Guidelines for Supporting Your Family Member, Friend, Partner or Roommate Who is Struggling with an Eating Disorder
Educate yourself about eating disorders. Eating disorders – anorexia nervosa, bulimia nervosa, binge eating disorder and other forms of disordered eating – develop and are maintained by a combination of factors, and the symptoms can serve as a very effective coping mechanisms. The individual is not able to snap out of it or use will power to overcome the eating disorder.
Express your concerns and communicate directly and openly. Don’t beat around the bush. If you have concerns, it is more helpful express them directly. This models good communication for the individual and also helps to avoid sending indirect and confusing messages.
Remember that denial is often part of the problem and that the person struggle with an eating disorder does not have to fully accept the problem before seeing a professional. Part of your role can be to encourage the person to talk to a doctor or counsellor about their symptoms, regardless of the diagnosis.
Offer your support by letting the individual know that you are available as a sounding board. Use your listening skills and allow the individual to express what is on their mind. Try to not to offer advice or to fix things.
Provide information and support on finding help. Assist the individual with finding eating disorder treatment and/or offer support in helping them to talk to family members, their partner, friends or other roommates.
Early intervention is believed to increase the likelihood of a faster recovery with fewer relapses.
Be open to letting the individual talk about their feelings. Part of the individual’s recovery from disordered eating is learning how to identify and express their feelings.
Compliment and reinforce characteristics and interests other than weight and appearance. Part of recovery for the individual to separate their self-esteem from appearance. You can help by commenting on strengths, abilities, and interests that are not related to appearance, weight or shape.
Share activities that don’t raise concerns about weight and shape. This can help the individual to learn to obtain self-worth from areas not related to weight and shape, and at the same time provide a distraction from urges to engage in disordered eating behaviours.
Allow the individual to be independent and in charge of their recovery. It is important that the individual start to build up their level of confidence in order to recover. To support this process, you will need to keep a balance between offering support and allowing the individual to accomplish tasks and make decisions on their own.
Realize that it is best for the individual to go at their own pace and to make their own decisions with respect to eating and recovery. If the individual feels coerced, your attempts could backfire.
Examine your own beliefs and attitudes about food, weight, shape, dieting and appearance for any fat prejudice. Comments may unknowingly exacerbate a desire for thinness and may be contrary to the approach the individual needs to recover. It is helpful to examine your own beliefs and attitudes and to be aware of any direct or indirect messages that you might be sending.
Treat your loved one as you would any other family member, partner, friend, or roommate. If you give the individual special status because of the eating disorder, you may inadvertently reinforce the eating disorder.
Have patience. Anorexia nervosa, bulimia nervosa, binge eating disorder and other forms of disordered eating can take a long time to resolve. Recovery takes time but is possible. Having symptom slips after a symptom-free period is not unusual and does not mean that the individual is giving up or is back to square one.
Avoid discussing weight, shape and appearance as it may add to the individual’s fear and preoccupation, and will probably be interpreted negatively. It also sends the message that the individual’s appearance or body size is important to you. Avoid making such comments even if the individual asks for your opinion. In this case, you might want to refer to this guideline and state that you don’t want to go there because you don’t think that it is in their best interest.
Don’t ignore the problem. Eating disorders are complex and usually do not go away on their own.
Don’t blame the individual, or yourself, for the eating disorder. Disordered eating is usually a coping mechanism for emotional regulation. Blaming reinforces a sense of failure and may create more distance from the individual. Self-esteem, confidence and feelings of adequacy are usually very low. It may seem that the kind and happy individual that you thought you knew has become angry, depressed or manipulative. Typically honest individuals may lie about their eating and/or symptoms from shame and embarrassment, or before they have developed alternative ways of coping. However, it is important to remember that this is part of the disorder and not a permanent change in your relationship or their personality.
Don’t accept that the problem can be dealt without outside help. This may may mean seeking advice from an eating disorder organization, doctor or counsellor.
Don’t demand change. If it were easy to change and recover from an eating disorder, the individual would probably have done so. They are more likely to benefit from your support and patience.
Don’t get involved in a power struggle. This is more likely to give the eating disorder strength and power. If you find that you are involved in a discussion or dynamic were the individual is arguing in favour of the eating disorder and you are arguing the other side, try your best to disengage and redirect the conversation.
Don’t take control or police eating or eating disorder behaviours.* This may lead to the individual feeling even more out of control (*there may be exceptions, depending on whether the individual’s life might be in danger and/or if the individual is very young).
Don’t rescue the individual. This can lead to feelings of ineffectiveness, incompetence and dependence.
Don’t give the eating disorder special status. This type of attention can reinforce the eating disorder and make it difficult for the individual to recover.
Don’t take on the role of a therapist. Your relationship is your most valuable asset. Don’t nag the individual about eating. You cannot cure them. They have to take responsibility for any changes and that will happen as they become ready.
A compilation from Guidelines for Supporting Someone Who is Struggling with Disordered Eating, Eating Disorder Resource Centre of British Columbia, and The Overcoming Bulimia Workbook by R.E. McCabe, T.L. McFarlane and M.P. Olmstead (pp. 198-200).