Supporting someone with an eating disorder…for dummies.

If he asks, "Are you actually going to eat ALL of that?" one more time...
If he asks, "Are you actually going to eat ALL of that?" one more time...

Four years ago, after completing day treatment, I saw my nurse practitioner for a check-up mandated by the program I had attended.  It was summer, and I already felt heavier than I actually was due to the August humidity.  A smile broke across her face as I entered the room.  “Amanda, your face is all filled out!  You look great!”

This was like a punch to the gut, like salt to the wound. 

You see, I was only three weeks into recovery, which meant the eating disordered part of me still screamed for validation.  I didn’t want to hear that I was healthy, that I was gaining weight.  Hearing these words made me feel as if I had failed at what I was best at: looking perfect, and losing weight.  And failing at something, in my irrational mind, meant I – the sum of me – was a failure. 

My mother has often told me that supporting someone who has an eating disorder is one of the trickiest feats to accomplish, similar to walking a tightrope on stiletto heels.  I agree with her to a certain extent; eating disordered behavior is not as black-and-white as abusing benzodiazepines or alcohol.  Alcoholics can avoid the liquor store; anorexics and bulimics still have to deal with Stop N Shop.  However, with the right support and guidance, a husband, friend or mother can flawlessly maneuver around calorie remarks and portion queries.  If you are concerned about a loved one, take a gander at the five tips below. 

1.  Please, please don’t talk about your diet.

Ok, so you just decided to do that new Acai berry cleanse.  And you’re wicked excited about it.  But does anyone really want to hear about it?  If you are making the “normal” individual feel guilty about slacking off on their daily jog, imagine what you are doing to someone with an eating disorder.  As soon as you mention anything number-related, the caloric multiplication tables in an anorexic’s brain will start computing.  And if you think you’re fat enough to warrant a diet, what do you think of her?

ED Translation:  “Mom’s doing the cayenne-pepper cleanse.  See, it’s normal not to eat and just to drink liquids.  Which means I’m disgusting for eating breakfast and lunch today.  Oatmeal + banana + sandwich + apple = 800 calories.  I hate myself, I am a disgusting human being.”

2.  Don’t comment on her portions.

When an eating-disordered individual is recovering from an eating disorder, she is typically put on a meal plan overseen by a registered nutritionist.  What us fast-food-obsessed Americans don’t realize is this: one can eat a large amount of healthy food without gaining weight.  For example, a normal dinner serving of mini-shrimp is 23 pieces.  And, if a woman has malnourished herself, her nutritionist may have her eating double the amount you do normally.  So, if the size of her salmon seems larger than normal, shut your mouth and keep it to yourself.  Even if you’re worried that she may purge later.  When you utter the words, “Are you actually going to eat all of that?”, she hears:  I shouldn’t be eating this; I must have gotten really fat.  Isn’t it rude to comment on anyone’s food?  So why would you do it to her?

3.  Do ask her how she’s feeling.

The point of an eating disorder is similar to the point of substance abuse; the individual suffering is attempting to numb feelings that she learned somewhere were inherently wrong or sinful.  In other words, food is made into a moral issue.  So, if you notice she hasn’t touched her lunch for two days, don’t nag at her out of worry.  Instead, observe what behaviors accompany restrictive eating.  Does she isolate?  Does he tend to apologize for his behavior more?  Sit down with him or her and express your concern that she may be hurting.  For it never really was about the food anyway; the food is just a vehicle to exert control over.  And if you ask her to express her feelings, you’re supporting her in a very important way: you’re sending the message that emotions are valid and worth talking about.

4.  Don’t keep People Magazine in the house.

And Cosmo, for that matter.  Studies have shown that women’s self-esteem plummets after reading a fashion magazine cover-t0-cover.  I, and other eating-disordered women I know, have used magazines like InStyle and People as inspiration to utilize “ana” and “mia” behaviors.  And what good does looking at Angelina Jolie’s unattainable bod do you for anyway?  Do you feel better about yourself after reading them?  Throw Self Magazine away and replace it with National Geographic or the Globe.  It’s just healthier (and brainier) for everyone.

5.  Remember your job is to support, not be responsible.

If you’re reading this, you’re close to someone who has an eating disorder, and care about that person very much.  Maybe so much that at times you’ve felt responsible for this individual, that the burden of “saving them” rests on your shoulders.  Well, I’m going to tell you something that may provide little-to-no comfort: if a woman’s not ready to recover, she won’t.  And you can’t do a thing to change her mind.  But, you can support her.  The best thing you can do for her is consistently express your worry and care for her.  No individual is responsible for another’s survival, and her choice is on her.  So, join a support group if needed.  MEDA (Massachusetts Eating Disorder Association) provides weekly support groups for those caring for individuals with eating disorders.  Visit for more details.

Be gentle with yourself.  You are courageous.  And imagine the ways in which you can take the focus off of image and numbers in your own life.

(Image provided by Google Images)

2 thoughts on “Supporting someone with an eating disorder…for dummies.

  1. It would really great if this piece was mandatory reading for…well, for everyone. It is so incredibly easy to learn to hate yourself and your body in this world, and so, so SO hard to undo that mentality.

  2. It is hard! It takes practice, I think…and I will admit to slacking off for large amounts of time. I also wish everyone would read it, as I feel it is a “tricky” disorder to know how to support. Thanks for the comment, Ariella!

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