Food, nutrition, health and wellness are all bound up together inextricably. But for people who have eating disorders, the simple act of eating a healthy, satisfying meal can become an overwhelmingly distressing affair.
There are several types of eating disorders, and across the board, these diseases are difficult to recover from. Especially anorexia nervosa, which has the highest mortality rate among all psychiatric disorders.
“It’s one of the scariest illnesses I’ve found in my career,” says Jennifer Kelman, a licensed clinical social worker, therapist and mental health expert on JustAnswer, an on-demand answer platform. “Once it takes hold, it’s a very hard cycle to break.”
With the right mix of support and professional assistance, recovery from anorexia and other eating disorders is possible.
If you’re worried that a friend or loved one may be showing signs of anorexia, bulimia, binge eating or another disordered eating pattern, the following tips and suggestions can help as you navigate the delicate recovery process.
[See: The Eating Disorder Spectrum — From Pregorexia to Drunkorexia.]
Learn More About Eating Disorders
“One of the best ways you can support someone with an eating disorder is to educate yourself,” says Katelyn Anderson, a pediatric psychologist at Children’s Hospital of Orange County in Orange County, California.
There are some common misconceptions about eating disorders, and getting the facts can help you give more appropriate support.
“A lot of times, you’ll hear people say this quick quip, which I have never liked, which is: ‘Someone developed an eating disorder because they’re feeling out of control, and it’s the only way then can control things,'” says Kelman, adding, “If you spoke with anyone who has an eating disorder, the last thing they’re going to tell you is that they feel in control. They’re actually out of control.”
Eating disorders are not about weight or food, Kelman explains. Rather, they stem from a disconnect between the person’s emotions and what they can express. For instance, an eating disorder can be a coping mechanism to mask overwhelming feelings, such as from trauma or sexual abuse, particularly for adolescents.
Anderson recommends checking out the National Eating Disorder Association (NEDA) website for resources, including toolkits for parents, educators and loved ones to help you learn more about eating disorders and how to support someone who is struggling.
[Read: Body Image and Mental Health]
Reach Out
So, what should you say when someone has an eating disorder?
There are several ways to broach the topic, which we’ll detail below, but the first thing to remember is to be sensitive and compassionate, says Sarah C. Wohn, lead psychologist with the Eating Disorders Medical Unit at Torrance Memorial Medical Center in Southern California.
Eating disorders are complex illnesses with many factors and influences, and they’re a manifestation of a mental health situation the person is grappling with.
“People are afraid to talk about it because they think it will be contagious,” Kelman says.
But that’s another misconception.
“I can’t make you go binge and purge tonight. I can’t make you obsessed with the scale,” she notes.
So don’t hesitate to let your loved one know you want to help when you see them struggling. Just don’t make assumptions about what you think would be helpful.
“Sometimes we try to help in ways that we would find helpful, but we all have different needs,” explains Jen Carter, a sport psychologist at the Ohio State University Wexner Medical Center in Columbus.
This is why it’s important to check in with the person and ask what type of help would be most valuable.
[Read: Could Your Child Have an Eating Disorder?]
Avoid Judgment
In an interaction with someone with an eating disorder, avoid any type of critique. After all, you wouldn’t judge someone harshly for developing multiple sclerosis or another chronic health problem, so why should it be any different for an eating disorder?
“Do your best to avoid commenting on someone’s physical appearance, as even positive remarks might be misinterpreted,” Wohn explains.
Phrases such as “you’re not fat, you look healthy,” not only completely miss the point, but can actually encourage disordered eating behaviors.
“These comments may seem kind or supportive but can inadvertently reinforce the idea that how someone looks is most important. These comments can also perpetuate the idea that being fat is something undesirable or something to be feared,” Anderson explains.
It’s also important to refrain from being the “food police” or giving advice on “healthy ways” to manage weight.
“Commenting on someone’s eating habits or how they should move their body can increase anxiety and insecurity,” Anderson adds.
Be Prepared for Pushback
When you do voice your concerns, be ready for your loved one to react negatively. Rarely is the conversation met with gratitude and a willingness to seek help.
“It’s met with resistance because, remember, you are peeling back an emotional layer that they don’t want peeled back,” Kelman says. “So it will be met with denial and justifications.”
But stick with it for best results.
“People now in recovery from eating disorders often share that the support and encouragement from family and friends were crucial in their journey to recovery,” Anderson says.
Use the Right Language
When broaching the topic of disordered eating, it’s best to frame your concerns as just that — your concerns. Rather than using “you” statements, such as “You’re not eating enough,” which can sound confrontational, accusatory and judgmental, frame the statement as “I’m concerned about your eating patterns.” This shifts the “blame,” as it were, onto you and your feelings and may help the person feel less like they’re being attacked.
In addition, Carter recommends using “dialectical ‘and’ statements” such as “I know you feel anxious when you eat AND everyone needs to eat to fuel their bodies. Let’s eat together.” Or, “I don’t know what to say, AND I want to support you. What could I say or do that might be helpful?”
It’s vital to avoid oversimplifying with statements like “just eat!” Carter adds.
“Individuals with eating disorders know what they need to do, but anxiety and altered neurobiology make eating so difficult,” she explains. “Often, individuals need a lot of support to work through the fear and guilt to nourish themselves adequately.”
Get Professional Help
There’s no doubt that your support is valuable to a loved one dealing with an eating disorder, but there’s no replacement for professional guidance and eating disorder therapy in navigating recovery.
“Encourage your loved one to consult with health care professionals — physicians, psychologists, dietitians and psychiatrists — who specialize in eating disorders. Sociocultural issues, family dynamics, genetics, societal pressures and other comorbid mental disorders all may play a role in the cause of an eating disorder,” Wohn explains. “Wrap-around care and early detection are extremely important for long-term recovery.”
Plan Meals Together
It might feel awkward at first, but encouraging the person to eat with you can help normalize eating in a safe context.
“Most of us feel pleasure from eating, but individuals with eating disorders often experience fear and guilt before, during and after eating,” Carter explains.
Conversation and connection with a trusted companion can help distract the person from obsessive thoughts while eating.
Remind Them of Their Goal
It may be obvious to you why eating disorders are dangerous: They prevent the body from getting the nutrition it needs, potentially harming the heart, digestive system, bones, teeth and mouth, and they’re linked with depression, anxiety, self-harm and suicidal thoughts and behaviors, according to the Mayo Clinic.
But to truly understand why recovery is the best path, your loved one may need to find their own why.
“Perhaps they want to go to college, learn a new sport or travel,” Anderson says. “Helping someone with an eating disorder connect with their personal goals and values can help them move toward recovery.”
Be Patient
“Supporting someone with an eating disorder requires empathy, understanding and a commitment to their well-being,” Wohn notes. “Be patient and never assume you know what they are going through.”
It’s also important to “remember that a person is not their eating disorder,” Anderson notes. “Separating the person from their illness can be helpful in seeing the eating disorder as the problem and the person you are caring for as part of the solution. This is called ‘externalization’ and can help to empower both the person struggling and their support system.”
Take Care of Yourself
When a loved one is in crisis, it can be difficult to take the time you need to care for yourself. But it’s absolutely essential that you look after your own health and well-being. Otherwise, you’ll be unable to provide good support to your loved one who’s struggling.
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How to Support Someone With an Eating Disorder originally appeared on usnews.com
Update 03/24/25: This story was previously published at an earlier date and has been updated with new information.
