You are probably feeling a little helpless and thinking what is there you can really do to help? You’re not alone as a lot of people have been in this position. With a little more information and guidance, please know that you can do a great deal to support your loved one.
How to Know if a Loved One Has an Eating Disorder
If there is a person about whom you are worried, the first step is that you are here and concerned about your friend’s thoughts or behaviors around eating. Sometimes it can be harder for a person with disordered eating to recognize the problem. At onset, an eating disorder can often resemble behaviors that our culture admires. Maybe your loved one has been dieting, but has become increasingly fixated and restrictive. Maybe they’re eating less and less when they are with you—or you never see them eat at all. Or maybe they eat a lot, and then immediately excuse themselves after the meal and disappear without explanation and do not return for thirty minutes. Maybe their exercise habits seem excessive or dangerous, or they obsess to you about their weight. That’s why it’s so important to become better informed on the signs and symptoms of an eating disorder in a friend or loved one first.
Educate Yourself About Eating Disorders
In order to be a good supporter, it will be important for you to learn more about eating disorders. Eating disorders are very poorly understood by the general population and myths abound. Understanding the facts about eating disorders can be a great place to start. You’ll learn easy-to-understand facts like “eating disorders are not choices, but serious biologically influenced illnesses.“ Even if this eating disorder started out as a diet, your loved one did not choose for it to tip over into a disorder. Other helpful resources include several major eating disorder organizations which have informative websites and other material to support carers.
Broaching the Subject
If you have not previously discussed with your friend or loved one your concern that they may have an eating disorder, you may feel anxious about raising it. This is not surprising. You can maybe start with “I’ve noticed that when we have dinner together that you eat very little,” or “I’ve noticed that when we go out for dessert you always rush to the bathroom.” This should be followed with a display of compassion: “I’m worried about you. Is everything okay?” Expressing it in this way—using an “I statement” followed by your direct observations—shows your concern in a way that they may be more likely to hear. Here are some tips for your conversation:
Don’t be discouraged if they deny the problem or do not want to discuss it. Just let them know that you are there for them if they ever want to talk to you about it. Show compassion and listen. Ask them if there is anything you can do to support them.
What to Do if They Deny the Problem and Refuse Treatment
A common—and often frustrating for loved ones—symptom of an eating disorder is anosognosia. People with eating disorders often lack insight into their illness, likely in response to malnutrition in the brain. As a result, they do not believe they need help. Remembering there is a biological reason for this can help you to better handle this behavior. Don’t think of them as being defiant or resistant. Instead, realize they have a deficit in their insight. If you encounter this, continue to show you care but don’t give in to their reality—continue to tell the truth. By continuing to present reality and gently expressing concern, you may eventually be able to chip away at the lack of insight and encourage them to get help.
Don’t Underestimate Your Ability to Help
Many people with eating disorders report that it was only because of other people in their lives caring about them that they recovered. Keep this in mind when things seem hopeless—you can be enormously helpful to your friend or loved one. Even if they are not engaging in treatment or seeming willing to accept help, reach out periodically to remind them you care about them and ask if there’s anything you can do to support them. Offer hope and remind them that most people with eating disorders do recover.
Encourage Professional Help
Eating disorders can be deadly. If your loved one is not receiving professional help, encourage them to seek it. A professional can assess your loved one’s symptoms, provide a diagnosis, and make treatment recommendations. A medical doctor is a great place to start; therapists and dietitians with eating disorder experience can also provide an assessment and treatment. You can learn more about the types of treatment available for your loved one. The National Eating Disorders Association and The Alliance for Eating Disorder Awareness are two U.S. organizations that provide referrals and treatment directories.
Interact Outside of Meals
Eating disorders can be painfully isolating illnesses because they make it hard for the person to socialize. To the extent you are able, continue to spend time with your friend or loved one with an eating disorder outside of meals. Try to engage the person in activities that don’t revolve around eating or exercise. Run an errand together, go to a show, watch a movie, or just hang out. Even if they refuse or resist, don’t give up on them. Keep trying and maintain the connection.
Offer Meal Support
One very tangible thing you can do to support a loved one with an eating disorder is to eat with them or help support their eating. You may even offer to go food shopping with them. For people with an eating disorder, meals can be extremely challenging. And yet, it is something they must do daily—several times! They can struggle with decisions about what to eat and may experience extremely high anxiety before, during, and after meals. They may also experience urges to purge after meals. Higher levels of care, such as residential treatment centers and partial hospitalization programs, provide support around meals, but for people in the outpatient setting, having people with whom to eat can be immensely helpful. Whether in person or over video chat, sharing a meal can be a wonderful support to a person with an eating disorder. During the meal, just be calm and supportive. Provide engaging conversation about neutral topics other than their eating disorder or food. After the meal, try to engage them in a distracting activity if they experience urges to purge. These urges often last about an hour after eating.
Challenge Diet Culture
Many eating disorders are perpetuated by a fear of weight gain, which is reinforced by our cultural ideals around thinness. Many professionals believe that one way to reduce eating disorders is to challenge societal structures and the 70 billion-dollar-plus U.S. diet industry that maintain this focus on being thin. A great way to support a person with an eating disorder is to provide counter messages. Encourage the acceptance of bodies of all shapes and sizes and discourage dieting. Diet culture is everywhere and it’s impossible to avoid it. But to the extent that you can, try to reduce the reminders that you can control.
For Parents of Children 18 and Under
If the person in your life you are concerned about is your child under the age of 18, we recommend taking a more directive approach. Children and teens with eating disorders often do not want help, and parents are responsible for their children and typically need to seek help for them on their behalf. Even if your child is unmotivated for treatment, there is a great deal you can do as a parent to help them recover. Learn more about family-based treatment for adolescent eating disorders, a leading treatment approach for children and teens.
A Word From Verywell
It’s great that you want to support your loved one with an eating disorder and by doing so have already proved you are an important person in their life. There is much you can do to help them. Keep in mind that caring about someone with an eating disorder can be challenging and the road to recovery is sometimes bumpy. Buckle up and prepare for the journey. Make sure you also have support for yourself so you can remain a solid support to them.
