Helping a loved one with an eating disorder can seem daunting. However, practical strategies can help when navigating treatment and recovery, whether for a child, spouse, or friend. Remain empathetic, understanding, and encouraging with your loved one as they seek treatment and make positive changes.
How Can I Know If Someone Has an Eating Disorder?
The first step in helping a loved one is determining whether they have an eating disorder. Unfortunately, doing so can be challenging because many people are uncomfortable discussing their disordered eating. As a family member or friend, you may see the signs before the person with the condition acknowledges these themselves. Many individuals with eating disorders do not feel they deserve or are sick enough for treatment.
When approached, your loved one may attempt to persuade you they are “fine” or you are “over-reacting.” Being armed with information about your concerns is a helpful and neutral way to approach the subject. Eating disorders are pervasive conditions often accompanied by other mental health issues, and many experience co-occurring eating disorders and depression.
The following are common types of eating disorders to be aware of:1
- Anorexia nervosa: People with anorexia often have a distorted body image and obsessions with thinness and restricting calories, often to the point of being harmful to their physical health.
- Bulimia nervosa: Bulimia includes binge eating episodes followed by attempts to purge or rid the body of calories, including vomiting, laxative use, fasting, or excessive exercise.
- Pica: Pica is the consumption of non-food substances, including dirt, clay, chalk, paper, soap, or ice. Nutritional deficiencies or psychological issues can cause pica.
- Binge-eating disorder: People with binge-eating disorder consume excessive amounts of food and continue eating despite feeling full.
- Avoidant/restrictive food intake disorder (ARFID): ARFID refers to the avoidance or restriction of food or specific foods. Unlike anorexia, a preoccupation with thinness does not cause ARFID. Rather, genetics, temperament, or a traumatic event like choking can trigger the condition. F6
- Rumination syndrome: Rumination syndrome occurs when a person repeatedly spits up or regurgitates undigested food before re-chewing and swallowing it. This behavior may relate to relieving a feeling of fullness and abdominal pressure.
- Other specified feeding or eating disorders (OSFED): OSFED is an umbrella term for disordered eating traits that do not meet diagnosable criteria.
- Unspecified feeding or eating disorder (UFED): UFED includes present disordered eating without sufficient information for a clinical diagnosis.
How to Help Someone With an Eating Disorder: 12 Tips
Learning how to help a friend with an eating disorder allows you to provide the best support possible. Those struggling with EDs need emotional support and, in many cases, professional intervention. Whatever your situation, remember to stay patient, empathetic, and level-headed when offering support.
Below are 12 ways to help someone with an eating disorder:2,3
1. Let Them Know You Support Them
Let them know you care when someone you love struggles with an eating disorder. You can offer a listening ear as they receive eating disorder help and develop new coping skills. Your support can help them feel more confident as they learn how to overcome an eating disorder and work toward healing.
2. Be Patient & Avoid Becoming Frustrated
Supporting a loved one receiving help for an eating disorder can be frustrating. However, staying patient and understanding is beneficial. One way to help is by asking your loved one how they want you to support them.
3. Stay Gentle & Understanding
One of the most important things to remember when helping people with eating disorders is to be gentle and understanding. Remember, someone recovering from an eating disorder may literally be fighting for their life. Treat them with kindness and care.
4. Focus on Things Other Than Their Appearance & Food
When offering praise, focus on character traits rather than appearance and performance-based compliments. Avoid discussing food, body, weight, and diet around your loved one–ask family and friends to do the same. Instead, prioritize other topics like their favorite hobbies, movies, or self-care activities. Shifting attention away from their eating disorder onto positive conversation can provide a welcome distraction.
5. Include Them in Activities
Many people may feel isolated when getting help for eating disorders. Others may hesitate when inviting them to events because of possible triggers. Invite your loved one to fun activities unrelated to food or eating. Help them understand they are still loved and valued.
6. Sit With Them During Meal Times
Helping someone with an eating disorder may mean sitting with them during and after mealtimes. People with eating disorders often struggle with anxiety related to eating, food, and related activities. Knowing a supportive body is nearby can help reduce these negative feelings. You can also help alleviate some of their discomfort by assisting with meal planning, preparation of meals, and grocery shopping if needed.
7. Provide Them With Helpful Information
You can help your loved one organize and gather information about their treatment. Appointments can sometimes be overwhelming, and you can provide support by tagging along and taking notes.
8. Share Personal or Supportive Stories
Sharing stories about when you overcame challenges can be helpful. Ask your loved one if they are open to hearing about these experiences. Alternatively, tell stories of when you remember them overcoming difficult situations.
9. Ask What You Can Do to Help
You may wonder what to do if your friend has an eating disorder. The easiest solution is often to ask them directly how you can help. Sit down and discuss what they need from you.
While various books and websites can provide a starting place, each person needs to verbalize what is and is not helpful. This process is one of trial and error that you and your loved one will experience together during recovery. Ask them what they need assistance with and let them know you want to help (i.e., chores, errands, appointments, etc.).
10. Encourage Them to Seek Treatment
People with eating disorders often hesitate to seek help. Encourage them, offer to attend appointments with them, and remind them you will support them throughout their recovery.
11. Don’t Make Assumptions
Don’t assume you know what someone is going through based on what you have seen or heard about eating disorders. The experience is different for everyone. Instead, ask the person to share their feelings and perspective.
12. Remember to Take Care of Yourself, Too
You cannot assist someone else when you neglect yourself. Eating disorders are overwhelming and challenging to deal with for everyone involved. Needing a break is expected and often necessary during this time. You cannot be everything for your loved one.
Consider seeking professional support to manage any stress or anxiety while helping your loved one. Support groups for family members can also be invaluable when you feel alone in dealing with the battle against an eating disorder.
What to Say to Someone With an Eating Disorder
You have probably thought about how to talk to someone with an eating disorder, but health issues can be sensitive, especially eating disorders. Knowing what to say without making matters worse can be challenging. Assessing your relationship and level of intimacy can help here, and your friend will likely appreciate your concern either way.
Below are ways to approach the topic of eating disorders with a loved one:4
- Ask questions: Asking helpful questions about their needs and condition signals you are genuinely interested in offering support.
- Sit back and let them speak: Listen patiently without interruption or interjection of opinion while your friend describes their eating disorder.
- Express concern in a neutral but specific way: Let your friend know you have observed certain changes or behaviors and how these make you feel.
- Avoid accusatory statements: Focus on providing your perspective and using “I” rather than “You” statements.
- Remain calm and reassuring: Attentive listening will reassure your friends that you are supportive and care about what they have to share with you.
- Respect their privacy: Let your friend know they can confidently and privately share their experiences. However, seek professional assistance immediately if they show signs of suicidal behavior.
What to Avoid When Helping Someone With an Eating Disorder
When helping someone with an eating disorder, saying or doing certain things can unintentionally do more harm than good. Carefully avoid blaming, shaming, being their therapist, or threatening them. Show them they can trust you by not sharing things they told you in confidence.
Below are things not to do when supporting a loved one with an eating disorder:
- Blame them for their condition: Blaming your friend for their eating disorder will not help and may postpone them seeking assistance or coming to you for support.
- Focus on food: Focus on feelings rather than food or weight. Eating disorders are not really about food and weight–those are just the symptoms.
- Shame them: Avoid making shaming statements. Your loved one may feel “bad” or “gross” due to your surprise or shock at hearing about their behaviors.
- Pressure them: Avoid pressuring your friend to discuss aspects of their disorder they prefer not to reveal.
- Break their confidence: Keep what your friend says private unless they share they are suicidal. Gossiping about their eating disorder will only increase their shame and damage your relationship.
- Play therapist: You are not their therapist. Encourage them to seek professional treatment rather than offer unsolicited advice. Eating disorders are life-threatening conditions that require specialized care.
- Threaten or manipulate: Threatening or guilting them into getting better is ineffective. Be honest about how you think and feel.
What If My Friend Doesn’t Want My Help?
Being ambivalent about seeking help and getting better is a part of the recovery process. However, this does not mean your loved one is disinterested in recovery but is struggling with what recovery may entail. Many individuals are also embarrassed that their eating behaviors have escalated and garnered the attention of family and friends. Accepting help is the equivalent of admitting they are sick.
When a friend is not expressing a desire to accept your help, realize you may not be the person who can reach them. Let them know you care and want to see them address their health issues. In the meantime, spending time with them and offering emotional support allows them opportunities to reach out when/if they desire.
Finding Help for an Eating Disorder
A person looking for help with an eating disorder can talk to their doctor or therapist for a referral. Online therapist directories and the National Eating Disorders Helpline can help you find a professional who can help. Eating disorder treatment can range from outpatient therapy to comprehensive inpatient treatment.
What Should I Do in an Emergency or Crisis?
At times, those with eating disorders struggle with co-occurring disorders such as anxiety and depression. With that, comes instances of suicidal thoughts and actions. Additionally, eating disorders can and do lead to medical emergencies. If you witness or are aware of an emergency with a friend or loved one due to a mental health condition, calling 911 is an option to receive immediate medical attention in the case of a life-threatening emergency.
If your loved one is experiencing a medical issue due to their eating disorder, but it is of a less severe nature, they may simply need you to take them to an urgent care or a local emergency room (ER) to be evaluated.
Final Thoughts
Seek help if you or someone you care about struggles with an eating disorder. Eating disorders can be serious and even life-threatening. One thing that makes eating disorders even more difficult is many people feel they cannot ask for help. Please know that you are not alone. There is help available, and people can and do recover and go on to live healthy, happy lives.
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