Approaching the issue may be particularly delicate, as someone may be dealing not just with physical complications but deep emotional pain. And their unhelpful behaviors are often developed as a coping mechanism to deal with difficult emotions, making it even harder for them to stop, and seek support.
Still, there are some ways you can help guide someone toward the type of care that can not only help them but potentially save their life. And your continuing support can be a crucial part of your loved one’s long-term recovery.
How to Spot Signs of an Eating Disorder
It’s important to understand that eating disorders are not always obvious and that different disorders can manifest in different ways.
However, when gauging whether someone may be struggling with a deeper problem, there are some general warning signs you can look out for, including: [1]
- A heavy focus on dieting, weight loss, and limiting food intake
- Obsession with body weight, shape, or size
- Hyper-focus on a food’s nutritional values, including levels of carbs, fat, and protein
- Excessive exercise, even when sick, injured, or exhausted
- Outright rejection or restriction of whole categories of foods, such as carbs
- Significant discomfort when eating around others
- Skipping meals or only taking notably small portions when eating
- Unusual food rituals or habits, such as not allowing foods to touch, eating food in a certain order, or only eating at a particular time
- Withdrawal from friends and activities that were once enjoyed
- Frequent dieting
- Frequently checking oneself in the mirror and judging perceived physical flaws
- Severe mood swings
Physical Signs of an Eating Disorder
Eating disorders are primarily mental health conditions, but the behaviors they encourage can also cause a variety of physical symptoms, including:
- Significant weight fluctuations
- Significant weight loss
- Significant weight gain
- Stomach cramps
- Constipation
- Acid reflux
- Menstrual irregularities
- Difficulties concentrating
- Abnormal lab results from medical tests
- Dizziness, especially when standing
- Fainting spells
- Feeling cold
- Sleep issues
- Calluses and scrapes across the top of finger joints as a result of self-induced vomiting
- Dry skin and hair
- Brittle nails
- Fine hair developing on the body
- Muscle weakness
- Discoloration of the teeth and more frequent cavities
- Yellow skin
- Cold, mottled hands and feet
- Swelling of the feet
- Poor wound healing
Again, these symptoms represent any number of eating disorders. Understanding the particular ways your friend or family member may be affected is one of the most important things about finding them the proper type of care.
How to Have a Conversation With Someone Who Has an Eating Disorder
If you’re concerned someone you care about has an eating disorder, or know for a fact that they do, talking to them about it can be a good way to help them start the process of seeking help.
Still, it’s important to approach this conversation with great care and empathy. Eating disorders often have very complex and traumatic origins, and talking about their condition is frequently very difficult or even triggering for people.
At the same time, you are likely not an expert on this subject, which can make approaching someone an intimidating prospect. Still, there is some advice that may help you have this important conversation in a helpful way. [2]
The time you decide to have this conversation can make a difference. If you can, find a time in your loved one’s schedule when they won’t be feeling overwhelmed or distracted by anything else. (A day where they’re working on a big project or studying for a test, for example, is likely, not ideal.)
Likewise, the location you choose is also important. Find a private place to have the conversation, ideally one where the other person feels comfortable. This will help them relax and open up more easily.
When speaking with your loved one, it’s important to use “I” statements – those that place you as the subject, and emphasize what you’ve been observing. For example, something like: “I have noticed you eating less and exercising more, and I’m concerned.”
This will help prevent your statements from feeling accusatory or judgmental. And in general, it’s a good idea to frame the conversation around the ideas of showing concern and offering support.
It may sound silly, but practicing what you want to say beforehand can have a number of benefits in such a sensitive situation.
It can help ensure you say everything you want to say, in the manner you want to say it, and don’t get potentially derailed by other feelings that may come up during such an emotional conversation.
Planning what you want to say ahead of time will also give you time to research the situation, including learning about the particular type of eating disorder your loved one is dealing with, and reading about what it’s like to live with this condition. This can help build empathy, and give you a greater sense of understanding going into the conversation.
Eating disorders are extremely complex, and you are likely not an expert on the subject. For these reasons and more, you should try to avoid providing “easy” solutions, like telling someone they should “just eat more.” This can likely even feel insulting to someone, and cause them to shut down.
Rather, if your purpose is to help someone agree to seek professional help, you should come prepared to discuss options. Do your research beforehand to look at the kinds of therapy or treatment programs that may help. You may even want to go so far as looking up specific programs in your area, and investigate whether the person’s insurance will cover their treatment.
Regardless, remember that you are having a conversation. You can bring up these specific options to show someone that help is available. Threatening them with an ultimatum if they do not enter treatment, however, may make the situation worse.
Unfortunately, people may not want to admit there’s a problem or change their minds about seeking treatment, even if you empathetically and compassionately make your case.
It’s not uncommon for these types of talks to leave people feeling defensive. They may lash out or shut down completely.
Be prepared for negative reactions, and don’t try to rush the conversation. Instead, try to leave things in a way that the person understands you’re open for future talks, and are there for them as an ongoing source of support.
This can help encourage someone to seek you out for help in the future, even if they’re not ready for it at the time of your conversation.
How to Get Someone Help
Helping someone with an eating disorder can be difficult and frustrating. You can speak with compassion, offer solutions, and make it clear there isn’t shame in admitting you are struggling. But ultimately, it is up to them whether they are ready to pursue treatment.
Although it is sometimes possible, particularly in life-threatening situations, to legally force someone into treatment, this type of help tends to complicate the situation, and, subsequently, the path to recovery.
Instead, try to have empathetic conversations with the person, ensuring they have time to express themselves. Make sure to also listen to what they’re saying, rather than simply waiting your turn to speak. This type of genuine friendship and support is generally a better way to secure someone’s trust, and give yourself a better chance at helping them.
And one of the most important factors in helping is patience. Remember that recovery takes time. It’s a long process that must be continuously maintained. Guiding a loved one to help is only one step. Once they’re actively in treatment, they will continue to need your support, love, and caring.
Supporting Your Loved One During Treatment
When treating a diagnosis as complex as an eating disorder, there are certain levels of care that someone typically goes through, depending on the severity of their condition.
The level of care and type of program they’re involved in may have different rules concerning how friends and family members can or can not reach out to them.
For people who are in serious crisis, such as those who require hospitalization for life-threatening complications, your options may be particularly limited in the early stages of treatment.
Some inpatient programs also don’t allow visitors at first. This helps give the patient time to process the situation and adjust to the program’s routines, which are designed to help them work on themselves and their own recovery. If you have a loved one in an inpatient program, your best bet is to research the rules or speak with a program representative to figure out when is the best time to visit.
As treatment progresses, patients are typically given more freedom, and at this point, someone may be able to speak or meet with you more easily. Still, it remains important at these points to put thought into your interactions.
Don’t push someone for details if they don’t seem comfortable or ready to discuss them. Don’t try to offer someone food, as this may be triggering, or against their nutritionist’s advice. And try to stay open and compassionate, reminding them that you’re there for them, if they need support.
Remember that your loved one is receiving guidance from treatment professionals, who have their best intentions at heart.
It’s also important to keep in mind that for many in recovery from an eating disorder, progress is slow – and not always linear.
Your loved one may experience moments of backsliding, where they re-engage in disordered behaviors they had previously stopped or greatly reduced. If left unchecked, this can even lead to a full-on relapse.
While this may feel discouraging, it is part of many recovery journeys. Yet that doesn’t mean they should go unacknowledged.
If your loved one expresses concern to you about their state of recovery, or starts expressing the idea that they’ve “failed treatment” in some way, you can talk to them to remind them that it will be okay.
Encourage them to continue eating disorder treatment, regardless of any hiccups. Remind them that you’re still here to help. And let them know that just because they’ve experienced backsliding doesn’t mean they’re a failure.
You may also want to talk about what happened with one of their counselors, who can help them work to avoid similar situations in the future.
Support After Treatment
Even once a person has regained control over their eating and achieved a healthy weight, they may still need or benefit from your support.
When the person has reached this stage of their recovery, you will still want to keep in mind their old struggles when talking and interacting with them. Avoid commenting on their weight or appearance, even if simply mentioning they look “different” now. Low self-esteem is a problem for many people with eating disorders, and it can continue long after they leave treatment.
Also, avoid making their condition or their recovery the sole focus of your relationship. Allow them to be a complete, multifaceted individual, and respect them as such.
Remember all the ways you have fun together, and engage in those activities together. This can remind them that they are so much more than their body image or eating habits. And laughter can make a huge difference in anyone’s mood and future outlook.
Be Supportive and Keep an Open Mind
With that said, if they want to talk about their old problems or any new ones, let them. Continuing to offer open ears and an open mind can be a great source of support for them.
If you notice your loved one struggling or appearing to embrace disordered eating habits again, encourage them to talk to an expert before it becomes a major issue. Let them know that this doesn’t represent some kind of failure. Even completely healthy people benefit from regular mental health check-ins as a form of maintenance and self-care.
Overall, just try your best to be a good friend. This can be the most vital role you play in your loved one’s recovery.
Resources
- Warning Signs and Symptoms. National Eating Disorders Association. Retrieved December 4.
- How to Talk to a Loved One About Their Eating Disorder. National Eating Disorders Association. Retrieved December 4, 2022.