What To Say and Do If You Know Someone With An Eating Disorder: Strategies from a Raleigh, NC Therapist
Dealing with a loved one's eating disorder can be an incredibly challenging and emotional journey for families and friends. Understanding the complexities of eating disorders and finding effective ways to offer support are crucial steps in fostering recovery and well-being. In this blog, we will explore practical advice, empathetic strategies, and valuable resources designed to help families navigate this difficult experience. My goal is to empower you with the knowledge and tools necessary to provide compassionate and effective support, ultimately contributing to your loved one's path to healing.
How do I know if my loved one has an eating disorder?
Recognizing the signs of an eating disorder in a family member can be challenging, but early identification is crucial for seeking timely help. Here are some key indicators that might suggest your loved one is struggling with an eating disorder:
Changes in Eating Habits: Noticeable shifts in eating patterns, such as skipping meals, eating very small portions, or avoiding certain food groups, can be red flags.
Preoccupation with Food and Weight: An intense focus on dieting, calories, body weight, or specific types of food may indicate an unhealthy relationship with eating.
Physical Symptoms: Look for significant weight loss or gain, frequent fluctuations in weight, gastrointestinal issues, dizziness, fatigue, or signs of malnutrition.
Behavioral Changes: Watch for behaviors like excessive exercising, making frequent trips to the bathroom after meals, or using laxatives, diuretics, or diet pills.
Emotional and Psychological Signs: Mood swings, depression, anxiety, social withdrawal, or extreme perfectionism can be linked to eating disorders.
Distorted Body Image: Expressing dissatisfaction with their body size or shape, even if others see their body as normal or underweight, is a common symptom.
Secrecy and Isolation: Becoming more secretive about eating habits or avoiding social situations that involve food can indicate a problem.
Ritualistic Eating Behaviors: Developing rigid eating rituals, such as cutting food into tiny pieces, eating very slowly, or always eating alone.
If you observe several of these signs in a family member, it's important to approach the situation with sensitivity and concern. Encourage open, non-judgmental communication and consider seeking professional help from a healthcare provider specializing in eating disorders. Early intervention can make a significant difference in the recovery process.
What do I do to help someone with an eating disorder?
Supporting someone with an eating disorder requires a compassionate, understanding, and non-judgmental approach. Here are some steps you can take and things you can say to help your loved one:
Choose the Right Time and Place For Conversation: Find a private, quiet, and comfortable setting where you can talk without distractions.
Express Concern, Not Judgment: Use "I" statements to express your feelings and observations without blaming or criticizing. For example, "I've noticed you've been skipping meals, and I'm really worried about you."
Be Prepared for Denial or Anger: Understand that your loved one might react defensively or deny there's a problem. Stay calm and patient.
Show Empathy and Support: Let them know you care and that you’re coming from a place of wanting the best for them. Some examples of things to say are:
"I care about you and I'm here for you."
"I can't fully understand what you're going through, but I want to help."
What are some things I can say to my loved one with an eating disorder?
Sometimes having scripts of things to say can be really helpful when you’re in the heat of the moment and emotion takes hold. I can give all the tips in the world, but people usually want some examples of things to say. Here are a few ideas. Please make them your own and always focus on coming from a place of compassion and empathy.
Acknowledge the problem:
“I’ve heard you throwing up in the bathroom after meals. I’m concerned about this behavior and I think it’s time to get help.”
“I’ve noticed you skipping meals lately, that you’ve been really tired, and your moods have been more up and down. I’m concerned about this behavior and its impact on you.”
“I’ve noticed you seem very stressed about food lately.”
“I noticed you’ve been spending more time working out and have a lot of rules about certain foods. I’m concerned you have an eating disorder. “
“I feel sad when we can’t hang out at restaurants like we used to. I’ve noticed you’ve stopped going out, insist on taking your own food places, and are focusing more and more on lifestyle changes, but I’m concerned it could be something bigger.”
Showing empathy:
"I care about you and I'm worried about your health."
"It's hard for me to see you struggle, and I want to help."
"I'm here for you if you ever want to talk about what you're going through."
"You don't have to go through this alone. I'm here to listen whenever you need."
"I can't imagine how hard this must be for you, but I'm here to support you in any way I can."
"It takes a lot of courage to face something like this, and I'm proud of you for being strong."
"You are important to me, and your well-being matters."
"You have so much to offer, and I want to see you healthy and happy."
Offering to get help:
"It might help to talk to someone who understands what you're experiencing. Would you like me to help you find a therapist?"
"There are professionals who can provide the support you need. I can help you look for someone if you'd like."
Following up and checking in:
"If you're ever feeling overwhelmed or just need someone to talk to, I'm always here for you."
"Your feelings are valid, and it's okay to talk about them."
"I understand that this is a sensitive topic, and I'm here whenever you're ready to talk."
"Take your time. I'm not going anywhere, and I'll be here to support you every step of the way."
These conversations can be hard and it takes courage to be direct. If you feel big feelings or have to bite your tongue during a conversation, find an outside support (friend, therapist, other family member who can listen) to talk to instead of directing anger, guilt, and shame at your loved one. Acknowledging an eating disorder with care and empathy can help your loved one feel understood and supported, making it easier for them to seek the help they need.
What not to do when supporting a loved one with an eating disorder?
Often, family and friends will run into power struggles when they push their loved one too hard on changing eating disorder behaviors. It’s very important that your loved one with an eating disorder has a treatment team that can direct their recovery actions instead. This takes the responsibility off the shoulders of family and friends, allowing them to provide empathetic support and strong boundaries so that they don’t get caught in power and control dynamics at home. It’s not helpful for any party to be the “good” or “bad guy” - let the treatment team play this role, as they are well equipped to handle resistance to recovery.
Tips for what not to do:
Don’t Focus on Weight or Appearance. Avoid comments about their weight, body shape, or appearance, whether positive or negative.
Don’t Blame or Shame. Refrain from making them feel guilty about their behavior or condition. Folks with eating disorders usually have deep feelings of guilt and shame already. Instead, acknowledge that eating disorders are difficult and focus on how you can support recovery oriented behaviors.
Don’t Take Over Their Recovery. Encourage independence and self-agency in their recovery process. Ultimately, the person with an eating disorder is in charge of their thoughts, feelings and reactions. Of course you may feel upset if they aren’t completing meals or having a difficult time, but it’s important for you to take responsibility for your own wellbeing. Recovery has to be the choice of the person trying to recover.
Don’t Take Responsibility. You are not in charge of if they complete meals or engage in eating disorder behavior. The person with an eating disorder needs to be willing and ready to recover.
Don’t Avoid Speaking Up and Offering Support. Many patients say that they wished people had spoken up sooner (even if they were resistant to hearing others’ concerns) because it meant loved ones were paying attention and they saw a problem before it got too big.
Don’t Engage In Your Own Disordered Eating and Exercise. One of the most difficult things for eating disorder patients is seeing family and friends engage in their own disordered eating because it normalizes harmful behaviors and perpetuates diet culture and eating disorders in a family system.
Don’t Avoid Support Groups or Therapy. Often, the “identified patient” (the person with the eating disorder) is not the only person in a family who needs support. There are numerous support groups, family therapy sessions, and online resources to learn more about eating disorders, diet culture, and how to avoid caregiver burnout. Use these resources.
How can I prepare myself to provide better support?
Educate Yourself: Learn about eating disorders to better understand what your loved one is going through and how best to support them.
Be a Positive Role Model: Exhibit consistent, adequate eating and non-extreme exercise habits without emphasizing weight or appearance.
Offer Practical Support: Accompany them to appointments if they are comfortable with it.
Help them find resources, such as support groups or informative literature.
Avoid Power Struggles: Don’t try to force them to eat or control their food choices. This can increase feelings of guilt and resistance.
Lean on your loved one’s dietitian and therapist for support around eating and reducing eating disorder behaviors.
Encourage Healthy Activities: Engage in activities that can boost their self-esteem and distract from eating disorder behaviors, like hobbies, social outings, or quality time together.
Be Patient: Recovery from an eating disorder can be a long and challenging process. Celebrate small victories and be there for setbacks.
Stay Involved: Continue to check in and offer support, even if they initially reject your help.
Be Consistent: Your ongoing presence and support can make a significant difference over time.
Supporting a loved one with an eating disorder can be challenging, but your empathy, patience, and understanding can play a crucial role in their recovery journey.
Where can I find support for eating disorders?
Finding support for an eating disorder is crucial for recovery. Here are several resources and places where someone can find help:
Healthcare Providers:
Primary Care Physicians: Can provide initial assessments and referrals to specialists.
Therapists and Counselors: Find a therapist who specializes in eating disorders.
Dietitians/Nutritionists: Can create personalized nutrition plans to help people find a normal relationship with food again
Specialized Eating Disorder Clinics: Inpatient and outpatient treatment centers offer comprehensive care, including medical monitoring, therapy, and nutritional counseling. Veritas Collaborative and Carolina House are local to Raleigh, NC.
Community Mental Health Centers: Often provide counseling and support groups.
University Health Services: Many universities offer counseling and support services for students dealing with eating disorders.
Support Groups:
Helplines and Hotlines:
NEDA Helpline: Call or text (800) 931-2237 for support, resources, and treatment options. NEDA also offers a crisis text line: Text “NEDA” to 741741.
Crisis Text Line:
Text “HOME” to 741741 for immediate support from a trained crisis counselor.
Educational Resources
Books and Literature: There are many books written by professionals and those who have recovered from eating disorders. Titles like Life Without Ed by Jenni Schaefer, Binge Eating Disorder: The Journey To Recovery And Beyond by Amy Pershing and Chevese Turner, and Sick Enough by Jennifer Gaudiani, MD can be insightful.
Apps and Digital Tools
Recovery Record: An app designed to support individuals in recovery from eating disorders by tracking meals, thoughts, and feelings.
Rise Up + Recover: An app for managing eating disorder recovery with meal logs, coping strategies, and resources.
Encouraging someone to seek support and providing them with these resources can make a significant difference in their journey toward recovery. If you or your loved one has questions about eating disorders, please check out these resources. You can also contact me to get additional support if you live in North Carolina or are local to Raleigh, NC.
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At Counselor Kate, my goal is to provide compassionate support to help individuals process and release trauma stored in the body with trauma and somatic therapy. Rediscover a harmonious relationship between food and your body through my intuitive eating services!