It can be scary and overwhelming if you have a family member, friend, or loved one with an eating disorder. Disordered eating is complex, and as much as we want to find help for the ones we love, navigating the process of getting professional help can be difficult.
We will go over some signs of an eating disorder, ways to access eating disorder recovery, and how you can support someone you know who is struggling.
What Is an Eating Disorder?
Most of us are familiar with eating disorders, though we may only know what we have seen on the afterschool specials we watched in our high school health classes. The full picture of disordered eating is much more complicated.
An eating disorder disrupts regular eating patterns, accompanied by destructive and negative thoughts and emotions surrounding food, eating, and weight. People who suffer from eating disorders tend to obsess over weight and body image, often eating in strange ways and exercising obsessively.
Though there are many different types of eating disorders, the three most common are anorexia nervosa (anorexia), bulimia nervosa (bulimia), and binge eating disorder (BED). Let’s take a look at these disorders and the warning signs.
Anorexia nervosa, commonly known as anorexia, is characterized by a restriction in food intake, usually severe and sometimes life-threatening. It results in weight loss or a refusal to gain weight, which leaves the person at abnormally low body weight.
Anorexia sufferers also tend to have compulsive concerns over gaining weight and a distorted sense of what their bodies look like. This is also known as body dysmorphia. Other eating disorders may also exhibit this sort of body dysmorphia.
Signs of anorexia include:
- Low, often dangerously low, body weight
- Refusal to eat in front of others
- Believing some foods are “bad” and not allowed
- Eating strange combinations of food just because they are low calorie
- Exercising excessively
- Obsession with weight, body image, or exercise
- Extremely low self-esteem
Also known as bulimia, this eating disorder involves overeating or binging and purging through vomiting, laxatives, or other means. Many people with bulimia also over-exercise to “make up for” extra calories consumed.
Those with bulimia often are not overweight or underweight, which can make the disorder more difficult to spot, at least initially.
Signs of bulimia include:
- Eating in secret or refusing to eat in front of others
- Eating a lot but never gaining weight
- Consistently going to the bathroom right after or during meals
- Obsessing over body weight, body image, or exercise
- Scraped knuckles or tooth enamel damage from forced vomiting
Binge Eating Disorder
Binge eating disorder is actually the most common of all eating disorders. This is surprising to some people who think of an emaciated person when they picture an eating disorder.
Binge eating disorder (BED) is different from other eating disorders in that, typically, the person binging is not excessively worried about weight but rather emotionally eating to excess and then feeling guilty afterward.
Those with BED might be dieting or simply not eating for hours on end and then will indulge in unhealthy food choices later. It’s important to note that occasional overeating does not qualify as BED; it is only when this is a consistent and excessive pattern.
Signs of BED include:
- Eating even when not hungry or when uncomfortably full
- Feeling out of control during binge episodes
- Frequently being on a diet, but not ever losing weight
- Obesity or weight gain
- Expressing shame and guilt about eating
- Eating in secret, never eating in front of others at mealtimes, or other disordered behaviors
Other Eating Disorders
Because eating disorders are so varied and complex, the DSM-5 reserves an entire category for disordered eating that isn’t necessarily defined as any other named eating disorder.
So don’t fret if you aren’t sure if they fall into one of the named categories. They still may need your help.
What Are Some Ways To Help a Loved One?
We are glad you asked! We have some expert tips on how you can help.
Of course, at some point, you may want to get professional help from a licensed mental health professional, but you can do plenty of things to help on your own.
1. Talk to Them
It sounds simple enough, but it isn’t always easy. You want to make sure you go in with a plan of attack — and ironically, that plan should not be to attack! It’s best to use “I” or “we” statements and come from a place of love and concern.
An example of this type of statement is: “I have noticed that you seem to be losing a lot of weight, and I rarely see you eating. I am feeling worried that you might have an eating disorder. Are you okay?”
It’s best to be firm and direct with the conversation and not use euphemisms, expressions, or skirt around the situation. It may feel uncomfortable initially, but the best way to get honest answers is to ask honest questions.
2. Be Compassionate and Validate Their Feelings
Of course, if you are close to this person, you have probably been affected by their actions. But it’s important to remember that this is not about you; it’s about them. Also, remember that this is a psychological condition, not a choice they are making. Be kind.
The person you’re talking to may feel like no one could possibly understand what they're going through. Of course, this isn’t true, but feeling alone is a common hallmark of eating disorders and psychiatric disorders in general. Make sure that they are feeling heard.
3. Avoid the Intervention
Yeah, we know you’ve probably seen the popular television show, but the truth is that harsh interventions are not the answer here. Confrontations are usually not taken well by people suffering from mental health conditions, and you won’t get the results you want.
Make sure not to blame them, and don’t get angry even if they are not receptive to your conversations. You wouldn’t get mad at someone for having cancer, and you shouldn’t be frustrated at someone for having disordered eating behaviors. They are just sick and may need a little push to get better.
4. Help Them Find Support Groups
If someone is not willing to get medical or psychiatric help, they may be willing to at least talk with people who understand what they are going through.
Support groups are excellent resources and are usually led by people with experience or expertise in the area. It’s also nice to know that you’re not alone in a struggle that consumes you.
There are local support groups and online options, so honestly, the sky is the limit. Those not willing to go to an in-person support group might be willing to try it online, so be ready with options for both. Try and calm the shame, guilt, and awkwardness and remind them that anonymity is possible.
5. Suggest That They Get Professional Help
Many people with eating disorders do not believe that they have a problem, and are resistant to getting help, so don’t despair if they don’t agree immediately. However, suggesting that they consider it is a good place to start.
People are much more likely to take advantage of professional help if they are presented with options for eating disorder treatment — perhaps options that don’t feel too scary. Even if you feel like your friend would benefit from intensive inpatient rehabilitation, you may want to start by suggesting therapy or a dietitian.
Then, if a mental health expert recommends a higher level of treatment, it is often received much more favorably. Depending on how close your relationship is with the person, you could even offer to take care of all the details.
If you’re willing, you could make the necessary phone calls or emails to get everything in order. Your loved one will likely feel overwhelmed and underprepared.
What Are Some Treatment Options for Eating Disorders?
If you have gone through the tough conversations and your loved one is willing to get professional help, it’s important to know the options. Just telling someone, “You need to get help,” is an overwhelming and intimidating prospect.
Though this is not an extensive list of every available option, the most common treatments for eating disorders are:
- Talk therapy: A good option is to work with a therapist, often using Cognitive Behavioral Therapy (CBT) to identify triggers and change behaviors.
- Nutrition education: A great option is to work with a nutritionist or dietician to change eating habits.
- Medication: Frequently, antidepressants are used to treat eating disorders and are surprisingly effective. Remember: this is a mental health issue.
- Inpatient treatment: If the condition is severe and accompanied by other medical complications, it might be suggested that a person live in a residential facility for round-the-clock care and help from many health professionals.
- Partial hospitalization/inpatient treatment: It is possible to spend most of the day at an inpatient facility and then go home to sleep in your own bed at night and on weekends. Typically every weekday is spent in a treatment center during the day.
- Outpatient treatment: For this option, the person would typically spend three to four days a week working with therapists, attending support groups, and working on their nutrition education, but would not have to stay in a facility.
If a friend or loved one finds themselves in a tough spot regarding an eating disorder, getting help from someone who cares about them can be the best medicine. Starting with a kind but direct conversation that hopefully leads to more formal treatment can make a difference.
As you navigate this process, make sure to take care of yourself. Odds are, you didn’t do anything to cause their eating disorder, and you alone can’t do anything to cure or treat them.
Just be their friend and help guide them in the right direction — towards therapy, support groups, and other types of treatment. Your compassion and kindness just might be the thing that changes their whole world for the better.
Therapy for Eating Disorders: Types, Efficacy, and Recovery | Healthline
Eating Disorders | NAMI: National Alliance on Mental Illness
How To Support A Loved One | National Alliance for Eating Disorders