If you’re worried about someone then it’s important to encourage them to seek treatment as quickly as possible to ensure the best chance of recovery. But treatment is only one aspect of the recovery journey, and there are ways outside of your loved one’s treatment programme that you can play a vital role in helping them get better, regardless of your relationship to them. This can range from being a listening ear, to going to the supermarket with them and supporting them after mealtimes. Each person is different and will need different things, but this will give you some ideas about what you can do to help. And remember, one of the most important things you can do for your loved one is look after yourself.
Mealtimes can be really difficult for both those suffering with an eating disorder and those supporting them. But there are things that you can do to help things go more smoothly and feel more comfortable for your loved one.
Eating disorders can make people behave in ways that seem out of character. While early treatment is always the best option and will give the sufferer the best chance of getting completely better, this can be upsetting and frightening, and they may try to resist it. Emotional or aggressive outbursts and hurtful comments or responses to your attempts to help aren’t uncommon, especially when the person feels challenged – remember this is not them but the eating disorder speaking. There are some things that you can keep in mind to make these times more manageable and avoid escalating the situation.
The eating disorder can cause your loved one to misinterpret what is being said to them, which can leave you unsure of what to say and concerned about upsetting them. Below are some examples of things that you may innocently say, and what the eating disorder may cause your loved one to hear instead. It could be helpful to share these with other people likely to talk to your loved one, to help them to understand more about the eating disorder and avoid upsetting conversations.
Just eat normally.
What may be heard: You’re not trying hard enough, it’s not difficult to eat, it’s your fault, you need to get over this.
Positive alternative: To outsiders it may seem like people with eating disorders just need to eat, or just need to stop purging or binge eating. This is not the case – eating disorders are not a choice but are severe mental illnesses that the person needs supporting through. It is therefore important to acknowledge to the person that you know it’s difficult for them, and you are there to support them.
You look well.
What may be heard: You look fat, you have gained weight, you’re greedy, you’re healthy now so things are easy for you.
Positive alternative: Any comments to do with your loved one looking “healthier” or “better” are often taken to mean they have put on weight. Instead of commenting on their physical appearance, try to ask the person how they are, or compliment something about your loved one that is unrelated to their body such as an item of clothing or an accessory.
I wish I had your control.
What may be heard: You are lucky to have an eating disorder, you are in control of the illness, it’s a good thing to be obsessive with food, weight and shape.
Positive alternative: Often eating disorders are used as a coping mechanism and a way to feel in control. However, when someone is suffering from an eating disorder the illness controls them and fighting against the thoughts and behaviours is extremely difficult. Avoid commenting on the eating disorder as if it is the person’s choice.
You just need to stop eating so much.
What may be heard: You are fat, you are greedy, binge eating isn’t a problem, you are making this up, it is easy to stop binge eating.
Positive alternative: Acknowledge how difficult things are for your loved one, and how distressing the eating disorder must be. Let them know that you are there to support them.
Get well soon.
What is heard: It’s easy to get over this, you aren’t trying hard enough, you are being a burden, hurry up and get better.
Positive alternative: Reassure your loved one that although you recognise how difficult things are for them, you are there for them and will continue to be throughout. Let them know how proud you are of them for challenging the illness.
I wish I had your body.
What is heard: You are lucky to have an eating disorder, you are just doing this to look a certain way, you need to keep doing the disordered behaviours.
Positive alternative: Try to avoid discussing your own weight and shape in front of your loved one as it can be unhelpful for them to hear. Instead focus on topics away from body image, food or exercise.
I can easily finish a packet of biscuits so know exactly how you feel.
What is heard: Everyone eats that way, you don’t have a problem, it is normal to binge eat, you don’t deserve support.
Positive alternative: While many people will overeat on occasion, and this may be triggered by difficult emotions, this is not the same as having binge eating disorder. Binge eating disorder is extremely distressing for the person and involves the person feeling a loss of control while eating a much larger amount of food than most people would eat in similar circumstances. It is good to be understanding, but important to avoid trivialising what the person is going through.
Externalising the eating disorder - viewing it as separate to your loved one - can empower you to help distance them from the illness and challenge the eating disorder behaviours. This challenge to the eating disorder may lead to your loved one acting out of character, but this is often the illness reacting as it feels threatened. By externalising the illness, you can also help your loved one to recognise their thoughts and behaviours as resulting from the eating disorder. To do this, it can be useful to address the eating disorder as distinct from your loved one.
Externalising the eating disorder can also help your loved one to feel less like they are being criticised or are to blame: you both recognise that it is the eating disorder.
Externalising the eating disorder will not be helpful for everyone. Some people may feel that the eating disorder is part of them, rather than separate, and may struggle with questions such as those above or find them patronising. It could also feel dismissive of what is going on for the person. If this is the case, it could be helpful to explore this with your loved one and their treatment team, to find a dialogue that works for everyone.
Carers often report that supporting their loved one affects their own physical and mental health. It's important to remember that you're not alone and it's important to look after yourself too.