What Not to Say: Helpful Guidelines for Family and Friends of Someone Struggling with an Eating Disorder

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{and reminders for us all to consider the impact of our words}

Walking with someone who is struggling with an eating disorder can be confusing, frustrating, and frightening. It’s difficult, at best, to know what to say, how to say it, and when to say it. 

Eating disorders are extremely complex illnesses, which means that there is no way we can ever fully understand them. There’s no perfect prescriptive narrative that will guarantee clear navigation of trigger and conflict landmines. 

However, based on what we do know about eating disorders through research and shared experiences of those who struggle, we have a framework of general guidelines that are helpful for those who do life with people struggling with these disorders. And given the world we live in that is more and more obsessed with diet culture every day, many of these guidelines and tips will be helpful for us all as we consider the impact of our words and actions upon society.

Biblically, we are asked to take captive every thought. Thinking about our words before we speak them is an example of loving God and loving others, the greatest commandments in the Bible. Even in our failed attempts, I believe God will honor our efforts when our hearts are turned towards Him.

Don't

  • Praise or belittle a person based on body size or appearance. Body size has nothing to do with a person.

  • Encourage weight loss or compliment a person who loses weight or diets. Even at an extremely dangerous weight, people praised my body size and complimented my “will power” to lose weight. I get that some people just didn’t know what to say, but for heaven’s sake, say nothing if that is the case. Even weight loss at an apparently “safe” level should not be praised. We have no idea how the weight is being lost/behaviors that are being practiced. Research supports that most diets are forms of restriction. 

  • Speak negatively about your body

    • This is a tough one for most people, as our society has perpetuated a general dissatisfaction with body size. But it is not helpful and can be damaging in the recovery process.

    • Discuss measurements, weights, or clothing sizes

    • Label foods as “good” or “bad”

      • No food is “good” or “bad.” Everything from pizza to spinach to PBJ’s can be part of a balanced meal plan. Healthy is relative.

      • Make fun of another person’s eating habits or food choices

      • Criticize your own eating

      • Consider a person’s weight important

      • Say someone is “healthy” or “well” because of body size

        • People of all different sizes live balanced, happy, productive lives

        • Expect perfection

        • Assume that an overweight person wants or needs to lose weight

          • Society strikes again here. Overweight does not equate unhappiness. Thinness does not equate happiness.

          • Reinforce the media’s view about what body types are acceptable or attractive

          • Use food as a punishment

          • Diet or encourage your loved one to diet

          • Comment on weight or body types

          • Get involved in a power struggle

          • Take control or police eating or behaviors 

            • Do allow the eating disordered person to be in charge of their own eating within the guidelines of a treatment team.

            • Argue at the table or discuss uncomfortable topics

              • Do make table time as pleasant as possible. Consider distracting with games, or purposefully plan positive conversations.

              • Overlook dysfunctional behaviors. 

                • This sends a message that behaviors are acceptable.

                • Enable the person

                • Use scare tactics. 

                  • They are not appropriate and do not work.

                  • Lose your temper when you feel frustrated by the person’s choices

                    • Remember that people who struggle with eating disorders also struggle with intense feelings of inadequacy. Attitudes of scorn, disgust, or impatience exhibited toward an individual with an eating disorder may intensify his/her symptoms.

DO

  • Recognize that food has a purpose. It is God’s perfect plan for us to fulfill hunger and provide nourishment for the bodies He created. 

  • Examine your own beliefs and feelings about body image and weight and consider how your attitudes, comments, and even nonverbal responses are being communicated to your loved one. Pay attention to your focus on your weight, body size, and diet; it may be contrary to the approach your loved one needs. And it may not be good for you, either.

  • Compliment and reinforce characteristics and interests other than weight and appearance. Part of recovery for your loved one is to separate the way he or she feels about herself from appearance. Compliment strengths, abilities, gifts, and talents that are not related to appearance, weight, or shape.

  • Participate in activities that don’t raise concerns about weight or shape. 

  • Express concerns and communicate directly and openly. Don’t beat around the bush. This helps avoid sending indirect or potentially confusing messages. Explain what you suspect by describing the person’s problematic behaviors.

    • Example: I am noticing that you’re skipping meals. You’re eating less at each meal. You’re exercising more, and it is obvious that you are losing weight. I’m concerned for your health.

      • Example: I’m noticing that whenever I buy candy bars or cookies, they disappear. When I ask you about them, you say you don’t know anything about it, yet I find wrappers g around. It seems that you are eating more than usual.

      • Offer support by being available to listen. Use listening skills and allow your loved one to talk about what is on her mind. Be sensitive. It’s not always helpful to offer advice or try to fix it

      • Allow your loved one to talk about his or her feelings. Part of recovery includes identifying and expressing feelings.

      • Treat your loved one like any other family member or friend. If you give your loved one a special status because of the eating disorder, you may inadvertently reinforce symptoms.

      • Be aware of your own and other family members’ needs. Eating disorders take a serious toll on a family or friendship. Take care of yourself.

      • Be patient. Recovery takes as long as it takes; it’s not perfect. A slip in recovery after a behavior-free time period is not unusual and does not mean your oved one is giving up or all hope is lost. Allow the person time to improve unless you suspect that his or her life is in danger. Come up with a plan that may include certain behaviors such as eating regularly or decreasing purging. If the verbal contract is broken, seek professional help.

      • Provide specific information for help including names of treatment providers and phone numbers. Have information available when you approach the person.

      • Ask how you can help with meals

        • Ideas: Remove binge foods from obvious places, join them at meal times, assist them at the grocery store

        • Understand that a person with an eating disorder is highly sensitive to non-verbal behavior and often misinterprets someone’s fleeting expression, a tone of voice, or even the movement of the body as a message of rejection or criticism. 

Resources: BYB Recovery Group Members, various online postings

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