How to Talk to a Loved One About an Eating Disorder

Navigating a conversation with your loved one about their eating disorder can be overwhelming — you want to make sure you don’t say the wrong thing — that what you’re doing is going to help more than hurt, and that your words are coming from a place of understanding, compassion, and respect. Taking the time to have this kind of difficult dialogue may be frightening, but is also an opportunity for growth. This article provides tips on ways you can approach this important discussion with love and understanding.

What is an eating disorder?

Eating disorders are serious but treatable mental and physical health conditions that can affect people of all demographics, body shapes, and weights. National surveys suggest that 20 million American women and 10 million American men will be diagnosed with an eating disorder at some point in their lives. 

Many people exhibit symptoms of disordered eating patterns that may not represent a full syndrome eating disorder. These disordered eating symptoms should be taken seriously, and the sooner the behaviors are addressed, the more likely there is to be a positive outcome.

Common types of eating disorders and their differences

• Anorexia nervosa is an eating disorder characterized by weight loss (or lack of appropriate weight gain in growing children), difficulties maintaining an appropriate body weight for height, age, and stature, and distorted body image. People with anorexia generally restrict the number of calories and the types of food they eat. Some people with the disorder also exercise compulsively, purge via vomiting and laxatives, and/or binge eat.
• Bulimia nervosa is a serious, potentially life-threatening eating disorder characterized by cycles of bingeing and purging behaviors, such as self-induced vomiting, designed to undo or compensate for the effects of binge eating.
• Binge eating disorder (BED) is the most common eating disorder in the United States, and the newest formally recognized in the DSM-5. BED is disordered eating characterized by recurrent episodes of eating large quantities of food, often very quickly, and to the point of discomfort. During these episodes, there is often a feeling of a loss of control, and an experience of a negative emotion like shame, distress or guilt afterwards. This differs from bulimia nervosa in that it is not necessarily followed by an episode of purging.
• Avoidant/Restrictive Food Intake Disorder (ARFID), formerly known as “Selective Eating Disorder,” is similar to anorexia nervosa in that both disorders involve limitation in the amount and/or types of food consumed. Unlike anorexia, those experiencing ARFID do not have distress about their body shape or size, or fears of excessive weight gain. Those experiencing ARFID tend to avoid eating due to apparent lack of interest in eating or food, avoiding food based on sensory characteristics like texture, or concern about perceived consequences of eating, like vomiting. ARFID commonly co-occurs with anxiety disorders, like obsessive compulsive disorder (OCD).

How to approach the conversation with someone you think has an eating disorder

1. Pick an appropriate time and place. Find a private place where you won’t be rushed or have an audience. A place they already feel comfortable, like at home, is best.
2. Use “I” statements and stick to the facts. Focus on behaviors you’ve witnessed firsthand, such as “I noticed you aren’t eating breakfast anymore.” Accusatory statements like “You’re not eating breakfast anymore!” can cause a person to feel defensive and less receptive to the conversation.
3. Rehearse. Practicing what you want to say can help ease any anxiety you have going into the conversation. Writing out your main points can also be a helpful way to clarify the point you want to make. By approaching this subject from a loving perspective, it will encourage open communication and create an environment where your loved one feels safe enough to express themselves honestly. 
4. Be prepared for a negative response. Some people experiencing an eating disorder might be grateful that someone noticed they’re struggling, others might become hostile and defensive, and some might brush off your concerns completely. All of these responses are considered normal. The important thing is to communicate your concerns, let them know you care, and leave the conversation open for further discussion.
5. Encourage them to seek professional help. Getting a timely, effective diagnosis and treatment is key to increasing a person’s chances for recovery. Offer to help your loved one seek out a health care provider or therapist, or even to attend the session with them. If they’re ready to start their recovery, SonderMind can help connect  them with a qualified mental health provider who specializes in eating disorder treatment.

There is no single “right way” of having these conversations; we all have different relationships with our family members and friends, as well as various communication styles. Even if the conversation seems poorly-received by your loved one, the important thing is that you addressed your concerns.

While it can be intimidating to bring up the subject of an eating disorder with a loved one, it is important to remember that it reflects genuine care and concern for them on your part. Taking the time to research what an eating disorder is can help you approach the conversation with understanding and knowledge. Utilizing an open, gentle attitude during the conversation enables for honest communication which will ultimately enable your loved one to feel comfortable enough to share their experiences with you. Together, you can work through this challenge and come out stronger than ever before.