Supporting A Loved One with an Eating Disorder

Seeing your loved one suffer from an eating disorder is not easy, whether it be your child, your partner, your sibling or your friend. It is so HARD to see someone you care about go through this. It can be overwhelming to support someone with an eating disorder.

If you are concerned about someone you know who may be developing an eating disorder, please reach out for help and support. I know it’s not always easy to express your concerns about this to someone you care about, however, know that it may be equally as difficult for the person you are concerned about to ask for help. Starting the conversation and creating a safe space to discuss your concerns and treatment options is a great first step to supporting your loved one through recovery.

REMINDER:  Everyone’s experience with an eating disorder is different. What may be helpful for one person may not be helpful for the other, so take the time to ask them how you can support their recovery.

What does it mean to be supportive?

To be supportive means to provide sympathy and encouragement (Dictionary, 2022). In the early stages, you may find it difficult to understand exactly what your loved one is going through, and that’s okay. The best thing you can do to show your support is to recognize your knowledge gaps on the subject and educate yourself. If you’ve made it to this blog post, you are probably already taking that first step (which is amazing!).

As their support person, you can acknowledge, validate, and encourage them to push through the difficult hurdles of recovery. By being supportive, you make them feel safe and help them find their way back to trusting themselves and those around them.

An integrative review of the literature that was published in 2014, explored the effectiveness of social support networks in eating disorder recovery. While family support has been shown to improve the speed and sustainability of ED recovery, their review concluded that significant others such as partners, friends, neighbors, colleagues, etc., helped the individual cope with their disorder.

There are many ways you can provide support. I like to divide it into 4 pillars:

• 1- Educate, educate, educate! There are so many resources available for caregivers to learn and understand what an eating disorder is, and how to apply this to their loved one.
• 2- Encourage:  remember that what your loved one is going through is truly alarming to them. The thought of recovery is not exactly an easy pill to swallow, but as their support person, you can gently provide them with encouragement and information (because you did all this research with #1), to seek professional support.
• 3- Ask questions: The only person who understands what they are going through is your loved one. Ask them questions in a compassionate, non-judgmental way to understand what they are going through and how you can best support them. Additionally, don’t be afraid to ask questions to health care providers and mental health professionals on how you can maximize your role as the support person.
• 4- Don’t ignore/Avoid: I know, confronting the issue and expressing your concerns to someone you care about can be difficult and uncomfortable, however, you do not want to ignore the red flags and pretend like there is no issue. Remember, it can be just as difficult for your loved one to ask for help, and by reaching your hand out, you are preventing the worsening of the ED. An article published in the Journal of Psychiatry in 2011, suggested that response to family-based therapy and individual therapy is the most effective when the individual is receiving treatment within the first 3 years of onset (Treasure J, Russell G).

Familiarize yourself with the red flags of an eating disorder to access professional support and proceed with early interventions to prevent the severity of the disorder. You can read my blog post What are eating disorders? for more information on warning signs.

Girl at the table for a meal. Not eating and feeling overwhelmed. Hands from family members encouraging her to eat

2 Types of Support:

During the meal:

Eating disorders bring on lots of feelings of shame and worthlessness (Musby, 2014). To them, and more specifically the eating disorder, food is bad and dangerous while their body is gross and unlovable. They feel guilty, ashamed, anxious, and sad. They wish they could “just eat”, but they can’t. It feels impossible.

Family/Partners/Caregivers play a huge role in supporting their loved one during a meal. However, stay tuned for more information on meal support strategies that will be coming in a future blog post!

Outside the meal: 

Your role in recovery does not only apply during mealtime. The eating disorder persists even outside of mealtimes. Naturally, you don’t want to say the wrong thing or hurt the person you care about, especially as they are trying to recover! The way you support your loved one is always going to be very unique to their circumstances. and you can discuss ways to best support them with the treatment team.

Here is a universal list of “Dos and Donts” when it comes to supporting someone with an eating disorder, outside of mealtimes:

DO

• Externalizing the eating disorder
  • Viewing the eating disorder as its one, separate entity can empower your loved one to distance themselves from the illness. When eating disorder thoughts and behaviors are present, you can externalize the disorder by saying “What is the eating disorder saying to make you feel unable to eat your snack?” or “How does the eating disorder make you feel?” or “What would the eating disorder tell you if you were to eat this meal?”.
• Learn more about their ED
  • Eating disorders are complex, so it’s important to learn more about them to better support your loved one through this. See my previous blog post What are eating disorders? to learn more about eating disorders and identifying warning signs.
• Listen without judgment
  

  2 people sitting on a couch having a conversation

  • You may not understand exactly why your loved one is avoiding broccoli, however, many folks with eating disorders feel ashamed and the illness reinforces that feeling of worthlessness and guilt. Ask questions and listen to their answers through a non-judgmental lens to better understand their experience and how you can support them.
• Be mindful of triggers
  • As you understand your loved one’s eating disorder more and more, take note of what appears to be triggering an eating disorder thought and/or behavior. By understanding what triggers, the eating disorder, you can manage them better in the future and find alternative tools to support your loved one through a difficult time, as opposed to triggering them.
• Be mindful of your language
  • Try to avoid using terms such as weight, calories, portion sizes, exercises, and bodies, and be mindful of weight/diet-centric conversations with others and yourself. The point is to avoid a trigger and also to promote a more neutral environment when it comes to food.
• Be patient
  • Recovery is not linear and it’s important to be prepared for the denial and resistance that come with the journey to recovery. Research shows that it can take an average of 6 months to 2 years for someone to recover from their eating disorder (Muhlheim, 2020). Everyone’s journey is different and as a support person, you must be patient and not give up.
• Ask your loved one what is helpful and not helpful for them
  • It’s important to take the time to listen to what your loved one is communicating to you and help them identify what you can do to help them recover and separate from the eating disorder.

DONT

• Make comments about bodies or appearance
  • 

    Finger pointing towards person in larger body

    This means not making comments about THEIR body, YOUR body or anyone else’s body. Someone with an eating disorder already has low self-esteem and are hyperfocused on their physical appearance (for many different reasons). So, doing this will only reinforcing the belief that body size and appearance is important and relevant to someone’s overall well-being.

• Get angry or frustrated with the person’s eating habits
  • Remember that recovery is a very difficult process for someone with an eating disorder. Getting angry or frustrated at their eating habits or progress will only hinder their relationship with you and impede on their recovery.
• Use threats, guilt trip or scold someone into recovery
  • You want to be transparent, understanding and supportive. Using threats such as “If you don’t eat ____, you can’t see your friends” will make the person feel worse and ashamed of their eating disorder. The ED is very powerful. Talk to the dietitian and therapist to find supportive ways to encourage the person to follow their treatment plan.
• Accommodate the eating disorder behaviours
  • Like a child in the toy aisle, the eating disorder will test their limits to get what they want. Remember that when a situation is particularly challenging and the person is having a difficult time challenging their eating disorder, do not respond by giving in to what the eating disorder wants (aka, don’t give the child the toy because they threw a fit). Show compassion, patience and love towards this person who is undergoing a very painful battle.
• Give simple solutions
  • Saying things like “all you have to do is love yourself” is patronizing and minimizing the lived experience of the person with the eating disorder. Although it is well intentioned, simplified solutions overlook the severity and complexities of eating disorders.

Psychology or psychotherapy online session. Video call with woman psychologist.

Conclusion & Self Care

To conclude, eating disorders, like many mental health conditions, are not often openly discussed. So, it can feel isolating to care for someone with an eating disorder. But, don’t feel like you need to do it alone. Seek support from local therapists, or online support groups. It’s important to remember that you are not to blame. There are many reasons why someone may develop an eating disorder and the important thing is that your loved one is seeking support

Remember that you are so important to their recovery, so you need to take care of yourself too! Full recovery is possible, and you are equally as resilient to this illness! You got this! Trust yourself because you know how to care for someone you love. Connect with a treatment team to guide you through this process.

Resources

• NEDA: How to help a loved one; https://www.nationaleatingdisorders.org/learn/help/caregivers

• Beat Eating Disorders; https://www.beateatingdisorders.org.uk/get-information-and-support/support-someone-else/tips-for-supporting-somebody-with-an-eating-disorder/

• Help Guide: Helping someone with an eating disorder: https://www.helpguide.org/articles/eating-disorders/helping-someone-with-an-eating-disorder.htm
• Anorexia and Other eating disorders: How to help your child eat well and be well by Eva Musby: https://www.amazon.ca/Anorexia-other-Eating-Disorders-compassionate/dp/0993059805

Eating Disorder Recovery Program

Recovering from an eating disorder is not easy, however it IS possible. With the high demand for eating disorder services, and limited access to acute care, we have developed a virtual, outpatient eating disorder program to increase accessibility to recovery from the comfort of your own home.

This program includes:

• Individualized session with a dietitian or psychotherapist (weekly)
• Group sessions (weekly)
• Meal support (weekly)
• Parent, Caregiver, Partner support group (weekly)
• Care coordination

Want to learn more about? Find more information on our website: https://www.thebalancedpractice.com/edprogram

Need support?👇

The Balanced Practice is a team of health care providers specialized in eating disorder outpatient treatment, disordered eating and intuitive eating. Our mission is to help folks heal their relationship with food and their bodies so they can live happily outside of diet culture!

We strive to provide evidence based counselling to support you, or your loved one, in achieving full recovery. Schedule a connection call now.

Written By Joelle Ciccarelli, RD

Revised by Marie-Pier Pitre-D’Iorio, RD, B.Sc.Psychology
Founder of  The Balanced Practice

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References

Beat Eating Disorders. (2022). Supporting someone with an eating disorder. Retrieved from : https://www.beateatingdisorders.org.uk/get-information-and-support/support-someone-else/tips-for-supporting-somebody-with-an-eating-disorder/

Dictionary. (2022). Supportive. Retrieved from: https://www.dictionary.com/browse/supportive#:~:text=adjective,Medicine%2FMedical.

Help Guide. (2020). Helping someone with an eating disorder. Retrieved from: https://www.helpguide.org/articles/eating-disorders/helping-someone-with-an-eating-disorder.htm

Muhlheim, L. (2020). Why full anorexia recovery is crucial for brain health. Retrieved from: https://www.verywellmind.com/brain-starvation-and-recovery-in-anorexia-nervosa-1138303

Musby, E. (2014). Anorexia and Other eating disorders: How to help your child eat well and be well (first edition). Aprica.

National Eating Disorder Association. (2022). How to Help a Loved One. Retrieved from: https://www.nationaleatingdisorders.org/learn/help/caregivers

Reach Out. (2022). How to help a friend with an eating disorder. Retrieved from: https://au.reachout.com/articles/how-to-help-a-friend-with-an-eating-disorder

Treasure J, Russell G. The case for early intervention in anorexia nervosa: theoretical exploration of maintaining factors. Br J Psychiatry. 2011 Jul;199(1):5-7. doi: 10.1192/bjp.bp.110.087585. PMID: 21719874.