How to talk to someone with an eating disorder

A question I get asked often is, "How do I help or talk to someone who I suspect is struggling with an eating disorder?"  This is an important question, as anyone who has been there can probably tell you that reaching out to someone struggling with an eating disorder can be a difficult thing to do.  The person who is struggling is likely someone you love and care for deeply and as a friend or family member, you want to be able to help them. This creates an emotionally charged conversation that many fear will end badly.

Here are the steps I share with a person wanting talk with someone who may be struggling with an eating disorder:

  1. Prepare. Gather resources and have them available when you approch the person. Any literature about eating disorders or where to go for help may help the person identify that they are struggling with an eating disorder. Also, in the case that they may have some awareness of their struggles, you are providing them with resources they may not know were available to them. Links to great resources: NEDA Eating Disorder Facts, NEDA Resource Information, Melrose Institute - Park Nicollet
  2. Talk. Find a good time to talk to the person. Speak to the person privately and allow for adequate time to talk openly and honestly. Communicate to the other person that you are very concerned about him or her. Calmly tell the person the specific observations that you have noticed and that are a cause of your concern. Focus on eating or exercise behaviors that you have noticed or other problems (e.g., withdrawing or isolating from others). Avoid using words that would define the person's physical appearance. Words such as "thin," "skinny" or "sickly" may define the exact body type that the person is trying to attain. 
  3. Listen. Allow the person time to respond to your concerns. Listen carefully and in a nonjudgmental and open manner. Listening is very important in this process. Face the person, maintain eye contact and an open posture. Avoid conflicts or a battle of the wills with the person.  If the person refuses to acknowledge that there is a problem, or any reason for you to be concerned, restate your feelings and the reasons for them and leave yourself open and available as a supportive listener.
  4. Respond. Summarize what you have heard, and tell the person you think he or she has a problem with eating, body image, or weight management. Restate your concern about his or her health and well-being. Explain that you think these things may indicate that there could be a problem that needs professional attention. Ask the person to explore these concerns with a counselor, doctor, nutritionist, or other health professional who is knowledgeable about eating issues.  If you feel comfortable doing so, offer to help the person make an appointment or accompany your friend on their first visit. Avoid placing shame, blame, or guilt on the person regarding their actions or attitudes.  Do not use accusatory “you” statements like, “You just need to eat.”  Or, “You are acting irresponsibly.” Instead, use “I” statements.  For example: “I’m concerned about you because you refuse to eat breakfast or lunch.”  Or, “It makes me afraid to hear you vomiting.” Avoid giving simple solutions.  For example, “If you’d just stop, then everything would be fine!”
  5. Get help. After talking with the person, if you are still concerned with their health and safety, find a trusted adult or medical professional to talk with (e.g., eating disorder specialist, doctor, school counselor or nurse, or minister). This is likely to be a challenging time for both of you.  It could be helpful for you, as well as the other person, to discuss your concerns and seek assistance and support from a professional. Problems that are particularly troubling and warrant seeking help immediately include: if the person is binging and purging several times throughout the day, passes out or complains of chest pains, complains of severe stomachaches or vomiting blood, or has thoughts of harming themselves or suicide.

Remember that you cannot force someone to seek help, change their habits, or adjust their attitudes.  You will make important progress in honestly sharing your concerns, providing support, and knowing where to go for more information! People struggling with anorexia, bulimia, or binge eating disorder do need professional help.

Lastly, know that you are not alone - there are great resources for parents, family, friends, and others who know someone struggling with an eating disorder. Please know that help is available and recovery is possible! Please visit NationalEatingDisorders.org for more information or call the National Eating Disorder Association Helpline at 1-800-931-2237.

 

This information was adapted from information provided by the National Eating Disorders Association (NEDA), at NationalEatingDisorders.org and the Melrose Insitute - Park Nicollet.