Eating disorders are common, but many people still find talking about them can be uncomfortable, or even a little awkward. Maybe you've stumbled over your words, accidentally said something that came off as insensitive, or couldn't bring yourself to say anything at all when someone in your life has disclosed that they are dealing with mental health issues. Though it's a tough conversation to navigate, experts tell Bustle knowing what to say if a friend may be struggling with an eating disorder can make a huge difference to their recovery.
Surveys have suggested an estimated 30 million people in the U.S. will deal with an eating disorder at some point in their lives, according to the National Eating Disorder Association (NEDA). As Healthline reported, there are six major types of eating disorders, including anorexia, bulimia, binge eating disorder, pica, rumination disorder, and avoidant or restrictive food intake disorder. Eating disorders can affect folks of any size, gender, and race — and they can be life-threatening even if someone "looks" physically healthy from the outside. In fact, the National Institute of Mental Health reports that research has shown that eating disorders — anorexia, in particular — has the highest mortality rate of any mental illness.
Given the seriousness of eating disorders, being able to have an open and honest conversation with a friend who might be struggling with one is extremely important. And, this difficult conversation begins with with simply listening and being compassionate. Laurie Wollman, LCPC, the Site Director at The Renfrew Center of Baltimore, says to approach the discussion with "understanding, respect, and sensitivity." This means, rather than acting frantic, or angry, try to express concern in a gentle, empathetic tone.
"The best way to support a friend suffering from an eating disorder is to be fully present when they are speaking to you, to hear them, and to validate the physical and emotional pain they are experiencing," Zia Onorato, LMSW, a clinician at Mountainside Treatment Center who specializes in eating disorders, further explains. "Affirm their experiences and feelings as valid, rather than negating their, often distorted, perceptions of their bodies, selves, and illness."
While listening to your friend with an open heart is essential, along with validating their experiences, try to be mindful of your responses. "Don’t focus on weight, calories, or any specific eating habits," says Wollman. This might seem confusing, since many eating disorder symptoms revolve around food and body image. But focusing on the physical aspect of the illness can do more harm than good.
"Comments such as, 'You look fine, you look the same, [or] you don’t need to lose weight,' are often times unhelpful to someone suffering from an eating disorder," Onorato explains. "By making these comments, you are denying that person’s reality, and invalidating their distorted view of their physical appearance. This can be frustrating, or triggering for sufferers when they do not feel understood, leading to further isolation."
Most importantly, Wollman says to suggest to your friend that they seek out the help of a therapist or physician. Unfortunately, you can't just love or support someone into eating disorder recovery; like with any other mental illness, people with eating disorders often need help from a mental health professional. According to the National Eating Disorders Collaboration, therapy, psychiatric medications, and nutritional counseling are standard treatment options for eating disorders. Research has found that additional activities such as yoga, and meditation, may also help manage eating disorder symptom, though it's important to note that yoga and meditation aren't standalone treatments.
If you have a friend who is unwilling to get support from professionals, Onorato says that being aggressive, or continuously pressuring them have a negative impact. "Forcing treatment upon another will not guarantee success. It [may] only create more distance and friction in your relationship," she explains. "Being available for a friend to voice their concerns, worries, and hesitations, allows that individual to work through the barriers in accepting treatment."
Eating disorder recovery isn't as simple as making a "choice," but having supportive friends can make a huge difference to the healing process. You may not always say the right thing, and you may not always be helpful. Yet, Onorato says that making sure you actually acknowledge your friend's eating disorder is way better than pretending "everything is fine," and saying nothing.
It's not always easy to navigate conversations surrounding mental illness and eating disorders, especially if you don't have extensive experience with this sort of situation. However, knowing what is helpful to say to your friend whose struggling with an eating disorder will hopefully make them feel more a little more safe, and supported.
If you or someone you know has an eating disorder and needs help, call the National Eating Disorders Association helpline at 1-800-931-2237, text 741741, or chat online with a Helpline volunteer here.