It is usually difficult to determine how to approach someone with what may be perceived as invasive commentary on their eating behaviors and mental health. It may feel much easier to let others live their own lives and mind your own business than ask someone about their health. However, eating disorders are the deadliest mental illnesses aside from opioid use disorder, and even disordered eating — which doesn’t warrant a clinical diagnosis but can be akin to an eating disorder — can really damage mental and physical health. Thus, if someone you know exhibits signs of an eating disorder, it’s essential that you speak up.
There are several types of eating disorders. Anorexia nervosa 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. “Once it takes hold, it’s a very hard cycle to break.”
However, 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: What a Dietitian Actually Eats]
Approach the Person Without Judgement
So, what should you say when someone has an eating disorder?
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. No one wants to develop an eating disorder, or any other type of health problem. So, when you approach someone with your concerns, you must let your concern be apparent and not blame the individual for their problem. It’s often helpful to try to have a calm conversation that allows you to share your worries.
You could start by saying, “I have noticed X, and I’m concerned about you. I don’t mean to be nosy, but I am worried about your health. Is there anything I can do? I want to support you.” “X” may be that a person has lost or gained weight or is exhibiting new exercise or eating habits. You don’t need to list every single observation that you have, but it may facilitate conversation to comment on something concrete that you’ve noticed.
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,” explains Katelyn Anderson, a pediatric psychologist at Children’s Hospital of Orange County in Orange County, California.
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.
[Read: Could Your Child Have an Eating Disorder?]
Gather Resources
One way to support a person with an eating disorder (or, really, any health problem) is to help them acquire resources. You may want to direct your friend to some helpful resources online, such as the National Eating Disorders Association eating disorders screening tool. You may want to let your friend know that you’re aware that eating disorders can be serious — even deadly — and that you care about them getting better and enjoying a healthy future. A good starting point for your friend may be to call the Anorexia Nervosa and Associated Disorders Helpline (U.S. 1-888-375-7767).
In addition to the screening tool, the National Eating Disorder Association offers toolkits for parents, educators and loved ones to help you learn more about eating disorders and how to support someone who is struggling.
For more information about how to help a loved one struggling with an eating disorder see the Anorexia Nervosa and Associated Disorders web page. It also offers information about free support groups.
Other resources can be found on the website of The Alliance for Eating Disorders and F.E.A.S.T supports families and caregivers of people with eating disorders. Lastly, Addictive Eaters Anonymous offers support for those seeking recovery from binge eating, anorexia, bulimia and other forms of addictive eating and compulsive exercise.
[Read: Body Image and Mental Health]
Help Them Get 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.
Consider helping your friend find a way to get professional help. It can be incredibly challenging when you are in the throes of a health problem to navigate health insurance and locate providers. Your friend may need to work with a doctor, therapist and registered dietitian. Offering to spend some time looking for providers that take health insurance or who have offices nearby can be a big help. U.S. News’s directory of behavioral and mental health providers allows you to search for therapists by location, specialty and the insurance they take; it is important to find a therapist with experience treating eating disorders.
“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.”
[READ: How to Improve Body Image]
Learn About Eating Disorders
“One of the best ways you can support someone with an eating disorder is to educate yourself,” says Anderson.
Eating disorders are often misunderstood; they are not just about food and physical appearance concerns. In fact, many symptoms of eating disorders, such as food restriction, obsessive exercise, and body surveillance, are often reinforced by our culture. The roots of an eating disorder may lie in emotional pain, distorted self-image, trauma and the need for control or comfort. That’s why treatment usually includes a team of providers that can offer nutritional counseling, therapy and emotional support. Learning more about eating disorders may be able to help you help your friend, and you may benefit as well.
Isabel Zarrow (19 years old) told me that her recovery from an eating disorder became possible “when the focus shifted from my appearance to how I feel inside. It’s not that I started to love my body, but I finally started to love and accept myself. That really makes the difference.”
Check In and Offer Support
A barrier to treatment for many people experiencing an eating disorder is feeling unworthy or not “sick enough.” Checking in with a friend and offering support can help them overcome this barrier and pursue or continue treatment.
Ellie Sanders (17 years old) recently wrote to her past self, the girl who had an eating disorder, “I want to take your hand and show you that things get better.”
Letting someone know that you believe things can improve for them and that you believe in them can go a long way. A sending short text, a small gift or even an uplifting meme can offer comfort and a needed boost on a difficult day.
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.
Be Patient
It can be scary for people to pursue help for a health problem, and more so when it is a mental health problem. Sometimes, people who need help aren’t ready to get it. It’s possible that you could talk with your friend, and they may not follow your advice at all. Try not to take this personally but continue to express your concern and offer support. Gently remind your friend that early intervention often leads to better outcomes.
Being a good friend to someone with an eating disorder means being present, compassionate and patient. Eating disorder recovery is difficult but possible.
“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.”
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.
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.”
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.
More from U.S. News
How Foods and Drinks Affect Our Mental Health
How to Prepare for Your First Therapy Session
Anxiety: Signs, Diagnosis, Causes and Treatment
How to Support Someone With an Eating Disorder originally appeared on usnews.com
