet. It's not like I want to catch her in the act either, I just want her to get help.

I've tried talking to her husband about it, but he's not completely convinced that it's bulimia. What do you think I should do? If she continues to lose weight she will look dangerously thin. Concerned Cousin

To see DEARSUGAR's answer

Dear Concerned Cousin
You did the right thing by talking to her husband about it. Perhaps he just feels that she has always been thin and does in fact have a small bladder. At least you've made him aware that there could be a whole lot more to it.

I would definitely try following her to the bathroom a few times to see what's going on in there before you have any kind of talk with her. Check her feet to see if they are pointing forward or backwards in the stall. Then watch to see if she washes off her hands and her mouth when she exits.

Keep in mind that as someone who is not suffering from an eating disorder yourself, there are many things you cannot do to help her get healthy. You cannot prevent a bulimic from purging and usually the problem really isn't about the food, it's about something bigger. The eating is just a result of deeper emotional pain she is most likely suffering. Eating disorders are attempts to escape, control or hide this self-hatred or pain and is something that has probably been building for years.

Before talking to her, I suggest you find some kind of local outreach for her. Collect the number of a psychologist, a clinic or even a hot line that she can call anonymously. Ultimately, there is not a whole lot that you can do for her until she is ready to deal with her emotions and acknowledge that she needs/wants to take steps toward recovery.

I would let her know that you just want her to be happy and to get better. Remind her of the physical damages and further emotional difficulties associated with eating disorders. Also, let her know that you will not discuss this private matter with anyone. It is important for her to be able to open up to you and to feel safe sharing her private and fragile feelings with you. This is not going to be an easy or a quick fix. Good luck.

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