Do’s and Don’ts of Discussing an Eating Disorder with a Loved One

When someone close to you is struggling with a serious mental health disorder like anorexia nervosa, it can be difficult to process and emotionally challenging. Unfortunately, millions of people have to deal with this situation – one percent of Americans will display symptoms of anorexia nervosa at some point in their lives – and it’s so key that they know how to talk to their loved ones about this disorder.

Many people with eating disorders are struggling to express themselves. Even with a loving family and circle of friends, a person with anorexia nervosa can feel conflicted and hopeless. That’s why, although you as a loved one can absolutely help (and should!), it’s important to be sensitive and do it the right way. Here are three ways you can be constructive when discussing anorexia nervosa, and then three more that might make the situation worse.

How to Talk to Your Loved One About Eating Disorders

DO – Educate Yourself and Prepare to Present Evidence About Treatment

An eating disorder may not always result in extreme weight loss, but there are other telltale signs which can help you rationally point out that there is a problem. If you use this blog and other resources to learn more about anorexia nervosa, you can help them understand their disorder and show objective evidence about the effects it can have. You can’t depend only on logic and evidence to make your case for treatment, but facts never hurt.

DO – Create a Safe Space for the Discussion

Make sure you pick a safe and comfortable time and place to discuss anorexia nervosa. A person with an eating disorder normally has higher stress and emotional disturbance at mealtimes, and a troubled relationship with food and eating in general. Because of this, it follows that you shouldn’t confront them at a family dinner or a restaurant. It’s much better to choose a time and place that makes them comfortable and as receptive as possible.

DO – Listen More Than You Talk

It’s easy to forget that people with anorexia nervosa often feel guilt or shame about their disorder, and feel they’re going to be judged.On the other hand, even though they’re often in denial about their disorder, they know something is wrong. When it comes time to have a serious talk about anorexia nervosa, try to listen to how they respond without judging. Let them express their feelings – it might be the first time they feel comfortable discussing it, and by simply letting them speak, you might be able to open the door to recovery.

DO – Gently Keep the Conversation on Topic

You should never be domineering when talking to a loved one who’s struggling with a mental health disorder like anorexia nervosa, but neither should you let the conversation get sidetracked. Your loved one may want to digress – they might want to talk about a co-occurring disorder, troubles at work or school, or anything that might shift the conversation away from eating disorders. Establishing what this particular talk is all about at the outset will help you get back to the subject at hand if it threatens to go awry. Just don’t snap or act accusatory when redirecting the conversation. You might say something like “I’m sorry you’re struggling with that –can we return to it after we have a plan for addressing your eating behaviors?”

DO – Validate Their Feelings

Behaviors can be harmful, both psychologically and physically, but they are always driven by feelings and distorted thinking patterns. Emotions can’t be “right” or “wrong,” however. When you’re talking to your loved one about eating disorders, make sure you understand that they can’t simply “get over it” or “just eat more.” Their feelings aren’t wrong – they need to be acknowledged, unpacked, and modified. Let your loved one talk about how they feel and acknowledge those feelings. Make sure they know that although the behaviors might be problematic, it doesn’t mean they are a bad person or somehow to blame for their feelings.

How NOT to Talk to Your Loved One About Anorexia Nervosa

DON’T – Make Accusations or Blame Them

Tying into the last point in the “do’s” column, remaining non-judgmental is essential to having a productive conversation about eating disorders. One very common characteristic of eating disorders is a sense of guilt and shame about disordered behaviors like fasting or excessive exercise. Blaming a person for these compulsive and disordered behaviors is counterproductive and will help neither of you. The last thing a loved one trying to help should do is make them feel any worse than they already do. Remember to separate the disordered behaviors from the person’s “worth.” Don’t pile on – it will only make them feel worse and might reinforce the unhealthy behaviors.

DON’T – Talk About Their Weight or How They Look

Keep the discussion focused on how the individual feels and the challenges they are facing due to their eating disorder. Anorexia nervosa is normally accompanied by a distorted body image and perception of weight – it’s part of the diagnostic criteria. Saying something like “You’re too skinny!” or “you’re not ugly!” seems like it could help, but these distortions have a way of keeping a person confused. Better to stick to discussing potential health consequences or potential next steps.

DON’T – Make an Ultimatum

If you tell your loved one who’s suffering from anorexia nervosa something like “stop acting this way or we’ll kick you out,” it will just push your loved one further away from you. Eating disorders have a way of twisting a person’s cognition into defending itself. Instead of trying tough love or another confrontational tactic, consider “DO” number 3 and listen to what they have to say – with no judgment.

DON’T – Make the Conversation About You

Especially when talking to a family member or close friend about difficult topics, it’s hard to stay objective. Your relationships and past experiences inevitably influence how you interact with a person. However, shifting the focus of a conversation about eating disorder treatment to you and your feelings is counterproductive, at least at first. Getting into a back-and-forth about how you feel about each other can bond and bring people closer, but the focus needs to remain on the immediate need for action to help this person with the issue at hand. You can offer to join in on family therapy sessions during treatment, however. This will give you both a chance to hash out how the disorder has affected your relationship and give you a chance to talk about your feelings as well.

DON’T – Give Up When the Conversation Stalls

We won’t sugarcoat it – talking about eating disorder treatment is hard for both sides. Your first attempt may not result in any significant action. You may have to table the discussion for a later date if things get too acrimonious or emotional. Remember that you care about this person deeply, though. If things get out of hand, don’t take it personally, and try to resume the conversation later when you’re both calmer. Eating disorder recovery is like tipping over a vending machine – you might need to rock it back and forth a few times before making any progress.

Let the Professionals Help

Anorexia nervosa is a complex and difficult-to-treat mental health disorder. The support of family and friends helps, but, likely, they’ll still need professional help following your discussion about the issue. Reach out to your doctor or therapist, and see about treatment at a residential or day treatment facility. It could be the light of hope your loved one was looking for.