I need help saving my sister from anorexia

My sister is 10. She weighs about *mod edit* pounds. She's been obsessed about losing weight for the last 6 months. We think someone made fun of her at school. A few days ago she was reading a book with my mom that was assigned in school. In the book one of the characters is stranded on an island and happens to say "well we can live for a week without food so long as we have water" and now my sister thinks she doesn't have to eat for a week. She hasn't eaten in 3 days and only has chewed gum and drank water.

She's afraid of eating foods that have iron because she doesn't want to get constipated like she used to. She also takes a laxative every night (her doctor prescribed this some time ago because she was having constipation problems). I think that the real reason she's afraid of getting constipated is because she thinks it will lead to weight gain.

Me and my mom are kind of at a loss. I feel so sick watching my sister hurt herself like this. My mom tries to convince her to eat but she cries out in defiance and refuses. She has a very strong will and doesn't budge on things. She doesn't really respect my mom. She kind of bosses her around and there is the implied threat that if my sister doesn't get her way she will have an aggressive temper tantrum on my mom so my mom doesn't like to force her.

Please give me some suggestion on what to or what not to do to fix this. I can't just sit by and watch my sister do this. My emotions are very angry about this and my instinct is to try to force or persuade her to eat but I know when someone like this is pressured they dig their heals in further.

My sisters father (not my father) feels the same as I do. He isn't over this week (he is on call for his job 24/7 every other week) but when he is I can tell he's angry at my sister too. He and my mom sit down and lecture my sister and she retorts rebuttals at every one of their statements or just tries to ignore them. Sometimes the atmosphere gets explosive with my sister being angrily defiant and my moms boyfriend being angry at my sister for "not being normal." I really don't know what to do. I know their efforts aren't working so we definitely need a different approach.

I'm not sure if theres a counselor she can talk to. One time my sister went to a counselor that was not at her school and it didn't go that well. She basically just didn't want to be there and no progress was really made.

Yes I do think educating ourselves about eating disorders would be a good first step.

I would like an open and supportive environment to be created in my home (and I recognize my sister's need for this) but I also recognize the obstacles to this in my mom's and my mom's boyfriend's personality. I really don't know how I could get them to feel and act differently about this problem toward my sister. My mom's boyfriend is kind of overbearing and an anger management case. He has an idea in his head of how my sister should be and when she has tantrums about eating habits or not wanting to eat certain things, he flips out and screams at her in anger. I think my sister feels like there's something wrong with her based on some of the things she's heard my mom and her boyfriend say (things that imply she has mental problems, not being normal etc). And to some degree it is true that she has some issues. Ever since she was small she would get upset about the smallest of things like the placement of the blinds on the window or and she would need some repetitive behaviors to be done in order for her to feel okay or safe or something. But I really wish my sister didn't think about herself in a way that she feels like she's messed up or not good enough.

Hi MattSS,

You're a very good older brother to be caring so much about your sister and wanting the best for her. You also bring up some important points about the challenges she faces if she is going to get better.

Your sister needs some very specialized help. Severe eating disorders require more than some counselling for the person who is suffering. Eating disorders often involve an entire family, and it sounds as though your family is definitely part of the problem as well. The Maudsley Method for treating eating disorders has a very high success rate because it treats the family as a whole. In order for the disordered person to get better, their environment has to get better as well. I realize that your family isn't going to like hearing that. Families don't like to think they're part of the problem. The fact is that in dysfunctional families there is always a scapegoat - the person with a problem who everyone focuses on because it means they can avoid their own problems.

Part of the problem is that your sister is 10 and people are trying to reason with her like she's an adult. It sounds as though she's had some ritualistic behaviours since a very early age and she's going to need intervention for that as well if her rituals around food are to be changed. That's characteristic of someone with very high anxiety. Anxiety makes people feel like their whole life is out of control. Unfortunately, some choose to control their food to gain some power over their life. In the end they're actually losing control but the disorder causes them to see it the other way around. It'll take more than ultimatums, threats, and being degraded or yelled at to stop. She needs the help of an eating disorder team who also know how to deal with pediatric patients.

Realize also that your sister is not going to want to get better. That's the disorder in her trying to stay alive - it's going to fight to the bitter end. She's so young though, and the longer a person waits to get treatment for an ED, the smaller their chances of recovery become. The first 5 years are crucial. She's going to cry, beg, and scream for you all to leave her alone, but the worse thing you can do is leave her alone.

Best of luck to you and your sister. Let us know how things progress and write here as often as you need to.