don't panic

It's never easy to accept you have a problem with food. Even when they are painfully thin, some people with anorexia simply cannot see that they are starving themselves. Those who binge eat are often too embarrassed to tell anyone what they do. Family and friends may be afraid of appearing disloyal if they seek medical help.

But eating disorders can be very damaging, so here are some ideas for getting advice and support.

the SCOFF test

Specialists at one of the leading eating disorder units in the UK recently devised a simple five question test to help identify those who have a problem. Anyone who answers 'yes' to two or more questions should talk to their doctor. They do not automatically have an eating disorder, but they may need help.

• Do you make yourself sick because you feel uncomfortably full?
• Do your worry you have lost control over how much you eat?
• Have you recently lost more than one stone in a three month period?
• Do you believe yourself to be fat when others say you are too thin?
• Would you say that food dominates your life?

getting help

Some GPs know more about eating disorders than others. It's worth finding out if one of the doctors in your practice specialises in emotional and psychological problems, including eating disorders. He or she can access immediate help in an emergency, arrange for you to see a specialist, or in less serious cases monitor your weight and progress.

dealing with delays

Unfortunately, you may have to wait some time to see an eating disorders specialist. If you need to talk to someone while you wait, try phoning the Eating Disorders Association Helpline on 0845 634 1414 (Mon-Fri 8.30am to 8.30pm, Sat 1.00pm to 4.30pm) or their Youthline on 0845 634 7650 (Mon-Fri 4.00pm to 6.30pm, Sat 1.00pm to 4.30pm). Their specialist advisors can talk to you about your problem and may be able to put you in touch with someone in your area who can help.

self help

If you are waiting to see a specialist or aren't ready to seek expert help, take a look at one of the many self-help books that have been written about eating disorders. Go to 'get help' for a short reading list and the Eating Disorders Association has a longer list. Comparing your experiences with other people's will show you that you are not alone.

If you don't want to go to a library or bookshop, order through an Internet bookshop, such as www.amazon.co.uk or www.whsmith.co.uk.

keep trying

Don't give up on treatment. It may take time to find the sort of therapy that works for you. Doctors choose from dozens of treatments for other illnesses such as high blood pressure and asthma. Eating disorders are no different!

if you're a friend or relative…

Convincing someone to seek help for an eating disorder can be very hard, especially if they won't accept they have a problem. Trying to talk with them about their problem is an important first step – whether it's excessive weight loss, over-exercising, secret bingeing or vomiting. But pressurising them may make them resentful.

Mealtimes can be particularly difficult and emotional issues or conflicts over food are best addressed away from the dinner table.

• offer information: Get helpful leaflets or self help books on eating disorders and make sure your friend or relative knows about telephone helplines, such as the Eating Disorders Association.
• offer support: Make sure they know you're there for them when they need you and try not to feel hurt if they seem unresponsive.
• don't judge: You'll need to do a lot of listening, but don't expect people to take your advice! Don't try to be counsellor and therapist, leave that to the specialists.
• know what to do in an emergency: If you are seriously worried about a friend or relative's physical or mental health, find out what to do in an emergency. Discuss the scenario with your doctor or specialist, so that you know what options are available to you in a crisis. Warning signs of physical danger are very low body weight (BMI less than 13.5), very rapid weight loss, and physical problems such as dizziness, confusion, excessive drowsiness, palpitations or vomiting blood.
  People with eating disorders also frequently suffer depression. You should seek a medical opinion urgently if you are worried that someone may be suicidal.
• support for you: Trying to help someone with an eating disorder can be very emotionally upsetting for you too. Talking to other people in a similar situation can help. The Eating Disorders Association may be able to put you in touch with someone locally.