National Eating Disorders Association

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Understanding my sister/how to help her

My sister has suffered with an ED and depression for many years and she hid it from myself and my family until a few years ago. She was admitted to in patient program for 3 months after she almost dropped out of school due to her ED and it initially helped. It has been a few years since she went to the facility or saw a therapist/psychologist regularly and since then, she has dealt with her ED and depression on her own and I would see her struggle but thought she was doing ok or knew how to handle her emotional upheaval from the therapy she received at the inpatient facility. I did not realize how much she was actually struggling until my girlfriend told me about the obvious signs, i.e. not eating consistently and being obsessive about what she ate, never communicating or being honest about how she was feeling, she would cry when we would go out to eat because she was not in control of her environment or what she could eat, and how skewed our sibling relationship was to an outside perspective. I did not recognize it but she often used me to deal with her emotional turmoil and I was always there to help her out and tell her everything was going to be ok. We never discussed anything serious nor did I ever confront her about her difficulties and not seeking help for them and I thought I was doing the right thing by being there for her. It is incredible difficult to tell her anything because I know how sensitive and emotional she becomes when we do talk about what she is struggling with and therefore I never confronted it. We also come from a family that doesn't talk about emotional issues and instead brushes them off and tries not to think about them and I am the only one in the family that she trusts talking to about her struggles. It has made both of us scared of confrontation and avoid difficult emotional discussions. I thought this was an adequate way to deal with her struggles, help her out when she was struggling, make her laugh and let her call/text me whenever she wanted, until it started causing problems in my relationship with my girlfriend. She would get angry and frustrated because I lacked the perspective to understand that my "help" was in turn letting my sister off the hook and leaving me emotionally drained and constantly worried about her well being. My girlfriend told me that I had to change something about my relationship with my sister because it was such a drain on our relationship and it wasn't a healthy way to deal with my sisters ED and depression. I decided, through my girlfriend's suggestions, to only talk to my sister once a week and let her know that she had to seek therapeutic or medical help because I couldn't always be there for her anymore. It was a drastic change to how we talked before but I felt that if I didn't do something drastic, I didn't think she would comprehend the magnitude of her issues and how important it is for her to seek help. It has been several months since I made this change and there seems to be little change on her part; I make sure to tell her she has to seek therapy or talk to someone else about her emotional struggles, even if it is a friend. I also make sure to tell her each week that she has to be more honest with me about what she is going through and if she has sought help. She is in school now and tells me that she is too busy or forgets to call counselors and I know it is her way of avoiding the issue. Each time we talk I confront her and she starts crying and shuts down and doesn't tell me much. I am just wondering what I should do? Do I not talk to her at all to let her know how serious I am that she seeks help? I am being too demanding when I ask her to seek help and not change much on my end? I told her that I will go to therapy too to help understand how to help her and change my way of dealing with confrontation and emotions. I want to keep talking to her but I don't know what to do and I am looking for help on how to talk to my sister and where to go forward from here.


Hi. I think it is great that you are trying to help your sister.sibling. I think what you are doing is good but I would try to not always be telling her your sister that needs to see a counselor, as you have already told her many times. I think if you make yourself available on the day of the week you speak she may be more open to sharing if she isn't shutting down the conversation because of the mentioning of the need for therapy. She knows what she needs. No one can force an adult to get help. Even a minor will not open up unless they want the help being offered. So, you are doing a great job. Thank you for caring for your sister. I think once she knows you aren't going to be on her case about counselling, she may be more open to it is her decision and she doesn't feel she is doing it for someone else. And she may talk to you more openly. Best of luck to you both and please let us know how things go. I am sorry it has been a few days that you got a response.



Hello BotanicalCo23,
You’re situation is very similar to mine. My sister has been struggling and ED for at least 10 years but she hid it well from the family because she has other health concerns that mask when her ED is taking over.
How has the advice you received on this website and forum helped you? I’m not sure how to speak to my sister without starting an argument every time we speak. She’s trying to control the way we communicate and my responses to her. She’s openly telling me I want you to speak to me this way not that way, but I don’t think it will help her. I feel like I need to be tough and somewhat motherly but she is telling me she wants me to keep it very light and not discuss her eating disorder. I feel like ignoring her illness and avoiding the subject is the wrong thing to do, but she wants me to trust that she is aware of the steps she needs to take to recover and just keep the conversations superficial.

Sissy -"Proper conversation".

Hey there,

You wrote :

"I feel like ignoring her illness and avoiding the subject is the wrong thing to do, but she wants me to trust that she is aware of the steps she needs to take to recover and just keep the conversations superficial."

Just some thoughts, but my guess would be that your approach would depend on if she actually is trying to get better or not. If she seems to be making progress, then "normal" conversations that help her remain in the world (rather than her withdrawing from normal day-to-day interactions ) can be of help, I think. But if it seems like she's not getting better, and simply want's others to avoid pointing that out to her, so she can proceed with her ED unchallenged, then thats' probably another thing altogether.

How does her attitude towards recovery seem to be ? People can be mindfully aware of all the "steps", but if they are not making a good-faith effort to take them, and accept professional help when it's offered to them, then it's pretty easy for things to just stay the same.


Hello BobJ48,
I’m getting mixed signals about her attitude toward recovery. Which is why trusting her is difficult for me. Her eating habits are improving but we don’t live together so I can’t be sure if she is purging when she gets home after dining with me. She refuses to go to a doctor or counseling which I think is necessary. As I mentioned, she has other health concerns that affect her diet and weight so in my opioin skipping doctors appointments is a terrible choice.

Mixed Signals


It's not uncommon for people to truly want to recover….but still find themselves unable to do so. So if it sounds like you are getting mixed signals, it may be a reflection of those sorts of difficulties.

I'm not sure it means she is untrustworthy as a person, but she may feel a lot of shame about her feelings of helplessness , and "to spare you anxiety" may not always be telling you the whole story.

"She refuses to go to a doctor or counseling which I think is necessary. "

I think you are right about this. People with EDs can be in real trouble, and know that they are, but at the same time, don't like the idea that they might not be in control. Which when you think about how EDs are supposed to be about being in control…maybe you can see the conundrum they are up against .

Going to see a doctor or counsellor….they can feel that doctors or counsellors aren't going to tell them anything they don't already know, or devise other sorts of mental rationals for not going. So yeah - They can come up with a lot of reasons to avoid confronting their situation, kind of like we all can sometimes. Because there's a part of them that can believe that there really is no hope for them. So why bother going ?

Which is not really true. People can get better, but I think they need to admit that things really are out of their control, which can be a very hard thing to do.

For any of us, really.

So yeah, at some point she's going to have to be willing to take some risks, if she's going to get better. Seeing a doctor or ED specialist - Those are just the sorts of risks that she may need to take for herself, if she continues to find herself out-thinking her situation.

My Sister

I am very new to this which is surprising because my sister is 65 years old. She has always been extremely thin since she was in her 20s but it wasn’t until a few days ago that I received a diagnosis from a team of doctors that she was suffering from both anorexia and bulimia and has been for about the past 30 years.

My sister and I have been extremely close our entire lives and I feel like she is my soulmate and we can talk about anything. But her eating disorder is something that never even occurred to me. She would always tell me that she has a very high metabolism and she eats lots of food but she just couldn’t keep on any weight. I have to say that she is so painfully thin you can see her spine and bones protruding from her body.

Our year ago she had major back surgery and had a 10 inch rod put in her back for what we all thought was stenosis of the spine. The surgery failed and ever since then she went on a downward spiral mentally. She suffers from bipolar 1 and OCD. Over the years her mental illness has been managed quite well but the past year she has been in such extreme pain physically which led to her downward emotional spiral into deep depression.

I always assumed that we could talk about anything because we always have. I come from a family of six siblings and she and I are the only two that are close. The other siblings are not close to her at all, because my family has a hard time tolerating her personality based on her constant complaining about her physical pain and depression and also the fact that she alienated most of my siblings many years ago because of things she has said that were hurtful to them. But my relationship with her has always been unique in that we just get along so well and accept each other no matter what. I must add that I am very close to my siblings and my mother so I feel fortunate in that way but I cannot talk to them about her because they have animosity toward her and so I feel helpless and without support even though I do see my counselor regularly. I have bipolar and depression also and so we can always relate to each other and have always supported each other throughout the decades. We spent much time together and laughed and always had a deep connection to each other unlike any other I’ve ever experienced. We even know what the other is thinking without even saying anything.

After her failed back surgery a year ago, she has been depending on me more and more in times of crisis, which at times could be multiple times a day. At first I would try to help her by listening to her and hugging her and telling her everything would be OK but it got to the point where I started suffering emotionally because I couldn’t handle it anymore. I am a highly emotional person and I also have borderline personality disorder so I started struggling to the point where I was having breakdowns over her problems and realized that I needed to set boundaries for myself. So at the suggestion of my counselor I implemented some boundaries as far as when I was available to talk, consistently reminding her I was not equipped to deal with both her major problems as well as my own, gave her multiple contacts to call, reminded her to see her mental health doctors, etc. but she would keep crossing those boundaries or not doing any of the things I suggested. I also should add that she has been noncompliant with psychotropic medications over the years also because she claims that the side effects are too severe. So as a consequence to that she has lost many psychiatrists because of their frustration with her.

So therefore she depended solely on me for crisis intervention on a daily basis and after six months of that I literally couldn’t take it anymore so I set a boundary that we can have a relationship but I can’t talk about her issues anymore. Her issues being her depression, her financial difficulties, her severe pain, etc. Nothing I ever said to her helped in anyway. She saw multiple medical doctors and none of them had any answers.

Fast forward to about two months ago and it finally reached a point where I had to reach out to professionals to learn how to cope with both loving her and being angry and resentful that she was putting me into the position of being her sole emotional support, which I am not equipped to do. I have my own issues and I also I am under the care of a psychiatrist and a counselor and do very well but I cannot handle someone else’s major issues as well as my own.

Because my sister lived alone and was begging me to help her and telling me that she couldn’t eat because her throat was so irritated and acid was coming out and her pain was unbearable and none of her doctors were helping her and she didn’t know what to do anymore I finally had to reach out to the police department and the officer told me that whenever she had a crisis I needed to call for them to do a welfare check. So the first time that happened, a couple months ago, I did that and she was sent to a mental health facility but she quickly got out after 24 hours saying it was a horrible place and they didn’t understand her at all and it made things worse. Then she would go back home alone and the next day be in crisis again and reach out to me again and I would try to talk to her and give her suggestions and advice which she would not take. So what ultimately happened is that in the last two months I have called to have a welfare check for her about four times and each time they would put her in a mental health facility and she would get out after a couple days and be just as bad or worse. It finally got to the point where the county had to intervene and she was placed under their care through the court system and was required to go to doctor appointments and if she did not then she would be placed in a psychiatric facility against her will. She failed the first appointment but they did not check on her until four days after her missed appointment and when they went into her house they found her emaciated, disoriented, with heart palpitations and found out she had not eaten in a week. So they placed her in the hospital to get her hydrated. After that she was placed in a locked facility for the past 10 days and I was not allowed any contact with her at all and it was breaking my heart in pieces because I just wanted to comfort her but I knew it was for the best. The facility told me that this is their protocol because when someone is in such physical and mental distress it is imperative that they get acute care without the intervention of family members at the beginning so I understand that completely.

I got a call finally yesterday from her team of doctors and they determined that they did a full evaluation and diagnosed her with both anorexia and bulimia and it is extremely advanced. I almost fell on the floor in shock. I didn’t know!! How could I have not made the connection? On Friday they are putting her in a assisted living facility to get her stabilized physically and then after that they are putting her in a special facility in another part of the state that specializes in mental illness and eating disorders.

This was such a shock to me. I never ever considered over the last 30 years that she was anorexic. She always told me that she wished she would gain weight but said she was eating a lot of food (which I never saw her eat because she eats at home alone) and she felt terrible that she was so thin but that’s just the way it works and I took her word for it because my four brothers and my dad are thin also And over the course of the years I have seen them eat a lot and still remain thin because we do tend to have a high metabolism in our family.

To make a long story short, my sister is now going to finally get the help she deserves for her anorexia and bulimia in a place that specializes in those areas. I am holding out hope that she will improve enough so that she can get back home again eventually but I realize it might take a long time or it may never happen.

What I want people to take out of my comment is that even someone you were extremely close to for many years, you can be completely in the dark about the fact that they have an eating disorder. This is the first time I have ever known someone with an eating disorder so it is all new to me even though I have seen documentaries on the subject. So if anyone who has a loved one who is suffering from anorexia or bulimia or both, please know that it was nothing you did or didn’t do that may have prevented them from getting proper treatment and there was nothing you could have done to fix them on your own. I realize now that what I did for her by continually calling for welfare check was the best thing I could’ve ever done for her even though at the time I thought I was being a monster. No she is in a safe environment where they are starting the process of treating her eating disorder. It will start with her admitting that she has an eating disorder and then it will go from there to actually treating the disorder itself.

I am trying to stay very hopeful that she will gain some weight and get better. I also know that the statistics show that someone her age who is been anorexic for three decades are not very good but I will never give up on my sister.

My heart goes out to all of you who are struggling to help your loved one. I have found that only professionals can help a person with an eating disorder and I am sharing my story because even though I had to take drastic steps to finally get her the help she deserves it was the only solution. Trying to convince a loved one that they have an eating disorder and need help for it is futile. Getting professional help for them is key. Good luck to all of you and you are all in my thoughts and prayers.


Hi. I just wanted to check in real quick to see how you are and how your sister is doing since your last posts.
Please feel free to post anytime to get support for yourself. Take care,



food disorder

it is very difficult for my sisters and my parents to hendle me whenever i get a stroke! :(

Thank You

Thank you for sharing your story. My sister hid her eating disorder very well for about 15 years. I’ve been feeling very guilty For not knowing the signs that her eating disorder was out of control, and sometimes I have trouble sleeping. Your story is helping me to see that many people with this this disorder are very good at hiding it and avoiding help to overcome illness.


my sister was 20 when she got eating disorder and it was very tough for me to hendle her!

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