How To Help A Loved One With An Eating Disorder

What you can do to help a loved one to overcome their eating disorder.

Barbara and her husband Dan came to me seeking help with their marriage. We commenced our work on clearing resentment and actions to bring them closer together. Although they told me that a key problem for them was communication, I discovered that what they were really lacking in, was the time to communicate and connect. I suggested they should take the time to share meals together and to use this time to chat. They could also share chores like cooking and dishes, or dine out so they had the time to talk and connect more. Barbara thought this was a good idea.

Dan expressed however, that this was not possible. He said that Barbara had to prepare all of her own meals exactly the way she wanted it, that she wouldn’t eat out in any restaurant because she had to control the food she ate, that the places were not healthy enough for her. She replied by saying ‘yes it’s true I won’t eat out as you don’t know how much salt, oil, and rubbish they are putting into your food.’ Ok, no problem I said, what about the cooking together part and sharing meals. ‘Well I eat the same dish every day’ said Barbara, and ‘Dan wouldn’t want to eat it once let alone every day.’ Barbara had been eating the same safe food for years to stay ultra slim and fit.  She didn’t want to give up control of her food for anything.

This behavior started two years prior after discovering that her husband was having an affair with his work colleague. Her devastation led to her becoming obsessed with staying thin and looking young. We came up with some alternative solutions for Barbara and Dan to work on strengthening their relationship.

Three months later, Barbara came to me saying she had recently celebrated her 50th birthday but couldn’t bring herself to eat her birthday cake. She expressed to me that she didn’t want to spend the following 30 years of her life eating the same food. So, we began working through the emotions that were controlling her relationship with food, and developed a plan that would enable her to break free over time.

We reduced her exercise from 15 hours to seven, agreed that she would dine out once each week, and start adding more variety into her diet. These small steps led to remarkable improvements in her life, including her relationship with her husband.

She continues to follow a healthy diet, but also engages in social activities including dining out, which she wasn’t able to enjoy previously. The main point here - is that change is always possible.

If you have a loved one that you think may be suffering from something similar, it’s helpful to be aware of the common signs and behaviors.

Common signs and behaviors associated with eating disorders

• Dramatic or consistent weight loss or gain
• Eating large quantities of food in less than 2 hours (binge eating)
• Habitual trips to the bathroom immediately after eating
• Secretly binging on large amounts of food
• Hiding food
• Anxiety over food before eating and meal times 
• Feeling guilty after eating
• Rigid food control refusing to eat food or types of food consistently
• Increase in consumption of laxatives, diuretics or diet pills
• Hoarding large amounts of food
• Exercising compulsively, often several hours per day
• Using prescription stimulant medications and/or illicit stimulant drugs to suppress appetite
• Preoccupation with weight, body size and shape, or appearance
• Over eating
• Low mood 
• Using food as a comfort or reward
• Isolating to eat
• Low self-esteem
• Lying about what food has been consumed
• Stealing food
• Mood is dependent on the amount of food eaten that day
• Repeatedly weighing of oneself and tracking progress 
• Repeatedly labelling oneself as fat or unattractive
• Withdrawal from friends and family, particularly following questions about his or her condition or visible physical/medical side effects
• Avoidance of meals or situations where food may be present
• Obsessing over calorie intake and calories burned via exercise, counting, analyzing and tracking food and weight

If you think that someone you care about is suffering from an eating disorder, there are some things to consider.

Share your concerns

Try and sit down with them when you know there will be no interruptions and have a chat, explain that you are concerned about them and start by asking them if they are ok. You don’t need to comment on their weight to begin with but just ask them how they are and see if you can get a general idea of what might be going on with them. If the subject of weight loss or weight gain does come up be prepared for different reactions.

A number of people get offended and often react angrily to comments about their weight or eating patterns. This is often a defense to take the spot light away from them and they may attack you because they fear you may take their control away.

Make sure that they know how much you care about them and keep reminding them that you have their best interests at heart. Keep trying to talk things through.

Another way people react is to be totally open about it and tell you what you want to hear, almost as if they have been expecting you to say something. This was what I used to do time and time again when people asked me about my eating and weight. Over the years so many well-meaning family members, friends work colleagues tried to talk to me about my thinness. They would ask me if I was ok, tell me to eat more, say that they were concerned about me and let me know that they were there for me. In fact, even complete strangers would give me advice on how to put on weight and what I needed to do.

The conversation went something like this “I am really concerned about you,  is everything ok?” If I felt they were talking to me from a place of love and care which was most times I would reply

“Yes everything is ok, I know I need to put on weight and I know I need to eat more and I am trying to do that, but I do find it hard and I am dealing with it in my own way.”

Basically I’d say exactly what they wanted to hear, I’d admit I had a problem but say I am trying to deal with it on my own in my own way. But really I was either not ready to change my eating habits or didn’t actually know how to stop the anxiety and guilt around food or how to stop the habits.

Most people would be surprised at how at ease I made them feel talking to them about it, as I would totally agree with them but the problem with this was, nothing changed.

Then they would come up with a certain type of food for me to eat or plan like say:

‘Exercise less; eat more carbs; try not to be sick; you just need a little more fat on you; do you like cheese, have a bit more cheese and dairy; you need to eat more meat and protein; well don’t lose any more weight’…  then the conversation was over.

I had over 500 conversations like this over the 20 years I suffered from an eating disorder. While I appreciated people’s love and concerns, it actually didn’t help me. What I needed was a solution; a plan of action; a qualified specialist who could work me through the situation. 

You see it’s very easy to agree to put on weight or lose weight for that matter. But when you are dealing with so much fear, guilt and anxiety around food or are addicted to using food to cope with emotions - doing the simple things can seem impossible.

If they are open with you, it is a positive sign they may be ready to change, but perhaps they don’t know how to change. On the other hand they could be telling you exactly what you want to hear so you will just leave them alone.

Give them tools and encourage them to take action

Based on what I shared above, I recommend the following approach for people suffering from both rapid weight loss as well as weight gain:

1. Ask them if they are ready and willing to address their situation
2. Ask them if they will consider getting help
3. Ask them if there is anything else they need to change
4. Give them some details of someone they can talk to, whether a professional or close family or friend that you strongly believe can help

Some other ways to help your loved one get through this include:

Talk to their closest friend or family member

Two is always better than one, so having a confidential chat with their closest friend or family member may help them where you might be unable to reach them. It will also give you a greater insight as others may confirm what you are thinking and if so then together you can come up with a plan to help.

Work with a coach

If your attempts to talk with them were not welcomed, working with a coach or therapist can be very beneficial. I’ve found in my own practice that when people have someone else to talk with who is not family, it can help expedite the healing substantially.

One of the biggest hurdles in getting support for people with eating disorders is that the person suffering often doesn’t love themselves enough to get the help they need.

Movies and tv shows to start difficult conversations

Some people use movies or tv to help get their point across if they feel like they are unable to raise the topic for fear of hurting the person or damaging their relationship. 

A movie or TV show where there are eating disorders woven into the story may support you to get the message through. Here are several movies that address eating disorders that you may find useful.

For under eaters

• To the Bone – an American drama that follows a girl as she battles anorexia
• Kate's Secret - a film about a seemingly "perfect" suburban housewife and mother who is secretly suffering from bulimia
• For the Love of Nancy - based on a true story of a girl suffering from anorexia Sharing the Secret – a film about a teenage girl's struggle with bulimia and its effect on her parents and friends
• A Perfect Body - a film about a young gymnast who develops an eating disorder

For over eaters

There are many reality tv shows that share stories from overweight people and their eating habits from the biggest loser, lose weight fast, fat club, too fat to be 15 and various others.

These movies and tv shows can be a talking point to open a conversation. I recommend sharing ones with success stories that inspire and motivate them.

Remember, eating disorders are complex and complicated for all parties involved, not just the person suffering. To discuss any issues you or your loved ones are experiencing, please feel free to reach out to me for help. As a former sufferer, I know what it’s like and I know from experience what works and what doesn’t. If I can leave you with one thought to reflect on it would be that eating disorders often reflect something much deeper than food and weight, they are often linked with low-self-esteem and self-hate.

Whatever eating disorder your loved one has, what they really need most is to feel loved, accepted and appreciated. Ideally they need to love themselves and appreciate themselves but as most people with a disorder struggle to do that, you can help them to get to that place of self-love by showing them how much you respect them, appreciate them and love them. It’s not an easy path but with the right support, help and advice there is definitely light at the end of the tunnel.

Lastly, I just want to stress that eating disorders are not only about the size of a person; they are about how they view themselves-how they treat their body and how they feel before and after eating.  Many people I have worked with look great on the outside yet on the inside they are consumed with guilt, anxiety and stress around food. They feel bad about eating and their habits, and this in turn effects their self-esteem and overall enjoyment of life.

For more help, download my ‘Emotions & Eating with Nicola Beer’ podcast from iTunes, Spotify or Stitcher.

From my heart to yours

Nicola