What to avoid saying to someone with an eating disorder and the best ways to offer help and support

Erin Heger,Mayra MendezJan 28, 2021, 23:49 IST

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If someone you love has an eating disorder, it's important you listen to them without judgement.laflor/Getty Images

When talking to someone with an eating disorder you should never comment on your weight or their appearance.
If talking to someone with an eating disorder, you should refrain from making comments about what they're eating.
Instead, to help someone with an eating disorder, you should listen to them and compliment them on things other than their appearance.

Watching a loved one struggle with an eating disorder can be difficult and you may not know how to respond. But your support can be a critical part of their healing.

Here are some ideas for what to say, what not to say, and how you can support a loved one struggling with an eating disorder.

Understanding eating disorders

An eating disorder is a psychological disorder characterized by severe disturbances in a person's eating behaviors and related thoughts or emotions. Eating disorders affect about 9% of the population worldwide and an estimated 28.8 million Americans will experience an eating disorder at some point in their lives.

There are several different types of eating disorders, including:

Anorexia nervosa, which is characterized by restricting calories and/or types of food.
Bulimia nervosa, which is characterized by binge eating and purging.
Binge eating disorder, which is characterized by recurrent episodes of eating large quantities of food.

An eating disorder is often coupled with poor body image and distorted perceptions and thoughts about their body, says Holly Peek, MD, the Assistant Medical Director of the Klarman Eating Disorders Center at McLean Hospital in Belmont, Massachusetts.

According to Peek, an eating disorder is a complex mental disorder that often occurs in the context of a variety of factors, such as:

Other mental health disorders, like depression or anxiety
Trauma
Bullying
Complicated family dynamics
Thin ideals perpetuated by the media

Eating disorders are not primarily about food, but rather underlying emotional distress, says Hilary Weinstein, a psychotherapist with her own private practice in New York City.

"People who develop eating disorders become preoccupied with thoughts about food and body image as a defense mechanism that distracts them from focusing on more painful thoughts or experiences," Weinstein says.

Knowing what to say or what not to say to a loved one with an eating disorder matters because saying the wrong thing, even if well-intentioned, can trigger behaviors and coping mechanisms like restricting, binging, or purging.

Don't comment on weight - yours or theirs

Commenting on the weight of someone with an eating disorder, no matter how well-intentioned, will just reinforce the thoughts and behaviors of the eating disorder, says Julia Baird, PsyD, a licensed clinical psychologist with Torrance Memorial Medical Center's Eating Disorders Program in Torrance, California.

Important: "When we comment on an individual's weight, we are placing focus on something external, their body, as being what is valuable and important about them. We live in a society that already places way too much value on appearance, we do not need to reinforce this," Baird says.

Not only should you avoid commenting on your loved one's weight, but you shouldn't comment on your own either, Baird says. These comments can be triggering for someone with an eating disorder and exacerbate their symptoms.

Some common phrases to avoid include:

Comments on how "healthy" someone looks - "You look so healthy!" or "You look unhealthy"
"No one likes the look of skin and bones"
"You don't look like you have an eating disorder"
"I hate how my legs look"
"Do I look fat in this?"

Instead, Baird suggests focusing on other aspects of the person, like how happy they seem or your concern they may not be taking care of themselves. When talking about yourself, try to steer the conversation away from appearance and talk about other parts of your life, like your family or job.

Examples of better things to say include:

"You look so happy today"
"I love how passionate you are about…"
"I'm feeling really accomplished at work lately. My favorite project..."

Don't comment on what you or they are eating

Making comments about what a person is eating or trying to police what they are eating can be extremely damaging, Weinstein says. Talking about your own food choices or body image insecurities also isn't helpful.

"[Those with eating disorders] are already so preoccupied with their personal rituals and rules about food that additional outside input can feel like sensory overload and cause them to question their already destructive behaviors," Weinstein says.

Avoid phrases like:

"You're not eating enough/too much"
"What diet are you on?"
"Do you know how many calories are in that?"
"I'm not eating carbs this month"

Commenting on what someone is eating will likely make them defensive and even more entrenched in their behaviors, Baird says. Steering clear of comments about your own food choices can also help model a positive relationship between food and body image.

"Sometimes the best way to be there for someone else is to be a model of someone who is striving to develop a healthy relationship with your own body," Baird says.

Don't praise their willpower

Eating disorders are not about willpower or self-control, Peek says.

"Eating disorders can be painful, lonely, and deadly diseases," Peek says. "Framing eating disordered behaviors as a positive act of willpower is misguided and can perpetuate symptoms of someone who may be truly suffering underneath their veil of perceived self-control."

Some common phrases to avoid include:

"Wow, I wish I had your self-control"
"I just love food too much to go on a diet"
"I wish I could exercise every day like you"

A person with an eating disorder might hear these comments as an encouragement to continue destructive patterns, says Weinstein.

Instead of reinforcing the false notion that eating disorders are about willpower, offer support by saying something like:

"I care about you and I am here for you. You are not alone."
"I know you don't see it right now but you are so much more than a body size. I would like to be a part of helping you see your worth."
"I can't imagine what you are feeling, but I want to try to understand, will you help me?"

How to help someone with an eating disorder

Helping someone with an eating disorder can be difficult, but your support is a vital part of their recovery. Asking open-ended questions about how your loved one is feeling and how you can help are good places to start, Peek suggests.

"No matter what their answer is, it can be helpful for someone to know that you are there and willing to listen in a non-judgemental way," Peek says.

Additionally, educating yourself on eating disorders can help you understand what your loved one is going through and help you find ways to encourage them to seek professional help, Baird says.

Some eating disorder resources include:

The National Association of Anorexia Nervosa and Associated Disorders (ANAD)
F.E.A.S.T. Families Empowered and Supporting Treatment of Eating Disorders
Health at Every Size
National Eating Disorder Association (NEDA)
EDReferral, Eating Disorder Referral and Information Center

Important: Eating disorders are dangerous and can result in serious health complications, like kidney failure, anemia, or death. If you are concerned about your loved one's immediate safety, call 911 or take them to the nearest emergency room.

Insider's takeaway

If you are concerned someone you love may be struggling with an eating disorder, show them support by openly listening and avoid topics of conversation that center around food, weight, or appearance.

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