Resources around Family-Based Therapy (FBT) are getting better for parents who are caring for a child with an eating disorder. This is a very good thing. But for those of us who are adults with the disease, it can be very difficult to find help.
Relapse rate is very high, so knowing how to help oneself is vital.
Below I an gong to give you my step-by-step guide to creating a solid plan. This, by the way, is not for someone in a critical condition or anyone in need of inpatient or hospital treatment. This is more for someone well into recovery. Also, I am not a doctor or a medical professional, so mind you listen to the professionals too.
1.Identify Your “ED Check Person.”
For those of us who are married, your spouse is probably the perfect person. If you are living at home, a parent is a good call. Whomever you choose, this is someone who you trust and who loves you.
Who is the perfect ED Check Person?
Someone who isn’t going to tell you lies in order to be nice to you. Someone who knew you pre-ED (or at least very well) and so knows what is an ED behaviour and what is you. Someone who won’t blink at confronting you.
You’ve already probably butted heads with this person over your ED in the past, as they have already tried to tell you that you are looking unwell, or that you are exercising too much, or that you need to eat more. The crux is, this has to be someone who loves you enough not to be too scared to tell you that you are sick.
In FBT this person is usually the mum or the dad or both of them together. For us adults, sometimes a parent is not the most accessible, so like I said a partner or housemate, or a good friend. (If you don’t have a close friend, partner or relative, then you can go to your GP or medical practitioner and ask for a bi-monthly check up in which your doctor can assess you.)
You probably already have someone in mind for this, and it might even be someone whom you have been avoiding because whenever they see you they tell you things that your ED doesn’t want you to hear. Suck it up. And you’re going to just love what I am going to tell you next … .
2. Establish the No-Argue Zone
Crucial step. In case you were wondering how this ED check person is going to talk to you about your ED. You probably already know you are prone to fly off the handle when confronted with ED stuff. Well, you have to make a vow, that when your ED Check Person tells you something ED related, it is a No Argue Zone. No ifs. No buts.
Argh! It’s so hard at the start!
Initially whenever my long-suffering husband told me I was looking underweight I either: a) totally ignored him and changed the subject; b) rolled my eyes and told him to leave me alone; c) lost my shit and started yelling; or d) told him I would eat more later in order to get him off my case.
Then, when I got savvy enough to realize that he was my biggest ally against Anorexia, I made this rule:
Instead of arguing, I shut up, listen, process, commit to change, then say “thank you.”
In that order. Because if I say “thank you,'” as a reflex without really letting what he is telling me sink in, then I don’t take action on it.
Part of the “no-argue zone” rule is that I have to immediately implement a change. If he tells me I need to put on weight I eat more and do less.
If my husband tells me that he thinks I am looking thin the deal is I do not argue. If I open my mouth it has to be to put some food in. Seriously though, I say thank you for telling me, and I immediately make changes so that I put some weight on. If he is really worried and he wants to check my weight or do anything else like enquire as to how much exercise I am doing. No argument, That is his job as my ED Check Person. It’s actually empowering to give that power to someone else. But it only works if you create a no-argue zone with them.
Suck it up and deal. You can argue with everyone else in your life, but not with your ED Check Person when they tell you something ED related. And obviously this only does as far as ED-related topics. I argue with my husband about everything else 🙂
3. Create an Anti-ED Behaviour List
Do this with your ED Check Person. Sit down and write down all the weird shit eating disorder behaviors that you need to kick. This might be a really long list to start with. Go into detail. This list will also change as you get into recovery — hopefully it will get shorter and less weird as you get more recovered.
Below are some examples. I have purposely kept this example list very general so that it doesn’t trigger anyone or give anyone ideas. The point is you have to create a very honest list that is specific to you.
- No juicing or smoothie drinking rather than eating meals.
- No Nibbling — if you want a biscuit you eat the whole biscuit.
- No Squirrelling — no hiding food.
- No drinking excessive water before meals.
- No cleanses.
- Three meals and three snacks a day regardless of how full you feel.
- Limit fruit to three portions a day. Un-limit chocolate 🙂
- Exercise is limited to X times a week for no more than X minutes at a time.
- Only full-fat dairy versions of yoghurts or cheese.
- Proper cutlery to eat meals with.
- No weird cutting up of food.
- No weird only eating food in a certain order.
Get the idea?
Oh, and if your ED Check Person suggests a list item that you disagree with, guess what? Exactly right. No arguing.
Then you both sign it, and you stick it on the fridge door or somewhere you will see it.
I love this. As a mostly recovered person with anorexia ( I don’t think it can ever totally go away and I’m always on guard) this is great. Even though a lot of my behaviours are much improved occasionally – mostly at times of extreme stress or tiredness – some creep back in. I usually check myself on it, but my husband makes sure I’m not doing anything damaging and if he’s worried, he’ll say so.
Thank you.
It is part of a larger resource I am working on right now for adults.
It’s working and I love the no argue zone if someone says they are noticing I’m slipping
Great! Keep going!
This is so very useful. I’m in stage one and today I let my husband know I’d read it and what I needed him to do more of. I also asked two friends that I app (not everyone locally is necessarily right for the job) to be my check persons. I’m an adult sufferer and feeling mentally stronger slowly but fighting the pull every day, particularly around lunches. I think I know why too. I think it’s because, by having crappy crackers, it takes longer and so passes time. So I told my husband this. This way, I can plan and make my lunch (I’m a stay at home mum ) alongside my husband’s and at the same time. There’s no getting out of it then.
I also like the idea (hate but like) of the ‘no argue’ tip.
Your plan is simple, succinct and sincere, easy to read and follow. I hope I can show myself the respect I deserve and stick by it. I have a nutritionist I see weekly to get weighed but until I show a regular consistent increase, I’ll not receive any talking therapy from the outpatient service I attend. I’ve fluctuated since being with them from 2014, but suffering undiagnosed for years. I am going to use your kit alongside the help I get now. I’ve also mentioned your work to the unit as I’m grateful to your blunt and brutal words. Thank you.
Hey,
Thank you for letting me know this was useful to you. It really means a lot to me and is the reason that I write. You know that if you plan for success and put all the things in place that you can make a full recovery, and your ED will hate that so it will try and sabotage. Stay strong and stay determined.
Wow Tabitha
I am a sixty year old woman who should know better have five children and should be looking after them not other way round bless them
Have been watching my weight for over 30 years and now on high risk list bmi 14 having help now but it is so hard to for aperson who thought they have been eating heatlhy for years but actually damaging my insides for years and now paying the price
But trying to eat as normal is soooooo hard your mind is so strong an to try and over come these thoughts of even slice of toast with butter nd jam as well as porridge in mornings is awful and semi skimmed milk full fat yoghurt this is only the start
you feel you got double chin thick waist already crazy thoughts but ohh so real and so hard to try and overcome
Do not want to end up going into rehab but if i dont try try to overcome these fears thats what will happen you would think this would be enough to scare me and i so want to do this for my family
reading your acticles and listening to you podcast makes so much sense
you are an amazing lady and helped so many people bless you
I do hope i can keep going and overcome this
Thankyou so much for taking time to read this when you have a minute
pam irwin