Answers To Your Top 5 Questions
By: Dana Dupuis, BANA Clinical Intake Worker
*The following article is based off of BANAs clinical experience working with family and clients. We also included information from the Academy of Eating Disorders*
If you are reading this you are more than likely supporting a loved one or a friend with an eating disorder, or you may be concerned that a special person in your life may have an eating disorder. You are probably scared, frustrated, afraid, worried and maybe even bewildered. You are not alone, and you play an important role in your loved one’s life and are crucial to them getting well or reaching out for help. With all of this said, you may wonder if you are saying or doing the right thing, worry that you are not doing enough, or be unsure about how to approach someone you are concerned about. In this article, we hope you will find a bit of comfort knowing you are not alone and that there are some simple things you can do that are extremely helpful to those suffering. It is important to allow yourself to not know all the answers and to accept that there are no quick and easy solutions. Be gentle and kind to yourself, and be confident that there are things that you can do to offer support!
Below we answer the top five questions we get asked from a loved one. We also included resources that go beyond this handout and we incorporated a link to a short video on how to approach someone you suspect has an eating disorder – you may prefer not to read an entire handout or resource book! Before we begin, the answers and resources below are geared towards adults struggling with an eating disorder and their families. However, if you are supporting a teen or child, some information below might be helpful for you, so don’t let that stop you from scrolling down.
Top Five Questions:
1) What is an eating disorder and does it last forever?
If you are like most people, you probably have an idea of what an eating disorder is that comes from television or social media. Unfortunately, as we all know, these sources are not always accurate; dare I say often times they are completely incorrect. Here is one misconception that we hear at BANA that is often seen on social media: ‘eating disorders are a young person problem, I am too old to struggle.’ An eating disorder can affect a person at ANY age (including youth and adolescents), and in fact at BANA the average age of our client is someone in their mid 30’s. Shocking, I know! Most people are surprised by this, so you are not alone if you thought this as well. Eating disorders affect ALL people, from all walks of life, backgrounds, sizes, shapes, ages and genders!
Another misconception that most people are surprised to hear is that men struggle with eating disorders. Men are often overlooked when it comes to their struggles with eating and body image. Please don’t overlook men in your life, they struggle sometimes more because of the stigma attached to mental health and especially around eating disorders.
Now, let’s get into some basic stuff about what an eating disorder is. We will also address if ‘they [Eating Disorders] last forever’ and the concept of recovery because they are both connected.
Eating Disorders are NOT a choice, they are serious mental illness. To quote the Academy of Eating Disorders, ‘Eating disorders can be recognized by a persistent pattern of unhealthy eating or dieting behavior that can cause health problems and/or emotional and social distress.’
Eating Disorders impact a sufferer’s entire life, from relationships, to work, school and finances. Food is used as a way to cope with one’s emotions and feelings and often time individuals struggle with other psychiatric disorders, such as anxiety, depression or problems with drug and alcohol.
The four main categories of eating disorders are anorexia nervosa, bulimia nervosa, binge eating disorder and other specified feeding or eating disorders (this includes purging disorder, night eating syndrome, atypical anorexia and low or limited duration bulimia nervosa and binge eating). If you would like to more information about each disorder, we have additional readings on our website (www.bana.ca)!
People recover from Eating Disorders, which is why early detection and prevention is so important. At BANA, we have seen so many people lead healthy, rich and fulfilling lives outside of their disorder (I like to call this ‘a life worth living’). Eating Disorders can last a long time or a short time, but that does not mean they last a lifetime. It is always important to be aware that negative Eating Disorder thoughts or behaviors can creep into the person’s life. This is why, when someone finds wellness, it is important for them to be diligent about what is healthy for them and to keep developing a life worth living (going to school, enjoying hobbies, finding and keeping a job, or developing relationships).
2) I feel like my family member/friend has an eating disorder, I’m scared, what can I do? How can I talk to them?
This is such a great question, and one we get asked often. First, learn about the Eating Disorder resources in your community. Call the community providers, ask them about their services and how someone can get connected to the program. You may want to inquire about fees, hours of operations, what type of therapy they provide, what age they service and ask who your loved one would meet with. You could ask to speak to that person to understand their role and what an appointment looks like. You never have to disclose any information about your loved one, you are simply asking about services. This information can be very helpful because if you choose to speak with a loved one about seeking help, you need to know about the services. You can also offer to attend your loved one’s first appointment (or to wait in the lobby). You can even offer to help your loved one to make the initial call for services (which can be so scary and overwhelming!). By making these simple gestures you are showing compassion, empathy, and trust.
Never push someone or give an ultimatum. Remain respectful and calm during your discussion with a loved one. It is important to use ‘I’ statements. For example, ‘I am worried about you,’ ‘I care about you,’ and ‘I want to support you.’ Talk about your loved one’s feelings and don’t force or push the conversation. Let the loved one share what they wish at the pace they want. This shows them that they are heard rather than being told what to do. This fosters trust, comfort, and respect which are important factors in creating a trusting relationship.
It is OK to tell someone that you are concerned about their health and wellbeing. It is also OK to encourage them to seek help. When having these conversations, pick a neutral location that feels comfortable for both you and the loved one. Try not to be negative or frustrated, which is easy to fall into! Let the loved one know it’s ok to talk and share, but also respect their privacy.
It is important to remember that the conversation may not go as you wish and that you can still remain open, loving and respectful. When you approach someone, they may deny or react with anger. Struggling with an eating disorder is filled with an enormous amount of shame and guilt, so do not rush the person.
Avoid simple solutions, such as ‘just stop purging.’ This minimizes the loved one’s experience and feelings. Of course, your loved one wants to stop purging; it is not that simple when thoughts, fears and worries are involved. If you decide to chat with a loved one about seeking treatment, avoid discussing weight, food choices and their appearance. Your loved one is already focused on this and it takes up the majority of their thoughts. Remember, we want to talk about how the loved one is feeling. Ultimately, there is no right or wrong way to have this type of conversation. But with a few guidelines above, you may feel a bit more prepared to talk to a loved one.
3) My loved one has just been diagnosed with an eating disorder. What can I do?
There are no concrete answers to this particular question, but there are so many things you can do. Our suggestion is to ask your loved one what they need or want during this time. You maybe surprised with their answer. At BANA, we asked our clients what they needed during their process of recovery from a supportive person and the majority of our clients said they wanted a hug! How heartwarming and how simple! Of course, we are not suggesting to run up to your loved one immediately and hug them (not everyone wants a hug!), but this example goes to show how a simple act can be helpful. It is easy as a supportive person to think that this isn’t enough, but it shows your loved one that you are there for them, and that they are not alone, and it can provide such a sense of comfort. Simple acts of kindness can go along a way; ask what your loved one what they need and hear what they have to say.
Another thing that our clients identified as helpful was to share their diagnosis with a loved one. With that said, learn about eating disorders and what the diagnosis means. Ask questions about what treatment will look like for your loved one and ask how you can support them specifically with that – but also respect their choice for privacy. You can offer to attend appointments with your loved one. For example, if your spouse was diagnosed with an eating disorder, maybe they would find it helpful if you joined in on a dietitian appointment or have a joint appointment with a counsellor. Of course, this is not required and may not be a good fit for every situation, but it is something to keep in mind and it can be very helpful.
Know that this time can be very overwhelming for your loved one or friend. Let them share their fears, concerns or thoughts. Also know that your loved one may need time to process the diagnosis and their feelings, so providing some space may be beneficial. If that is the case, just let the loved one know you are there for them when they are ready.
4) My struggling family member/friend keeps talking about food, weight and eating disorder behaviors. What can I do support them?
This is another great question!
Depending on the context of the comments around food, weight and disordered behaviors, it may not be a bad thing that your loved one is sharing their thoughts. However, if the comments are chronically negative or demeaning, you may want to help and be supportive. It is important to remember that your role is as a supportive person, so do what you feel you are capable of. With that said, at BANA we believe it is so important to model balanced behavior around food and our bodies. What this means is being aware of the language we use. When we adopt a sensible approach, we can start to change the conversation around weight, shape, and food, or at least to foster a different perspective (which is very helpful for someone going through the process of recovery). For example, instead of calling foods “junk”, “bad”, “healthy”, “unhealthy”, and so on you can call them “occasional food” or “fun foods” or just call them food. Why label them? By not labeling foods as good or bad we create a more balanced/less punishing approach, which is helpful for your loved one. Also, avoid commenting on appearance and/or weight. Be aware of your own biases around weight/shape and be mindful of how you discuss your body and food choices around your loved one.
If your loved one said they feel like they have gained weight or are fat or want to lose weight, ask them to share their fears and what this means to them and why they think losing weight is better. You may want to discuss societal pressures to look a certain way and how this ultimately doesn’t make us feel good about ourselves.
Lastly, it is important to set limits and boundaries around these discussions. Maybe you and your loved one agree to have one conversation a day that revolves around eating disorder behaviors and food and then moves on to topics not related to disordered eating behaviors. We like the idea that one our clients shared with us recently: over dinner they pick a different topic to discuss. For example, one night they discussed a new hobby she was interested in. This is such a great idea and can make meal time a bit more enjoyable and maybe something to look forward too.
5) I am living with my partner who an eating disorder. I am at a loss and so frustrated, what can I do to help them?
Self-care is so important. It is easy to get worried and concerned about your loved one and forget about your own needs, especially when living with someone who is struggling with an eating disorder. As much as we want our loved one to get better ASAP, they get better at their own pace and on their own time. This is why it is so important to take time for yourself, so you can be there for your loved one.
There are many things you can do to support someone even if they are not 100% ready for change. We have mentioned a few tips above, such as making meal time fun, being a positive example around food and body image, and being kind. It is also important to always include the loved one in family events, outings, and so on. Even though they may not want to attend or participate you can still ask them to join. It shows the struggling individual that they are always included.
Be a healthy role model when it comes to food choices; choose nutritious foods, include fun foods to show your loved one it is part of normal balanced eating. Don’t act like the food police, mind your own plate and don’t force your loved one to eat because this will only lead to arguments and hurt feelings. It also leads to lying and secret behavior around food and eating.
Lastly, as we mentioned above, ask your loved one what they need. Ask them what is helpful for them and what is hurtful. Avoid shaming your loved one and don’t accuse them. Don’t use ultimatums as they add a tremendous amount of pressure on your loved one. An example of this would be: “if you don’t go into treatment, I will leave you”. These types of statements again lead to secretive behavior.
In conclusion, we hope that the above article provided you with some tips on how to support a loved one or friend. Although, it can be very difficult and frustrating at times, it is important to remember that you are an important piece to your loved one’s wellness. Be kind and gentle on yourself and know that recovery for your loved one is possible.
*This has a section for Women who are supporting men with eating disorders
Websites/blogs for family members
https://www.bana.ca/resources – shameless plug, but we have some awesome resources for family and friends and information about eating disorders
For those who retain information best through visuals and words:
How to talk to someone about eating concerns: