How to help someone with an eating disorder – a therapist’s guide

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How can you offer support if someone close to you is living with an eating disorder? Madeleine Gauffin, Licensed Psychologist and Psychotherapist at Livi, shares her advice

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It’s difficult to watch someone you care about struggling with an eating problem, and it can be hard to know how to help. Recent global estimates suggest up to 8% of people have an eating disorder at any point in time. Sadly, the numbers have also risen during the Covid-19 pandemic.

Right now, being a source of support is more important than ever. Taking steps to better understand eating disorders is a useful strategy to support someone living with one.

What is an eating disorder?

An eating disorder is a mental illness that can affect people of any gender, age, race, religion, body shape or weight. While they are more prevalent among women, men can have eating disorders too.

‘Eating disorders are a symptom of an underlying pain or inner conflict,’ says Madeleine Gauffin, Licensed Psychologist and Psychotherapist at Livi. ‘Patients try to control things within themselves by controlling external factors, like food.’

‘One of the main qualities with eating disorders is being very disciplined, which might manifest as exercising excessively, restrictive eating or having a lot of anxiety about specific foods or food in general.’

What are the common types of eating disorder?

Anorexia nervosa (AN)

Where someone tries to control their weight by not eating enough, exercising too much, or both.

Bulimia nervosa (BN)

Where someone loses control over how much they eat, then takes extreme action to avoid gaining weight.

Binge eating disorder (BED)

Where someone eats big portions of food until they’re uncomfortably full.

What are the warning signs of an eating disorder?

While each case is different, many people have similar patterns of behaviour. ‘It very often starts with cutting out certain foods, such as sugar, fat or meat,’ explains Gauffin.

‘You may have noticed that your friend or relative is significantly lowering the number of calories they eat or eating extremely small portions, which may be signs of anorexia. On the outside this might seem “healthy”, but it can be covering something deeper, like an eating disorder.

'When someone is living with anorexia, there’s no realistic understanding of what nutrition the body really needs to be able to function. The focus is on getting as few calories as possible.

‘Bulimia and binge eating present differently, but the catalyst for the behaviour is often the same. These illnesses are still governed by control.’

Eating a lot of food very quickly and eating alone might be warning signs of binge eating disorder. Following careful eating schedules, making frequent trips to the bathroom and excessive exercising can be signs of bulimia.

People may withdraw and completely isolate themselves. ‘This is often a consequence of food being such a universal part of our lives,’ says Gauffin. ‘Many environments are triggering.’

How can I help support someone with an eating disorder?

While we may have good intentions, offering unsolicited advice to your loved one may cause more harm than good. The most important thing is to listen and be there for them.

1. Try not to be confrontational

Accusing someone of not eating enough or demanding they seek help isn’t helpful at all,’ says Gauffin. ‘Try to find another way to connect with the person. Say, “I’ve noticed that you seem to be cutting out certain foods and I’m worried about you,” or simply, “How do you feel today?”’

2. Consider your own language around food

Living with an eating disorder can be exhausting. Many people might experience an inner monologue of dos and don’ts around food, so be mindful of the way you talk about eating.

‘Avoid talking about diets, exercising or food because these are things that people with eating disorders think about for a lot of their day,’ says Gauffin.

3. Continue to include them – in a helpful way

When it comes to socialising, make plans that don’t centre around eating. ‘Try to find other activities that aren’t food-related, so that they can just be themselves, without having to withdraw,’ says Gauffin. ‘It’s very painful and challenging for someone with an eating disorder to be sat in a café, for instance, while their friends are all eating pastries. These social situations also open them up for questioning, which can be extremely difficult.’

4. Be there for them

‘People with eating disorders tend to want to protect themselves from anyone who might try to change their eating habits,’ says Gauffin. ‘They might be afraid of being convinced to eat more or having to exercise less. Instead, just showing that we want to be around them and that we want to try to understand how they’re feeling is a positive step.’

5. Finally, ask this one simple question…

We often struggle or simply forget to see things from the perspective of others and go on autopilot advice, which may not be helpful. ‘Try not to take the role of the psychologist or those providing treatment,’ says Gauffin. ‘Instead, ask, “How can I support you in this?” It’s something we don’t ask enough.’

This article has been medically approved by Madeleine Gauffin, Licensed Psychologist and Psychotherapist at Livi.

Speak to a GP about eating disorders

If you’re worried about someone who is affected by an eating disorder (or any other illness), speak to a doctor.

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