We know that people don't come equipped to handle eating disorders. There's no file folder in the back of our minds dedicated to talking to and being around someone struggling (like that episode on Spongebob where he tries to be a waiter and has a folder on how to handle all aspects of his life but can't remember anything and gets so frazzled). That may be how you feel if someone you know is struggling with an eating disorder: confused, helpless, like you're in uncharted territory. It's completely understandable. The most important thing when it comes to someone you care about having an eating disorder, is just being there for them and letting them know you will provide support if they decide they want it. But that being said, here are some things you should keep in mind when trying to help those people:
- Don't be the food police: Eating disorders are mental illnesses but food is definitely involved. It's the symptom, the coping mechanism. I understand you want to make sure they're getting the nutrients their body needs, but hovering and trying to shove food down their throat is not going to do any good and may lead them to push you away. If you are really concerned about their food intake or eating habits, suggest that they see a dietician (if they aren't already)
- Don't comment on their body: If they're gaining weight from Binge Eating Disorder, if they're losing weight from anorexia, if they're gaining weight while in recovery, etc. do NOT talk about their body. Even if you think the comment is a positive and complementary one, the person with the eating disorder will most likely not take it that way. Your mind begins to twist and warp any piece of information when you have an eating disorder and many people find comments about their body to be triggering.
- Express Concern not Confrontation: Confrontation can be dangerous in a normal setting and can get even worse if you're dealing with someone who has an eating disorder. The lives of people with eating disorders revolve around lies. They want to hid their behaviors because they refuse to lose control but also because there’s probably a sense of shame over what they are doing. People with eating disorders are not naïve, they know what they’re doing is wrong, dangerous, and potentially life-threatening, which is why when confronted nine times out of ten they will jump to the defense if they feel like they’re being attacked. The best thing to do in this situation is to openly but gently express your concern. Be concrete but not accusatory. For example: “I’m concerned about your rapid weight loss” or “I’ve noticed your eating habits have changed.” You don’t want to come off as a “bully” but you also need to stand your ground and state your facts.
- "Just eat:" At some point in time, everyone with an eating disorder has heard “just eat something” or “I don’t understand why you don’t just eat.” If it were that simple, they wouldn’t be struggling with food in the first place. Before you have an eating disorder, food is just food. It’s what we eat to nourish, stay alive, and use as a form of celebration. Once you develop an eating disorder, your mind convinces you that food is toxic, that its the enemy and if you get to close its going to annihilate you. You can encourage your loved one to eat (without being the food police), you can sit with them during a meal and let them know you’re there and you’re trying to understand, and as mentioned previously, you can set them up with a dietitian who specializes in eating disorders. Though food is not the root problem, it becomes a major issue regardless and is an extremely sensitive topic for the person struggling.
- Try to refrain from talking about bodies, weight, other people's eating habits, etc: The main reason I say this is because people with eating disorders find this to be extremely triggering, numbers specifically. When people openly discuss their weight (ESPECIALLY in a negative manner) the eating disordered brain flips a switch and encourages their destructive behavior. It could be for a number of reasons: a sense of competition, comparison to other people, a sense of shame for their own body, and so on and so forth. We all make comments like “I shouldn’t have eaten that” or “Ugh I feel so fat today.” Its understandable, its normal, and we do it all the time. I’m not telling you not to do that anymore (though you shouldn’t anyway because it does more harm than good), I’m just encouraging you to be more aware of what you say around your loved one who is struggling. Their brain is like a minefield and you never know what comment will blow them into oblivion.
- Don't talk about their struggles to others: As I’ve mentioned a few times already, eating disorders are heavily rooted in shame. Talking about their behaviors, habits, and struggles to other people will most likely magnify that sense of shame. Unless the person with the eating disorder confirms its alright to fill people in on what’s happening, you should probably try your best not share it with people outside of their immediate support system. Obviously, you as a caring and concerned individual need to talk about it, which is fine. Many people suggest family therapy because eating disorders affect far more than the people who have them. They affect their entire dynamic of life: friends, family, school, work, their ability to focus and function. Depending on the situation, people are probably going to notice that your loved one is struggling. And we all know that some people are extremely blunt and will flat out ask you what’s wrong. In those situations it is entirely up to you but I suggest being as vague as possible. You can admit something is going on, you can confirm they are struggling, and if you’re truly comfortable disclosing it, you can mention they have an eating disorder. However, I would encourage you to leave out the details, especially if the person struggling isn’t around to defend or explain themselves (and most times they won’t want to.) Just like anything else, when we are having a hard time we usually don’t want people poking and prodding in our personal issues so just try to keep that in mind.
- But they don't look sick : What most people also don’t realize is that eating disorders aren’t always obvious. Your loved one may not be skin and bones, they may not have a feeding tube shoved up their nose, and they may not be bingeing to the point where they put on 20+ pounds. That doesn’t mean there isn’t a problem. There are many people with eating disorders who aren’t affected on the outside. In fact, most bulimics remain in their normal weight range, that’s why it can go undetected for so long. However, though their outside may look “normal” it may not be the case internally. Eating disorders have serious and potentially fatal side effects including but not limited to: heart problems, electrolyte imbalances, hair loss, tooth decay, hypotension (low BP), lightheadedness, esophageal problems (more common with bulimia as a result of purging.) This isn’t meant to scare you or guilt you, but rather make you aware that the problem will not always jump out at you. It can be very difficult to ascertain what’s going on inside of our bodies, which is why it is imperative that a medical doctor be a part of your loved one’s treatment team.
I know I’ve thrown a lot of information at you today but I think its important to have as many tools as possible when it comes to supporting someone with an eating disorder. Unless you’ve ever had one, you cannot fully grasp how much they are truly struggling. That being said, the more informed you are, the better support you can provide. If you want to learn more about eating disorders and how to help someone who has them there are many resources available:
Websites:
Books:
“Life Without ED” by Jenny Schaefer
“Brave Girl Eating” by Harriet Brown
“Help Your Teenager Beat an Eating Disorder” by Dr. James Locke and Dr. Daniel Le Grange
“Dying to Be Thin” by Dr. Ira M. Sacker and Dr. Marc A. Zimmer
