I had an eating disorder growing up – these days, you’d say I’m “in recovery.” It feels important for me to start there; consider that my diploma on the wall: Natalie Grigson, Anorexia and Bulimia Survivor, 2000 – 2013.
It’s my way of telling you: I know how it is. I know what feels triggering to hear from friends or family; what well-intended things can potentially send someone running back to the scale or those delicious, delicious white chocolate Oreos. So today, I want to share with you – from an insider’s perspective – what to do (and not do) if someone you love has an eating disorder.
- DON’T ignore it, hoping it will resolve itself.
When I was a teenager, I was bulimic. It took my parents years to reveal to me that they knew about my disordered eating.
When my disorder swung the opposite direction into anorexia, once again, nobody said anything – that is, except for phrases that actually validated and fueled my disorder (which I’ll get to in a moment.) It wasn’t until I was thin enough that somebody I hardly knew and hadn’t seen in years sent me a message saying – you look sick – that I actually got it. I was sick.
I understand. It’s a hard thing to approach – perhaps harder with eating disorders than any other sort of addiction. When somebody is abusing drugs, you can say, “Hey Ned, I notice you’re doing coke every night. Seems like a problem.” If someone is drunk all the time, it’s pretty easy to spot. “Sylvia is asleep under her desk again.” But when somebody has an eating disorder – be it anorexia, bulimia, binge eating, or orthorexia – well that is much harder to pinpoint, much less confront the person about.
So I advise you to trust your instincts on this one. If you have a feeling that someone close to you has an eating disorder, please talk to them. Don’t wait to see if it will resolve itself, because like any other addiction, it usually doesn’t.
- DON’T remark on how thin someone is becoming.
It doesn’t matter if you mean this as something negative that your loved one should be aware of or concerned about. It doesn’t matter if you mean it as a compliment. Whether you say “Marla, you look so thin! You should eat more!” or “Marla, you have lost weight! You look great!” all Marla’s disordered-eating-ears are going to hear is I’m doing it right. Keep going.
It took me, not only reading the words You look sick (which, let’s face it, can’t be twisted into a compliment in the same way that You look so thin! can be in our diet culture), but it also took me being ready to really receive them. I knew I was on borrowed time with my eating disorder; I knew it wasn’t sustainable if I wanted to live for years to come. It’s likely that your friend or family member knows this, too – but addiction is often stronger than logic or even the desire to live. So do say something – if they’re not ready to hear the words, the worst it can do is create some distance between you – but you’ll at least know you tried. And perhaps one day when they’re ready (as was the case for me), they’ll remember your words and will be saved by them.
But DO NOT remark on how thin someone is getting.*
- DON’T remark on how fat someone is becoming.
Okay, do I really need to tell you guys this? Do not remark on someone’s gaining weight! The only reason that this seems more obvious than the previous point is because diet culture has brainwashed us that thinner is better. But really, this is the exact same thing as our previous point – just stop remarking on people’s weights, sizes, and shapes, whether they’re getting bigger, smaller, thinner, fatter, or staying the same.
Likewise, stop remarking on your own weight, size, and shape – whether you’re getting bigger, smaller, thinner, fatter, or staying the same. Talking about this in front of someone who might have an eating disorder is very damaging.
So just stop.
- Oh, and DON’T tell them they look “healthy” either.
This might seem confusing for people who have never had an eating disorder. If someone you love was looking unhealthy – perhaps they were so thin they looked emaciated – and next time you see them, they have put on some weight. They look stronger. Healthier. Their skin is glowing. Their hair has stopped falling out. Whatever. I understand the impulse to say, “Wow, you look so healthy!”
But for someone who is recovering from a restrictive disorder like anorexia, you might as well say, “Wow, it looks as though you failed at the project of having control over your life and body,” or “Gee, you’ve really gotten fat.” (I don’t consider “fat” a bad word – some people are thin, some are fat, just like some people have brown hair, some blond. NBD. But because we’re steeped in diet culture, being seen as “fat” is very scary to someone with an eating disorder, and being called “healthy” feels just the same to someone who restricts or purges.)
- DON’T make mealtimes a battleground.
If someone is anorexic, don’t try to force them to eat. Even if they do as you wish, they’ll likely feel immense guilt afterward and/or resentment toward you. Leave this to a professional. Likewise, don’t try to force someone to not eat. If someone is overeating, bingeing, or addicted to a certain food, attempting to force them not to eat will do more mental harm than good.
In short, don’t make mealtimes a battleground. It can only result in an even worse association with food for your loved one, and that is certainly not what they need right now.
- DON’T blame or get angry with the individual.
This is not a choice for people. It is an addiction and is sneaky and sly and highjacks people. Addiction speaks through people – it has us lie, it has us sneak off to throw up or eat meals alone, it has us isolate, it has us convinced that we’d die without it. It is so powerful and hard to shake. It won’t be helpful if you get angry or blame your loved one for their addiction.
Similarly, making the disorder about you or your family is not helpful. If you have the thought – “Why are you doing this to [me / our family]?” – please do not share this with your loved one, as it will only further their feelings of shame (which is not helpful.)
I’m certainly not suggesting that there isn’t a place for your feelings – I think it is imperative that you express and feel what comes up in relation to someone with an eating disorder – just not with them. Not while they’re struggling.
- DON’T try to be a therapist.
More than most, perhaps, I understand the desire to be the person who helps someone heal. It can feel validating, powerful, even selfless. But the real selfless act here is to not try to play the role of healer, or therapist, or advice-giver.
You can be a friend; you can be supportive. But you are not qualified to be this person’s therapist, nutritionist, or doctor. Even if you happen to be a therapist, nutritionist, or doctor, it would be a huge conflict of interest to mix the professional with personal here and could be harmful to your loved one’s recovery.
*Side note: even if you’re not necessarily under the impression that somebody has an eating disorder, try this on for size: STOP TELLING PEOPLE THEY LOOK GREAT BECAUSE THEY’VE LOST WEIGHT. We need to stop enforcing the idea that thinner is better – that losing weight should be a source of compliments or attention. We don’t know to what lengths someone is going to lose weight – they may have an eating disorder that we can’t see. Or, reinforcing the importance of thinness to them may well give them an eating disorder.
So, next time someone you haven’t seen in a while looks a little thinner, rather than praise their body, why not just say, “I haven’t seen you in forever! [Skip: you look great!] [Skip: Wow, you’ve lost weight!] [Skip: You’re so thin!] IT’S SO GOOD TO SEE YOU!”
Okay. Now that we’ve discussed several things to avoid doing for someone with an eating disorder, I want to leave you with some things you definitely can and should do. Remember, these tips are for approaching someone who has, or who you suspect has, an eating disorder – whose life is not in immediate danger.
If you are worried somebody’s life may be in immediate danger (they are purging multiple times every day, they’re severely underweight, hair loss, other medical problems), talk to a doctor or professional about a possible forced medical intervention.
- DO say something.
Again, trust your instincts on this. If you have reason to believe someone you love has an eating disorder, you’re better off saying something than possibly just letting it get worse. It will let the person know you care – even if their disorder has them get defensive or even distance themselves from you. Let them know they are not alone, that you love them, and that you will help however you can. Be sure to express from a place of open support, rather than pressure or neediness.
- DO ask them what’s happening in their life.
Food and weight are not the underlying issues in eating disorders; they’re the symptoms for something deeper. Ask your loved one what’s happening in their life. Be curious. Listen attentively and don’t interrupt. Be a safe person to talk to. Some great, simple questions to ask are: Are you okay? How are you doing? Do you want to talk? If they’re openly in recovery: How is your recovery going? How can I best support you? Remember, you’re not a therapist – but you can be a friend.
- DO advise them to seek help.
I repeat: You are not a therapist. Well – maybe you are a therapist – but you are not this person’s therapist. What you can be, though, is the person who helps your loved one find support. That could look like therapy, an in- or out-patient program, a 12-step program, a support group, group therapy, etc. If somebody has an eating disorder, they need professional support.
- DO be patient.
Recovery takes time – and in fact, don’t be surprised if “recovery” lasts a lifetime. I have gone years and years being free of eating disorder symptoms, only to find them crop back up at various times of stress in my life. This may be a lifelong battle, or just background noise for your friend or loved one. There’s nothing you can do about this. But be patient. Be there.
- DO listen.
Hold space for your loved one to talk, cry, scream, get defensive, angry, storm out on you, lie to you, deny. Offering advice won’t land well. Remember, if your person has an eating disorder, that disorder does not want to be healed – it will fight tooth and nail to stay in control – and that might mean lying, sneaking around, pushing you away. Don’t take it personally. Hold space. Again, be patient.
- DO remember it’s up to them.
It is scary AF to watch someone you love slowly kill themselves. I know this. But if that person is not ready to get help, they won’t be helped. You can tell them you’re there, you love them. But only they can decide to get help, and they can only make this decision when they are ready. I’m sorry it has to be that way. I know it is an impossible thing to swallow. But you can’t save this person.
- DO get support – for yourself.
As I mentioned above, watching someone hurt themselves with an eating disorder, or any type of addiction, is terrible. It feels impossible at times to be so helpless; to have so many emotions come up.
It isn’t helpful to express these feelings of hurt and pain to the person with the eating disorder. There may come a time for this later in recovery, but when they’re in the thick of it, believe me, they’re already swimming with enough shame and pain of their own.
Still, you can’t be expected to hold all of this yourself. Eating disorders, like any other addictions, effect far more people than just the one. So, seek a support group or therapist, or at the very least, a friend or two, who can hold and support you in your pain around this.
If you’ve read this to the end, chances are, you or someone you love is struggling. And I am so sorry for that. I know it’s hard, but it isn’t forever.
This too shall pass.
For more information on eating disorder recovery, check out these resources: