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The Eating Disorder Recovery Blog

How to Help Someone Recovering from an Eating Disorder

What to say, and what not to say

Chances are, with 1 in 20 Aussies experiencing an eating disorder at some point in their lives, at some point you’ll find yourself wondering how to help and support someone you know and love.

One of the main difficulties that I see affecting my patients, is that no-one knows what to say to them! And of course, I’ve heard many a story of ridiculous and inappropriate comments being made! I know you’re not one of those people, because you’re here reading this article, but when you think about what some people feel is ok to say, it does highlight just how weird Western culture’s attitudes towards eating and body image are. I was brought up in diet culture, too, and there’s certainly a lot to un-learn if you want to promote the pursuit of healthy relationships with food and body image!

So, for those of you who are wanting to support a loved one with an eating disorder, prevent a child from developing one, or maybe start working on your own body image and relationship with food, I’ve put together a few tips:

DO- consider how your own body image troubles might influence your words and actions.

One of the hardest parts of recovering from an eating disorder is the fact that every time you leave the safe cocoon of your HAES aligned treatment provider’s office, it seems like the whole world is obsessing over the latest ‘body transformation’ story, and making negative comments about the bodies of those around them, as well as their own.

Unfortunately, others’ comments about bodies only reinforce the idea that there is a ‘right’ body to have, as well as the toxic idea that your body says something about your worth as a person, or the way that you look after your body (which is untrue). This is crazy talk, and the belief that ‘your body is a reflection of your lifestyle’ is constantly being refuted by good quality science… But the myth is still all around us, because there’s a $6 Billion+ industry that needs to maintain it. (That’s just the size of the industry in Australia!) Each one of us sees an estimated 300+ advertising images in a day that only show one body type, and promote this as healthy and aspirational. When the fact is, that very few humans actually come in this size! Why aren’t the rest of us being represented? (But that’s another rant for another time!).

Although not all people with eating disorders actually developed their illness by attempting to manipulate their body size, the fact remains that anyone working on recovery IS going to be working on stopping the behaviours that are currently impacting their body size and shape, and this is likely going to result in visible changes over time- usually involving some weight gain. This is so much harder to do when you live in an environment that constantly tells you body size is important.

Verdict: The world would be a lot safer for all of us if we stopped using someone’s body size or shape as an indicator of their health or worth.

Do instead: Show your friend/ loved one that their value to you doesn’t change as their body might change, by regularly reflecting on all the non-physical things you love about them.

 

DON'T- suggest they try the new diet (or lifestyle…) that worked for you.

Fact: having an eating disorder is not a choice, not a lifestyle, and not a diet. An ED is a severe psychiatric condition, with physical health, mental health, and social components, so it’s a vast oversimplification to think that a person could be healed with a meal plan or new set of eating ‘dos’ and ‘don’ts’.

Actually, a major part of recovering from any type of eating disorder is building the capacity for flexible eating- i.e. having less rules! And what happens to anyone- ED or not- when you feel you’ve ‘broken’ a rule in your diet-of-the-day? You feel guilt, shame, and doubt your virtue as person. Those with EDs are experiencing these feelings ALL DAY, maybe even dreaming about food guilt! It’s exhausting.

The verdict: Being around diet-talk is really difficult for a person with an eating disorder, so sharing your own diet beliefs, no matter what they are, is almost guaranteed to harm, not help.

Do instead: Practice being a good listener: meaning let your friend/ loved one talk, without judgement, and without feeling the need to offer them ways to ‘fix’ things. An empathetic ‘that would be so hard’ or ‘I’m so sorry you’re having to deal with that every day’ can go a long way.

 

DON'T- tell them they look better, or ‘healthier’ having gained OR lost weight.

Actually, just don’t comment on their weight at all. Or anyone else’s. For any reason. Ever!

One of the main diagnostic features of all the major eating disorders is a preoccupation with weight and shape. Your friend or loved one is probably ALREADY feeling highly visible and vulnerable because of their weight gain or loss. So when you mention it, you risk confirming all of their fears, and supporting what the eating disorder (and our culture) is telling them about the importance of weight.

The verdict: How we look is the least interesting and important thing about a person. What else can you talk about?

Do instead: Rather than commenting on how their appearance might be changing, try asking how they’re feeling today. Or, if they’re happy to talk about their eating disorder with you, whether they feel like just venting about how difficult and suckey the process of recovering can be. You might also want to tell your friend/ loved one if you notice they’re happier, or seem more like their old self.

 

DON'T- assume that an eating disorder is about self-control. And if the individual is in a small sized body, don’t ask for weight loss tips.

So often, people with restrictive EDs are praised for having such amazing self-control, especially if they’re also in a smaller body, or have lost weight due to their illness (and no, they might not look emaciated. All EDs, including life threatening Anorexia Nervosa- despite being associated with thinness in the past- can also exist in a person of higher weight). The irony here, of course, is that eating disorder behaviours are NOT AT ALL about feeling in control!

For most people, carrying out their eating disorder behaviours does not feel like there is any conscious choice in the matter. Many say that they feel more like compulsions. So when a random at work says ‘I wish I was as disciplined as you!’, or asks for diet tips, it’s really hard for someone with an eating disorder to have a non-sweary response to that! You’re also putting them in the position of having to choose between advocating for themselves and probably outing themselves as having an ED in the process (don’t forget there’s still unfortunately a huge amount of stigma associated with having a mental illness- choosing who to disclose your illness to is a whole other kettle of fish!), or laughing it off & changing the subject in the hope that the person won’t bring up the topic again after seeing how disinterested they are… Yet they will likely feeling the impact of those behaviour-reinforcing comments for days to come.

The verdict: Loss of weight is not necessarily a good thing. It can be due to many unhealthy or difficult things, including cancer, bereavement, many chronic physical health conditions, and many non-ED mental illnesses, as well as an eating disorder. Flipping the coin, weight gain is also not necessarily a bad thing. People might gain weight due to starting life enhancing or even life saving medical treatments, eg to manage psychiatric conditions, to control severe asthma, or fertility treatments. Weight changes are more often than not outside of an individual’s control, and it may be highly upsetting for others to point out these changes publically.

Do instead: Praise people for their non-physical attributes. Everyone loves to be recognised for their hard work, dedication, how much they mean to you as a parent, their value to you as a friend, etc.

 

DO- keep inviting your friend to dinners etc, but refrain from commenting on their food.

Social eating is one of the MOST anxiety-provoking situations for someone with an eating disorder! So, if your friend with an ED is in a position where they’re able to go to your dinner/ BBQ/ movie date that involves eating, the best way to support them is by just modelling normal eating*, making good conversation, and not commenting on their food choices. Regardless of how your friend with an ED looks, how bubbly they might (or might not!) be, they might still be having a lot of trouble with unfamiliar foods, lack of food options they feel ‘safe’ with, worry about eating foods prepared by others, worry about what others’ are thinking about their food choices, the fear that someone will comment… you get the idea!

*Wait! Back up, um… what’s ‘normal eating’?!?

Well, it’s definitely not what most of us brought up in Western countries were taught! Very briefly, it’s:

  • Eating when you first notice hunger, rather than putting it off until you feel grumbles and headaches.
  • Choosing foods you enjoy, find satisfying, that leave you feeling energised after eating them
  • Not avoiding particular foods or food groups because of perceived health value, and not experiencing guilt, or a need to compensate, for eating particular foods. Actually, not even categorising foods as good Vs bad/ healthy or unhealthy in the first place. (Obviously not discussing legitimate medical limitations on food choices here, eg Coeliac disease).
  • Letting your body tell you how much to eat- not adhering to portion size rules. This means eating until you’re satisfied, not stopping before you’ve eaten enough, and not continuing to eat past the point of comfortable fullness.
  • Understanding that your needs will change day to day, season to season, through life stages, when you’re fighting off an infection etc. Adjusting what you eat according to appetite, rather than sticking to a plan.

Are all those things easy for you to do? Do you disagree with any points? Perhaps this is an area where you also might be holding onto some disordered eating beliefs and behaviours?

The verdict: Sometimes, just going to a social event and eating something there, even if it looks insufficient, or unbalanced to someone else, is a HUGE step forward in that person’s recovery. There’s just no way to know what they’re working on at the time.

Do instead: Keep the conversation off of the food (unless you just want to share how much you’re loving the meal you ordered!), eat your own food without any comments about its perceived health value, calories/ carbs/ anything else count-able, or reference to your own body size. Show your friend that you enjoy their company. Being a good friend is always helpful J

 

If you’re reading because you’re recovering from an ED: what would you add or change about this article? I would love to hear your stories of times you’ve had to advocate for yourself, and times you haven’t known what to say. You can email me via the contact form below J

If you’re reading for someone else: thanks so much for reading this article to the end! I know that trying to understand and help means the world to your friend/ loved one. If your question wasn’t covered above, and you’re in doubt, just ask what your friend or loved one would want. (Please email me so I can write about your topic another time!). And please consider sharing the article with friends or family if you think it could help. PS- A quick copy and paste of the URL into an email or any social media post should grab the image & blurb 🙂

 

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