When you find out a friend or family member has an eating disorder, it’s natural to feel worried, anxious, angry, and confused. Before you try to step in and say anything, remember that an eating disorder¹ is a complex behavioral condition that cannot be fixed with a simple conversation. In reality, it takes quite a bit of time and patience before your loved one may even feel comfortable enough to talk to you about their issues.
This guide will help you to understand everything you need to know about these disorders and the best ways to support someone who has one.
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If you suspect that a friend or a family member has an eating disorder, it may be difficult determining when you should speak up. You may be worried you will say the wrong thing or that they may not even have an eating disorder. However, if you are genuinely concerned, the best thing you can do to help them is to reach out. This is especially true if you start noticing any of the following red flags that can indicate your friend or family is suffering from an eating disorder:
Avoiding meals or making excuses to avoid situations that involve food
Obsessively reading labels or counting calories
Banning certain food groups or types of food and eating only tiny portions
Developing restrictive food situations
Taking prescription stimulants like Adderall, diet pills, or even illegal drugs
Bingeing or overindulging
Hiding stashes of high-calorie foods such as candy or chocolate
The disappearance of a large amount of food over a short time period
Empty food packages being hidden in the bottom of the trash
Isolation, primarily when bingeing, so they will not be discovered
Purging or doing things to compensate for eating
Frequent trips to the bathroom after eating
Bathing, showering, or turning on water after eating to hide the sound of purging
Taking laxatives or diuretics
Using mouthwash or perfume to mask the smell of vomit
Periods of fasting or intense exercise after eating
Frequently complaining of upset stomach, constipation, or diarrhea
Issues with body image
Frequent comments about feeling fat or worrying about gaining weight
Wearing oversized clothing or multiple layers to hide their body and any weight gain
Extreme preoccupation with weight, such as constantly weighing themselves or criticizing their body
Constantly fluctuating weight
If you are ready to talk to someone about their eating disorder, you should not address your concerns during a meal or while eating. Rather, it is best to find some time alone where you can talk to them privately. Start by letting them know what you have observed and that you are worried about them. You can bring up how you noticed them heading to the bathroom every time after they eat or how they seem to eat very little at dinner. Make sure to let them know that you are worried about them and their well-being.
As you are having this conversation, don’t get discouraged if your loved one doesn’t want to talk or denies that there is a problem. Your main goal of this conversation is just to let them know that you are there for them while also genuinely listening to what they have to say and offering the compassion and support they need. By opening this line of communication and showing them that you are not there to judge, it can help them to open up to you when they are ready.
Although your conversation may be well-intentioned, it’s important to understand that there is a right and wrong way to approach this delicate subject. Before having this discussion with your friend or family member, make sure you understand what kinds of comments you should avoid:
Don’t give them an ultimatum – Unless the person you are worried about is a young child, you can’t force them to get treatment. This is their decision, so giving them an ultimatum will only create additional pressure and could lead to more denial or secrecy if they don’t feel comfortable talking to you about it.
Don’t comment on their appearance – They are likely to already be hyper-aware of their body. This is why even assurances about how great they look can backfire. Instead, it is best to steer clear of any conversations related to their weight and appearance and focus on discussions related to their feelings.
Don’t try to give simple solutions – Eating disorders are not a simple problem that can be fixed with a quick solution. If they were, people would not be suffering from them for so long.
Don’t shame them for their eating disorder – Statements such as "you need to eat" are not helpful. "You" statements, in general, come across as accusatory and can make the person not want to continue the conversation. Instead, try to focus on "I" messages that can indicate to the person how concerned you are for them. For example, "I am worried about you when I hear you vomiting in the bathroom."
Other than showing your friend or family member that you are there for them, you should also encourage them to get treatment. The longer the eating disorder continues, the more harmful it can become, even fatal, so it is important to urge them to see a medical professional as soon as possible.
A medical professional can assess your loved one’s symptoms, provide them with a diagnosis, and make recommendations for treatment. They can also figure out if there are other conditions related to the eating disorder that may require medical intervention, such as an anxiety disorder, substance abuse, or depression.
If your loved one is unsure which doctor they need to see, their primary doctor or general practitioner is a great place to start. However, dietitians who have experience in handling eating disorders, or even therapists, are also excellent alternatives. For further information about the types of treatment available, you can also check out organizations such as the National Eating Disorders Association,² which provides treatment and referral directories for those suffering from an eating disorder.
If your friend or family member is hesitant or refusing to see a doctor, ask them to just get a physical check-up to help ease your worries. It may even help if you offer to make their appointment or let them know you can go with them if they want.
There is nothing more stressful for a parent than seeing their child suffer and not being able to do anything about it. However, you should know that talking to your child and seeking the right help for them can make a big difference in the success of their eating disorder treatment.
Engage with them
If your child is suffering from an eating disorder, it can make it hard for them to open up or socialize with you and others. By continuing to spend time with them outside of meals and engaging them in activities that do not revolve around exercise or eating can show them that you are there to support them.
Listen to doctors
Depending on your child's treatment plan, you may need to be completely in charge of their meals. This will help your child re-establish a healthy eating pattern and interrupt some of their problematic eating disorder behaviors, including overexercising, bingeing, and purging. Once the doctor feels that your child's behaviors are under control, you may be asked to help monitor your child to ensure they do not slip back into old habits.
Avoid power struggles
Do not try to force your child to eat when they do not want to. This will only lead to more secrecy and lying. However, this does not mean that you can’t work on strategies to hold your child accountable for their behavior to help them to change. For example, if your child is refusing to eat, you can try telling your child that if they don't eat, they can’t go out to play because you are worried they will get sick or hurt because of their vulnerable state. Just make sure to let them know that this is not a punishment, just a medical concern.
When it comes to eating disorders, it’s important to understand that every person is different and there is no quick fix. An eating disorder is often a lifelong struggle, with setbacks along the journey to recovery. By showing your friend or family member with an eating disorder that you love and support them, you can make a world of difference in helping them to recover.