How to Help Someone With an Eating Disorder: 15 Tips

Understanding Your Loved One’s Eating Disorder

When approached, your loved one may attempt to persuade you they are “fine” or that 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 misuse, fasting, or excessive exercise.
• Binge-eating disorder: People with binge-eating disorder consume excessive amounts of food and continue eating despite feeling full.
• 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.
• 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.
• 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 involves disordered eating without sufficient information for a clinical diagnosis.

Warning Signs of 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 people with eating disorders do not feel they deserve or are sick enough for treatment.

Potential warning signs of an eating disorder can include:

• Restricting food or excessive dieting: People with eating disorders may eat very little or claim they’re full during normal mealtimes. They may also exhibit extreme dieting behavior. 
• Binging: Binging refers to eating a large volume of food very quickly. If food is disappearing without explanation, this may be a sign of binge eating.
• Purging: Purging entails compensatory behaviors intended to eliminate food. Common purging techniques include self-induced vomiting, laxative abuse, excessive exercise, and fasting.
• Distorted body image: Many people with eating disorders perceive themselves to be fat or larger than they really are. These untrue thoughts about their body image may occur even if they are medically underweight.
• Altered appearance: Eating disorders can cause weight fluctuations and several other physical symptoms including bloat, puffiness, skin discoloration, and hair loss.

How to Help Someone With an Eating Disorder

Learning how to help a friend with an eating disorder allows you to provide the best support possible. Those struggling with eating disorders 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 15 tips for how to support someone with an eating disorder:^2,3

1. 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. Because there can be so many treatment options, it may be helpful to spend some time paring down options. For example, look for 2-3 local therapists certified in treating eating disorders. Consider also finding a registered dietitian that is in-network with their insurance. The fewer barriers to getting help, the better, so consider presenting your loved one with a simplified list.

2. Learn About the Specifics of Their Disorder

Every eating disorder is different, although symptoms can certainly overlap. It’s important to remember that eating disorders do not necessarily have a physical look and people of every size and shape struggle with them. Once you have an idea of which disorder your loved one has, educate yourself on the main symptoms and best options for recovery.

3. Let Them Know You Support Them

Showing up without any expectations or conditions is important for someone struggling with disordered eating. 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 their eating disorder and work toward healing. 

4. 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 and giving them time and space when they need it. Recovery is a long journey, so don’t get discouraged if your loved one doesn’t change their behaviors overnight.

5. Externalize Their Eating Disorder

Remember that your loved one is not their eating disorder; instead, they have thoughts and feelings that coincide with having an eating disorder. Externalizing may sound like, “your eating disorder is telling you not to eat,” instead of “you just don’t want to eat!” This can also help lessen the stigma and show your loved one that you are not making their eating disorder their entire identity.

6. 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.

7. 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 dieting around your loved one, and 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.

8. 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 and that you want them to feel included as much as possible.  

9. Find Ways to Build Their Self-Esteem

People with eating disorders generally have very low self-esteem, even if they do not outwardly present that way. With that, focus on praising them for their worth (without mentioning their appearance). Encourage them to participate in activities and relationships that make them feel good about themselves. Always let them know that they are worthy of love and that you are grateful to be in their life.

10. 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. Having a supportive person 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.

11. 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.

12. 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. You can also tell stories of when you remember them overcoming difficult situations.

13. 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, then follow through on their requests. 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.).

14. 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.

15. 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

Knowing what to say to someone with an eating disorder without making matters worse can be challenging. Assessing your relationship and level of intimacy can help here, and your loved one will likely appreciate your concern either way, but it’s important to focus on the facts of the situation, listen without judgment, and ask as many clarifying questions as you need to in order to come up with an appropriate recovery plan together.

Below are ways to approach the topic of eating disorders with a loved one:⁴

• Pick a good time: Don’t address their eating disorder just before, during, or after a meal. Ideally, aim to talk about it when the setting is relaxed and neither of you is in a rush.
• Be prepared for denial and pushback: Eating disorders often coincide with denial and resistance. Don’t take this personally, but anticipate that it may come.
• 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 loved one 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, calm reassurance will help your loved one know that you are supportive and care about what they have to share with you.
• Ask if they have any reasons for wanting to make a change: Assess whether your loved one has a desire to get better. Even if only part of them is interested in recovery, that could still be a very positive sign.
• 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 Not to Say to 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 say when supporting a loved one with an eating disorder:

• Don’t 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.
• Don’t use ultimatums: Ultimatums often add undue stress and resentment within a relationship. Unless you’re truly planning to cut this person out of your life or remove all access to resources, this isn’t the right move.
• Don’t comment on their appearance or their weight: Avoid discussing how they look regardless of how their body changes.
• Don’t offer simple solutions based on your experience: Your loved one’s eating disorder is uniquely theirs. Don’t try to simplify the experience or assume you know what they’re feeling based on anything you’ve gone though.
• Don’t 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.
• Don’t 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.
• Don’t pressure them: Avoid pressuring your friend to discuss aspects of their disorder they prefer not to reveal.
• Don’t 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.
• Don’t play therapist with them: 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.
• Don’t threaten or manipulate: Threatening or guilting them into getting better is ineffective. Be honest about how you think and feel.

What If My Loved One Doesn’t Want My Help?

When a friend or loved one 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.

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.

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, or you could use an online resource like Equip Health. Eating disorder treatment can range from outpatient therapy to comprehensive inpatient treatment.

How Are Eating Disorders Treated?

Eating disorders are generally treated with a multifaceted treatment team. Severe eating disorders may require brief hospitalization and/or inpatient care, while milder eating disorders may be treated primarily with outpatient therapy and/or support groups. Treatment needs may change over time, and what worked in one recovery episode may need to be revised if a relapse occurs.

Treatment options for eating disorders include:

• Individual therapy: Individual therapy for eating disorders addresses the root causes of an eating disorder and provides a sense of unconditional support throughout the recovery process.
• Family therapy: Family therapy options like the Maudsley method can help individuals and loved ones be on the same page during recovery. It may establish important boundaries and communication skills.
• Nutritional counseling: Nutritional counseling helps people learn how to eat appropriately for their body’s unique needs.
• Hospitalization: Hospitalization for eating disorders provides acute stabilization when someone is in medical distress.
• Residential facilities: Residential facilities offer 24/7 monitoring, support, and care, and they may be recommended for moderate or severe eating disorders.

Should I Visit Them While They’re in a Facility?

Whether or not to visit someone in an eating disorder recovery facility depends on multiple factors. Some people value having visitors when they’re in treatment. The support reminds them to keep going. However, others may prefer to be left alone. Some people feel embarrassed to be in a facility and don’t want to be negatively judged. When in doubt, ask. Don’t show up unannounced and always respect their visitation requirements.

Will They Be Cured When They Come Home?

There are no cures for eating disorders. Instead, your loved one may be more medically and emotionally stabilized after leaving a treatment facility. However, they are still in the very early stages of recovery. In addition, many people relapse just after returning home, as the readjustment can be distressing. Eating disorders, in general, require lifelong commitment and management.

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 can come instances of suicidal thoughts and actions. Additionally, the repercussions of eating disorders can 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 need you to take them to an urgent care or a local emergency room or urgent care facility to be evaluated.

Getting Support as a Carer

It can be undoubtedly challenging to look after someone with an eating disorder. With that, you must seek your own support during this time. You risk burning out and/or resenting yourself or your loved one if you fail to look after your own needs. It could be helpful for you to talk to a therapist so that you will not take on the whole burden of your loved one’s mental health yourself, so you can be realistic about the expectations and responsibilities that you place on yourself.

Fortunately, you can seek care in several ways, including:

• Your own individual therapy
• Support groups for loved ones caring for others with mental illnesses
• Self-care via spending time with other loved ones
• Family therapy
• Couples therapy (if your partner has an eating disorder)