Eating Disorder Awareness Month

February is Eating Disorder Awareness Month.  I thought this would be a good opportunity to talk about ways you can help a loved one whom you suspect or know has an eating disorder.

If you suspect a loved one, friend, or co-worker to have an eating disorder, here is how you can help: 

Generally it is a good rule of thumb to let them take the lead.  If he/she mentions a struggle with weight, eating, or exercise, you can use this opportunity to simply let them know you are there to support and listen to them without judgment. 

Do not talk about how other people look, or how you want to lose weight, especially during mealtimes.  It seems to be a cultural phenomenon for people of all shapes, sizes, and genders to speak about weight loss, calories, and other peoples’ sizes, while eating.  “Oh my goodness, I shouldn’t eat that -- it must have a million calories!” (while consuming said food).  This takes the pleasure out of socializing and eating, while also making anyone with an eating disorder very uncomfortable to the point of not eating at all and possibly leaving. 

Do not suggest a diet, fix, treat, or cure.  It is tempting to offer advice, such as dieting or exercise to someone stating that he/she wants to lose weight.  Even with the best of intensions though, this is unhelpful, even if you only suspect this person may have an eating disorder.  An eating disorder is beyond simple dieting.  Someone struggling with an eating disorder typically knows a lot more than you would about diets, calories, and any suggestions you might make.  They are thinking about food, eating, exercise 24/7, even if this doesn’t seem obvious.

Suggest that this person seek professional support, but then drop it.  If you press someone about seeking help, they are less likely to take this advice and they will feel judged and/or watched.  Let them know you think it might be a good idea, but let them come to their own decision, in their own time.  There are more suggestions below for parents who are not able to wait any longer for the sake of their child’s health.

Do not be the food police.  Even though you have good intentions, the person you are trying to help and support will feel watched and judged by you if you start giving advice or guidance.  

Know your own limitations.  You can only help someone so much if they are not willing to seek help from other places.  You can listen, but be sure you are caring for yourself throughout the process.  You do not want to feel like his/her therapist because it can create resentment in both of you and damage a positive relationship for this person in need.  You think you’re doing well by them at first, but ultimately you may be taking away their biggest support (YOU!) when they need it most (later once they have gone into treatment with a professional). 

Focus on YOU as much as possible.  Remain patient with your loved one/friend and realize that the process of healing from an eating disorder will take time.  Recovery is day to day, moment to moment.  You can be there to listen and provide a distraction for the person by offering to do fun things with him/her when they are able and ready.

Plan fun, food-free activities.  So many social gatherings revolve around food.  Try suggesting other adventures to do with this friend or loved one.  You could go for a walk together.  You might suggest going to a concert without the obligatory dinner/lunch.  You could make an appointment at a spa and have a massage or get your eyebrows/nails done.

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For Parents or Caregivers Only:  (I do not suggest the following options to friends because it would be overstepping)

If you are a parent of a minor (or really a parent of any age child) with an eating disorder, these ideas change slightly.  If your child is dangerously overweight or underweight, you will have to be more involved in getting him/her a supportive professional team in place.  Typically, forcing someone of any age into treatment will be counterproductive, but when it comes to the health of a child, it is also needed at times. 

First, educate yourself about eating disorders.  Take time to learn about the basics of eating disorders. In order to be most helpful, you must be somewhat knowledgeable.  Eating disorders are a coping mechanism for an underlying stressor, so you might want to think about the stressors in your child’s life, without judgment or blame.   You can start by looking at the NEDA website: www.nationaleatingdisorders.org

Try to allow enough time to give your child room to make the decision him/herself.  Follow the above ideas initially, but if your child does not reach out for help or assistance, you might need to speak with him/her more directly with love, kindness, and support.  Continue listening without blaming or threatening, and without making suggestions or giving advice (other than suggesting professional support).  Let the professional provide the guidance and make suggestions. 

You might want to research eating disorder specialists in your area.  If you find a good therapist, he/she will probably be able to suggest other practitioners in the area that could be useful, if necessary.  With eating disorders, the professional approach is often an integrative team approach, including a psychotherapist (eating disorder specialist), registered dietitian, psychiatrist, medical doctor, all with experience in working with eating disorders.

If you decide it is necessary to intervene and get your child into treatment against his/her will (initially), be sure to continue to focus on YOU.  Do all you can to calm yourself down before speaking with your child about this issue.  Plan how you are going to approach your child, so you can be prepared, focused, and as compassionate as possible.  You need to be calm, so your child can freak out.  Be sure to get the support you need in order to be productive with your child.  You may need to meet with a professional prior to speaking with your child to get information, reassurance, education, and support (this would not typically be the same professional that would work with your child).  Know that no matter how gentle, compassionate, and caring you are with your child in this situation, it will probably feel wrong in the moment.  Just do the best you can to be honest, compassionate, non-accusatory, and non-judgmental. 

Kimberly Atwood is a psychotherapist in private practice with offices in Doylestown, Pennsylvania and Midtown Manhattan, NYC. She specializes in working with people in their 20’s and 30’s dealing with eating disorders, intimacy issues, and related anxiety.  For more information, please visit her 'Finding Your Voice' Blog .