Watching someone you love go through an eating disorder such as anorexia or bulimia is a traumatic and frustrating experience.
This Eating Disorders Awareness Week we asked an expert for advice for the friends and family of someone suffering conditions such as anorexia and bulimia.
It's hard to know how to react to and treat someone with an eating disorder. We asked Emmy Gilmour, clinical director of the Recover Clinic for her advice for friends and parents.
"The first thing to do is to approach the person with your concerns," Emmy says. "There's a tendency to avoid bringing the issue up for fear of pushing the person away but one of the tools someone with an eating disorder uses is to act defensive or even aggressive and you need to be quite persistent."
"The second is don't minimise it. People don't want to make a fuss of it and that's part of the problem. Someone with an eating disorder thinks it's not a big deal that they're not eating - so when you don't act like it's a problem it makes it easier for them to justify it and continue."
But, she cautions, don't make it all about food. "An eating disorder is a coping strategy, it's a tool someone's using because they don't know how to cope with how they feel. Talk to them about what else is happening in their life and how they feel about it, rather than focussing entirely on weight and food."
Early signs of an eating disorder
"Early beginnings of behaviours that might cause you a red flag include cutting out entire food groups," Emmy explains. "Suddenly becoming vegan or vegetarian or cutting out gluten. Anything that ultimately leads to them cutting out fat and carbs - we need those things in our diet.
"And also becoming withdrawn and not talking, not sharing what they're feeling. If something seems wrong, talk. You don't want to wait for someone to be in a state of crisis before you do something."
How to help
"The first thing to do is get professional help and advice. One option is to your GP but most GPs aren't trained in eating disorders so ask for a referral to your local eating disorder team team."
She also suggests free helplines including The Recover Clinic's, that are manned by physicians who are trained to give this sort of advice and may be more helpful in the first instance.
"It's also important how you frame the experience. You want to encourage the idea that you're in this together against the disease rather than getting into a battle about what they are or aren't doing with food.
"Align yourself with the sufferer and get their input into what you should do. Ask what they would find helpful - maybe eating together, or cooking together. And make sure they see that you're willing to work with them."
Friends, schools and university
Friends at school and even university often find it difficult to bring up the subject of an eating disorder and often are inexperienced. Emmy tells us that she sees many friends who have contacted parents of those who they're concerned about - which is the right thing to do.
"If you don't have a relationship with the parents, speak to a member of staff at your school or university. As a last attempt, some write anonymous letters to their friend detailing their concern."
The road to recovery
It's important to keep communication open once the eating disorder is out in the open. Relapse is common.
"You can't control lapses or prevent them from happening but make sure the conversation is kept open and don't get complacent. Often when people start to feel better, they think they don't need to take as good care of themselves and they can hit the deck quite quickly.
"Dealing with eating disorders is a process and recognition and awareness are key to helping someone along the road to recovery."
If you are concerned you or someone you know has an eating disorder and need advice, The Recover Clinic offers a free helpline with staff trained in to offer advice. You can also see the NHS Choices site for more information about eating disorders.