This weekend I realized that my sister’s eating disorder is becoming a problem again. She is getting married in three months. We are Irish but have not lived in the same country for 9 years. She is 31 and I am 28. She has never been overweight. We are both small (5’1”) but she is naturally curvy with a full chest and a bit of a belly whereas I have always been wiry and flat-chested. As a teenager and young adult she dieted frequently and her weight fluctuated constantly, although never by more than dress size. About 5 years ago, while I was living in France, she started having problems with her boyfriend (she’d been seeing him for 4 years at the time – he’s now her fiancé). She started to lose a huge amount of weight and became thinner than she’d ever been. She insisted that the weight loss was due to exercise and healthy eating. After about six months her boyfriend ended the relationship and my sister took a work transfer that would have her in India for a year. She moved in with my parents for the two weeks before the departure. My mother was very worried about her at this stage and confronted her, saying she believed she had an eating disorder. My sister denied it. A few days later my mother walked into the bathroom (there is no lock) while my sister was making herself throw up. My sister became very aggressive and stormed out of the house. She didn’t speak to my parents again before leaving the country.
On a trip home from India she patched things up with her boyfriend and when she came back to Europe she began to talk a little about her problems and appeared to be recovering She transferred to London after the job in India finished and her boyfriend moved in with her. She put on some weight and said she had come to terms with her body. She did a huge amount of exercise but seemed to be eating normally.
I’ve since moved back to Ireland and a few weeks ago she was staying overnight in my house because I live on the way to the airport and she’d an early morning flight. I cooked a coconut curry for dinner. Later on, I went to the toilet and noticed that the toilet water had bits of a milky substance in it. I was quite worried but wasn’t 100% sure of what I’d seen.
This weekend I went to London as she wanted me to accompany her for a wedding dress fitting. My sister cooked dinner. Soon after we’d finished eating I went to the toilet (she’d been just before) and noticed definite traces of what we’d eaten in the toilet water. I am absolutely certain that someone had recently been sick there.
I really need advice on how to handle this. My sister is an extremely volatile person and I have no experience dealing with this sort of thing. I really believe that I should tackle it, but I am not a confrontational sort of person and I’m not sure how to approach it. My husband thinks I should tell her fiancé but I truly believe she’d never forgive me if I did that. She will in Dublin again at the weekend and staying in my house on the Sunday night as she’s another early morning flight. I think I will try and talk to her then. I am prepared for a very aggressive reaction but I’m worried that she’ll either deny it or say she’ll sort it out and do nothing. Or else that she’ll say it’s only temporary so she’ll fit into her wedding dress (this wouldn’t reassure me as it’s not the first time she’s done this sort of thing but I’m not sure I can successfully argue the point with her. I’d really appreciate it if someone could give me some insight or advice…

That's a pretty textbook example of bulimia. The failed diet turned nasty. It certainly is very hard to stop, because binging and purging is like a "free ticket"; like, have your cake and stay thin too. I'd like to suggest something, but I don't know what you should do because I don't know your sister.

Chances are she "quits" every time she purges. That probably prevents her from seeing it as a problem. It is most likely that it can only be resolved actively; that is, it won't go away. When you talk with her, don't be confrontational. Talk in terms of your perceptions: she can counter your allegations("You're hurting yourself") with denials("No, I'm not"), but it's harder for her to dismiss you if you say that you're worried, or "It seems to me that...". She's probably angry because she's scared that her "free ticket" is being threatened, and scared of confronting the fact that there's a problem at all. It could even be that she's testing you to see if you care enough to push the issue(girls are tricky like that).

I'm sorry you have to deal with this. I sincerely hope you are able to make progress with her.

Go to www.sfwed.org and look on the links on the left side of the page. It's very informative, and has answers to the questions you're looking for. I hope it helps!

As a former bulimic, I will speak from my personal point of view.
First off, it does sound to me as though your sister has a problem. It is very likely that this problem is a very well established problem, and that getting well again (if it ever really happens- I'm a believer in the fact that one can heal physically but never heal fully from the thoughts that got you there to begin with) will be a very, very difficult and long process.
When I was sick, very little of what others said in regard to my eating disorder got through to me. I didn't get better until I decided that I was ready to get better. I had to do it for myself.
I think that your best bet in this situation is to sit your sister down one-on-one and try to listen to her rather than preach about how horrible bulimia is. Please don't preach to her. She is surely aware of how horrible it is already. Let her know that you know, but also let her know that you understand that she needs to get better for herself and not for anybody else. Let her know how much you care for her and that you are there for her when she needs somebody to talk with. Gain her trust if it isn't already there. She needs help standing on her own two feet again- she's quite obviously in a very dark, depressed state.
Bulimia is so complex and difficult to deal with- especially for those around the bulimic. I think that the whole thing is really hard to understand from the outside. Just be patient with her. She needs to seek out help on her own at this point in her life.

Good luck.

i second everything that stellar said and unfortunately have no new advice.
my housemate, i suspect, has recently become anorexic. im still deciding what to say. not to mention its bizarre seeing it from the outside now that im rational and what not...its like arguing with a wall that just can't hear you. so frustrating.

Thanks very much for that. I really appreciate the input. What you've said has been especially helpful, Stellar.
Do you think I'm right not to tell her fiance?

Thanks very much for that. I really appreciate the input. What you've said has been especially helpful, Stellar.
Do you think I'm right not to tell her fiance?

For now, I think that you should focus on talking with her. Feel things out with her, first. If you go to her husband and he doesn't already know about it, she could come to resent you for it. You don't want her to have a reason to resent you right now, because she needs you.

There are a lot of factors to consider before even considering speaking with her husband. For example, is their relationship healthy? Is he a good communicator? Will he understand that preaching to her or making her feel guilty for her actions won't make her better? Will he do these things anyway (even subconsciously), regardless of the fact that he understands that they won't make her better? These are all important questions to ask, because you don't want to make her feel backed into a corner. If her husband is unable to be supportive, then he will be in the perfect situation in which to make her feel backed into a corner. If their relationship is good, he is a supportive husband, and he is good at communicating with her, then he is in the perfect sitation to help her through her problem.

The best way to get through this initial period, in my opinion, is to speak with her about this. Let her know that you know about and that you care for her (love her?). Let her know that you want to see her love for herself, again. Tell her that you are there to listen and not to preach. If she does admit that she has a problem, then you two can discuss your next course of action. If she doesn't, then be patient with her. She may need some time to come to terms with it, herself.