Warning signs in siblings of people with eating disorders
When someone has an eating disorder, mealtime routines and organization often need to be modified to follow the guidelines provided by the professional team, whether for anorexia nervosa, bulimia nervosa, or other eating disorders. Eating meals together as a family is one of the recommendations . This family time helps the person with the disorder to take their mind off the food and share difficult moments, but it can also lead parents, now more vigilant, to question the eating habits of their other children. It is often necessary to monitor access to the bathroom, physical activity, and attempts to exercise in their room.
Self-care guidelines for families in cases of eating disorders
An eating disorder shifts the focus of parental concern to the affected individual. This inevitably relegates other family members, including the parents themselves, to a secondary role. Managing this situation is not easy. We may find that eating disorders, anxiety, and depression also appear among siblings. Sometimes, imitative behaviors emerge in relation to the sibling with the disorder.
But when should we worry and how should we act in this case?
Warning signs in cases of brothers and sisters of people with eating disorders
These signs will be more or less important depending on the type and intensity of the behavior and its impact.
Changes in eating habits
It's common for a child or teenager to experience varying levels of hunger, and even to occasionally refuse food, eat unhealthily, or eat at irregular hours. They might also mimic a sibling who doesn't eat much or who eats excessively. If they aren't physically unwell, we should consider the possibility of emotional distress that might be causing this behavior. If they don't mention it, it could be an isolated incident. The best approach is to observe and be cautious. If the behavior persists, we'll need to sit down with them and ask them again.
Self-esteem issues
Self-esteem is key; if a teenager has a healthy self-image, they are less likely to fall into the trap of eating disorders, which are often based on trying to improve physical appearance to feel better in other areas (often relationships). Parents can do a lot to foster it.
Changes in character
You should be alert if there are sustained changes in character over time: irritability, sadness, withdrawal.
Caring for the siblings of people with an eating disorder
Behaviors similar to a brother or sister with an eating disorder
Observe if siblings exhibit similar eating behaviors to the child diagnosed with an eating disorder, such as becoming vegetarian at the same time as their sibling's eating problem, skipping meals or complaining about portion sizes, excessively cutting food into bite-sized pieces, a desire to eat alone, a urge to exercise more, new complaints of constipation, or increased food intake, especially of sweets. In this regard, eating behaviors are more concerning than clothing or makeup habits; it's the overall picture that matters. Keep in mind that having an eating disorder can lead to a loss of connection and harmony within the family. Siblings may feel lost, and imitation can be a way of seeking that lost connection, not just parental attention. Parents are the first to notice these changes. If in doubt, it's best to seek a professional evaluation.
Decline in previous academic performance
If we detect a change in academic performance, usually a drop in relation to the previous level or an unusual improvement linked to a sudden increase in study hours.
Appearance of self-harm
The reasons why a teenager self-harms can be varied: they may be related to relationships with others (avoiding an unwanted social event, seeking help from a family member who is perceived as unaware of this distress, etc.) or to managing their own emotions or mental states (reducing anxiety, feeling alive, calming or counteracting feelings of guilt, etc.). Ultimately, it is a symptom of emotional distress.
Loss of menstruation
Absence of menstruation is a common symptom in eating disorders. Complete withdrawal of menstruation may occur when there is significant weight loss or irregularities in the menstrual cycle.
If the person with an eating disorder has a twin brother or sister
Twin siblings have a higher risk due to genetic predisposition, especially in the case of anorexia nervosa, but let's not forget that eating disorders are multifactorial, and that it is not enough to share genetics, but we must also consider the personality traits of each child and the influences of the environment.
It's helpful to find time to be with the other children, so they can have experiences that are separate from the eating disorder; and ask them how their sibling's eating disorder affects them. This gives them time to enjoy with their parents and also a chance to talk about their feelings.
It is also recommended to explain the situation to the tutor at the siblings' schools so that they can support them.
If in doubt, it is advisable to consult the professional team treating the affected child , who may consider speaking with the siblings or including them in a family session where they can express their concerns.
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