Eating disorders have the highest mortality rate of all mental illnesses, yet they are also one of the most misunderstood. I get asked what is and isn’t helpful to someone with an eating disorder a lot, so I wanted to touch on six lessons that everyone should learn, because everyone knows someone who’s struggling with this disorder.
Lesson One: Know what you’re getting yourself into.
Eating disorders are confusing, demanding and life threateningly serious. Warning: handling someone with an eating disorder is not for the faint of heart! It takes a lot of strength and courage, because of what eating disorders bring out in the suffering individual. The most compliant person will become stubborn. The amiable will become angry. The warm and friendly will become cold and distant. The moment you cross their eating disorder, the moment you try to make them eat or stop purging, is the moment that you become unsafe. You must walk in to the relationship prepared to fight fire or you will be seriously burned. The reason for this drastic change is simple. You are ripping (or threatening to rip) away their best friend, their comfort, their protection, their reliability and control. Would you be okay with someone doing that to you? I think not. The point of this lesson is, be prepared to fight to the death, because the eating disorder will stop at nothing less.
Lesson Two: Put on your listening ears.
I recently spoke with a dear friend from treatment who said that what helped her most was people listening without trying to fix anything. She just needed to be heard and validated in her feelings. And so did I and many others I have met. I was an emotional wreck wrapped up in a pretty package. I was afraid, angry, tired, confused and lonely, but I had no idea what to do about these thoughts and feelings racing through my mind. I felt like I was going insane. Thus having a friend that would just sit with me and listen was huge. I didn’t want anyone to try to fix it. I just wanted to be heard and validated.
Lesson Three: Watch your mouth.
If you are trying to be sensitive to the needs of your loved one, then you will feel like you’re walking on eggshells around them. I remember my parents telling me in the midst of my disorder that they felt like they had to walk on eggshells around me, because they didn’t know what they could and couldn’t say. I had no response for them then and I still don’t have a concrete one now. However, there are a few things people said that I know didn’t help. First of all, don’t say “I understand” if you don’t actually understand. (*Hint: if you didn’t have an eating disorder and aren’t a professional in the field then you probably do not understand, so just admit it.) Second, don’t downplay your loved ones feelings. They have a right to each and every one of their fears. They may be irrational to you, but believe me they are all too real for them. So don’t say things such as, “It’ll be fine, you’ll get over it, it’s not that bad, it’s just a phase, just eat something, pray about it and it’ll be fine.” Those responses will make them feel like their disorder isn’t that bad, that they need to be sicker to get help. It will confirm the lies they already believe about themselves. It will make them withdraw from you and others, because the dismissing of their very real problem makes them afraid to share for fear that people will think they are crazy. I know I only shared what was really going on in my mind with my therapist, because I was too afraid to tell anyone else about the voices in my head and the irrational anxiety/crying at the thought or act of eating. Lastly, don’t comment about weight. Just don’t. It will not end well. Basically, be sensitive and think before you speak. Try to put yourself in their shoes and if you don’t know what to say don’t say anything at all.
Lesson Four: Ask questions.
If you are in the position of friend to someone with an eating disorder then one of the best things you can do is ask intentional questions. “How did ____ make you feel? What were you thinking when ____ happened? What can I do to help you? How can I support you?” It might seem like they don’t like the questions on the outside, but I guarantee it’s good for them to process aloud and will make them feel loved, known, cared for and like you see and acknowledge the hurt inside of them.
Lesson Five: Give support and space.
Support is necessary, but it has to be the right support combined with space. Mealtime support was particularly good for me, but I absolutely hated it. I was afraid to eat in front of people, especially when I knew they were specifically watching me. I refused mealtime support whenever possible until I got into treatment and had to have meal support. What I learned was that meal support is extremely helpful in treatment, because there was no judgment, just support from people who understood and were walking alongside me. Give non-judgmental support, but also give space. Don’t ask what they’ve eaten unless they specifically ask you to keep them accountable. Constant questions about food add pressure and anxiety to their already overwhelmed, overloaded mind. Don’t make a big deal about the food, because it’s not about the food at all. Your focus on what they’re eating exacerbates their already hyper-focused on food mind. It’s the dietitians job to handle the food and make sure they have adequate meal time support. Your job as their friend or loved one (unless directed otherwise by a professional) is to give them support and space by focusing on their heart & mind.
Lesson Six: Recognize the reality.
The last thing you can do is acknowledge that this is a disorder and a disease, not just a fad or diet plan. Recognize the reality that they have a mental illness, a mental disease, and cannot get well on their own. Tell them that while you do not understand the disorder itself, you do recognize that it is a serious problem. This will make them feel safe around you and hopefully, give them the courage needed to face their fears.
Everyone is different, so every eating disorder will be different. There are no magic words or cures that will work for everyone, because every single case is different. Thus these lessons are not all encompassing. They are not six easy and foolproof steps to getting someone through recovery, but they are solid guidelines to follow.