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Question:  I'm worried about my little sister. She is 20, just finished second yr Uni and is getting skinnier by the day, 5'6" and 44 kilos. When I ask her why she is losing so much weight, she makes light of it, saying it is just the stress of exams. I'm not aware of her having emotional problems but isn't this the cause of anorexia nervosa?

Answer (1)  44 kilos and still reducing at 5'6" is worrying! If your sister does not wish to take anyone into her confidence at this stage, there is not much that can be done, short of some sort of confrontation that may be fruitless. Even trying to discuss related issues that may drive her weight loss, will probably make her suspicious and even more evasive. Keep a close eye on her by all means but try not to play policeman. Be available when the crunch comes and seek outside help and advice if you think things are getting too out of control.

Answer provided by David White, Psychotherapist

Answer (2)  Your little sister is indeed below normal weight, and from your email, this was not always the case. However, there can be many reasons for this. You seem to be in a difficult position. When you ask direct questions, such as why she is losing weight, she replies in a manner that indicates the subject is off limits. By the way, a person can have "emotional priblems" (including being unduly stressed over exams) without members of her family being aware of it. In fact, it is common. Perhaps when the exams are over, you may take an opportunity to spend some time together. If you listen instead of asking, she may let you know what is going on. 

Answer provided by Dr Wendy Sinclair, Psychotherapist

Answer (3)  "Emotional problems" is a very general term and one that lots of us don't like to identify with. Your sister certainly sounds very thin and may (or may not) have a problem with her attitude to eating and to her body. I am no expert on this but there is good support available, including for families, if your sister has anorexia. I would suggest you stay close to your sister, don't judge or harass her, and speak about your concerns to her and to others as the time feels right. If there is a problem seek professional help as soon as possible.

Answer provided by Fiona Halse, Psychotherapist

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