How to Support Your Loved One Struggling with an Eating Disorder
By Becky Belinsky, LMFT
What is an Eating Disorder?
Eating disorders are a complex medical and psychiatric illness. Eating disorders are classified as a mental illness in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Health Disorders (DSM-V), and are considered to have biological, psychological, and social underpinnings; as such, they require treatment by a team of professionals. Eating disorders affect people of all genders, ages, races, and socioeconomic statuses. Contrary to popular belief, you cannot tell if someone is suffering from an eating disorder based on looking at them. If someone you love is suffering from an eating disorder and you are wondering how to support them, here are some basic Do’s and Don’ts.
Check in with them about emotions instead of food.
Eating disorders are about so much more than food, and not only can it be triggering to discuss food (more on that later), but it is important to support your loved one with the challenging emotional aspects of the disorder that are often underneath the surface. Instead of commenting on their food, try asking how they are doing and if you can support them with anything emotionally.
The society we live in – one that values appearance, thinness, and “control,” one that normalizes dieting and the desire to lose weight – is an extremely challenging place in which to recover form an eating disorder. One of the most helpful things you can do is to educate yourself on eating disorders and diet culture, and explore your own biases and beliefs about weight, body, and food. See below for a list of resources of where to start.
Ask them what you can do to support during mealtime.
Eating is hard for someone recovering from an eating disorder, and it can be helpful to ask your loved one what would be best for you to do. Remember that it is their job to eat, but you can support them. Often times distraction is helpful – playing games, having an interesting conversation, watching TV, etc.
Respect loved one’s boundaries if they discuss them with you.
For many people recovering from an eating disorder, speaking up about what they need or setting boundaries can be very difficult. If your loved one expresses a need or sets a boundary, try to listen and respect this boundary. As the person recovering grows, your relationship with them may change but this is a good thing and important to their recovery.
Take care of yourself.
Supporting someone recovering from an eating disorder can be exhausting and draining work. It is important to take care of yourself so that you can keep being there to support them. You can talk to friends, seek your own therapy, or join a support group for friends and family of those with an eating disorder. Full recovery from an eating disorder can take 7-10 years. Have patience your loved one, and yourself.
Don’t engage in “diet talk.”
In the society we live in, diet talk is the norm so it may take some time and effort to unlearn this, but it is an essential part of creating an environment in which it is safe for your loved one to recover. The problem with diet talk is that it normalizes and reinforces that being fat is bad, which can be a barrier to recovery. Diet talk includes comments like:
Dividing food into “Good” food vs. “bad” food; or “I’m so bad for eating French fries”/ “You’re so good for eating a salad”
Saying “Cheat day”, or labeling food as “guilt free,” “dirty,” “clean,” as these reinforce - the above
Discussing calories/portion size/the amount of carbs/fat/protein in a food
Discussing weight loss and diets (this includes current popular “lifestyle” diets like intermittent fasting, Keto, Whole30, etc.)
Food rules (amounts, times you can eat, diet tips, etc.)
Don’t comment on food.
Similar to avoiding diet talk, avoid commenting on food – yours, your loved one’s, or other people’s food. Judgement and focus on food can be triggering as it may reinforce or teach harmful messages about food, and just bring attention to food in general. Unless you are working with your loved on in therapy and have the support and guidance from a professional, don’t put pressure on your loved one or demand or try to get them to eat.
Don’t comment on appearance or body – your loved one’s, yourself, or other people.
Part of recovering from an eating disorder is moving away from appearance and body/weight being important aspects of self-identity and self-worth, so hearing people comment on this is triggering and reinforces the incorrect belief that it is important. Even saying seemingly “positive” things about someone’s body (like “You look well,” or “Have you lost weight?”) does this. Instead, talk to your loved one about qualities they have that have nothing to do with appearance. Reassure your loved one that you will love and support them NO MATTER what happens to their body.
Don’t take on the responsibility for their recovery.
It is your job to support your loved one, but you can’t do the work for the person. It is up to them to take ownership of their recovery and their actions. If you try to do it for them, you will become exhausted and burnt out, and it actually can enable the eating disorder and robs your loved one of the opportunity to do their own work and grow.
Resources for further education and support