What To Say To A Person With An Eating Disorder

Where Did That Gallon Of Ice Cream Go I Just Bought It Last Night

You know where it went. I ate it. But when you ask this questionI just feel ashamed and hate myself. I already feel terrible because I ate a whole gallon of ice cream. And Im so sick I can barely move today, but Im also feeling like withering up and dying because I feel like such a failure.

Better Question: Are you okay? Do you want to talk?

Just Focus On Being Healthy

To a person with an eating disorder, healthy may mean something completely different than how you view it.

Neidich says that a focus on health is usually what gets people into disordered eating to begin with. Diet and wellness culture are two of the biggest culprits when it comes to eating disorders in general, she says. Orthorexia is acknowledged by most eating disorder therapists as being a distinct diagnosis which overly focuses on only eating clean, healthy food. This disorder often leads to the development of other eating disorders.

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I’m Here For You And I’m Not Going To Leave

We all need someone there sometimes. Everyone needs to talk to someone sometimes. And yes, we know it’s getting a bit repetitive and boring. But the same fears, the same struggles come up again and again. And knowing that someone is there for us to listen, to find distraction or just to talk to about random things it all means more than you could ever imagine.

As I’ve said before, and I won’t stop saying it recovery is difficult, it’s tiring and stressful. You put your heart and soul in trying to eat again and it takes the life out of you. Don’t mistake not showering, not brushing teeth or hair, or any other self care for laziness. They’re exhausted and need a friend, not a critic. It’ll get better, it just takes time. Don’t judge what you haven’t experienced.

There’s the everlasting fear that people find the constant “whining” about food/body image will scare them off. Don’t let it scare you off, stick with your friend. It’s going to be worth it when the day comes that they walk up to you to ask if you fancy one of their home made cupcakes and you both delve into one.

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General Tips For Supporting Someone

• Recognise that you are not to blame.
• Acknowledge to your loved one that they are not to blame.
• Recognise how distressing the illness is for your loved one.
• Educate yourself about eating disorders where you can.
• Ask your loved one how they are feeling and what they are thinking, rather than making assumptions.
• Avoid discussing weight, shape, food, and diets in front of your loved one, and model a balanced relationship with your own food and exercise.
• Remind yourself that things can change and reassure your loved one that recovery is possible.
• Ask your loved one what you can do to help for example, helping them to stick to regular eating, putting in boundaries following mealtimes, having a space to talk about how they are feeling. Your loved one may respond that you can just leave them alone or that you cant do anything to help, so here it can be helpful to remind them you can hear their distress and how difficult things are, and you are there if they need you.
• Recognise any accommodating or enabling behaviours behaviours that you do to help reduce your loved ones distress from the eating disorder, for example, cleaning up vomit or cooking different meals for them, but that collude with the disorder and cover up the negative consequences of the behaviours.

What To Say Instead:

• Are you okay? I can tell things are tough for you right now, is there anything I can do to support you?

• Do you want to talk? Im here for you if you want to talk.

• No one is perfect, go easy on yourself.

• Would you like to see someone who can help you through this?

• I love you no matter what.

Overall, avoid being the food police, commenting on food choices, and swerve any and all conversation about body size, weight, shape, etc. We are conditioned to share a collective discontent over our bodies, and often bond over lamenting about body size. Do your best to avoid this kind of talk with your loved one, and instead support them, encourage them, and compliment them on things that have nothing to do with their outward appearance. Your support and understanding is needed to help them through this.

Have you found yourself struggling with what to say to someone with an eating disorder? Share your experiences with us! For more information and support make sure to join our newsletter to find out all our practice has for you.

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How Are Eating Disorders Treated

Treatment will be different depending on the type of eating disorder your friend or relative has.

It will usually involve some kind of talking therapy because help with eating and putting on weight alone is usually not enough.

Your friend or relative will talk to a therapist about the emotional difficulties that led to their eating disorder, and they will learn healthier ways to cope with these feelings. Their treatment may also involve them working through a guided self-help programme.

During their treatment, they will also have regular health checks to look after their physical health.

Treatment will take place over a number of weeks so your friend or relative can get used to the changes slowly. The earlier they start, the better their chances of making a good recovery.

Genes Alone Cant Predict

While the influence of genetics on health and eating disorders cant be denied, genes are hardly the end-all in terms of prediction.

Eating disorders can be spurred by a persons perception of what their body should look like often influenced by images on social media or television.

Sometimes things can be exacerbated by preconceptions from peers or even doctors, said Hirsch.

Its imperative that we address weight bias by educating physicians on the nine truths teaching them that eating disorders affect people of all shapes and sizes, that positive body image promotes health rather than the contrary, and that dietary restriction strategies can increase the risk of developing eating disorders, she said.

Physicians also need to stop judging and blaming patients for their weight, she added.

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Yale Power Program Is Studying The Best Ways To Help

POWER offers a variety of clinical trials for children and adults focusing on such areas as the use of medications to treat binge-eating, plus such treatments as cognitive behavioral therapy . A new treatment trial is examining behavioral and/or medication treatments for adults with loss-of-control eatingthe central feature of binge-eatingfollowing bariatric surgery.

One approach the program is studying is CBT for teens. The trial provides treatment over four months, first focusing on the eating pattern. To do this, they ask participants to write down everything they eat, what time they eat, how they were feeling, and what they were thinking at the time they ate. We look for patterns with the teen and help them to eat meals and snacks on a regular, predictable schedule, Lydecker says. Parents attend the sessions once a month as well, which is helpful for a discussion of such practical issues as how to buy groceries for a child who may insist on only eating certain foods.

Thinking about weight loss as a solution to problems in a childs life is like saying that weight is a problem, which is a message the child will likely internalize.Janet Lydecker, PhD, director of child eating and weight initiatives for Yales POWER Program

Ways To Help Without Directly Speaking To Them About It

Oftentimes, your family member or friend might not realize or accept that they have an eating disorder. The best chance for treating this problem is by speaking with a mental healthcare professional.â

Here are some ways you can guide your friend or family member toward seeking help without directly speaking to them about it.

• Continue to let them know they’re welcome. This person may be in a place where they’re self-isolating. It may be hard to encourage them to engage in the outside world. But keep trying. Even if they say no, being invited will let them know you still value them as a person.
• Shower them with love. Telling them how much you love them and appreciate them can build their self-esteem and help them through this challenging time in their life.
• Listen to them. This may be difficult, but simply giving them your time and listening to them without judgment can mean the world to them. It can be tough to hear them speak about themselves and what they eat but not giving advice or passing judgment is what’s important.

Offering support is essential, and you can do this indirectly by:

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Walk Out Together: How To Be A Good Friend Through Recovery

As your friend comes to terms with her struggle, you can help by looking up local treatment centers that specialize in eating disorders .

You can also model healthy habits. Eat for energy, and exercise for strength, letting any remarks about food reflect your intentions.

Above all, do your best to maintain balance. Give space when needed, but dont enable. Encourage change, but dont expect to be the hero of her story.6 Be her sidekick. After all, thats exactly what she needs.

1 Janniello, Lizzie. 12 Tips for Talking With Someone Who Has an Eating Disorder. Project Heal, February 10, 2017.

You’re Worth More Than Your Eating Disorder

Something that’s often forgotten and overlooked, is that the person suffering and the eating disorder are two separate things. Someone has an eating disorder, no one is an eating disorder. The terms “anorexic” and “bulimic” were created and have been used wrongly. Someone has anorexia, they’re not an anorexic. Hearing from someone that you’re worth more than the hell you’re going through gives that little sparkle of hope that can help someone through a hard time.

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Avoiding Treatment For Eating Disorders Can Lead To Other Problems

Treatment can be critical for a multitude of reasons, one being that eating disorders have one of the highest mortality rates of any mental health illness. They can eventually lead to such serious physical complications as cancer, diabetes, and organ failure, if not treated. They are associated significantly with suicide attempts, adds Ivezaj.

Michael Lerner, MD, a Yale Medicine otolaryngologist, says cases that go untreated can lead to symptoms usually associated with such conditions as acid reflux. When the larynx or throat is continually exposed to acid and pepsin from the stomach, the result can be chronic inflammationand in the worst cases, eventual precancerous changes, he says.

In severe cases, frequent and vigorous retching or vomiting can lead to stricture of the esophagus, which can result in dysphagia , Dr. Lerner says. People with these conditions might find that they feel the urge to clear their throats frequently or notice a foreign body sensation in their throat. So, otherwise common symptoms such as voice change and throat sensitivity, which are typically attributed to allergies or acid reflux, could, in fact, also be due to an eating disorder, he says.

Why Is It Taking So Long For You To Get Over This

Because recovery is a long process. These patterns and habits and coping mechanisms have been formed for the past years and I have to actively work to change them. And Im frustrated with myself. When youre frustrated with me, its even worse. I just need your encouragement to keep going. I need your love and support, but most of all, I need your patience.

What to say:

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Talk To Your Loved One

Itâs understandable to be afraid the person will get upset or mad if you try to talk to them. Maybe you arenât sure you have the right words. As long as you’re thoughtful about what you say and how you say it, it’s OK to have the conversation. Some dos and donâts can help:

Donât say: âWe need to talk right now.â Talk to your loved one when they are ready and willing. Choose to chat in a place where they feel comfortable — for example, at home instead of in public. Itâs best to avoid places where food is involved, such as a restaurant.

Donât say: âYou have to get help.â Your loved one might not be ready to get help — or even admit that they have a problem. Itâs up to them to decide they want to get better. Let them know that youâll support them if and when they want help. One way to do this is to avoid âyou statements.â For example, âYouâre eating too much,â or âYouâre worrying me.â Instead, use âI statementsâ — âIâm worried about you. I’m here if you want to talk.â

Donât say anything about weight. Never mention your loved oneâs weight, regardless of whether they look thinner, heavier, or the same as usual. Even statements that you mean as positive can be misunderstood and viewed as criticism. Plus, worries about weight or dieting can make a person more likely to have a binge. Thatâs why itâs important not to discuss your own weight or eating habits in front of them, too.

But do say:

I Like Your Hair/bag/shoes/etc

Everyone likes to get a compliment every now and then, but avoid saying “you look healthy/good” because this could be heard as “you look bigger” in the ears of someone in the early stages of recovery. However, giving a compliment about hair, shoes or maybe even their make-up can boost confidence and make the other feel better about themselves.

Compliments are difficult to receive due to this devil on your shoulder whispering in your ear that everyone is lying. It can be a challenge to convince someone in recovery that they look good, so the smaller the compliment the more likely it is to be accepted. Avoid compliments about someone’s body, focus on other things.

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Shattering The Thin Young Woman Stereotype

When thinking about who might have an eating disorder, its common to conjure an image of a slender, young white woman with perfectionist tendencies, but the truth is that they affect all kinds of people, regardless of race, sex, socioeconomic status, or any other factor, Lydecker says. Although eating disorders are most commonly diagnosed in adolescents and young adults, they affect individuals of all ageseven the elderly.

Many adults report a range of disordered eating including behaviors such as binge eating, intrusive and distressing thoughts about eating, weight, or shape, and body image concerns, says Valentina Ivezaj, PhD, who works with adult trial participants.

Binge-eating disorderidentified as a formal eating disorder only relatively recentlyhas challenged stereotypes by showing that people with eating disorders can have very thin physiques, or have normal weight, overweight, or obesity.

Whats also important, Ivezaj says, is the way we talk about these disorders. We like to use people-first language because we see it as less stigmatizing and more respectful. For example, we would say a person with obesity or overweight rather than an obese or overweight person, Ivezaj says.

In severe cases, frequent and vigorous retching or vomiting can lead to… narrowing of the esophagus, which can result in… swallowing issues.Michael Lerner, MD, a Yale Medicine otolaryngologist

You Should Eat More/less Of That

Remind yourself that you are not your loved ones doctor or nutritionist. Instead, allow the person to follow the nutritional recommendations of their treatment team, Weatherston-Yarborough advises.

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Don’t Comment On Weight Yours Or Theirs

Commenting on the weight of someone with an eating disorder, no matter how well-intentioned, will just reinforce the thoughts and behaviors of the eating disorder, says , a licensed clinical psychologist with Torrance Memorial Medical Center’s Eating Disorders Program in Torrance, California.

Important: “When we comment on an individual’s weight, we are placing focus on something external, their body, as being what is valuable and important about them. We live in a society that already places way too much value on appearance, we do not need to reinforce this,” Baird says.

Not only should you avoid commenting on your loved one’s weight, but you shouldn’t comment on your own either, Baird says. These comments can be triggering for someone with an eating disorder and exacerbate their symptoms.

Some common phrases to avoid include:

Get Help When You Need It

When youre working to maintain your recovery from an eating disorder, help can take many forms.

In some cases, an honest conversation with a member of your personal support network can provide the ideal amount of assistance. In other cases, the best course of action might be to attend a support group meeting, schedule an extra session with a therapist or counselor, or enter a treatment center.

If youre concerned that a specific holiday-related event may threaten your recovery, getting help may involve talking things through ahead of time with a close friend or trusted family member. If possible, you may want to invite this person to attend the event with you or at least make sure that they will be available to talk on the phone or exchange text messages during the event.

If you are a member of a support group or are under the care of a therapist or counselor, these can also be excellent sources of help to prepare for the event and to process your experience afterward.

Whats most important is understanding that you are not alone and that asking for help is not a sign of weakness or failure. Realizing that youre struggling and getting the right type of assistance are evidence that you are taking your recovery seriously and that youre committed to doing whatever you need to do to protect your health.

During the holidays or at any other time of year, proactive self-care may be the best gift you can give yourself.

References

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