Athletes and Eating Disorders; what parents and coaches need to know…

Elizabeth Hunkins is a therapist at Aurora Behavioral Health Center in Summit

Elizabeth Hunkins is a therapist at Aurora Behavioral Health Center in Summit

Sport activities offer such an array of benefits for individuals from improved confidence, self-esteem, social skills and healthy activity.  But when does having “fun” cross the line that places an individual at risk for possible eating disorder?

Competition in athletics can be a factor that leads to psychological stress, which increases risk factors for disordered eating patterns in males and females.  A study in 1992 found that 62 percent of females in sports suffered from eating disorders (mirror-mirror.org).  It is believed that since that study was completed that eating disorders among athletes continue to be on the rise.  Many parents, coaches and even physicians fail to recognize the signs of eating disorders in these individuals.  Athletes are at a greater risk of medical complication due to the demands they place on their body.

There are too many stories of athletes that have suffered from this disease. In July of 1994, top US gymnast, Christy Henrich died of multiple organ failure after a US judge told her she was “too fat and needed to lose weight to make the team”, and subsequently dropped to 47 pounds. She resorted to anorexia and bulimia, which eventually took her life.  Cathy Rigby, another Olympian suffered with this disease for 12 years and went into cardiac arrest two different times (mirror-mirror.org).  Not only is this happening on the elite level, it is happening on every level of competition in sports.

What are some early warning signs of an eating disorder in an athlete?

  • Rapid weight loss
  • Going to bathroom after meals
  • No breaks in weekly training (should have 1-2 days off per week)
  • Increased concern about body fat/calorie intake
  • Rigid behavior around food (refuses food groups, eating fat free/eating in isolation)
  • Social withdrawal from family and peers
  • Preoccupied with training/exercise and becomes upset if unable to workout
  • Will continue to workout even when ill/sick
  • Other areas in life becomes unmanageable (relationships, work, school)
  • Loss or irregular menses

Coaches need to educate themselves on the dangers of eating disorders and recognize early warning signs and intervene.  Education needs to be provided on healthy nutrition, and proper refueling.  Coaches need to be positive, encouraging and motivating; not harsh, negative and critical to athletes.  Parents should attend a training session to observe their child and the coach’s training.  A parent should not witness a coach pressuring their child to “WIN at any cost”.

Coaches should encourage athletes to develop a healthy routine with adequate emphasis on eating, hydration and life balance. Coaches should praise their efforts and their achievements.  If there are negative comments about an athlete’s appearance/weight and performance, then it is time to change coaches/programs for the well-being of the individual and seek assistance from a professional.

Liz Hunkins, LCSW is a therapist at Aurora Behavioral Health Center in Summit

If you or someone you know may be struggling with an eating disorder, please contact Aurora Behavioral Health Services at 877-666-7223 or visit our web site at Aurora Behavioral Health Services

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Would you recognize the signs of an eating disorder?

Whether you’re a professional caregiver, a friend, or a family member, you could be the first person to recognize and offer assistance regarding a patient’s eating and weight concerns. Identifying the problem early is important.  Early detection and treatment improves the prognosis.

PosterFlyerSCOFF is a screening tool developed to identify patients who may be experiencing an eating disorder.

The SCOFF questionnaire is effective as a screening instrument because it is simple, memorable, easily applied and scored.

One point is assigned for every “yes”; a score greater than two (≥2) indicates a possible case of anorexia nervosa or bulimia nervosa.

The SCOFF questions

  • Do you make yourself Sick because you feel uncomfortably full?
  • Do you worry that you have lost Control over how much you eat?
  • Have you recently lost more than One stone (14 lb) in a 3-month period?
  • Do you believe yourself to be Fat when others say you are too thin?
  • Would you say that Food dominates your life?

Read more information about What every Primary Care Physician should know about eating disorders.

NEDAwareness Week is February 24-March 2, 2013. This is the largest education and outreach effort on eating disorders in the United States.The aim of NEDAwareness Week is to increase awareness and education about eating disorders and body image issues for effective recognition, early intervention and direction to care.

If you or someone you know may be struggling with an eating disorder, please contact Aurora Behavioral Health Services at 877-666-7223 or visit our web site at Aurora Behavioral Health Services. Access an Eating Disorders Screening Tool, or learn about the Eating Disorder Program at Aurora Psychiatric Hospital.

Women

Everybody knows somebody with an eating disorder

NEDAwarenesweekNational Eating Disorders Awareness Week is the largest education and outreach effort on eating disorders in the United States, taking place from February 24 to March 2, 2013.

The aim of NEDAwareness Week is to increase awareness and education about eating disorders and body image issues for effective recognition, early intervention and direction to care. This year’s theme is EVERYBODY KNOWS SOMEBODY.

Do you know somebody affected by an eating disorder?

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Melissa Arvin

Judy Arvin knew somebody. Her daughter, Melissa, lost her life to an eating disorder. Following Melissa’s death, Judy formed Someday Melissa – a 501(c)3 nonprofit organization, that was established to promote awareness of the dangers of eating disorders.

Click here to read Melissa’s story or watch the full movie trailer.

You can also access an Eating Disorders Screening Tool, or learn about the Eating Disorder Program at Aurora Psychiatric Hospital.

If you or someone you know may be struggling with an eating disorder, please contact Aurora Behavioral Health Services at 877-666-7223 or visit our web site at Aurora Behavioral Health Services.  

 

What is Weight Stigma Awareness week?

How do you feel about your body shape and size? Do you judge a person by their weight?

The Binge Eating Disorder Association recognizes September 24-28 as National Weight Stigma Awareness Week. BEDA’s goal is to bring awareness to the way we judge ourselves and others based on weight.

Sandy Blaies, Manager of the Eating Disorder Program at Aurora Psychiatric Hospital says “Our society values thinness and perpetuates societal messages that obesity is the mark of a defective person.

We place a value on the size and shape of our bodies. We uphold stereotypes of body image and assume a person is healthy or unhealthy based on their weight. I am always careful of telling a young person they look thinner. Instead, focus on how the color they are wearing looks good on them, or how you love their smile. What you say matters.”

According to the RUDD Report from the Yale Rudd Center for Food Policy & Obesity, close to one of three overweight girls and one of four overweight boys report being teased by peers at school. Among the heaviest group of young people, that figure rises to three out of every five.

Peers see obese children as undesirable playmates who are lazy, stupid, ugly, mean, and unhappy. Negative attitudes begin in pre-school and may get worse as children age.

Those who are victimized because of their weight are more vulnerable to depression, low self-esteem, poor body image, unhealthy weight control practices and suicidal thoughts. Also, weight-based teasing makes people more likely to engage in unhealthy eating patterns.

Weight stigma can also lead to social isolation, poorer interpersonal relationships, and self-blame by those who are targeted. BEDA warns that many of these consequences can lead to eating disorders.

Sandy Blaies suggests “We should focus on health measurements that are more meaningful than numbers on a scale. Use an approach which is less about dieting and more about a lifestyle change that emphasizes “intuitive eating”: listening to hunger signals, eating when you’re hungry, choosing nutritious food over junk.

In addition, encourage exercise, but for its emotional and physical benefits, not as a way to lose weight. It advocates tossing out the bathroom scale and loving your body no matter what it weighs.”

If you or someone you know may be struggling with an eating disorder please contact Aurora Behavioral Health Services at 877-666-7223 or visit our web site at Aurora Behavioral Health Services

What is the Maudsley approach to treating anorexia?

Anorexia nervosa was initially recognized more than 125 years ago and today has one of the highest mortality rates among all the mental health disorders.  Advancements have been made to help treat this disease, but it continues to be on the rise.

Elizabeth Hunkins is a therapist with Aurora Behavioral Health Services.

Family based treatment (FBT) for anorexia nervosa (AN) is an outpatient treatment option that strives for weight restoration and addresses the adolescent’s development after weight has been restored.

This treatment model has been shown to demonstrate efficacy in numerous research studies, and consequently been a highly successful treatment alternative to higher levels of care.

One 2010 study, published in the Archives of General Psychiatry, showed 49 percent of those who had been in family therapy were in full remission, more than double the 23 percent of those who had been in individual therapy. And among patients who were in remission at the end of the treatment itself, only 10 percent of the family-therapy group had relapsed a year later, compared with 40 percent of those who had individual therapy.

In the Maudsley method of treatment, parents play an active role in the recovery process.  Parents are a key resource and essential for successful treatment for AN.  Maudsley does not believe there should be any “blame” on the family due to this illness or any hostility or criticism towards the adolescent.

Phase 1: Weight restoration:  The therapist’s focus with the family is about the dangers AN and severe malnutrition play, and assisting parents in re-feeding their child. The re-feeding stage is one of the most stressful points for the patient and also for the parents.  Therapists need to be mindful how this affects the entire family.  Helping the parents stay focused on the re-feeding and not get into power struggles with the illness is key.

The therapist helps the family understand the difference between their child and the illness, and continues to help towards the goal of weight restoration.  Usually during the beginning phase of treatment the therapist observes a family meal to provide an opportunity to assess the family’s interaction around food and then to assist/encourage parents in ways to help their child “eat a little more” as food is medicine.  Parents may need coaching that it is important to take time for themselves, as this can be stressful on a marriage.

Phase 2: Returning control over eating to the adolescent: The patient’s acceptance of the parents’ role in re-feeding, weight gain, and taking more control over the eating disorder behaviors are all positive signs that the family is entering phase 2 of treatment.  This phase encourages parents to help their child take more control over their eating and parents continue to maintain and watch over the adolescent’s physical health.  This phase will also begin to start discussing other family relationship issues that had to be postponed during the re-feeding phase.

Phase 3: Establishing health adolescent identity: This phase begins when the adolescent is able to maintain above 95% of ideal weight on his/her own.  Treatment shifts to the impact of AN and addressing other important treatment issues; identity issues, boundaries, personal autonomy, etc.

This treatment has shown great promise with those adolescents who have had AN if the family is willing to play an active role in treatment. Parents need to be aware of the time commitment this treatment will take prior to starting this treatment-as this treatment is not for every family.  The Maudsley therapist also believes in a treatment team approach, working with other medical professionals for the best successful outcome.

More information about the Maudsley approach can be found online at Maudsley Parents.

If you or someone you know may be struggling with an eating disorder, please contact Aurora Behavioral Health Services at 877-666-7223 or visit our web site at Aurora Behavioral Health Services.

Preventing suicide: a sister’s emotional plea

This heart-felt letter was written by a sister who lost her brother too soon.

In 2011, my younger brother chose to end his life. He was so very smart, handsome, and kind-hearted. He was a talented potter. He appreciated beauty in the simplest things. He gave kindness to everyone and expected it in return. He had a wicked sense of humor. And he was tormented by a barely diagnosed and untreated mental disorder.

Since that day, my family has been on a roller coaster of emotions: guilt, anger, shame, fear, loneliness, despair and overwhelming sadness.  We would have done anything to get him the help he so desperately needed, but he didn’t want it. So, this letter is a plea to anyone who has ever considered suicide; it’s a desperate plea not to do it.  There is someone out there who loves you, who needs you, and who wants to help you.  It may be someone in your family, it may be one of your friends, it may a doctor or a therapist or a teacher or a religious official, but someone wants to help you.

There are so many things we’ve learned over the last eight months. I learned what it’s like to be unable to sleep because of the terrible thoughts in your head. I’ve learned what it means to watch your parents cry wretchedly and not be able to comfort them. I’ve learned how to deal with grief in a way that allows it to be focused and not “shoot out” all over the place. I’ve learned that people move on and forget about you and your family; they say and do rude things without even thinking about it. I’ve learned that you should pay attention when the person with suicidal ideas stops talking because that’s when they are going to take action. I’ve learned that hindsight really is perfect vision.

Perhaps the most shocking of those things I’ve learned came in a conversation with my therapist. I was horrified to learn that people who are suicidal think that everyone they know will be better off if they are gone. This is so wrong. We are not better off because my brother is gone. The world is not better off because he is gone. Just like no one would be better off if you were gone. Your family, friends, co-workers, pets, and anyone who know you will not be better off because you are gone.

Whatever your personal situation is may seem overwhelming and insurmountable right now. It may seem like suicide is the only way out. It’s not the only way out; it’s the wrong way out. You will be missed very much. Someone will cry for you; someone will feel a sense of suffocating guilt that they couldn’t help you and that you are gone while they are still here; someone will be angry with you; someone will be lonely because you are gone.

Suicide is not the answer—don’t do it. While it may be hard to do and the thought may be overwhelming, I urge you to get help. Please learn from my family’s experience and know that you are wanted and loved and you will be missed.

Sincerely,

A loving, concerned sister

Suicide is the 11th leading cause of death among Americans. The World Health Organization estimates that about one million people around the world die by suicide every year, and CDC (Centers for Disease Control & Prevention) 2007 data indicates more than 34,000 suicides occurred in the U.S. This is the equivalent of 94 suicides per day; one suicide every 15 minutes.

Visit these web sites for more information:

For more information about treatment for individuals experiencing anxiety, feelings of hopelessness, or thoughts of suicide visit the web site for Aurora Psychiatric Hospital

Aurora Behavioral Health Services offers complete mental health treatment options, provided by highly trained professionals in a caring, confidential manner to meet individual and family needs.  If you or someone you know needs help, contact us — online or by phone at 1-877-666-7223 — as soon as possible.

Is your child ready for the new school year?

Back to school sales are being promoted already in just about every retail store. Is it really time to start planning for the new school year?

Kradwell School offers these tips for making a smooth transition from summer vacation to new school year.

One of the best ideas is to keep a child’s mind sharp when not in school. Use the summer to read, access a local library, engage in a science project at home or visit a museum for a fun history lesson.

Similarly, kids who don’t write during the summer have to relearn to write (and spell) when school starts. Practice handwriting and spelling. Correct the spelling and ask for neat handwriting Here are a few ideas:

  • Have them write a few sentences about what they’ve done that day or week.
  • Write letters to friends or relatives
  • Encourage kids to write thank you notes
  • Teach your child how to write and send an email message
  • Create a family newsletter or blog
  • Suggest your child keep a journal

Before your child starts kindergarten, it would be GREAT if they could write their name correctly, know their numbers to 20, say the alphabet (and letter sounds), and know basic shapes and colors.

Find out about your child’s school.  Whether your child is returning to the same school or starting at a new one, it’s always a good idea to be aware of any changes at the school. Is there a new principal? What’s going on with the curriculum?

As most school districts start in September, schools tend to be open a month before. You can call the school directly and speak with an administrator or visit the school for information.

Whether you attend an “open house” or schedule a one-on-one conference, you should meet with your child’s teachers. By talking with your child’s teachers and/or going to the Department of Education Web site for your state, you can also find out key benchmarks on the academic calendar, such as which tests are administered and when. The teacher may also be able to provide you with a copy of a lesson plan or syllabus that gives you an idea of what will be taught in class.

You should also tour of the building-be aware of all the facilities your child may come into contact with. And don’t forget the guidance counselor. That person will be another key ally for you and your child. Guidance counselors have access to all of your child’s academic records. They also have knowledge of programs to help your child in and out of school. They’re also trained to provide basic counseling services to your child if he is having problems in school.

 Get your child into the back-to-school routine. During the summer, staying up late and sleeping in are the norm. But as the start of school draws near, children need to get back into a routine.

About three weeks before school starts, have your child go to bed 15 minutes earlier at night and get up 15 minutes earlier in the morning. When school is two weeks away, have your child go to bed 30 minutes earlier at night and get up thirty minutes earlier in the morning. When your child is about to start school in a week, have him go to bed an hour earlier at night and get up an hour earlier in the morning.

Kradwell School is dedicated to serving the needs of students in 5th through 12th grade who have experienced overwhelming difficulties in traditional educational environments.

By developing a bedtime routine, your child will be less resistant to the early morning wake-up calls to get ready for school. In addition, you can prepare the evening before for morning routines surrounding starting school each year.

Select clothing, including shoes and socks, and have them laid out. Hair accessories, backpacks zipped and ready, lunches made or at least decisions about what will be in the lunch, and determining weather-appropriate attire helps to minimize morning madness. Having a set place for backpacks minimizes lost homework or missing items in the harried morning routine.

Make sure your child gets enough sleep. Sleep experts from the National Sleep Foundation say that kids need their rest to perform well at school. Follow their practical tips for setting your kids’ back-to-school sleep clocks at least two weeks before the school year begins.Pre-school and school-age children should receive 10-11 hours of sleep each night. Establish those bedtime requirements, and then stick to it.

Organize your family’s time. As appointments and daily schedules for the year form, take note of them and write them down. Use a large calendar to keep track of schedules and events or place a weekly schedule for each person on the refrigerator or other prominent place in your home. Make a habit of checking it twice a day – in the morning and at night. Teach this habit to all of your family members.

Buy and organize school supplies.  Depending on your child’s grade level (K0-12), the type of supplies needed will vary. Some schools send a list out a couple of weeks before the school year. If no such list is provided, many stores provide free school supply lists for their customers. They’re pretty concise and arranged by grade level. Be prepared to have to go out and purchase something else the night of the first day of school. There is always one teacher who requires a certain supply but doesn’t let their students know until the first day of school.

Set goals and expectations. The start of the school year is a wonderful time to re-examine school performance – both academically and extra curricular activities. Remember to set doable goals and try not to over stress your teenager. Be sure to set the time for homework-establish a learning schedule, including parameters for homework.

Setting aside a designated period of time after school or in the early evening that is to be used only for schoolwork is a strategy that has been proven effective for many students. There are several factors that can influence the decision about which time is best. Some children, for example, may complete homework more successfully by beginning immediately after school, leaving the rest of the late afternoon and evening for other activities. Others may need time to “wind down” after being in school all day before they’re relaxed and focused enough to complete homework successfully.

Emphasize the positive. Kids pick up on your attitude. If you complain about shopping for back-to-school clothes and supplies, they’ll pick up on it. If you speak negatively about your child’s teacher, they will start the year thinking negatively about him or her. Instead, identify what excites your child and focus on that. Talk to each other about the school year coming up and reaffirm with your child that you are there to help whenever help is needed-be sure to tell your child this and don’t assume they already know. It is easier to handle stress from outside sources – like school – when you know someone is on your side.

Don’t wear them out! Kids who are signed up for five different summer camps, tutoring, piano lessons, and ballet will never get the ‘break’ that comes with summer break! Give them downtime. Let them play. Let them sit around and say ‘I’m bored’ every once in a while. This advice should also be applied year-round. Limit our kids to 1-2 extracurricular activities at a time during the school year. As they get older, maybe they’ll show that they can handle more or less than that. Let your child know that school is their main priority and biggest responsibility.

Kradwell School is a private, nontraditional, nonsectarian fifth through twelfth grade Program. Kradwell School is dedicated to providing a child-centered, flexible, educational environment that meets the diverse academic, emotional and social needs of students.

Fall enrollment is now underway (2012-2013).Contact Leslie Newman 414-395-8125 or mail leslie.newman@aurora.org to arrange a visit to Kradwell School.  Openings are available in both the middle and high school programs. For more details about Kradwell School, enrollment information and a video tour of Kradwell school, visit www.kradwell.org.

What should every doctor know about eating disorders?

Statistics from the National Eating Disorder Association indicate approximately 24 million people suffer from anorexia nervosa, bulimia nervosa and binge eating disorder in the U.S.

Yet, too many eating disorders are not caught until the illness is entrenched often to the point at which there has already been irreversible physical health damage done, making the illness much more difficult to treat. Studies have repeatedly shown that early intervention leads to better treatment outcomes.

Primary care physicians play a critical role in identifying an eating disorder in a number of ways. Physicians can reduce the potential for an eating disorder by educating patients on nutrition, body image, and risk factors. They can also be the first to identify early warning signs such as changes in weight, vital signs, or other physical complications.

If doctors are able to intervene more promptly and the illness is treated at an earlier stage, it helps alleviate the serious health consequences that accompany prolonged eating disorders; lessens emotional turmoil involved for the entire family; and reduces the financial burden of treatment significantly.

The American Medical Association’s (AMA) latest online course, Screening and Managing Eating Disorders in Primary Practice, a “first-of-its-kind” curriculum, was developed to educate physicians about eating disorders, with the goal of earlier detection and intervention.

If you or someone you know may be struggling with an eating disorder, or you would like to make a treatment referral, please contact Aurora Behavioral Health Services at 877-666-7223 or visit our web site at Aurora Behavioral Health Services

Additional NEDA resources for primary care physicians:

  • WHAT’S UP DOC
    WHATS UP DOC is a helpful guide for physicians. Using this handy acronym you will be sure to cover a wide array of significant topics with you patients.

If you have questions about our services or suspect someone has an eating disorder, please call 414-454-6694 or visit our website. If you would like to schedule an appointment for an assessment, please call 414-773-4312.

A New Home!

Caregivers and patients in the Eating Disorder Program at Aurora Psychiatric Hospital are enjoying a new home. Still housed within the hospital, on the 28 acre wooded campus, the program has moved to a new area, designed specifically for the patients attending the eating disorder program.

The United States, as a whole, is obsessed with weight. The National Eating Disorder Association (NEDA) reports that, on any given day, almost half of American women are on a diet and a quarter of men are also trying to lose weight. But for five to 10 million females and an additional one million males each year, the desire to be thin will turn into a more serious eating disorder where eating is no longer about feeding a physical hunger, but becomes about satisfying a psychological need.

The Eating Disorder Services at Aurora Psychiatric Hospital approaches an individual’s eating disorder from a biological, psychosocial and psychological focus. Understanding the complexity of the illness, theAuroraPsychiatric Hospital’s program helps individuals develop the skills to take better care of themselves from a nutritional, emotional and social perspective. One of the initial steps is to address the physical needs of a patient. “When someone enters the program, they are experiencing a lot of anxiety regarding food,” explains Anne Sprenger, RD, registered dietician withAuroraPsychiatric Hospital. “A dietician meets with them at the very beginning of their treatment to initiate the process of re-feeding them. We set nutritional goals and help them develop personalized steps to work toward those goals.” The program is customized to each individual. Food allergies, and religious and cultural preferences are taken into consideration. Initially the meals are planned for them, but as individuals progress they become actively involved in understanding how to select healthy choices. “Education is a vital component of our nutritional services,” continues Anne. “We need to get our patients the correct information regarding nutrition, explain how they can take care of themselves from a nutritional perspective and give them the support they need to get back on track with eating healthy, balanced meals.” As clinically indicated, patients can participate anywhere in the full continuum of inpatient, partial hospitalization or intensive outpatient programs. An individual’s needs are taken into consideration when trying to find the most cost-effective approach to deal with an oftentimes lengthy process. All options include psychiatric treatment, group and individual therapy with a general emphasis on cognitive behavioral therapy and dialectical behavioral therapy; education groups; family involvement; relapse prevention, in addition to the nutrition program. “Despite the outward physical appearance of some eating disorder sufferers, the toll taken on the inside is far more devastating,” explains Sandra Blaies, LCSW, supervisor of Eating Disorder Services atAuroraPsychiatric Hospital. “The Eating Disorders Program offers a wide variety of complementary therapies ranging from art therapy, mindful yoga and food challenge experiences to help patients learn how to identify and express their feelings or emotions.” In addition, family involvement is an integral part of a patient’s care. Family education and support groups for the family and friends of patients provides both the education they need to support their loved one, as well as gives them a channel through which they can address their own fears and frustrations. “In our program, families and friends are considered a valuable resource in the recovery program,” addsSandy. Indications that someone may have an eating disorder range from binge eating or food restriction, to self-induced vomiting, abusing laxatives or diet pills, a preoccupation with food, calories, nutrition and/or cooking, crash dieting, denial of hunger, perfectionism, extreme weight loss or low body weight.

If you have questions about our services or suspect someone has an eating disorder, please call 414-454-6694 or visit our website. If you would like to schedule an appointment for an assessment, please call 414-773-4312.

I think my friend may have an eating disorder. What would you say to them?

I think my friend has an eating disorder, but I don’t know what to say. Talking to someone about an eating disorder is one of the most difficult conversations you can have.

These ideas, adapted from the National Eating Disorder Association, can help.

• Set up a time to talk, and have your discussion in a private and relaxed setting

• Express your concerns openly and honestly, in a loving, supportive and non-confrontational way

• Talk in a calm and caring way and explain the specific things you have seen or felt that have caused you to worry, and that you think these things may indicate that there could be a problem that needs professional attention

• Ask your friend if they would be willing to explore these concerns with a professional. If you are both comfortable, you can help make an appointment with a counselor, nutritionist or doctor, and go with your friend.

• Avoid conflicts or a battle of the wills with your friend if they refuse to acknowledge that there is a problem, or any reason for you to be concerned. Think of this initial conversation as a starting point. Your friend may be initially defensive, but hopefully will think about what you said. Be sure to share that you are available as a supportive listener.

• Avoid critical or accusatory statements that place shame, blame, or guilt on your friend regarding their actions or attitudes. Do not use accusatory “you” statements like, “You just need to eat.” Or, “You are acting irresponsibly.” Instead, use “I” statements. For example: “I’m concerned about you because you refuse to eat breakfast or lunch.” Or, “It makes me afraid to hear you vomiting.” • Avoid giving simple solutions. For example, “If you’d just stop, then everything would be fine!” Express your continued support. Remind your friend that you care and want your friend to be healthy and happy.

• After talking with your friend, if you are still concerned with their health and safety, find a trusted adult or medical professional to talk to. This is probably a challenging time for both of you. It could be helpful for you, as well as your friend, to discuss your concerns and seek assistance and support from a professional.

National Eating Disorders Awareness week goes through March 3. Access an Eating Disorders Screening Tool, or learn about the Eating Disorder Program at Aurora Psychiatric Hospital.

If you or someone you know may be struggling with an eating disorder, please contact Aurora Behavioral Health Services at 877-666-7223 or visit our web site at Aurora Behavioral Health Services.