Tips for Supporting Someone with an Eating Disorder

Understanding how to support someone suffering from an eating disorder is an extremely challenging task. Even professional psychologists and researchers who have spent years studying eating disorders have a hard time distilling the illness as they are, by nature, very complex and manifest in a variety of forms. Rooted in shame and accompanied by some of the highest rates of stigma in the mental health field, issues pertaining to disordered eating must be treated with the highest levels of sensitivity, empathy, and compassion.

Suspend your own judgment and disbelief

You may have found your way onto this page if you are already supporting someone with an eating disorder or perhaps if you have preliminary concerns about someone you care about. You may have noticed a change in their behaviour around food, exercise, and the body. Maybe someone has approached you with their eating or body concerns or maybe someone in their tight support network has informed you of an issue. Whatever it is, difficult conversations lie ahead. There are two very important phenomena to wrap your head around before expressing your concern to the unwell person:

An eating disorder is not a choice

First and foremost, you must recognise it is not their choice not to eat. It may seem like it is, but it’s not. Full stop. The disordered eating behaviours often appear completely counterintuitive to the non-sufferer, and you may be quick to judge it as an unhealthy lifestyle choice or a diet gone too far. You may find yourself thinking: why don’t you just eat? The solution is right there in front of you! Although understandable, this is very reductive thinking. You must remember this person is no longer in control of their behaviours or desires and they did NOT choose to end up in this place with an eating disorder. Instead, they got stuck here and it’s important that you make them feel supported as they attempt to get out.

An eating disorder sufferer has a very intimate relationship with their eating disorder

The second thing to remember is they have a relationship with their eating disorder, and this is a relationship a non-sufferer will never quite understand. An eating disorder is a behavioural outcome of other forms of psychological distress like anxiety, stress, trauma, perfectionism, and low self-worth. In the same way an addict turns to their drug of choice to alleviate distress, a person with an eating disorder turns to disordered eating and over-exercising whereby they are granted a feeling of control that other aspects of their life and selfhood may lack. The control of their eating and appearance thus alleviates the uncomfortable feelings of stress, anxiety, and low self-worth.

In this way, the disordered behaviours are self-soothing and become very addictive for the sufferer. There will often be a reluctance and fear to let go of the disordered behaviours as it has become the person’s private safety net and means of self-regulation. This is why extensive talk therapy as well as continual participation in normal social activities are important aspects of recovery. It is important for the person to develop coping mechanisms outside of the eating disorder.

Be attentive to someone with an eating disorder, but don’t forget to treat them normally.

Now that you understand a little more about the nature of the eating disorder, there are some supplementary things to keep in mind to help you be the best support possible to your loved one. Most of the following tips concern the initial difficult conversation(s), but you will also find them useful to your supporting role throughout the entire recovery journey:

• Read up on eating disorders and educate yourself before discussing the eating disorder with the person. Beyond this article, there are many resources that will help you distinguish truth from the many myths and stereotypes circulating about eating disorders. This will ensure you don’t accidentally say the wrong thing, minimise, trivialise, or mock the person. Remember they are likely feeling very vulnerable and defensive when talking about their eating disorder.
• The way the conversation is received is person-dependent. There is a very good chance they will be relieved to hear you express your concern and care. But be prepared to also be met with anger and defense. If the conversation swings this way, remain calm and nonjudgmental but firm. Repeat the concerns you have, and acknowledge you could be wrong, but another second opinion won’t hurt.
• It might sound over the top but practice what you want to say. At least rehearse saying the specific observations you have made over the weeks or months that have led you to your concern. Things become emotional and heated in these conversations as the person possesses a lot of shame. Be prepared by knowing and sticking to the facts.
• Be mindful of your timing. Don’t arrange to see them and lead with a discussion about the eating disorder. Ease into this conversation in a safe and familiar setting so they don’t feel intervened but instead supported.
• Have the next step prepared so your concerns are properly addressed. If you only come with your concerns and no next step, it is likely the conversation will be brushed under the rug and left in the past. This might be contacting an online service, local doctor, or a family member.
• Be attentive and check in regularly but try your best to treat them normally at the same time. Now that the difficult conversation has happened, the person will often be more open and willing to discuss it with you. This is important for their recovery as the more people they let in, the more likely it is they will be able to see their eating behaviours objectively.

Nobody should face eating issues alone

If you would like some more information about the difficult conversation; require provision in providing ongoing support; or if you yourself have eating, exercise or body-image concerns, please reach out  via our eating disorders web-page. Peaceful Mind Psychology has a reputation for its exceptional level of support for individuals struggling with eating-related issues. Our team of psychologists are well educated and experienced in providing specialised support using evidence-based therapy for eating disorder treatment. Our treatment approach, combined with our values of empathy, kindness, and honesty, ensures you receive the best possible treatment. We believe in setting goals that move you through the different phases of recovery, but we also understand that this happens at your pace. Support can also be found for those suffering from eating difficulties, as well as for their loved ones, via eating disorder coaching support such as is provided by Uncovery.

Family Based Therapy is the most effective treatment for adolescents

Often new clients call enquiring on behalf of someone under the age of 18. If this is you, you will be told by one of our receptionist team members that our practice policy requires they try Family Based Therapy (FBT) first. This is a policy we are quite strict with at Peaceful Mind for reasons that are in the best interest of the young person. FBT, also known as the ‘Maudsley Family Based Treatment’ is shown to be the most scientifically based and effective intervention for under 18’s struggling with almost all types of eating difficulties. This intervention recognises the role the whole family has in the young person’s recovery. While FBT involves collaboration across different mental health professions (GP, dietician, psychologist), the intervention asks the caregiver(s) to take a major and active role in structuring their child’s meal plan. FBT recognises the caregiver(s) to be the expert on your child’s life and the family environment they are recovering in. If your child is under the age of 18 and you have tried FBT and find you require further support, you may be eligible to see one of our psychologists, so please inquire today. If you have some concerns about your child or adolescents’ eating or exercising behaviours, Feed Your Instinct is an interactive tool to help you assess further.

 

For more information on EDs and support for carers visit Butterfly Foundation and Eating Disorders Victoria. Candid Conversations is a podcast by Eating Disorders Victoria discussing all things related to EDs by professionals with lived experience.