Harm Reduction

Harm reduction aims to promote safety and improve quality of life, even if disordered eating behaviours are still present in an individual’s life. Reflect on your disordered eating and how it impacts your life. Do certain behaviours have a more negative impact on your physical health or emotional well-being? Are there aspects of your disordered eating that make your daily life more challenging? Asking yourself these questions may help guide you toward potential starting points. You might prioritize behaviours that pose the greatest risk to your health, or behaviours that make it hard to enjoy things that are important to you.  

For example, running without adequate energy intake can be dangerous. I’ll start by ensuring I’ve eaten before going on a run. Running multiple times a day limits my time with family and friends. I'll begin by cutting down my daily running time. 

Identifying markers of physical and emotional well-being that you can check quickly and easily can help you assess what's working and what's not. Consider how your body feels before, during, and after engaging in a behaviour; are you experiencing any pain, feeling dizzy or fatigued? Reflect on your emotions; do you notice a shift in your mood? If you’re experiencing distress, this may be a sign to adjust your behaviour.  

For example, before and after going on a run I will assess how my body feels. Do I have any pain that is higher than a 5/10? Do I feel dizzy or faint? If yes, I can adjust more. 

Challenging disordered eating is hard work and can come with many complex or intense feelings! Consider what coping strategies could help you navigate difficult emotions that may arise during this time. You might find it helpful to list them. If you’re having trouble thinking of ideas or want to try something new, check out our coping strategies page. Can you think of any challenges that may make it more difficult to use your go-to strategies? Consider how you might work around these challenges. You might plan ahead by having a set of backup strategies in place or reaching out for support. 

For example, I know there will be a part of me that wants to exercise more, so I’ll plan to soothe my emotions by journaling when I get home. If journaling doesn’t work, I’ll distract myself by watching a movie.

Mapping out your support network can help you identify where and how you can access help. First consider what supports you already have in place, this can enable you to determine what is missing from your network. Perhaps there are resources among your current supports that can help fill the gaps. You can also check out our service provider directory to locate additional sources of support that are accessible to you. 

For example, I’ll call a friend when I get home from my run and plan to talk about this with my support group later this week.

• Delay behaviours: If an urge to engage in a disordered eating behaviour arises, set a timer, and try to sit with the urge until it reaches zero. During this time, practice distress tolerance techniques, coping strategies or distract yourself. Once the timer is up, reflect on the advantages and disadvantages of acting on the urge or not acting on the urge.
• Reduce frequency or intensity of behaviours: Think about the number of times you engage in a behaviour across a day or week and aim to decrease the frequency. For example, if you engage in a behaviour every day, try shifting to a pattern of every other day. Or, think about the intensity or duration of a behaviour and aim to replace it with something gentler or reduce the amount of time engaging in it. For example, choosing to walk rather than run.
• Receive regular medical care and check-ups: Schedule regular appointments with your primary care provider or visit a walk-in clinic to have your vitals monitored. This can help ensure your body is continuing to function as it should be. 
• Reach out for support: Connect with our Helpline or Live Chat, attend a support group, or reach out to a loved one.

• Keep in mind that any food is better than no food. What foods are easiest for you to access, prepare, and eat, even when you are low in resources (which could mean finances, energy, or time)? These might include packaged convenience foods, nutrition supplement drinks, or pre-cooked store-bought meals.
• Take nutrient supplements like multivitamins (ideally with guidance from your primary care provider or a dietitian).

• Hydrate, hydrate, hydrate. Ensure you are consuming fluids. This also doesn’t necessarily need to be water. Instead, could you drink juice, a sports drink, milk, or soup broth? Perhaps eat a popsicle or watery fruits like watermelon, strawberries, or cucumber?
• Avoid brushing your teeth immediately after purging; instead, rinse with fluoride and water. Baking soda and water can also help neutralize the stomach acid that is brought up from vomiting. 
• Brush your teeth with fluoride toothpaste to protect and strengthen your enamel.
• Schedule regular appointments with your dentist.
• Plan to take your medication at a time of day that is furthest from purging.
• Schedule regular endoscopy check-ups (consult with your doctor around recommended frequency).

• Try replacing higher intensity exercise with gentler movement - For example, incorporating lower impact exercise, like walking, yoga, or tai chi.
• Take time to stretch and warm up before exercising.
• Consider exercising with someone who knows your limits or has been in conversation with your doctor. If no one is available to exercise with you, try going to public spaces like a park or gym to avoid exercising alone.

No, harm reduction is not necessarily in opposition to abstinence, rather it recognizes that abstaining or eliminating disordered eating entirely may not be a realistic or desirable goal for all people, especially in the short term. For instance, harm reduction acknowledges that disordered eating may function as a coping strategy for some. It may not be realistic to expect a person to refrain from disordered eating if they have not yet developed new, more adaptive coping strategies.

Harm reduction also acknowledges that many people are unable to access treatment and professional supports, however there are strategies and techniques that can reduce harm and can be done in the person’s own environment.

Eating disorders can be really challenging to cope with, and often eating disorder thoughts can impact a person’s desire and want to engage in harm reduction. 

Using reframing can be helpful to gently challenge the disorder eating thoughts. This is often most effective when replacing the disordered eating thought with a more balanced, neutral, and rational thought. 

For example, if the thought of “I can’t avoid exercising” is present, try replacing it with “My eating disorder doesn’t want me to avoid exercising, and I can try to reduce a little to avoid hurting my body more”.