Next Monday marks the start of Eating Disorder Awareness Week, which typically gives me time to reflect on my own recovery. But this year, I thought I’d focus on something a little different, which is by *far* the most common question I receive from people:
“How do I support a loved one with an eating disorder?”
Honestly, I should enlist my family (and/or friends, specifically my high school friends who have seen me through 25+ years of various forms of recovery) to write this. And one day I would like to sit down and interview everyone in my life who has supported me to get their own viewpoints and hear their own experiences as a support crew.
But, for now, you get my perspective.
I don’t claim to be the authority on this subject, and what has worked for me may not translate to your own situation (cue my lawyer-brain putting in all kinds of disclaimers).
First…THANK YOU. From the bottom of my heart, thank you for asking this question. Supporting someone with an eating disorder is so incredibly difficult, in ways that I only began to see recently. I never appreciated how hard it was for my parents, for example, to drop me off at a hospital when I was 16 and leave me there over the holidays, all while I kicked and screamed and begged to go home. I thought it was the worst time of my life - I can’t begin to imagine how hard it was for my parents to make that decision.
So now that I’m coming at this from a place of gratitude, the follow-up to that is you cannot fix someone who doesn’t want help. Please don’t take it as a personal failure if you can’t seem to get through to someone. As cliche as it is, you can’t recover for another person. My friends and family watched me flounder for years, just praying that I’d wake up every morning and not die in my sleep. But they had tried forcing treatment, they had tried interventions. Until I wanted to recover for myself, there was nothing they could do aside from tell me I was loved and be there for me.
Ok, so now you are feeling pretty helpless, huh? But I promise, you are not. If you are looking for concrete ways to help, some suggestions follow:
Be mindful of your own language around (1) food, (2) bodies (yours and other peoples), (3) exercise. Something that is a huge support to people struggling with an eating disorder is to have a safe space where others don’t talk about weight, “good” or “bad” foods or “burning off calories.”
In addition to being mindful of your own language, proactively shut down any kind of diet or wellness talk. Be an advocate. Change the subject. Say “bodies are not up for discussion here.” Grab that hunk of sourdough and take a huge bite and say “all foods are good foods” to whatever keto bro is telling you carbs are bad.
Let your loved one know that you are a safe space and they can confide in you without fear of punishment or judgment. Eating disorders can be filled with shame. Things that we engage in can seem shocking. For example, I never wanted to tell my parents that I was throwing out my lunches in high school because I knew I would get in trouble and would lose their trust. So if someone comes to you to confess, please don’t hold it against them. Take that confession as a sign that they want to get better. They want help.
Ask “how can I best support?” and expect that your loved one will probably not have an answer. And that’s ok. You could ask more pointed questions: “would it help you or make it worse if we had meals together?” “Would you like someone to go with you to your doctors appointment?” Conversely, your loved ones may have concrete asks, which may require a lot of courage on their end. When I was struggling in my mid-30s, I asked if my friend would be ok with me sending him pictures of my meals before I ate for accountability. That was a tough ask on my part, but I knew I needed the support at the time. Being open and affirmative to asks like can be life-saving.
Threats and punishments don’t work. This is probably more for parents with kids still in their care, but “tough love” usually ends up backfiring. It will only encourage your loved one to hide their disorder even further, and disorder thrives in secrecy.
If you are wanting to approach a loved one with your concerns, make it about behaviors and patterns, not about weight (and a reminder that not everyone’s weight changes with an eating disorder). For example: “I’ve been noticing X, Y, and Z (insert behaviors such as “withdrawing”, “refusing to eat meals with us”) and I’m concerned. I wanted to check in and see what’s going on for you.”
Having said that, there are sometimes when it may be ok to address the physical. This is likely limited to when someone already knows and admits they have a problem (otherwise, you don’t want to be commenting on someone losing a bunch of weight due to, say, cancer or depression, etc). So if someone already has admitted they are struggling with an eating disorder, and you are very concerned about their health (and honestly, that they may be on the edge of death), here’s a way to approach it: “I see this physical change in you and I’m very concerned about it. I worried that you may be minimizing how bad this has gotten.”
Validate their struggles. The vast majority of people with eating disorders do not “look” like they have eating disorders. Most are of a “normal” weight. The size of their body doesn’t indicate how badly they are struggling. An example on how to validate when someone shares with you: “I can hear how painful this is for you and I am so sorry you are going through this. I so appreciate you confiding in me and I want to help.”
Try to not compare your situation to theirs. It’s a human tendency to want to relate, but with zero offense, that 30 day diet that you did stupidly in college doesn’t compare to someone who has spent years binging and purging in secret. This is not at all to minimize your own issues, but comparison rarely has the intended effect. If you do wish to relate, prefacing with, “In an effort to relate” can be a helpful tool.
For those who are athletes, or who are trying to untangle their relationship with exercise, know that this is a SUPER gray area, and every person is different. Limiting exercise or movement may be warranted for some people, but it’s not a one-size-fits all approach. I’ve written more about that here.
Check in, and keep checking in. You don’t need to mention the eating disorder when you check in, just see how they are feeling.
Know that you are going to screw up and say or do the wrong thing at some point. It’s ok. It’s normal. Don’t beat yourself up.
If it is your romantic partner you are supporting, think about couple’s therapy. The disorder and/or recovery can and probably will take a toll on your relationship. This may be an unpopular opinion, but please also don’t beat yourself up if you can’t stay in that relationship anymore because of it. I’ve had a few boyfriends leave me (in large part, or at least they said) because of the disorder. It absolutely broke my heart, but I understand and I can’t really hold it against them. It takes a special person to be able to support and it’s not always a fair ask, especially if the loved one refuses to admit they have an issue.
Finally, please take care of yourself and know your own boundaries. You are not obligated to save someone. It’s ok to admit that it’s too much. You are not a failure if you feel like you can’t do it anymore.
For more resources, please check out Project Heal or NEDA. For athletes, check out the Stanford FASTR program. And my email is open: raceipsablog@gmail.com. I can sometimes be terrible at responses, but this one is important to me so I’m here to help.
I’ll end this the same way I started - THANK YOU. Your support means the world to me and to the loved one you are helping.
How to Support a Loved One in Eating Disorder Recovery
This is really well written and so interesting to hear from the other side of the spectrum. I have a loved one with an ED and took a large role in caring/supporting her when she was very sick and I think everything you said rings true. I would also note that I started therapy when helping her and it really helped me develop strategies and also heal my own food/body issues that were making it harder for me to help her. Thankyou x
Just got around to reading this. Thanks for your courage and honesty. This is very concrete and helpful. I love you and support you on your recovery. You are the best.