How to support someone who has an eating disorder

If someone close to you is dealing with an eating disorder, it’s possible they won’t tell you. That’s because eating disorders usually isolate the person who has them. This can make it even more difficult to recognize the condition. 

Knowing they have support from even just one person in their life who cares about them can make a huge difference. This support can be essential for your loved one to seek out help for an eating disorder. 

While the stakes are high, know that recovery is possible and you may have more influence than you think. In fact, some therapy approaches for treating eating disorders include the person’s inner circle.

Recognizing the signs of an eating disorder

People with eating disorders often go to great lengths to hide them. That’s why it’s so important to be equipped with knowledge to see the signs. Different eating disorders manifest differently, so it’s helpful to know what to look for with each. That said, some signs may overlap. 

Anorexia nervosa

People with anorexia nervosa restrict the amount they eat or don’t eat and may look underweight. Keep an eye out for these signs in your loved one’s behavior:  

• Fearing weight gain
• Thinking they’re overweight though they’re underweight
• Restricting the amount of food they eat
• Refusing to eat
• Losing extreme amounts of weight
• Experiencing dizziness or fainting
• Teeth wearing away
• Having stomach aches
• Binge eating and then purging food (anorexia can look like bulimia)
• Exercising excessively
• Increasing anxiety around food, meal time, and body image 

Bulimia nervosa

People with bulimia nervosa consume a lot of food and then get rid of the food, typically by vomiting or using laxatives. Signs of bulimia can include: 

• Eating large amounts of food at once
• Vomiting after eating 
• Having extreme mood swings
• Worrying about eating and/or their weight
•  Misuse of laxatives, diuretics, or other medications
• Exercising excessively
• Having damaged teeth and gums
• Fluctuating weight
• Swelling in the hands, feet, cheeks, or jaw
•  Reports that they cannot stop eating or control what or how much they are eating

Binge eating disorder

People with binge eating disorder eat uncontrollably and feel like they can’t stop eating. Watch out for signs like: 

• Eating large amounts of food at once
• Eating alone or in secret
• Isolating themselves
• Gaining weight
• Eating until feeling uncomfortably full
• Increasing depression symptoms 
•  Eating much more rapidly than normal
• Feeling that one cannot stop eating or control what or how much one is eating

Other specified feeding or eating disorders (OSFED)

People who might be diagnosed with OSFED don’t meet the criteria for eating disorders like anorexia, bulimia, or binge eating disorder but still have an eating disorder. Signs of these conditions can include: 

• Losing extreme amounts of weight 
• Dressing in clothing to hide their body and/or to feel warm
• Worrying about weight, calories, food
• Purging (vomiting, using laxatives, etc.) after meals
• Feeling uncomfortable eating around people
• Skipping meals or only eating small amounts
• Having extreme mood swings
• Feeling dizzy 
• Fluctuating weight 

Pica

Pica is a mental health condition that involves compulsively eating items that aren’t food. People with pica usually have nutritional deficiencies because of this behavior. 

Avoidant/restrictive food intake disorder (ARFID) 

ARFID is characterized by avoiding certain foods or only eating foods with specific textures. But, unlike other eating disorders, this behavior happens because the person is afraid they may choke or vomit. 

Four ways to prepare to talk to your loved one

Telling your loved one that you suspect they have an eating disorder can be stressful. You want the conversation to go well and to push them toward treatment if appropriate — not away. 

If you notice some of the warning signs above, that’s your signal to start a conversation. But don’t go in unprepared. 

Here are some of the best ways to prepare for this kind of conversation: 

1. First, educate yourself about the eating disorder you think your family member or friend has. They might not realize the long-term damage they can cause to their brain and body with their eating behavior. You can point this out in a loving and gentle way.
2. Don’t go in cold. Rehearse what you want to say and even write down your main points. This way, if you falter at times during the conversation because of anxiety or other emotions, you can keep going. 
3. The setting is just as important as what you say . Pick a private place and choose a time when you and your loved one are most likely to feel at ease. The less chance for someone to overhear, the better. 
4. Prepare for possible pushback. While your friend may be relieved that someone finally noticed their behavior, you might also run into anger or denial. Let them know why you’re concerned, that you care, and that you’re there if they want to talk.

Tips to help the conversation go well 

How you deliver your message to your loved one can encourage them to see you as a trusted person. Here’s what to keep in mind going into the conversation:

1. Speak from your own perspective. Use “I” statements like, “I’ve noticed some changes around meals and eating ,” and, “I’m wondering if you’re open to sharing more about this ” By sticking to your experience and opening the lines of communication, you’re less likely to put your loved one on the defensive.
2. Point out the facts. Heightened emotions might come up on both your end and theirs and could derail the conversation. You could say something like, “  “You’ve mentioned using laxatives a few times and made some comments about not being happy with your weight. I know this can be difficult to discuss but I wanted to take the time to check in a little more.” 
3. Make promises sparingly or not at all. It can be hard to be the only one who knows about your loved one’s eating disorder. You can say that you’re there to talk, be a source of support, and inquire if they are open to getting more professional support. 

Just as important, you’ll want to know what not to say. Be careful to avoid comments about their appearance or any weight loss. If your friend is open to looking into treatment, don’t dictate which program they should choose. Instead, ask them what they think might work for them. You can even offer to help them research options.

Don’t forget about taking care of yourself, too. Supporting a friend with an eating disorder can take an emotional toll. If there are other people you can confide in, lean on them. And if you can bring others into the loop who can also support your loved one, that’ll take some of the strain off of you.

Offering support through recovery

Your loved one may want to recover but might be overwhelmed with where to start. This is where a recovery program can come in. Sadly, eating disorders are the second-most deadly mental illness, with most deaths from anorexia. But, with treatment, your loved one has a fighting chance at leaving their disordered eating in the past.

Recovery is almost never a straight trajectory. It can be difficult for your loved one to confront their eating disorder and take steps to heal. If your friend is in an in-patient program, you might not be allowed to visit them. Anything that helps them feel loved (like a care package without food, for example) can go a long way.  

Relapses happen, too. In fact, around 30% of people with eating disorders relapse. Let your friend know you’re there for them if their symptoms resurface. If this happens, let them know you’re not judging them and that you just want them to be healthy and happy. 

Find care with Rula

Eating disorders are mental health conditions that are challenging to combat. But supporting someone with an eating disorder can encourage them to get the help they need to recover. Remember to listen with compassion and non-judgment, and remind them that healing is possible.  

With Rula’s easy-to-use therapist matching tool, you can find a therapist who takes your insurance, is currently accepting new patients, and can meet with you as soon as tomorrow.

Find care with Rula