If someone close to you has an unhealthy relationship with food, how can you tell if that person has an eating disorder? What's the best way to approach such a sensitive conversation, and when should you seek medical treatment to help someone with an eating disorder? It's a tricky line to walk, but important nonetheless.
Eating disorders can have dangerous, even deadly, consequences. It's important to speak up, but it is likely a sensitive subject for your loved one and an uncomfortable topic for you. However, many people recovering from an eating disorder say the support of family and friends was crucial to their healing, the National Eating Disorders Association reports.
Here's how to help.
It's natural to worry about gaining weight, but some people become so preoccupied with food and weight that they find it hard to focus on other aspects of their lives. This mindset can be an early sign of an eating disorder.
Studies show that 1 in 20 people will struggle with an eating disorder. Teenagers and young adults are most susceptible, and women and girls are 2.5 times more likely to experience eating disorders than men and boys. However, eating disorders can affect anyone. Eating disorders include:
Anorexia nervosa: People with anorexia nervosa have a distorted body image that makes them think they're overweight, even when they are dangerously underweight. They obsess about food and weight control, weigh themselves repeatedly, eat very small quantities of only certain foods, and often refuse to eat with others. Some people with anorexia nervosa also engage in bulimic behavior.
Bulimia nervosa: People with bulimia nervosa regularly engage in binge eating and feel they lack control over these episodes. Desperate to avoid weight gain, they try to purge the calories through self-induced vomiting, excessive exercise, misuse of laxatives or enemas, fasting, or a combination of these behaviors. Unlike people with anorexia nervosa, people with bulimia nervosa usually maintain a healthy weight or are slightly overweight, but they are intensely unhappy with their bodies.
Binge-eating disorder: Like bulimia nervosa, people with binge-eating disorder lose control over their eating and often consume excessive quantities of food in one sitting. They feel shameful and stressed about this behavior, which can lead to more binge eating, but they do not compensate with purging, fasting, or excessive exercise, so they often become overweight or obese.
Recovery is possible for most people with eating disorders, but they usually need medical attention to make a lasting change. People with eating disorders know their behavior is abnormal and unhealthy, so they typically attempt to hide it and might not seek treatment on their own.
Understand that eating disorders are real mental health conditions caused by a variety of genetic, biological, psychological, and social factors. Shaming or nagging won't help someone with an eating disorder, and it might worsen the condition. Instead, before discussing your concerns, read up on eating disorders so that you can have an informed and empathetic conversation.
Find a private place where your loved one feels comfortable, and you won't be distracted or interrupted. Give yourself plenty of time so you don't feel rushed. You should also be prepared before you enter the conversation so that it can go as smoothly as possible. Think about what you want to say and rehearse it. If you're struggling to remember your main points, consider writing them down. This allows you to hone your message and can help reduce your anxiety.
Mention behaviors that you have personally witnessed, from your own point of view. "You" statements can make it sound like the other person has done something wrong. For example, instead of "You never eat," try "I've noticed that you barely touch your dinner anymore, and that worries me." Likewise, "I've heard you getting sick in the bathroom several times lately" is less accusatory than "You've been making yourself throw up."
It can be tempting to say "just eat" or "just stop overeating," but eating disorders are complex conditions with complex causes. They require more than simple solutions.
Remind your loved one that many people face eating disorders and other mental illnesses. There's no reason to be ashamed, but there is reason to get help. Offer to help find a physician or therapist, and to attend sessions with them when appropriate. Your loved one might appreciate your concern, but they might also be defensive, embarrassed, or angry.
Even if you don't get through right away, your friend will remember your words and might seek help in the future. In the meantime, if you suspect an emergency situation, such as suicide or medical complications, call 911 for immediate help.
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