If you’re worried about a colleague and suspect they might be struggling with an eating disorder or are showing some worrying signs and would like some support on how best to approach that person, ABC is here for you.
You may feel uncertain as to how you can help your colleague, especially if you have little understanding or experience of eating disorders. The information below provides a brief outline of Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder, in order to help you to feel more confident in approaching the person struggling. Please note that it is not your role to diagnose an eating disorder and this information does not take the place of professional help and support.
If the person you’re concerned about is showing some of the behaviours listed below, it’s important to try and guide them towards seeking the appropriate help. If you’d like to talk to one of our helpline co-ordinators for personal advice, call us on 03000 11 12 13 option 2.
About eating disorders
A person struggling with a restrictive form of eating disorder will have continual weight loss. Anorexia Nervosa is characterised as weight loss leading to maintenance of body weight less than 85 per cent than normal. Despite being underweight (often to the point of emaciation), the person struggling sees themselves as much larger than they really are. It is clear to everyone else that they are underweight, which is often why many people find it difficult to understand anorexia. The person struggling will experience an intense fear of gaining weight or becoming fat and will suffer from thought and mood disturbances, which worsen as BMI falls. Anorexia Nervosa has the highest mortality rate of any psychological illness, due to the risk of heart failure and suicide. Treatment requires medical monitoring as well as emotional support for the underlying causes.
Spotting the Signs
- Continuing weight loss (often accompanied by denial or indifference)
- Avoiding socialising at lunchtime or eating in a group
- Hiding in loose fitting clothes or alternatively, showcasing weight loss by wearing fitted clothing
- Complaints about being cold
- Use of laxatives or diuretics
- Personality traits – conscientious, driven, perfectionist, usually alongside anxiety and anxiety disorders such as OCD
- Work performance can fluctuate from high achievement to absence
A purging form of anorexia is characterised by continuing weight loss and the symptoms listed above in addition to self-induced vomiting (purging).
If you notice some of the following signs and behaviours, it could be that this person is struggling with Bulimia Nervosa or a type of purging eating disorder.
Most people with bulimia will be at normal or near-normal weight and you may notice that they experience weight fluctuations. Those struggling will restrict their eating, skipping meals in an attempt to control their intake and manage the emotions they’re experiencing that can be very powerful. This resolve then breaks down, as a result of intense hunger and often an emotional trigger and the person then binges on large amounts of food, most commonly high-sugar or forbidden foods, such as carbohydrates. The resulting emotions of shame, guilt and despair are overwhelming and the person will then makes themselves sick to rid themselves of the calories consumed and the distress they’re experiencing.
Those suffering from Bulimia get caught up in powerful cycles of dieting/restricting, bingeing and then purging which becomes more dramatic, with many of those struggling to consume immense amounts of food during binges. This can happen several times a day. Those suffering from Bulimia Nervosa can experience life-threatening physical complications due to the chemical imbalance caused by excessive vomiting and laxative abuse.
Spotting the Signs
- Frequent trips to the bathroom, especially straight after lunch
- Grazed or sore knuckles (signs of self-induced vomiting). You may have even found evidence of this
- Swollen salivary glands
- Skipping meals or eating alone
- Complaints about a sore throat or feeling under the weather
- Possible purging methods – laxatives, SIV, slimming pills.
- Fluctuations in mood and emotions, which can change quite dramatically over the course of the day
- Absences from work
- Fluctuation in work ethic, from a lack of motivation or focus to bursts of energy and performance
Binge Eating Disorder
Binge Eating Disorder was diagnosed as an eating disorder in its own right in Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013.
A person struggling with Binge Eating Disorder will eat large amounts of a food in a short period of time (much more than is needed physically) and these episodes will be recurring and associated with feelings of loss of control. It is the accompanying emotions (as with all forms of eating disorders) that distinguish this as a disorder. The person affected will often struggle with guilt, embarrassment, self-loathing and is likely to feel very ashamed of their binges and will likely eat alone. The difference between Binge Eating Disorder and Bulimia Nervosa is the absence of self-induced vomiting after a binge. Those struggling will often have a higher than normal BMI, which can cause physical problems such as diabetes, high blood pressure and joint pain.
Spotting the Signs
- Persistent tiredness or lethargy
- Weight gain
- High BMI
- Low mood
- Eating alone
- Fluctuations in mood and productivity
- Hiding in loose fitting clothing
- A seemingly extrovert personality, which often hides the person's inner emotional distress
- Absences from work due to poor physical health
Ways You Can Help
We know it may feel daunting knowing what to do or say to help someone you are concerned about. But the most important thing is to be willing to listen with a non-judgmental approach.
Find a time to chat one-to-one and provide a listening ear. Try starting the conversation with:
“I’ve noticed you’ve not been yourself recently. Has there been anything worrying you?”
Perhaps you’re aware that they’ve been going through a lot personally and you’re keen to show your support:
“I know you’ve been having a tough time recently, how are you coping? If you fancy going for a coffee sometime, it would be good to talk and catch up.”
Perhaps your colleague has already confided in you and has already suggested seeking professional help. If you know them well, you might suggest going with them for support or offering to talk before or after their appointment.
What Not To Do/Say
Although some of these things might be said or done with the best of intentions, they may actually make things more difficult for the person concerned.
Don't offer to go on a healthy eating plan or diet alongside them or make references about your own weight or shape. If you’re able to eat alongside them, ensure you set a good example by having balanced and sufficient lunches.
Avoid comparing your experiences or making assumptions about their situation.
Don't comment on weight loss or the person’s appearance.
Do not act confrontationally or appear intent on getting to the heart of the problem. Listening to the person and reassuring them of your support is key.
Don't assume the person isn’t interested in socialising or joining in and therefore not including them in plans. A person struggling with an eating disorder or showing signs of one will be experiencing varying levels of emotional distress and will feel unable to socialise or engage in the same way as they used to. Food is also very central to socialising and once an eating disorder begins to develop, it becomes an illness that affects all aspects of that person’s life. Normal events such as going out for coffee, going out for a meal become very difficult. However, you can help by extending invitations as you would normally, allowing them to decide if they would like to come and ensuring the person feels able to participate at a level they feel comfortable with.
Most of all, do talk about them or your concerns for them with other people. Most companies will have procedures for this in place. It is important to respect their privacy and essential to keep their trust. However, if the person’s life is in danger or you’re worried about their safety, it is vital you make the appropriate contact.