Eating Disorders: How to be supportive…

Friends and family are often key to encouraging loved ones with eating disorders. Whether they are unaware that there is a problem, afraid or ashamed to reach out, many sufferers find it difficult to seek help. 

However, as dietitians we also hear about some of the hurtful and misguided things people say to people with eating disorders so while the intentions may be good, the comments can be insensitive and possibly even harmful.

 

Recommended Do’s:

• Be patient and nonjudgmental
• Try to learn as much as you can about eating disorders, there are many excellent organizations and websites with helpful information such as:

      www.NationalEatingDisorders.org 

      http://cydadiet.org/data/originals/2014/11/leaflet-diataraxes-updated.pdf  

     http://www.mazi.org.cy/mazi/page.php?pageID=5

• Try to be a good role model, this is not necessarily always “healthy eating.” If you are also frequently concerned about what and how much you eat you may worsen the problem. 

 

• Encourage social activities that don’t involve food. 

 

• Take the pressure off in mealtimes; this means, don’t talk about or make comments about their food, how much they eat or don’t eat, or how they eat.

 

• Understand that the person is not looking for attention or pity

 

• Be prepared for negative reactions. Some eating disorder sufferers are glad that someone has noticed they are struggling. Others respond differently. Some may become angry and hostile, insisting that you are the one with the problem. Others may brush off your concerns or minimize potential dangers. Both of these responses are normal. Let them know you care and leave the conversation open. 
• Remove potential stigma. Remind your loved one that there’s no shame in admitting you struggle with an eating disorder or other mental health issue. Many people will be diagnosed with these issues during their lifetimes, and many will recover. 
• Stay calm. Avoid expressing frustration with the person. Express your concerns gently. Ask, “Are you willing to consider the possibility that something is wrong? ”Expressing your concerns may be awkward at first, but such efforts can provide the bridge to help the person. Even if the person does not acknowledge a problem during your discussion, you have raised awareness that you are paying attention, are concerned, and want to be a support.
• Suggest professional help in a gentle way, offer to go along. Offer to help the sufferer find a physician or therapist if they don’t have one — or leave a list of resources behind for the person to look at on his/her own.

 

Recommended Don’ts 

• Accuse or cause feelings of guilt or place blame on the person.
• Do not comment on appearance, “you look great today,” as it may be interpreted as you have gained (or lost) weight. Compliment the person’s personality, successes, and accomplishments.
• Overly simplistic solutions. Being told “Just stop” or “Just eat” isn’t helpful. It can leave the sufferer feeling frustrated, defensive, and misunderstood. 
• Make promises or rules you cannot or will not follow (e.g. promising not to tell anyone).
• Invade privacy and contact the patient’s doctors or others to check up behind his/her back
• Demand weight changes.
• Discussions that center around numbers such as body weight, calories, and amount of food, time and quantity of exercise.

 

• Take the person’s actions personally 

 

• Do not try to take charge or make threats (e.g. if you do this once more I’ll…), you cannot force someone to get treatment and becoming the food police will not help the situation ( but do call 112 if you believe the person’s condition is life-threatening)

 

Even if you don’t feel the discussion was well-received, don’t despair. You shared your concern and let them know that you care and you are there for them. You may also have planted a seed that they should seek help. The seed may not take root immediately, but over time, the concern can help move an individual towards recovery.

Lastly, being a good support means that you also have to take good care of yourself and attend to the stresses you feel from the situation. This is important to serve as a model of healthy behavior for the person you are trying to support. Don’t let your loved one’s eating disorder completely rule your life.

 

Eleana Liasidou

Clinical Dietitian- Nutritionist, MSc

 

Bibliography:

• CNN (2019). Going to extremes: Eating disorders. [online] Available at: http://edition.cnn.com/interactive/2012/03/health/infographic.eating.disorders/index.html [Accessed 5 Sep. 2019].
• Eisler, I., Simic, M., Blessitt, E. and Dodge, L. (2016). Maudsley Service Manual for Child and Adolescent Eating Disorders. [ebook] King’s college hospital NHS. Available at: https://www.national.slam.nhs.uk/wp-content/uploads/2011/11/Maudsley-Service-Manual-for-Child-and-Adolescent-Eating-Disorders-July-2016.pdf [Accessed 5 Sep. 2019].
• Geller, J., Goodrich, S., Chan, K., Cockell, S. and Srikameswaran, S. (2019). Clinical Practice Guidelines for the BC Eating Disorders Continuum of Services. [ebook] Ministry of Health. Available at: http://mh.providencehealthcare.org/sites/default/files/BC%20Eating%20Disorders%20Clinical%20Practice%20Guidelines.pdf [Accessed 5 Sep. 2019].
• National Eating Disorders Association. (2019). How to Help a Loved One. [online] Available at: https://www.nationaleatingdisorders.org/learn/help/caregivers [Accessed 5 Sep. 2019].
• H-Kids, NSW Health (2008). Eating Disorders Toolkit, A Practice-Based Guide to the Inpatient Management of Adolescents with Eating Disorders, with Special Reference to Regional and Rural Areas.. [online] MH-Kids, NSW Health. Available at: http://cedd.org.au/wordpress/wp-content/uploads/2013/09/MH-Kids-Eating-Disorders-Toolkit-A-Practice-Based-Guide-to-the-Inpatient-Management-of-Adolescents-with-Eating-Disorders.pdf [Accessed 5 Sep. 2019].
• National Eating Disorders Association (2018). Parent Toolkit. [ebook] National Eating Disorders Association. Available at: https://www.nationaleatingdisorders.org/sites/default/files/nedaw18/1.%20ParentToolkit.pdf [Accessed 5 Sep. 2019].
• Nationaleatingdisorders.org. (2019). National Eating Disorders Association. [online] Available at: https://www.nationaleatingdisorders.org/ [Accessed 5 Sep. 2019].