Do you know someone with an eating disorder or perhaps suspect that someone you know may be struggling?
Do you want to help someone with an eating disorder but just don’t know what to do or say? Maybe they suddenly eliminate foods and go vegetarian, vegan or keto (whatever the diet of the day may be); or you find them standing over a kitchen counter, polishing off that cake you’d been saving.
Eating disorders are complex mental illnesses that exist on a large spectrum. Not all eating disorders get formally diagnosed, nor do they all match up perfectly to definitions. Most eating disorders don’t look like the versions of ED’s that you see on TV (the starkly thin, young white female).
People with eating disorders can’t just “eat normally.” They cannot escape food, because it is necessary for survival, yet it is both their obsession and worst enemy. They are likely acutely preoccupied with their body size, hyper-aware of how their body looks in clothes, their weight, or if people are watching them eat. It’s not your job to fix them, but you can be a support in their recovery.
What Should you NOT say to someone struggling with an Eating Disorder?
- You aren’t fat! You look so healthy!
To the ears of someone with an ED (eating disorder), this does not translate to the well-meaning comment it was likely intended. Healthy to someone with an eating disorder or a distorted body image does not have a positive connotation. The best thing you can do is to not comment on body size at all. Saying “you aren’t fat” also perpetuates the belief that being fat (using the term fat as a descriptor) is inherently bad and to be avoided. You can’t tell anything about a person’s health just by looking at them, regardless of if they’re in a larger or a smaller body.
- You are so skinny! What is your secret? I wish I had your willpower!
Okay, this is actually something you shouldn’t say to anyone, period. This can be especially problematic to someone with an active eating disorder or those vulnerable to disordered eating, as it can be the validation their ED is seeking. To them, it says that their efforts are not only working, but that their underlying belief that being in a smaller body makes them more worthy, acceptable, and interesting is true.
- Why is there so much food disappearing from the kitchen?
You may notice that food has been disappearing at an alarming rate. Calling attention to this, and targeting the person likely behind it, is only likely to fill that person with more shame, on top of the internal shame they are already experiencing. Avoid confronting the person about it, as they likely already feel extremely embarrassed and are beating themselves up enough.
- Maybe you should cut out flour, sugar, carbs, or why don’t you go on a diet?
The root of binging is restriction, so this is the body’s survival mechanism – a biological response to the threat of scarcity and starvation. Suggesting they eliminate the foods they usually binge on will only make them feel guiltier and out of control around food. Not only this, but the person with an ED has likely tried many diets! Dieting is the biggest predictor of an ED, so suggesting more rules and rigidity around food is only going to feed into the disorder.
You can’t diet your way to a better body image or relationship with food.
- Why can’t you just eat?
If only it were that simple! More often than not, an ED has very little to do with food itself. They are a mental illness that often have co-morbidities such as body dissatisfaction, low self-esteem, perfectionistic traits, personality disorders, history of trauma, body dysmorphia, and more. It would be like telling someone with depression just to smile.
- Just stop binging!
Binging is not caused by a lack of willpower or self-control. In fact, it is often caused by trying to tightly control eating, leading to feeling restricted and deprived. If you’ve caught them in the middle of it, they are likely deeply ashamed and embarrassed. If you’ve caught them purging, their deepest secret has been revealed and they are probably overcome with shame. No one chooses to have an eating disorder. It serves some kind of purpose – a crutch, self-soothing technique, a coping strategy. They must develop the tools to cope in other ways, along with normalizing eating, before expecting those behaviors to disappear.
- Isn’t that too much food? Do you know how many calories are in that?
First of all, commenting on anyone’s food choices is never a good idea. It’s likely to cause unnecessary food preoccupation and feeling self-conscious about food choices. A person with an ED is likely already hyper-aware of their food choices and feel that others are watching them eat. Commending on their food choices only affirms their fear that their eating is being observed and is on trial.
What to say instead:
Are you okay? I can tell things are tough for you right now. Is there anything I can do to support you?
Do you want to talk? I’m here for you if you want to talk.
No one is perfect. Go easy on yourself.
Would you like to see someone who can help you through this?
I love you no matter what.
Overall, avoid being the food police, commenting on food choices, and swerve any and all conversation about body size, weight, shape, etc. Your support and understanding is needed to help them through this.
iLiveWell Nutrition wants to help you to a place of trusting your body. Check out our 1:1 Counseling and Support Groups, where you will have the support you may need to rediscover your body trust. Thank you again for trusting us with your nutrition care.
Adrien Paczosa is a Registered and Licensed Dietitian practicing in Austin, Texas and the surrounding counties.
She is the owner and founder of I Live Well Nutrition her Dietitian practice which started in 2007 and serves clients in the Austin, Texas area in two locations. Fearless Practitioners, the division of her business that offers training to dietitians and wellness professionals.