5 Tips for Caring for Someone with An Eating Disorder

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By: Etta Eckerstrom Recovering from an eating disorder is HARD. It takes time, mental energy, and physical energy to commit to a meal plan, attend appointments, and fight the voices in your head that scream, “you don’t deserve this.” Many people choose or are placed into residential treatment as a result, an environment where recovery becomes the only and top priority. But residential treatment programs are expensive, and not every individual can afford the cost or time associated with them. As a college student, the thought of leaving my friends and classes behind for a semester, or committing my summer to a residential program, was too hard to even consider. So, with the guidance of an amazing team of outpatient providers, I was able to recover.

Recovering from an eating disorder is hard, but throw in a full course load, extracurricular engagements, and the typical campus “diet culture,” and you have the perfect storm of stressors, triggers, and barriers to fuel the eating disorder’s voice in your head. Having a support system outside of a treatment team can make recovery that much easier, but many well intentioned friends and family members do not know how they can be the most help.

Here are five suggestions that I wish I had been comfortable enough to bring up to those close to me early on. While some may seem small, each can make a difference in a friend’s recovery.

1. Please do not make comments about what your friend is eating, how much, etc.

A lot of students use mealtimes as a time to catch up with friends, grabbing lunch between classes or dinner at the end of a long day. For someone with an eating disorder, eating in front of people can often be scary, either because they have rituals around food that they don’t want others to notice or they fear judgment from their friend as to what or how much they are eating. If you know your friend is going through recovery, it is especially important to keep the conversation away from their plate. Even if you yourself have been through recovery, your friend’s meal plan could be entirely different, depending on where they are at in the process. Keeping the conversation away from food turns the meal into just a time to catch up on each other’s lives and can reduce your friend’s anxiety.

2. Please do not talk about the new workout plan you started or how you were “good” because you worked out today.

Many people going through recovery are either banned from exercise or placed on a very restricted exercise plan. This can be anxiety provoking, as they are eating more and unable to engage in activity that used to be a way to reduce guilt and anxiety surrounding food or weight gain. Hearing about your hour long workout at Barre or how you have been at the boxing gym five times this week can quickly lead to a comparison game, and induce feelings of guilt for not doing the same. Saying “I was so good for exercising today,” can quickly make your friend’s brain jump to, “Well I couldn’t workout today, so therefore I am bad.”

3. Be aware of buying into “diet culture."

This is good advice for anyone, regardless of whether or not they have a friend who is in recovery for an eating disorder. “Diet culture” is what tells us that there are good foods and bad foods, that exercise is a way to “make up” for any “bad” foods consumed, and that restricting to get that “spring break body” is normal and okay. In reality there is only food, period. Exercise should be a way to destress and boost energy. And restricting food is never normal, or okay. Yet the amount of times I hear people make comments such as, “I’ll have to be at the gym for x amount of hours to burn this off” or “I was so bad today, I had ice cream” or “Oh, I can’t eat that, spring break is in two weeks,” is disappointing. Even comments that seem casual, such as “I haven’t eaten all day” or “I skipped breakfast this morning,” can be triggering and invoke comparison anxiety in your friend. For someone in recovery, all of these thoughts can mirror ones they have on a daily basis. Diet culture is sadly the norm in our society, but being aware of staying away from these types of comments can have a huge, positive impact on your friend’s recovery, as well as in combatting its pervasiveness. These were three things that you should not do, but what about things you can do to help your friend while he or she is going through recovery?

4. Be patient and understanding.

It can be hard to watch someone you love and care about struggling, and there may be times you wish you could talk them into eating. But showing them compassion and especially patience throughout the process is so important. Recovery is far from a linear process, so if your friend cancels on dinner or seems to be eating less than usual, do not immediately assume he or she has relapsed. Some days will be much harder than others, but blaming, yelling, or expressing frustration with them only adds to any feelings of guilt, anxiety, or frustration that they themselves feel. As much as you may wish it, your friend will not recover overnight. Instead, remind them that you are there for them, and suggest non-meal activities, so they can still spend time with you in a less stress inducing environment. They likely spend a lot of their week talking and thinking about recovery already, so time with you can be a mental break from that part of their lives.

5. If you have a friend you are concerned about, either who is in recovery or showing symptoms, tell them what you notice. If you notice your friend has been skipping meals, going to the bathroom after meals, at the gym more than usual, or seems to be losing weight, one of the best ways to bring it up to them is by explaining to them what you notice. Approach them one on one and in a private environment, and begin by saying, “I have noticed x, and am worried.” People with eating disorders will want to protect it with everything they have, so jumping in immediately with, “I think you have an eating disorder,” can lead walls to go up and for them to lash out defensively. They can’t argue with behaviors and signs you have seen with your own two eyes, however. They may dismiss the importance or claim there is nothing to be concerned about, and in that moment, it’s okay to back off and let them know you will always be there for them if they need to talk. A person must ultimately choose recovery, but I believe it’s important not to give up. If they continue exhibiting this behavior, going to an adult or a parent may save their life. Recovering from an eating disorder is hard, but so can being there for someone who is. Every individual is different and will respond to offers of help and support in different ways, but let these serve as a starting point for helping your friend along on his or her recovery journey.

About the Author: Etta resides in Nashville, TN. She is earning a degree in public health and psychology from Vanderbilt University. At Project Heal, Etta is dedicated to having a positive impact, directly or indirectly, on those who are in recovery. She is passionate about empowering others and educating people on eating disorders. She can often be found studying at coffee shops around Nashville, going for a run, and spending time with friends. Etta's favorite ice cream flavor is anything with chocolate.