Supporting a Loved One

What is helpful vs. unhelpful when supporting someone with an eating disorder.

Watching someone you care about living with an eating disorder can be extremely tough, especially when you can’t imagine why someone would ever want to do that to themselves. Here is a brief list of some common do’s and don’ts (of course, remember that every individual is different, but these are some general guidelines):

Helpful…

  1. Listen
    1. Active listening skills include eye contact, meeting them at eye level, nodding and making it known that you are hearing what they are saying, letting them speak uninterrupted, and putting yourself in their shoes as they tell you what they are experiencing. 
    2. Put aside judgment and/or bias when listening so you can respond with compassion and an open mind.
  1. Learn
    1. Ask questions when you don’t understand and be open to the possibility that someone who is struggling may not have the capacity to explain the pain they are experiencing.
    2. Educate yourself with evidence-based, up to date information and inclusive resources regarding eating disorders, specifically, as well as mental illness, weight stigma, and diet culture. 
    3. Consider other perspectives by learning about stories of others who have struggled. 
  1. Take Action
    1. Provide support when it is appropriate. Determining when it is appropriate goes back to listening and learning. Listen to when and how your loved one asks for support. Learn about other support available such as treatment, groups, professional care, recovery-oriented books, sites, podcasts, etc. 
    2. Advocate for your loved one. If they are struggling, they may find it hard to advocate for their own needs or set boundaries. Be there to help them find and amplify their voice to receive the support they need. 
    3. Be willing to make changes. If your loved one has expressed that their recovery is hindered by things that you say or do, ask what you can say or do instead to be a better support. 
    4. Encourage them to follow through with recovery goals. This can include goals around food, body image, symptom use, or building a treatment team (dietitian, therapist, etc). This can also include encouraging them to resist isolation and participate in activities unrelated to the eating disorder.
    5. Examine your own thoughts, beliefs, and behaviors related to food and body image.
    6. Be a model. Eat with them to provide an example of normal eating. Practice self-care together such as journaling, meditation, mindful movement, etc. 
  1. Communicate
    1. Although supporting a loved one is first and foremost not about you, expressing your own thoughts and feelings can be helpful too, if done in a gentle and caring way. It is helpful to use “I feel…” statements to express your feelings about the situation. For example, “I feel disconnected from you and that makes me sad…” or “I feel sorry for the way that I handled this situation in the past” or even “I feel concerned about your wellbeing”. Being open in this way models appropriate ways of expressing feelings and may help your loved one feel more comfortable expressing their own. It may even be what they need to hear in terms of feeling loved, cared for, and valued unconditionally. 
    2. If you are struggling to express yourself in a helpful rather than hurtful way, seek your own mental health treatment. This will also model to your loved one how they can seek more support while improving your own coping and communication skills. Additionally, supporting your loved one is stressful and it may be helpful to have your own support to vent and help you through the situation.
    3. Let your loved one know what you value about them that IS NOT related to the eating disorder. Remind them of their long-term goals, values, and strengths that have nothing to do with health or appearance such as intelligence, creativity, or compassion. Let them know they are inherently worthy and loved. 

Unhelpful

  1. Invalidate
    1. Believe and validate your loved ones thoughts and feelings even if they do not resonate with you. Their experience is uniquely theirs and understanding may only come from listening and learning. Some helpful phrases to use may include “I understand that what you are going through is very painful” or “I can see how that is triggering for you”.
    2. Do NOT invalidate your loved one’s struggle by assuming that their needs are aligned with yours. Your loved one may need to combat their eating disorder by removing themselves from situations in which they could be triggered (i.e., holiday meals, family events, going out to eat, shopping trips, etc.). This may be stressful for you, but know that they are not intentionally throwing a wrench in relationships or inconveniencing you. However, you are allowed to express how you feel the relationship would be better if your loved one was able to make peace with their eating disorder. An example phrase could be, “I understand that it is hard for you to go out to eat, but I would love it if in the future we could go out to celebrate and have fun together”.
  1. Ignore
    1. Pretending everything is okay or minimizing the severity of your loved one’s struggle will only lead to a more difficult struggle in the long run. Provide support as soon as an issue comes up. This includes using “positivity” as a method for deflecting. Phrases such as, “Look on the bright side” or “It could be worse” are considered “toxic positivity” and invalidating.
    2. Do not ignore or minimize your own mistakes or ways you may have been unhelpful in supporting your loved one. It may be uncomfortable, but awareness is the first step towards positive change. 
  1. Assume
    1. Do not assume that if they’re not seriously under or overweight, they’re ok. Eating disorders can contribute to many severe medical issues, such as malnourishment and electrolyte imbalances, in bodies of ANY size.  Not only that, but anyone can experience serious emotional and psychological pain no matter the physical condition they are in. It is extremely important to recognize that eating disorders do NOT look the same on everyone. AKA, you cannot assume what disorder someone is struggling with just by looking at them. 
    2. Do not assume that if their weight changes, this corresponds with a change in their health. Although recovery goals may include weight restoration when needed, recovery is measured by overall well being. Overall, commenting on weight or appearance is not helpful. Do NOT use valued judgment phrases such as “You look good now that you’ve got a little meat on your bones” or “You look great now that you’ve lost weight”.
    3. Do not assume one person or experience can be blamed as the cause of the eating disorder. This invalidates the complexities of eating disorders. It may be more helpful to support your loved one in identifying triggers that make it more difficult for them to maintain a recovery oriented mindset. Instead of saying something like, “This is your mom’s fault since she put you on a diet” you could say, “I can see how your mom perpetuating diet culture was triggering for you”.
    4. Do not assume that their story is the same as others’ who have an eating disorder. This includes celebrities and/or media presentations of eating disorders.
  2. Force
    1. Adding calories or ingredients to foods without telling them is disrespectful to your loved one’s bodily autonomy. You want to respect boundaries and maintain trust with your loved one. They may also be repairing their relationship with food in their recovery, and manipulating their food in this way interferes with their journey towards intuitive eating. 
    2. Do not use threats or ultimatums to push someone who is struggling to stop using eating disorder behaviors.  You can be firm in setting boundaries around their use of eating disorder behaviors around you, but also have empathy for their struggles. 
    3. Do not expect them to face all their fears at once. Support them in challenging themselves at a pace that encourages progress, but allows for rest. Along with this, it is unhelpful to punish someone for using disordered eating behaviors. Instead, try using positive reinforcement. 
    4. It is not your duty to monitor their food intake or take on the role of the “food police”(Unless you are enrolled in a Family-Based Therapy program with professional direction). This includes: following them whenever they go to the kitchen or bathroom, criticizing what foods they are choosing to eat, or watching them as they eat. Instead, offer encouragement or pose questions such as, “Do you feel that this choice is challenging your eating disorder?” or “Is this what your authentic self is wanting to do at this moment?”.
  3. Perpetuate
    1. Although there are several factors that may lead someone to struggle with an eating disorder, diet culture and weight stigma only perpetuates the idea that being in a certain body makes you more attractive and/or worthy. You can support your loved one by modelling and affirming a neutral or positive affect towards all bodies, including your own. 
    2. This also includes judgments around food or promoting food “rules”. For more information on how food rules can be harmful, here is an article.  
    3. Don’t focus on appearance. Don’t compliment or criticize appearance whether it be your loved one, yourself, or others. This goes for “health” habits as well. Don’t compliment or criticize someone’s eating or exercise habits. 
    4. Do not ask them for advice on “healthy” eating or exercise behaviors (including weight loss!). Diet culture often presents disordered eating habits as healthy when they are actually very harmful. AKA, do NOT ask them things such as, “how do you do it?” or say things like, “I wish