My loved one has an eating disorder (ED). I often feel like when I try to be supportive, I end up making them more upset. I really want to be supportive but I don’t want to overstep. What do I say to them?
Firstly, you are not alone. Unfortunately, eating disorders are widely misunderstood and misconstrued which is why it often feels like we say the “wrong” thing despite our best intentions. To understand how to speak to your loved one with an ED it’s important to have some basic context and information on these illnesses.
Let’s first talk about what an ED is not. One of the biggest misconception we might hear is the assumption that an ED is simply a fear or dislike of food or intense fear of weight gain. You may think this is irrational, which makes it hard to understand how to support the person; however it is important you understand this barely scratches the surface. This may or may not be a PART of someone’s ED, but EDs are like an onion with many layers.
It is important to note that you are NOT responsible for causing your loved one’s ED. Taking this perspective can be helpful in not feeling defensive when speaking with them, allowing you to be able to be a better listener and hold space for your loved one’s feelings and struggles. The cause of EDs are not entirely understood but are likely a combination of genetic, biological, environmental and/or social factors.
You also don’t have to entirely understand your loved one’s experience to be supportive. In fact, you likely won’t be able to fully understand, and being able to accept and admit this can be the best way to hold space and support your loved one. Many folks with EDs report they actually feel most supported and seen when their loved ones outright admit they don’t understand! This keeps the focus on the person you are trying to support and allows you to instead ask how you can take action to support them. Most of the time they are willing to share and wanting to express this!
It’s not about the food, but talk about food and weight can be triggering
Just as important as it is to remember that you didn’t cause your loved one’s ED, you need to understand that at their root, EDs have nothing to do with food, calories or weight on their own. You can think of food, calories and weight as projections of a person’s internal struggles that likely go beyond their capacity to cope.
Focusing on these external factors provide the person a sense of control or distraction from what’s really going on underneath. Each person has a different ED narrative and each fear, behavior and struggle have a different meaning. No two EDs are the same.
What NOT to say to someone with an eating disorder
Now that you have a better understanding of the cause of EDs and some possible insight into your loved one’s mind, let’s talk about what NOT to say to someone with an ED and better statements to show support.
“You look so much healthier!”
This is well meaning, however if the person with an ED gained weight they likely feel a lot of shame and distress about it. You saying they look “healthy” in their mind means that you notice their weight gain, something that is already hard to accept.
“I just want you to be ‘healthy'”
Again, this is well meaning, however many people say this with the implication that the person needs to change their body or weight in some way. It is important to remember that weight gain or loss is a symptom of ED behaviors—whether that be binging, restricting, purging, over exercising. It can also be a result of recovery behaviors as the body re-adjusts to a stable eating pattern again.
In the ED’s minds, the word “healthy” is likely tied to perceptions about weight and appearance. It is best to refrain from using the word healthy to express concern.
“But I see you eat?”
This can make someone feel not “sick enough.” Many people with EDs are eating in some capacity, it is their relationship to food and the behaviors and rules around it that impact their life that you don’t see that create the disorder. It has nothing to do with the amount of food they are or are not eating.
“But you’re not underweight? Or you don’t look like you have an ED.”
This is the one of the biggest perpetuations of ED stigma. In fact, the majority of people who have an ED are NOT underweight. Many folks with EDs report hearing this and feeling like they aren’t “sick enough” to deserve help, which only perpetuates the illness and secrecy.
“Have you tried X,Y,Z? Just stop XYZ or start eating X,Y,V”
Your goal is to hold space for their experience and to encourage them to seek support and care, not provide suggestions! Again, your suggestions may make sense in your head, but EDs are serious, complex illnesses that require professional care. The solution is not as simple as it may seem on the surface, and providing suggestions can cause the person’s suffering to feel minimized or misunderstood.
Bottom Line
Anything that has to do with appearance changes, amount of food eaten, type of food eaten, weight is off limits. Regardless if it is meant in a positive or negative or concerned way. Again, each person with an ED has their own relationship and beliefs about these topics. What you mean by saying these things is likely not what they are going to hear, so it is best to refrain all together.
Recap: Important things to remember
- Don’t assume you know what the person is thinking or feeling.
- Accept you likely will not understand and don’t need to understand to be supportive. People struggling with EDs often carry a lot of shame about their illness and others trying to provide “logical” solutions only adds to feelings of shame and suffering. This is not an issue that can be solved with logic or one that someone can “think” their way out of. Remember, it’s an emotional issue, emotions need to be heard, felt and processed.
- Validate how difficult this is for the person, manage your own expectations. Recovery takes time.
- It is not about you! This is their recovery and a choice they have to make. Adding pressure or unrelated consequences can be harmful and destroy trust. You job is NOT to offer solutions or advice.
- EDs thrive on secrecy, creating an open, non-judgmental space for the person to come to is key.
- Refrain from compliments that are based in appearance. Folks with EDs tend to be hyperaware of their bodies and body changes, recovery can be especially difficult with body changes.
