Eating disorders are complex mental illnesses characterized by persistent disturbances in eating and eating-related behaviours that result in harm to one’s physical health, mental health, and/or psychosocial functioning. These behaviours often serve as ways of coping with distressing life circumstances, interpersonal difficulties, and/or negative emotions. Eating disorder behaviours may also be symptoms of malnourishment or starvation, and/or a response to a difficult, stressful, or traumatic situation. You can learn more about the different types of eating disorders under Eating Disorders & Treatment.
As our society normalizes many disordered eating behaviours, such as worrying about calories or eating the 'right' way, it can be challenging for some people to recognize there is a problem. Additionally, shame and denial are common in the eating disorder experience which can make it hard for people to seek or accept help. There is no singular way to express concerns to someone with an eating disorder, and different approaches will work for different people at different times.
Be Patient. When you approach the individual for the first time, do not be surprised if they reject your expression of concern. They may react with anger or denial. For many folks, having an eating disorder corresponds with experiencing shame and pain. It's also important not to rush the person, and instead recognize that it will take time for the person to make changes.
Be Informed. It's important to understand that an eating disorder is a complex mental and physical illness and that the individual’s symptoms may be helping them cope with distress. Remember: eating disorders are not about food or vanity! Learning about eating disorders, the warning signs, symptoms, and resources available for their particular illness increases your ability to help them. It may be worthwhile to share what you have learnt with them. You can also call the helpline or chat with us online for support and direction to relevant resources in your area. It is up to the individual to decide what to do with the information.
Be Compassionate. Eating disorders are complicated illnesses, and the food, weight, and body image issues are symptoms of deeply-experienced distress. Try to recognize that the individual would prefer to have healthier coping mechanisms; however, they are doing the best they can at the moment. Show compassion for the pain that they are experiencing.
Be Encouraging. Foster their confidence in their ability to recover. Affirm their qualities and abilities that are unrelated to food or physical appearance, and remind them that they are more than their eating disorder. Acknowledge and celebrate any healthy changes in thinking or behaviour.
Be Non-Judgemental. It's important to express your own needs in your relationship with the individual without blaming or shaming them. Many individuals hide their eating disorder to avoid being stigmatized or as a protective response due to past negative experiences. Creating an environment free of judgement will help them feel more secure and better able to acknowledge and deal with the eating disorder.
Focus on feelings and relationships, not on weight and food.
Find ways to keep calm, focused, and respectful during difficult conversations.
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Anger and denial are common responses. Sometimes people don’t realize they are ill – this can be a result of various factors, such as: the psychological effects of starvation; living with symptoms for such a length of time that these have become the norm for them; or experiencing benefits as a result of the effects of their eating disorder (e.g., positive comments about their eating, exercise, or body). They may have fears around how change might look or not having support for their healing. Continuing to have open and honest conversations about your concerns and using “I” statements can be helpful.
If you’re feeling overwhelmed or scared – that’s normal. Know that you’re not alone. Eating disorders are treatable, and full recovery is possible. The fact that someone has opened up to you and asked for help indicates that there’s a part of them that really would like to get better and that they really trust you!
Accessing support and treatment as early as possible increases the chance of their recovery and minimizes the risk of needing more complex care. Have an open conversation with them to see if they already have any next steps and other people they want to inform in mind, and offer to support them in taking those steps if you can. If they don’t know what to do next and you’re unsure about how to help, you can still offer supportive listening and assure them you’ll be learning along with them.
If you didn’t notice anything was wrong, try not to blame yourself. Getting stuck in feelings of guilt won’t help the person; what will help is taking their concerns seriously. Ask what you can do to be supportive and help them get better.
Reading more about eating disorders and what the person affected may be experiencing can be a great starting point. You can connect with us through our helpline or live chat to learn more about where to start and how you can help.
If the person you’re supporting finds their treatment ineffective, you could invite them to discuss the ways in which it could better meet their needs. Encourage them to be open about these concerns with their treatment team. You could offer to help them prepare for that conversation (e.g., role play, make notes) or even accompany them to help with talking through their options.
Sometimes the hesitation and feeling of being stuck is not necessarily an issue with the type of treatment they’re receiving, but rather a broader struggle with the idea and process of recovery. For many people, disordered eating serves a purpose in their life and often provides some sort of comfort, safety, or familiarity, which is why treatment and intentionally challenging the eating disorder mindset can evoke fear and grief. Recovery isn’t linear, and it’s normal to have conflicting thoughts and feelings throughout one’s experience. Read more about the stages of change here.
Unpacking some of the underlying reasons as to why they’re feeling stuck may help with identifying and reaffirming their motivations to recover. Encourage them to keep speaking up and communicate what they’re experiencing. They don’t deserve to carry this all on their own, and perspectives from supportive people in their lives can help.