Sister's starving herself

I recently found out my sister is anorexic. She was having stomach cramps because she hadn't been eating and was missing her periods.

My sister has always been very thin. She's never eaten a lot, but she did eat. She's always dressed up nicely and cares about how she looks. We've also had a few family problems that have affected both of us. Is resorting to anorexia her way of responding to this or is it just about self-image? I've also been wondering if this is a cry for attention; my sister is known to crave attention and affection.

Now that we've known this for a few weeks, she's still not eating that well. She's started her cycle again, but I know this doesn't solve anything. How are we supposed to make her eat? Force her? Give her better food? I was thinking about researching high nutritional diets for her, but I think I need some help.

Understandably, you're very concerned about your sister's wellbeing. It must be frustrating for both you and your mum. Being aware of the health implications if she continues to starve herself must be very upsetting.

The causes of any eating disorder vary tremendously according to the individual. There is a lot of pressure from the media and society to look a certain way, with an emphasis on 'thinness', and such distorted ideals are generally a far cry from reality. But Eating disorders are not always simply about issues of self-image.

Unhealthy relationships with food can begin when food is used to cope with difficult feelings, such as boredom, anxiety, anger, loneliness, shame or sadness. Some people use food to ease painful situations or feelings, or to relieve stress, perhaps without even realising it. So this could be a way of your sister reacting to the family problems you mention.

When food begins to rule a person's life, a person's relationship with food can become dangerously unstable. This may develop into anorexia nervosa.

Overcoming anorexia usually needs more organised help from a clinic or therapist. You do not mention if your sister is now receiving any form of professional treatment. Her local doctor (GP) should be able to explore the options available to her and refer her onto more specialist services. Perhaps it would be helpful to offer accompanying your sister, to give her extra support.

For further support and information, you, or your sister, might like to contact the Eating Disorders Association (EDA) on 0845 634 7650. You can also get more information, advice and support networks, including a message board on their website. Anorexia affects many people but it's important to know it is possible to overcome the condition. Sometimes it helps to talk to others who share a similar experience, so it may be worth letting your sister know about this website.

If your sister finds talking helpful, a talking therapy, such as counselling, may benefit her further. A trained counsellor or therapist will be able to assist her in identifying any underlying issues she may have which could be contributing to her situation. These could include elements of control, low self-esteem, depression, or family problems as you mention.

The relationship between diet and emotional and mental health (or food and mood) is interesting - and is becoming more recognised. A balanced diet, including all the food groups and plenty of fresh fruit and vegetables keeps the body healthy, but can also be really important in keeping the mind balanced.

Equally, an important part of stabilising emotional health through food is about how you eat, not just what you eat. In order to keep your blood sugar level stable, and consequently, your energy levels stable, it's important to eat regularly and not skip meals - especially breakfast. Eating foods with a slow release of energy (low glycaemic index) will keep body and mind fuelled much more steadily. These are things like wholegrain rye bread, basmati rice and oats.

If you're interested in the connection between food and emotional health, it may be worth taking a look at the Food and Mood website, should you wish to talk to someone about the specific needs of your sister.

It's great to hear how supportive you are trying to be, but this must be putting a lot of pressure on you and it's important to think about your own emotional wellbeing. If you, your mum or sister would like to speak to someone in confidence and without judgement, about any issues mentioned in your message, you can call SANELINE on 0845 767 8000.

Updated: 06/06/2011

Question answered by SANE