Eating disorders impact nearly 10 percent of the population in the United States and are accountable for about 10,200 deaths annually, ranking them among the most fatal mental health conditions. These severe illnesses can affect individuals of any gender, age, or background.
Being confronted with an eating disorder can evoke feelings of helplessness, fear, and anger. Observing a loved one engage in behaviors like restricting food intake, compulsive exercising, purging, or binge eating can be challenging to comprehend and perplexing to make sense of. It may feel like trying to solve a mystery, deciphering subtle clues and relying on intuition more than concrete evidence, in an attempt to uncover what is right in front of you.
Adding to the complexity, eating disorders thrive in secrecy. Concealing behaviors, telling lies, and manipulating situations to support the disorder are inherent components of the illness. As an observer, this can lead to doubt and uncertainty about the reality of what you are witnessing.
Many friends and family members often feel as though they are walking on eggshells, with an unspoken issue always present. People may choose to remain silent out of fear of upsetting the individual or disrupting the limited communication that exists. While the discomfort is genuine, it is also strategic. The eating disorder relies on it. Articulating what you observe and feel is crucial for practicing direct, empathetic communication.
The initial step is to release the notion that a single conversation will bring about a complete transformation. Remove the pressure to fix, cure, or resolve the situation. These illnesses are deeply rooted in thoughts, impulses, and compulsive behaviors, and recovery does not hinge on persuasion. However, reflecting back what you observe, expressing concern, and acknowledging that you see through the façade of the eating disorder can show that you are aware of what is happening and refuse to enable the disorder. So, how can you initiate that conversation in a respectful, supportive, and honest manner?
Focus on well-being.
Commence by expressing your concern for the individual’s overall well-being rather than commenting on their appearance or specific actions. Instead of remarking, "You’ve lost a lot of weight," you could say, "You appear more withdrawn lately, and I am concerned about you."
Stick to observations, not accusations.
Utilize "I" statements to ground your message in objectivity rather than judgment. For instance, stating, "I’ve noticed you are avoiding meals around us, and I am wondering if everything is alright," is more likely to be well-received than "You are not eating enough. You have a problem."
Be prepared for resistance.
It is normal for individuals with eating disorders to deny the issue or feel ashamed about their struggles. Resistance, whether in the form of denial, defensiveness, or anger, is common and does not indicate that you have erred in your approach. In fact, it may signify that your decision to speak up was appropriate. Instead of pushing for an admission, reassure them of your support and willingness to check in regularly.
Focus on connection, not control.
Eating disorders often provide a false sense of control in a chaotic world. If your words come across as an attempt to strip away that control, they may have a negative impact. Rather than pressuring someone to change, concentrate on maintaining an open relationship. Asking a simple question like, "I want to understand what is happening. Can you share with me?" can help sustain the dialogue and demonstrate that you are a trustworthy confidant.
Offer resources, not ultimatums.
If the individual expresses receptiveness, you can inform them that assistance is available through therapists, support groups, or treatment programs. You could offer to research options or accompany them to an appointment. The delivery of the message is often more significant than the content itself. If seeking help is presented as a condition for love, it may push them further away. However, when the offer is perceived as an open invitation rather than a demand, it is more likely to be accepted.
There are no perfect words that will instantly prompt change. Your consistent presence, coupled with compassion, speaks volumes beyond any script. Supporting someone through an eating disorder can be emotionally draining. Seeking support for yourself is essential to continue offering assistance.
To locate a therapist, please visit the Psychology Today Therapy Directory.