How to Support Someone Struggling with Body Image or an Eating Disorder
If you are close to someone who is struggling with body image, disordered eating, or a diagnosed eating disorder, you may often feel that you are walking on egg shells, always afraid of saying something that may upset your loved one. Even a simple compliment like “You look great!” can result in tears. This reaction is inexplicable to someone not suffering from these issues, which can make interacting with your loved one fraught and tense where once the relationship was enjoyable and easy.
How to Help:
You may be wondering what to say to the person without upsetting him or her, especially if this person is under stress from school, work, or personal relationships. As someone who has suffered through anorexia and is currently in recovery, I can offer an inside view of how my family has best supported me; however, I realize that my own experiences cannot encompass every eating disorder sufferer. In order to best explain how to help someone suffering from an eating disorder, I have researched several well-research and popular websites about eating disorders, such as the National Eating Disorder Association (NEDA), National Association of Anorexia and Other Eating Disorders (ANAD), Something Fishy, the National Institute of Mental Health (NIMH), and several other reliable institutes, such as Columbia University, Mayo Clinic, and The Center for Anorexia at Sheppard and Pratt.
If you know which eating disorder is affecting your loved one, becoming educated about that eating disorder can be immensely helpful, for both you and the sufferer. While you may not completely understand how an eating disorder affects someone personally, having a general knowledge about eating disorders can help you understand the feelings and thought processes that occur within your loved one. If he or she is unable or unwilling to speak about the eating disorder, your best choice of action may be to research online to hear from both medical professionals and patients who have submitted their own personal experiences.
Resources for Supporters:
A great website that is full of information on all eating disorders is the website of the National Eating Disorder Association, or NEDA. The NEDA website offers information about anorexia (AN) , bulimia (BN) , binge eating disorder (BED) , and eating disorder not otherwise specified (EDNOS), more recently known asother specified feeding and eating disorder (OSFED) . These articles present the symptoms, complications, and treatment of all eating disorders and can help you become familiar with the illness from which your loved one suffers.
NEDA provides several resources for helping speak to your loved one about how an eating disorder is affecting his or her life. If you are a parent with a child struggling with an eating disorder or body image issues, NEDA has written a lengthy “parent toolkit" that covers common myths about eating disorders, how to begin a discussion with your child about eating disorders, and most importantly, how to be supportive of your loved one . While this toolkit is almost 100 pages long, the content is quite extensive and informative.
Advice for Supporters:
However, if you are a parent supporting your family, you may not have the time to read almost 100 pages about eating disorders. To be frank, I am an unemployed biologist, and I don’t feel that I have the time to read through so much information. No judgement here! However, the most pertinent and helpful section of the toolkit is entitled “How to be supportive (p. 12),” and includes the following advice :
- Educate yourself about eating disorder behaviors, as well as learning the difference between common eating disorder myths and facts.
- Ask your loved one how you can be supportive, then be open and willing to hear his or her answer, and be prepared for defensiveness if the eating disorder remains an uncomfortable topic.
- Know that you cannot “save” your loved one, and recovery often requires professional help through an eating disorder specialist and a dietitian, if not treatment within an eating disorder treatment facility.
- Be patient and calm with your loved one, and avoid blaming him or her for the eating disorder. If you feel yourself becoming frustrated or upset, be prepared to walk away from the conversation with a firm but kind, “I do not want to be upset with you, and I need a break from this conversation. I will check in with you later. I love you.”
- Try not to make demands of the person in regard to food or weight. While you may feel angry about the person’s inability to gain or lose weight or to eat appropriately, threats and blaming will not be helpful to his or her recovery.
- Avoid making negative comments about body shape or size for anyone, including yourself. For most individuals suffering from an eating disorder, avoiding conversations about food, calories, weight, and body image are best avoided, even if the comments are positive.
- Lastly, be sure to get support for yourself. Having a child with an eating disorder can be a scary and frustrating time, and you will need to take care of yourself if you want to continue to care for your child.
Talking to Your Loved One:
This information can also be used to hold a discussion with a friend or other loved on about a possible eating disorder. If you are the parent or friend of someone who is not open about his or her eating disorder or even denies having an issue with eating and body image, you may be wondering how to best begin an open conversation him or her. NEDA recommends setting aside a time to speak with the person in a safe, quiet, and private place that is unlikely to cause interruptions . This safe place may be the person’s bedroom or a comfortable living room. Considering the nature of the issue to be discussed, you may want to avoid having this conversation in a place associated with food, such as the kitchen or a restaurant or cafe, and especially avoid having the conversation before or during a meal.
NEDA also offers several helpful tips for beginning this discussion with someone who you suspect struggles with an eating disorder, described as follows :
- Calmly explain your concerns about your child’s behaviors without placing blame or attempting to shame the child. Simply express your concerns by saying, “I notice you seem to be unhappy lately and have not been eating with the family. Is there anything I can do to support you? I love you and want to help you in any way possible.”
- Your child may deny the existence of a problem, due to shame or guilt. If so, you may leave resources with him or her such as the information found on the NEDA website, which also includes a support forum .
- If your child seems open and honest about his or her struggles, you may suggest following up with a medical professional, as no amount of love and support from a family member can treat an eating disorder. If appropriate, offer to accompany the child to this appointment as emotional support.
- In the case of a child expressing feelings of hopeless in regard to recovering from his or her eating disorder, you can gently remind him or her that thousands of people have recovered, and recovery is possible, even if personal recovery feels out of reach. You can even share the “stories of hope" posted on NEDA’s website or the true, inspiration accounts of recovery on the ANAD website [7, 12].
Additional resources exist for supporters who wish to become knowledgeable about how to best help someone dealing with an eating disorder. The Association of Anorexia and Other Eating Disorders offers “What Not to Say" when supporting a loved one with an eating disorder, and the Columbia University offers "Ten Critical Steps When Helping a Friend Who May Have an Eating Disorder" [8,9]. Furthermore, the eating disorder support websites "Mirror, Mirror" and "Something Fishy" have a short, easy-to-read articles about how to approach someone who may be suffering from an eating disorder [10,11].
Even if you’ve read every article you can find about eating disorders, the most helpful way to support your loved one is be to be patient, open, and supportive. From my own experience, I can say that my significant other does not understand anorexia, despite holding a degree in psychology and attending many family sessions with me during residential treatment. However, he is my most valuable support, because he is non-judgmental and willing to just listen. He often says, “I can’t understand why you feel that way, but I am listening and I love you.” He also avoids all conversations about calories, weight, and body image, which is immensely helpful. Just remember that while you cannot cure your loved one’s eating disorder alone, you can make the difference in his or her recovery simply being supportive of him or her.
 Anorexia nervosa. 2014. National Eating Disorder Association. http://www.nationaleatingdisorders.org/anorexia-nervosa.
 Bulimia nervosa. 2014. National Eating Disorder Association. http://www.nationaleatingdisorders.org/bulimia-nervosa.
 Binge eating disorder. 2014. National Eating Disorder Association. http://www.nationaleatingdisorders.org/binge-eating-disorder
 Other specified eating and feeding disorder. 2014. National Eating Disorder Assocation. http://www.nationaleatingdisorders.org/other-specified-feeding-or-eating-disorder
 Parental toolkit. 2007. National Eating Disorder Association. http://www.nationaleatingdisorders.org/sites/default/files/Toolkits/ParentToolkit.pdf.
 NEDA Forum. 2014. National Eating Disorder Assocation. http://www.nationaleatingdisorders.org/forum.
 Stories of Hope. 2014. National Eating Disorder Assocation. http://www.nationaleatingdisorders.org/stories-of-hope.
 What Not to Say. Date unknown. Association for Anorexia and Other Eating Disorders. http://www.anad.org/wp-content/uploads/2010/11/What-Not-To-Say.pdf.
 Ten Critical Steps When Helping a Friend Who May Have an Eating Disorder. Date unknown. Columbia University Medical Center. http://www.columbia.edu/cu/aims/articles/Helping%20a%20Friend%20-%20Eating%20Disorders.pdf.
 Thompson C. and Farrar T. 2014. Approaching Someone with an Eating Disorder. Mirror, Mirror. http://www.mirror-mirror.org/approach.htm.
 What You Can Do. Date unknown. Something Fishy, Org. http://www.something-fishy.org/helping/whatyoucando.php.
 Multiple authors. Recovery - true inspirational stories. 2014. Association for Anorexia and Other Eating Disorders. http://www.anad.org/my-recovery-story.