Interviewer: How do you identify an eating disorder in someone else and what help can you offer if any at all? That's coming up next on The Scope.
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Interviewer: You might not have an eating disorder but chances are you probably know someone who does. Everyone knows somebody who has an eating disorder. Here is Dr. Nick Galli, Assistant Professor of the Department of Health Promotion and Education. The question is how do you identify someone with an eating disorder?
Dr. Nick Galli: There are some signs that you can recognize somebody who has an eating disorder. I think one of the most important signs is how they talk about food and what their relationship is with food, if they seem to be orally preoccupied with food and eating at a certain time or eating a certain thing, or constantly seem to be trying a different diet. That could be an indication there's something going on.
Physically you might recognize someone as being severely underweight, somebody is having very dry hair, dry nails, and dry skin. In some cases people who are severely underweight might grow a fine layer of hair on their body called lanugo as a way to keep themselves warm since their body weight is so low. So there are some physical symptoms that you can recognize.
But to me it's more the behaviors. Food is a centerpiece often times for people with eating disorders, and so they might sort of put on a pedestal and make it more important than someone else might. It might affect their relationships and their social interactions. It's just something that people with eating disorders think a lot about, is food.
Interviewer: Is it more that food is bad or food is good? Or is it kind of it just depends on the person?
Dr. Nick Galli: Yes, it's definitely not food is good. It's not food doesn't tend to be something enjoyable. It's tied to the way the person feels they want to look and how do I need to eat in order to look a certain way. And here are the bad foods that I can't eat; maybe foods that have a lot of fat they might classify as bad and have very rigid rules about what food they can't eat. So I definitely wouldn't say that food is thought of as a good thing. There may be safe foods that, hey, I can eat carrot sticks and that's all I'm going to eat because it's low calorie and there's no fat.
Interviewer: So they don't really have a healthy relationship with food?
Dr. Nick Galli: No.
Interviewer: So when you see somebody like a close friend, a family, a relative, and you kind of see these signs and symptoms, how to you help them?
Dr. Nick Galli: It's a difficult thing to watch, absolutely. You can't help them. Like anything else they have to want to be helped. You can't be the police. You can't try and want to try to fix them. You approach them from a place of concern. You share your observations and what you're seeing. You ask them, how are you feeling? Are you okay? Can I help you? I'm concerned; I'm seeing you, you're not eating. You've lost a lot of weight. Your mood is fluctuating; what's going on? And if they want to engage with you in that conversation, then it's how can we get you connected with a professional, a doctor, or a dietician or somebody who specializes in this area. And how can I help you do that, because that can be a scary thing.
On the other hand if someone is defensive and isn't ready to have the conversation and then it's just, okay, well you can't force the person to have the conversation. It's I'm here if you need me, but I want you to know I am concerned and we should talk more about this, and maybe we should consider talking to a professional. But ultimately nothing gets better unless they want it to.
Interviewer: Okay.
Dr. Nick Galli: But the most important thing is presenting yourself as someone who's there, who cares and who wants to help.
Interviewer: What I'm hearing is just a lot of this just take charge, get some help for yourself. Does it really matter if someone tells you, hey, I see what's going on. Let's get you some help. Does it really matter in the final end, or is it just more of a self reflection thing?
Dr. Nick Galli: I do think that the person needs to decide for themselves, that they want to get better. But I don't think it's something that you do on your own, and that doesn't just mean you have your support of your medical team, but the friends and family are equally important in terms of just you're going to have some tough days, and having that person to talk to, to call, or that person to talk to.
It's about getting the right type of support from the right people. Friends and family aren't there to diagnose and to prescribe, but they are there to provide emotional support, whereas the doctors and the dieticians are there to give you the tools to actually work through. So I think someone would have a really hard time recovering if they didn't have any support. No matter how good their medical team is, if they didn't have support from their friends and family it's just going to make it a lot more difficult. You need somebody there.
Interviewer: A support system.
Dr. Nick Galli: Yes.
Interviewer: Any final thoughts?
Dr. Nick Galli: I would caution you from going in there with an attitude of what's wrong with you. Like I said before, don't be the police, resist that urge. Because I think that we come to that at some point where we're just like, oh, my gosh, why don't they just get it? Look at it as a complex problem and know that it's not your place to be the police. It's your place to be a supporter.
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