How to support someone you love who has an eating disorder

Eating Disorder Awareness Week takes place in the last week of February every year, and this year’s theme is ‘Anyone can be affected’.

Eating disorders represent some of the most complex and challenging mental health issues of our time. Their complexity arises from biological, psychological, and societal factors.

Eating disorders frequently occur alongside other mental health issues such as anxiety, depression, and obsessive-compulsive disorder. This overlap can make both diagnosis and treatment more complicated.

Societal pressures, cultural ideals regarding body image, and exposure to unrealistic standards in the media can play significant roles in the development and persistence of these disorders.

Over 1.25 million people in the UK are thought to have an eating disorder. They affect individuals across all demographics and do not discriminate based on age, gender, race, religion, sexuality, or background. Yet, despite their prevalence, eating disorders are often shrouded in stigma and misunderstanding.

This article aims to dispel common misconceptions about eating disorders and provide guidance on how to support a loved one who may be struggling. It will begin by explaining eating disorders, addressing common misconceptions, exploring practical ways to help someone affected, outlining what not to say, and concluding with information on treatment options and self-care strategies for supporters.

What is an eating disorder?

A major misconception is that eating disorders are solely about food and weight. The reality is that eating disorders are complex mental health conditions, comprising psychological, genetic, and environmental factors. Individuals may experience intense preoccupations with their body shape and weight, which may lead to the engagement in harmful behaviours in the pursuit of control over their bodies.

Additionally, individuals may experience a distorted body image, leading to overwhelming feelings of negativity, especially when they perceive themselves as "fat." Eating disorders often involve significant emotional struggles. For example, a person's relationship with food may give them a sense of control or an illusion that they are coping, even if they are unconscious of the underlying reasons for this behaviour.

Notably, an eating disorder is never the fault of the individual. Anyone struggling with an eating disorder deserves prompt and compassionate support to help them on their path to recovery.

How eating disorders can manifest can vary significantly from one person to another. 

So you know, receiving a diagnosis can feel validating for some but dehumanising for others. For some individuals, a diagnosis may offer comfort, clarity and a pathway for treatment. However, it can feel dehumanising because it can seem to reduce their complex personal experiences to a single label. This may lead to feeling misunderstood or overlooked, especially if the diagnosis is perceived as overshadowing their individuality. Ultimately, as diagnostic labels are based on symptoms, they do not fully capture an individual's unique lived experience.

Common misconceptions

Misconception 1: "People with eating disorders look ill."

The truth: Many people with eating disorders may maintain a weight that appears “healthy” or may be classified as “overweight.” Eating disorders can therefore be challenging to identify because it’s not always possible to tell if someone has one just by looking at them. Crucially, recovery involves addressing thoughts and behaviours, not just weight restoration (the latter may not be required).

Misconception 2: "Eating disorders are a choice."

The truth: Eating disorders arise from complex biological, psychological, and sociocultural influences. They are not a choice and require specialised treatment with compassion and understanding.

Misconception 3: "Eating disorders only affect young girls."

The truth: Eating disorders can affect anyone, regardless of age, gender, ethnicity, or socioeconomic status.

How to support someone with an eating disorder

Supporting a loved one with an eating disorder is critical because the involvement of family and friends significantly improves recovery outcomes. Research suggests that individuals with robust support networks are more likely to engage in treatment and sustain recovery. The following section outlines why your role matters and offers practical guidance on providing adequate support.

1. Encourage professional help: Early treatment improves recovery chances.

2. Be present: Listening without judgment can make a significant difference. Sometimes, practical things like accompanying them to the supermarket or providing support after mealtimes can be helpful. Everyone will have unique needs, so it’s valuable to be attentive to what your loved one may require.

3. Educate yourself: Understanding eating disorders equips you to offer better support.

4. Promote open communication: Ask how they feel and what they need without making assumptions.

5. Model supportive behaviours: Avoid discussions about weight, food, or diets. Demonstrate a balanced approach to food and exercise.

6. Recognise enabling behaviours: Actions like cooking separate meals or covering up behaviours (e.g. cleaning up vomit) may inadvertently enable the disorder by covering up their negative consequences, even if they are coming from a place of care.

What not to say

• "You don't look like you have an eating disorder." (Invalidates their experience. Eating disorders are mental health conditions and aren’t always visible. Comments like this may discourage a person from seeking help).
• "Just eat more/less." (Oversimplifies the issue and ignores the complex psychological factors involved in eating disorders. Recovery involves so much more than altering eating habits).
• "I wish I had your discipline." (Reinforces harmful behaviours and misunderstands the nature of eating disorders - which are not about discipline but instead deep emotional struggles).
• "You're just doing this for attention." (Trivialises their suffering. Eating disorders are severe conditions that require understanding and treatment).
• "Why can't you just stop?" (Adds guilt and shame).
• "You look healthy now." (May be misinterpreted as pressure to maintain a specific appearance or as a suggestion that their struggles are over, which may not be the case).
• "Everyone has food issues sometimes." (Minimises their experience).

Instead, be a supportive listener and encourage open dialogue. Compassionate, empathic and supportive communication plays a crucial role in recovery and helps build trust, reduce feelings of shame and cultivate a sense of safety. 

Treatment for eating disorders

If you or someone you love is struggling with an eating disorder, it is crucial to know that help is available and recovery is possible.

Treatment for eating disorders should involve a comprehensive multidisciplinary approach that is tailored to the individual's needs. Interdisciplinary teams should include qualified therapists, dietitians/nutritionists, and medical doctors/psychiatrists/GPs. Remember, you are not alone; resources and support systems are available. 

Self-care for supporters

Supporting someone with an eating disorder is both emotionally and physically demanding. Prioritising your well-being can positively influence your loved one's recovery process. For example, loved ones who engage in weekly therapy and self-care activities find they are better able to provide consistent, non-judgmental support.

Here’s how you can take care of yourself:

• Acknowledge your feelings. Feeling frustrated or helpless is okay; you are expected to experience various emotions. Allow yourself to feel all these emotions without judgement, and consider seeking support.
• Set boundaries by protecting your well-being by communicating limits when you need time for yourself.
• Practice stress management by engaging in activities such as yoga, mindfulness, meditation, or being outdoors in nature.
• Seek professional support: consider engaging with therapy to gain coping strategies and a space to process your emotions.
• Connect with others in similar situations to create a support network. This can provide comfort and reduce feelings of isolation.
• Focus on healthy habits and maintain your own physical and mental health.
• Celebrate small victories: recognise and celebrate progress for your loved one and yourself.

Taking care of yourself is essential, as prioritising your well-being will enable you to offer meaningful and sustained support. Whether you have an eating disorder or support a loved one who does, recovery is possible for you both; you can recover with compassion, understanding, and appropriate treatment from qualified professionals.