Want to help, but not sure how - Possible Eating Disorder

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Want to help, but not sure how - Possible Eating Disorder

Postby Misfit » Wed Jun 14, 2017 10:15 pm

Hi,

I like to go to my local park to exercise and often use the exercise equipment there, e.g. Steps, exercise bike. I have seen a female, who appears a teenage girl, a few times, using the equipment too. She look svery skinny. Her arms are very skinny and her face looks quite thin too.

I'm not sure if it would be fair to say the exercise she does is excessive, but I remember one day, a child asked her if she had finished on the piece of equipment she was on, and she said, in what appeared to a rude way, that she hadn't. I'm not sure if she has been counting how long she has been on the equipment but she does appear to concentrate. it appears to be more than "leisurely" exercise.

There was one time when I made conversation with this female and she didn't seem to want to interact. Fair enough, but I am worried she has an eating disorder and wonder if she has any support, or has received a diagnosis and appropriate treatment. She appears unhappy and she did not make eye contact with others when I saw her today. I was tempted to start a conversation and maybe ask something like, "Do you enjoy exercising?" I don't feel comfortable seeing her exercise when it seems like it may do her harm.

Do you think I have reason to worry? What would you do? x
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Re: Want to help, but not sure how - Possible Eating Disorde

Postby alexh » Wed Jun 14, 2017 11:03 pm

I have also wondered if there is anything that could be done.

I lived near my child placement base and ran in the area. I saw several young people who attended the service running regularly, one with a parent. I saw a woman who was not a client but who I saw running so regularly, and who was so low in weight that I felt the same dilemma I think you are experiencing. Wherever I have run it has been the same, although mostly i have not been in a service where I thereby knew for sure.

I thought about what it might be like as a very low or high wrought person to be approached by a well meaning stranger or even a professional with advice. I believe in fact this happens fairly regularly to people who others perceive to have problems.

I think the probability of it being successful is very low. The success rate for those who seek treatment for an rating disorder is low, what is it for people who are not yet contemplating making a change in their lives?

What need would this action meet in you? How does the idealised/fantasised interaction proceed?

Wider ethical questions street whether we should address the over weight person eating too much, the person drinking too much alcohol, the pregnant woman smoking, the parent criticising their child harshly or smacking them, and so on.

I smiled at the woman I saw. If I were to speak to her I would probably just have said Hi. I think 'do you enjoy exercising?' is not that subtle!
I have spoken to people who appear distressed or possibly acutely ill in some other situations. In those cases I ask if they are OK and then if they want any help. That could be another way to go, seeking an invitation which can be declined or dismissed
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Re: Want to help, but not sure how - Possible Eating Disorde

Postby lingua_franca » Thu Jun 15, 2017 1:24 am

I don't think it's your place to say anything, and if she does have a problem then talking to her might do more harm than good. Speaking as someone who has a history of eating disorder, I used to find the idea of strangers scrutinising me and possibly making comments very anxiety-provoking and upsetting (and I know that this is a common experience among sufferers, not just my take). I used to spend a long time in supermarkets examining food labels and eventually leaving with nothing but Diet Coke, and once I was approached by a stranger who wanted to express concern. All this achieved was to make me walk further to use a different shop in future, and I felt angry at what I experienced as a violation of my privacy by someone who didn't know me. I think Alex also makes very valid points about whether we would intervene with other unhealthy behaviours. Perhaps my own history is causing me to over-empathise with this young woman, but it seems to me that people feel more entitled to comment on female weight and shape than they do about other things, and this is problematic in its own right.

Of course, there is also a possibility that this girl isn't ill. People come in all shapes and sizes and unless someone is actually emaciated it can be very difficult to tell their state of health just by looking at them. I remember that in one of your recent threads you said you are very interested in eating disorders and are keen to get a job in this field, so your interest could be contributing to how you interpret this girl's behaviour.
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Re: Want to help, but not sure how - Possible Eating Disorde

Postby mungle » Thu Jun 15, 2017 11:47 am

It might be helpful to think about what we know about change models. Thinking of the stages of change model we might accept we can not do a lot if someone is in the 'pre-contemplation' stage with a health behaviour (whether it's anorexia, smoking, eating too much, over or under exercising etc.) and instead the most we might realistically achieve is to give that person an experience of a positive interaction with another person and the chance to be viewed and responded to as a person, rather than as a behaviour or problem. If this person is a stranger, who has not sought us out in our professional role for help, then it seems unlikely a short, one-off interaction will lead to a change.

Personally, I would be more likely to respond positively or with curiosity to someone with whom I had an established relationship (or someone I had sought out for help). If someone else commented (however subtly - I would be primed by all my previous experience to spot it and even interpret an ambiguous comment as negative) I would experience shame and most likely react with one of the following; verbal aggression, withdrawal and isolation or minimising.
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Re: Want to help, but not sure how - Possible Eating Disorde

Postby Geishawife » Thu Jun 15, 2017 2:15 pm

I agree with the other replies, I really don't think it is up to you to say/do anything. Knowing nothing at all about this person, you have no idea whether she is ill or not and, if she is, whether she is currently undergoing treatment If she does have an illness such as an eating disorder, depending on the nature of her illness and any treatment she may or may not be receiving, be aware that that treatment could possibly be compromised by a stranger attempting to get involved (however good your intentions).

lingua_franca wrote:Of course, there is also a possibility that this girl isn't ill. People come in all shapes and sizes and unless someone is actually emaciated it can be very difficult to tell their state of health just by looking at them.


Perhaps I am also a bit sensitive to comments about weight, but for other reasons. The quote above rings especially true for me. As someone who has spent their entire life being built like a twig, I cannot begin to tell you how irritating it is to have people assume I have an ED!! I gave up going to the gym because instructors where always wanting to talk about my "issues" with food. WHAT ISSUES??? I eat well, eat most foods (the majority of them healthy, occasionally some not so healthy) but just do not gain weight (not even when I was pregnant!).

So, please tread very carefully here. I have no doubt you mean well, but I would strongly advise you to keep your own counsel in this situation.
Last edited by Geishawife on Thu Jun 15, 2017 2:19 pm, edited 1 time in total.
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Re: Want to help, but not sure how - Possible Eating Disorde

Postby lingua_franca » Thu Jun 15, 2017 3:20 pm

Geishawife wrote:Perhaps I am also a bit sensitive to comments about weight, but for other reasons. The quote above rings especially true for me. As someone who has spent their entire life being built like a twig, I cannot begin to tell you how irritating it is to have people assume I have an ED!! I gave up going to the gym because instructors where always wanting to talk about my "issues" with food. WHAT ISSUES??? I eat well, eat most foods (the majority of them healthy, occasionally some not so healthy) but just do not gain weight (not even when I was pregnant!).


I'm sorry you had that experience. I am on the board of trustees for an eating disorder charity, and when we were developing a training scheme for gym staff on how to spot and support people with an exercise problem, I was uneasy at the emphasis that was being placed on weight and shape. Your experience makes me feel my unease was well founded. People with bulimia who purge through compulsive exercise are highly likely to be at 'normal' weight anyway, so encouraging instructors to guesstimate weight and BMI isn't helpful even for those who genuinely are struggling, and it's just going to make women who are naturally slightly built feel self-conscious (especially as instructors are taught to recognise denial as a symptom of ED, so they won't accept "WHAT ISSUES???" as a truthful response!). I wanted to design posters with helpline numbers that could be discreetly placed in the toilets or changing cubicles instead, but for some reason ED organisations and gym staff seem to want to intervene more directly - maybe they're worried the gym could be liable if someone who is unwell gets badly hurt on the premises? Either way, it's annoying.
"Suppose a tree fell down, Pooh, when we were underneath it?"
"Suppose it didn't," said Pooh, after careful thought.
Piglet was comforted by this.
- A.A. Milne.
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Re: Want to help, but not sure how - Possible Eating Disorde

Postby Misfit » Thu Jun 15, 2017 7:07 pm

Thanks for your replies. It's a sensitive subject and I hope I haven't caused any offence. I won't be saying anything to this lady apart from a friendly Hello but do hope she's okay. I don't think it's people's place to interfere with people's lives as it may cause offence and/ or make things worse, so will leave things be.
Yeah I made a thread about eating disorders recently but not sure if I'll go forward with applying for jobs related to it. Struggling with work life. I didn't apply for the one I saw by the way. x
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Re: Want to help, but not sure how - Possible Eating Disorde

Postby Geishawife » Fri Jun 16, 2017 10:53 am

No offence taken on my part, Misfit. It is an interesting topic of discussion.
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Re: Want to help, but not sure how - Possible Eating Disorde

Postby lingua_franca » Fri Jun 16, 2017 2:51 pm

I wasn't offended either, and I didn't mean to sound as if I was criticising your interest in eating disorders in any way - I just wanted to point out that having a strong interest in a topic can colour our perceptions and how we interpret what we see. For example, I remember one of the qualified CPs on here writing that at one time they were seeing autism everywhere because that was their working environment.
"Suppose a tree fell down, Pooh, when we were underneath it?"
"Suppose it didn't," said Pooh, after careful thought.
Piglet was comforted by this.
- A.A. Milne.
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Re: Want to help, but not sure how - Possible Eating Disorde

Postby Misfit » Fri Jun 16, 2017 11:09 pm

lingua_franca wrote:I wasn't offended either, and I didn't mean to sound as if I was criticising your interest in eating disorders in any way - I just wanted to point out that having a strong interest in a topic can colour our perceptions and how we interpret what we see. For example, I remember one of the qualified CPs on here writing that at one time they were seeing autism everywhere because that was their working environment.


That's okay, I didn't feel as though you were criticising me, and see what you mean. That's interesting x
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Re: Want to help, but not sure how - Possible Eating Disorde

Postby MarkM » Sat Jun 17, 2017 6:01 pm

lingua_franca wrote:People with bulimia who purge through compulsive exercise are highly likely to be at 'normal' weight anyway, so encouraging instructors to guesstimate weight and BMI isn't helpful even for those who genuinely are struggling, and it's just going to make women who are naturally slightly built feel self-conscious (especially as instructors are taught to recognise denial as a symptom of ED, so they won't accept "WHAT ISSUES???" as a truthful response!).

People*? (:



I'd definitely agree with the previous posters, and I think there's some really good and thoughtful advice in this thread! [=
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Re: Want to help, but not sure how - Possible Eating Disorde

Postby lingua_franca » Sat Jun 17, 2017 8:49 pm

Women. As I said in an earlier comment, women's bodies are subjected to far more public scrutiny than men's, as you can see from magazines' fascination with women's weight loss, street harassment rates, and yes, speculation about eating disorders. It wouldn't take me long to find articles wondering if this or that female celebrity has food issues. It would be much more difficult to find similar articles about men. I have also yet to come across a man who has been stopped in a sports centre and quizzed about unhealthy exercise habits, and this was actually commented on when I was in treatment for anorexia - several women patients had been approached by staff at their local pool/gym, but none of the men had, even though they had been exercising at emaciated weights. This is probably one of the reasons why it's so easy for male sufferers to fly under the radar for so long - they're less likely to get confronted, because a.) people still see eating disorders as an overwhelmingly female illness and b.) they feel a lot less entitled to waltz up to a strange man and comment on how he looks.
"Suppose a tree fell down, Pooh, when we were underneath it?"
"Suppose it didn't," said Pooh, after careful thought.
Piglet was comforted by this.
- A.A. Milne.
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Re: Want to help, but not sure how - Possible Eating Disorde

Postby MarkM » Mon Jun 19, 2017 8:48 pm

Hmm. I don't disagree that women are more affected by this but I personally think that limiting a comment like that to "women" may further perpetuate what's already going on? Maybe not, but I think language is powerful like that. And on a side note, I can assure you that it does happen (albeit, yes, very rarely). And when it happens, there's a pretty high chance it makes people who are naturally slightly built feel self-conscious.
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