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Surviving an Eating Disorder: Strategies for Family and Friends
"Surviving an Eating Disorder" became an instant success when it was first published in 1988, not just because it was among the first books to alert America to the serious dangers of a silent but widespread disease, but because it offered effective solutions and support for family and friends of those with eating disorders. Eight years after its publication, the book continues to sell briskly and generate continuing interest from readers. This new edition has been revised to address the cutting-edge advances made in the field of eating disorders, discuss how the changes in health care have affected treatment and provide additional strategies for dealing with anorexia, bulimia and binge eating disorder. It also includes updated readings and a list of support organizations. Without a doubt the best book on the subject, it is required reading for those suffering from eating disorders, their families and professionals.
288 pages, Paperback
First published April 1, 1988
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October 9, 2012
**Surviving and thriving**
As an eating-disorder therapist, I’m always on the lookout for resources to help families, partners, and friends better understand the complex world of eating disorders. I felt like I struck gold when I discovered this book, and it’s now on the top of my recommended reading list.
Beyond just covering the basic eating disorder 101’s (which it does quite impressively), this book offers comprehensive, clear, and concrete strategies for supporting loved ones who are suffering from eating disorders, including anorexia, bulimia, and binge-eating disorder. The table of contents speaks for itself:
Introduction: How to Survive
Part I: Gaining Perspective
Chapter 1: What You See—The Behavioral Aspects of Eating Disorders
Chapter 2: Hidden Feelings—The Psychological Aspects of Eating Disorders
Chapter 3: Rules and Relationships—The Family Context of Eating Disorders
Part II: Confronting the Problem
Chapter 4: No More Secrets—Bringing It Out in the Open
Chapter 5: When She Says Nothing is Wrong—Coping with Denial
Chapter 6: No One Can Go It Alone—Seeking Help
Part III: Using News Strategies
Chapter 7: What to Do About the Problems with Food—Practical Advice for Disengaging from the Food Fights
Chapter 8: When It’s Hard to Let Go—Understanding What Keeps You So Involved
Chapter 9: Developing a Healthier Relationship—Relating to the Person, Not the Eating Disorder
The book is packed full of so many gems that powerfully summarize the underlying, and often overlooked, components of an eating disorder. Here’s just a small sample:
***An eating disorder is not merely a problem with food or weight. It is an attempt to use food intake and weight control to solve unseen emotional conflicts or difficulties that in fact have little to do with either food or weight. An eating disorder is *never* simply a matter of self-control. Healthier eating habits and stronger willpower are not the missing ingredients that will make the problem disappear. (p. 40)
***Because the symptoms of bingeing, vomiting, exercising, or starving can be so disruptive and frightening, it is easy to pay attention only to those behaviors. To do so, however, misses the point. The overt symptoms are just the tip of the iceberg. Beneath the surface likes a much larger piece of the picture—a complicated and complex world of feelings and experiences that are very much a part of the eating disorder. Both the visible and invisible parts need to be acknowledged in order to understand the disorders of bulimia nervosa, anorexia nervosa, and binge eating. (p. 53)
***In every eating disorder, it is only when the person is able to find healthier means of taking care of herself and generating internal sources of self-esteem that she can give up attempts at coping that have, ironically and tragically, led to further emotional and physical damage. Only by understanding the protective and adaptive functions of these behaviors can *you* begin to appreciate why it may be so hard for someone to just “give it up.” (p.42)
***Sometimes one feeling conflicts with another, such as wanting to be grown up and wanting to remain a child at the same time. Feelings can be, and often are, intense for the eating-disordered person, who fears being overwhelmed by them, or worse still, overwhelming others with them. The fear of her feelings then exacerbates the problem, leading the person to panic and rush to food. (p. 52)
***Not only is the eating-disordered person in need of approval, but inside she is “hungry” for care and affection as well. Often she has been so attuned to everyone else’s needs that her own have gotten overlooked. Despite feelings of dependency, women with eating disorders don’t want to rely on or need other people. Feeling dependent or needy leaves them feeling weak or like a failure and is to be disowned and avoided at all costs. For some women, there is an intense fear that others will be overwhelmed by their needs and leave them or stop loving them. To avoid this, they try to be perfect inside and out. The strain is enormous. (pp. 52-53)
***The self-imposed demands of perfection and the fear of rejection that eating-disordered people experience interfere with the development of comfortable, intimate relationships. The dilemma is a difficult one. If someone can’t reach out and allow herself to need someone else, to be vulnerable to someone else, how can she really get to know that person and let herself be known? (p. 53)
***As the eating-disordered person is more fully able to accept herself as well as her feelings about others, the need to block out parts of herself through food can be lessened. One aspect of this is helping her differentiate her feelings from physiological hunger. People with eating disorders tend to misinterpret emotional experiences as hunger and respond by eating. (pp. 123-124)
Along with these gems, one of my favorite parts of the book is the practical advice offered for disengaging from the “food fights,” including these rules (pp. 172-212):
Rule #1: Accept your limitations.
Rule #2: Accept the other person’s right to be different from you.
Rule #3: Don’t purchase (or avoid purchasing) food solely to accommodate the eating-disordered person.
Rule #4: If a meal plan has been established by a professional, unless you are involved in a therapeutic refeeding program with your child, do not comment on what is eaten.
Rule #5: Don’t make mealtimes a battleground, even if you are refeeding your daughter.
Rule #6: Be willing to negotiate household chores involving food.
Rule #7: The eating-disordered person is responsible for her behavior whenever it affects others.
Rule #8: Do not monitor someone else’s behavior for her (even if you are invited to) unless this is part of a treatment plan set up with the support of professionals guiding the way.
Rule #9: Do not use money to control another person’s eating behavior.
Rule #10: Do not anticipate someone else’s needs. Ask!
Rule #11: Don’t make eating out a battle of wills.
Rule #12: Do not offer advice or opinions.
Rule #13: Do not play therapist.
Rule #14: Do not comment about someone’s weight and looks.
In addition to all of this invaluable information and insight, the book is infused with hope. In the authors’ own words:
“Someone with an eating disorder has a long road to recovery. How she manages food and weight issues along the way will be part of her independent struggle to get well. What you do can make a big difference both for you and for her. Remember, this is an opportunity to fine-tune your relationship and to provide a strong base from which everyone can grow and change.
There are many ways in which you can create an environment that allows for a richer, fuller way of relating that can minimize the need for the maintenance of a symptom…Don’t go it alone. Be patient, and learn to discover the ways in which you and the person you care about can enjoy one another and expand your relationship, even if the person is critically struggling with her eating and weight.
This is not an easy task. But if you continue your efforts, there is much hope for the future.” (p. 254)
Clearly, I can not recommend this book highly enough! I’m confident that family and friends who take this book to heart will be able to survive—and ultimately thrive—while supporting their loved ones through this difficult journey.
As an eating-disorder therapist, I’m always on the lookout for resources to help families, partners, and friends better understand the complex world of eating disorders. I felt like I struck gold when I discovered this book, and it’s now on the top of my recommended reading list.
Beyond just covering the basic eating disorder 101’s (which it does quite impressively), this book offers comprehensive, clear, and concrete strategies for supporting loved ones who are suffering from eating disorders, including anorexia, bulimia, and binge-eating disorder. The table of contents speaks for itself:
Introduction: How to Survive
Part I: Gaining Perspective
Chapter 1: What You See—The Behavioral Aspects of Eating Disorders
Chapter 2: Hidden Feelings—The Psychological Aspects of Eating Disorders
Chapter 3: Rules and Relationships—The Family Context of Eating Disorders
Part II: Confronting the Problem
Chapter 4: No More Secrets—Bringing It Out in the Open
Chapter 5: When She Says Nothing is Wrong—Coping with Denial
Chapter 6: No One Can Go It Alone—Seeking Help
Part III: Using News Strategies
Chapter 7: What to Do About the Problems with Food—Practical Advice for Disengaging from the Food Fights
Chapter 8: When It’s Hard to Let Go—Understanding What Keeps You So Involved
Chapter 9: Developing a Healthier Relationship—Relating to the Person, Not the Eating Disorder
The book is packed full of so many gems that powerfully summarize the underlying, and often overlooked, components of an eating disorder. Here’s just a small sample:
***An eating disorder is not merely a problem with food or weight. It is an attempt to use food intake and weight control to solve unseen emotional conflicts or difficulties that in fact have little to do with either food or weight. An eating disorder is *never* simply a matter of self-control. Healthier eating habits and stronger willpower are not the missing ingredients that will make the problem disappear. (p. 40)
***Because the symptoms of bingeing, vomiting, exercising, or starving can be so disruptive and frightening, it is easy to pay attention only to those behaviors. To do so, however, misses the point. The overt symptoms are just the tip of the iceberg. Beneath the surface likes a much larger piece of the picture—a complicated and complex world of feelings and experiences that are very much a part of the eating disorder. Both the visible and invisible parts need to be acknowledged in order to understand the disorders of bulimia nervosa, anorexia nervosa, and binge eating. (p. 53)
***In every eating disorder, it is only when the person is able to find healthier means of taking care of herself and generating internal sources of self-esteem that she can give up attempts at coping that have, ironically and tragically, led to further emotional and physical damage. Only by understanding the protective and adaptive functions of these behaviors can *you* begin to appreciate why it may be so hard for someone to just “give it up.” (p.42)
***Sometimes one feeling conflicts with another, such as wanting to be grown up and wanting to remain a child at the same time. Feelings can be, and often are, intense for the eating-disordered person, who fears being overwhelmed by them, or worse still, overwhelming others with them. The fear of her feelings then exacerbates the problem, leading the person to panic and rush to food. (p. 52)
***Not only is the eating-disordered person in need of approval, but inside she is “hungry” for care and affection as well. Often she has been so attuned to everyone else’s needs that her own have gotten overlooked. Despite feelings of dependency, women with eating disorders don’t want to rely on or need other people. Feeling dependent or needy leaves them feeling weak or like a failure and is to be disowned and avoided at all costs. For some women, there is an intense fear that others will be overwhelmed by their needs and leave them or stop loving them. To avoid this, they try to be perfect inside and out. The strain is enormous. (pp. 52-53)
***The self-imposed demands of perfection and the fear of rejection that eating-disordered people experience interfere with the development of comfortable, intimate relationships. The dilemma is a difficult one. If someone can’t reach out and allow herself to need someone else, to be vulnerable to someone else, how can she really get to know that person and let herself be known? (p. 53)
***As the eating-disordered person is more fully able to accept herself as well as her feelings about others, the need to block out parts of herself through food can be lessened. One aspect of this is helping her differentiate her feelings from physiological hunger. People with eating disorders tend to misinterpret emotional experiences as hunger and respond by eating. (pp. 123-124)
Along with these gems, one of my favorite parts of the book is the practical advice offered for disengaging from the “food fights,” including these rules (pp. 172-212):
Rule #1: Accept your limitations.
Rule #2: Accept the other person’s right to be different from you.
Rule #3: Don’t purchase (or avoid purchasing) food solely to accommodate the eating-disordered person.
Rule #4: If a meal plan has been established by a professional, unless you are involved in a therapeutic refeeding program with your child, do not comment on what is eaten.
Rule #5: Don’t make mealtimes a battleground, even if you are refeeding your daughter.
Rule #6: Be willing to negotiate household chores involving food.
Rule #7: The eating-disordered person is responsible for her behavior whenever it affects others.
Rule #8: Do not monitor someone else’s behavior for her (even if you are invited to) unless this is part of a treatment plan set up with the support of professionals guiding the way.
Rule #9: Do not use money to control another person’s eating behavior.
Rule #10: Do not anticipate someone else’s needs. Ask!
Rule #11: Don’t make eating out a battle of wills.
Rule #12: Do not offer advice or opinions.
Rule #13: Do not play therapist.
Rule #14: Do not comment about someone’s weight and looks.
In addition to all of this invaluable information and insight, the book is infused with hope. In the authors’ own words:
“Someone with an eating disorder has a long road to recovery. How she manages food and weight issues along the way will be part of her independent struggle to get well. What you do can make a big difference both for you and for her. Remember, this is an opportunity to fine-tune your relationship and to provide a strong base from which everyone can grow and change.
There are many ways in which you can create an environment that allows for a richer, fuller way of relating that can minimize the need for the maintenance of a symptom…Don’t go it alone. Be patient, and learn to discover the ways in which you and the person you care about can enjoy one another and expand your relationship, even if the person is critically struggling with her eating and weight.
This is not an easy task. But if you continue your efforts, there is much hope for the future.” (p. 254)
Clearly, I can not recommend this book highly enough! I’m confident that family and friends who take this book to heart will be able to survive—and ultimately thrive—while supporting their loved ones through this difficult journey.
March 16, 2021
Helpful - the specific scenarios, guidelines, and possible solutions at the end
Not helpful - could use more information on both genders; no mention of ARFID
Not helpful - could use more information on both genders; no mention of ARFID
March 6, 2021
I wish I didn’t need to read this book but alas, EDs are real and happen in all families by no particular fault or cause. If you are struggling with a loved one having an ED, this book is a must-own resource.
July 6, 2023
I read this book from the perspective of someone who has suffered years of Anorexia and has been in recovery for a while, I wanted to better understand the impact the eating disorder can have on loved ones, and I was curious about what advice and support is out there for their own healing. This book did not disappoint. The first chapter details the different eating disorders, symptoms, how they develop, potential complications etc. And the rest of the book goes through various challenges family and friends may experience as someone who is responsible for the care (parent), in a loving equal relationship (partners), or shares a home (roommates/friends). The authors primarily focus on the impact of bulimia and anorexia although other eating disorders are occasionally mentioned in examples. The advice given for parents and spouses is robust, but a bit repetitive for roommates and friends (likely because of the limited nature of impact in this dynamic). The end of the book talks about the importance of taking care of yourself and making sure your needs aren't lost while caring for someone with an eating disorder - great advice but it was a bit repetitive in the final few pages.
Overall, I recommend this book to those who need it.
If you have an eating disorder and are curious (like me!) just be mindful of when you read the book because many of the examples have heights and weights or specific amounts of lost or gained weight which could be enticing information for the eating disorder.
Overall, I recommend this book to those who need it.
If you have an eating disorder and are curious (like me!) just be mindful of when you read the book because many of the examples have heights and weights or specific amounts of lost or gained weight which could be enticing information for the eating disorder.
October 12, 2022
honestly it was my fault. i was looking for a book to help myself and i saw the title and thought that it's a book about helping myself not someone else.
tbh idk if it's becuz i am the one struggling with the ed that's why i feel like everything written in this book is obvious and everyone should know and shouldn't have to be written and sold for people to learn about.
i rly did enjoy the stories of different families and friends becuz it made me so relieve to know that i am not the only one struggling.
i know it is written by many phd doctors but sometimes it just felt like it is written by a boomer who's trying to understand teenagers these days.
also i didn't like how they made it sound like it is rly surprising that boys have the same problem too.
i did skip a few pages here and there becuz i just don't lfind it helpful.
tbh idk if it's becuz i am the one struggling with the ed that's why i feel like everything written in this book is obvious and everyone should know and shouldn't have to be written and sold for people to learn about.
i rly did enjoy the stories of different families and friends becuz it made me so relieve to know that i am not the only one struggling.
i know it is written by many phd doctors but sometimes it just felt like it is written by a boomer who's trying to understand teenagers these days.
also i didn't like how they made it sound like it is rly surprising that boys have the same problem too.
i did skip a few pages here and there becuz i just don't lfind it helpful.
This entire review has been hidden because of spoilers.
June 27, 2022
By their nature, eating disorders destroy lives — not just of the sufferers, but their loved ones, too. Surviving an Eating Disorder is for those family and friends at the end of their rope.
Because I nearly died of anorexia, I felt rather guilty reading this book. It forced me to confront what people who cared about me went through as I nearly died. It must have been hell. For them, I am grateful.
Because I nearly died of anorexia, I felt rather guilty reading this book. It forced me to confront what people who cared about me went through as I nearly died. It must have been hell. For them, I am grateful.
February 21, 2018
Good help!
This book helped me understand the disorders. It was very helpful. I have a friend, (we are both in our 30’s) who is bulimic. This didn’t offer much help for someone like me to help my friend, but at least I understand the condition better.
This book helped me understand the disorders. It was very helpful. I have a friend, (we are both in our 30’s) who is bulimic. This didn’t offer much help for someone like me to help my friend, but at least I understand the condition better.
March 26, 2022
The most practical and useful of the ED books I've read.
October 11, 2022
made me cry but extremely helpful from within and without the perspective of someone with an ed
November 6, 2023
Such a good resource for anyone with a loved one struggling with an ED. Gives much needed information and perspective along with strategies to use going forward.
June 21, 2008
Perhaps the most controversial tome in my personal library, this book will make any person who has been teased about their weight or even thought to be a person with an eating disorder very uncomfortable in reading it, as it's almost as if it could be a tool to self-diagnose.
However, it is a useful tool, at least it was for me, in using it as a reference in a paper I was writing for my college sociology class.
However, it is a useful tool, at least it was for me, in using it as a reference in a paper I was writing for my college sociology class.
November 24, 2016
I read this to help me better understand how best to help other people, and to let other people help me. Most of the advice was for parents/children, which was not applicable. Some of it was about dealing with adult relationships, friendships, romantic partners, roommates, co-workers, and that part was helpful. I will be rereading it, and sharing some of the applicable bits with the applicable people in my life.
June 1, 2013
This book was very useful to me when a friend developed an eating disorder. It lays out what the disorders are, their characteristics, how they may be treated, and what role friends and family can play. It's just detailed enough without being too long or boring.
June 24, 2013
If you know anyone suffering from an eating disorder, READ THIS BOOK! It has tons of information. Very helpful.
August 21, 2014
While i liked it and appreciated all the information in it as it pertains to being a support to my daughter. I liked "The Secret Language" and "My Life Without Ed" more.
September 14, 2021
Mostly helpful, updated, and helps reduce feelings of isolation and desperation.
March 30, 2009
This is an excellent resource -best book I have read on the subject
July 28, 2015
Fabulous insight to what people struggling with this illness feel and think and experience!
August 29, 2015
Good reminders of things I already knee, but helpful to get me back in friend mode.
Displaying 1 - 19 of 19 reviews