Supporting someone with an eating disorder
If you’re worried about someone, and you think they may have an eating disorder, then it’s important to encourage them to seek support and help as quickly as possible : research has shown us that early intervention is vital to prevent the illness becoming chronic and treatment-refractory. Helping someone with an eating disorder will be very challenging and distressing for you too and you should consider looking for your own support.
There are a lot of things you can do to help your person with an eating disorder. Remember that everyone is different and will need different things,(and what works will often change from day) but this will give you some ideas about what you can do to help.
What to do at mealtimes
Mealtimes are likely to be very hard for the person you’re supporting. Below are some ways you can help them out:
If you live with them, plan to eat together. Arrange with them and anyone else who will be present what time you’ll be eating, where and what you'll be eating; planning can really help cut down anxiety, especially in the early stages of recovery.
Meals ideally should be balanced, with a range of foods and 'normal' portions, taking into consideration the dietary needs of everyone else at the table as well as the person with the eating disorder.
Make sure you have everything necessary for the planned meal. Last-minute changes could cause the person to panic, and in the case of anorexia and other restrictive eating disorders, they might limit their food intake.
Shopping with them may allow you to introduce new foods that they’re willing to eat in the case of restrictive eating disorders,and help them through choice paralysis while shopping. It can discourage them from buying food to binge on where bingeing is a factor in their eating disorder.
Keep conversation neutral, avoiding discussion of food, what they've eaten, not eaten or comparing it to intake at yesterday's meal. Obviously avoid mentioning weight.
You could have the television, radio or music on to help distract them and to draw attention away from them.
Be aware that people with restrictive eating disorders may need to physically adjust to eating more, as well as mentally adjusting. Start slowly and be wary of pressuring them.
You may need to offer encouragement to help them start eating, and further encouragement throughout the meal. Be firm but acknowledge how hard for this is for them.
After a meal, suggest doing something together, like watching a film, to take their mind off possible compensatory behaviours such as purging or exercising, or off the idea of bingeing.
Support beyond meals
Outside of mealtimes, there are lots of ways to support someone and show them you value them. You may find that their eating disorder causes them to withdraw, but keep inviting them to join in with group and family activities. Offer compliments that don’t relate to their physical appearance, and try to find things to do with them that don’t involve food. Don’t be too critical of yourself if you do make a mistake – eating disorders make us incredibly sensitive and often really irritable, so you can’t always account for things the person you’re supporting might feel sensitive about, and at least this will be something you can learn from.
Whether you live with the person you’re supporting or not, just being there for them and showing them you understand this isn't their fault or their choice and believe they are worthy of support will make a big difference. And once they’re in recovery, make sure that they feel able to approach you again if they need to in the future – full recovery is completely possible, but relapses are not uncommon.
A child with an eating disorder
Remember, it’s important to address the thoughts and feelings maintaining an eating disorder, not just the behaviour. There are many different therapies that can do this, and no single therapy is the best choice in all cases. Depending on how young they are, you may have a lot of say over their treatment, so remember that if your child isn’t responding well to one form of treatment, they may respond better to another.
Be mindful of other children and how the eating disorder might be affecting them. They may need their own emotional support.
If your child has been referred to Child and Adolescent Mental Health Services (CAMHS) and turns 16 or 18 (depending on the service) they will need to move to Adult Mental Health Services (AMHS). Remember any transitions can be incredibly stressful and can lead to lapses. Be ready.
A partner with an eating disorder
If you have children, try to involve them if possible – while you may feel the impulse to shield them, children are very sensitive and will probably realise something is wrong. Explain the situation in age-appropriate terms, offering reassurance, and encourage them to ask questions.
Remember eating disorders are isolating and secretive illnesses by nature, and often cause feelings of low self-esteem and a distorted perception of body size and shape. Because of hormonal shifts caused by eating disorders, sex-drive is usually extremely diminished. Your partner probably will not want to be physically or emotionally intimate while they’re ill. They are not rejecting you, the eating disorder is making their decisions. Try to understand things from their point of view, but communicate your feelings too. Try to keep doing things together as a couple and as a family. Again think about support for you to vent and touch base with others who understand what you're going through.
Looking after a housemate
If you don’t feel comfortable speaking to them about your concerns, you could try talking to someone they’re closer with, such as one of their friends or relatives.
If you’re both students, your university or college might be able to help. University halls often have resident tutors you can talk to. Many universities have an advice service, specific mental health service, and counselling team, as well as a medical centre.
Your housemate may know they have, or be in treatment for, an eating disorder when you meet them. Moving, or having housemates they’ve come to rely on move out, can be a difficult transition, and anything you can do to help them adjust will be useful. They and the people they previously lived with may have come up with a plan for coping with mealtimes, so talk to them about whether there’s a role you can take over.
If they’ve moved away from their regular doctor, you could offer to go with them when they go to see their new one.
Looking after a friend
Offer practical support such as accompanying them to appointments and helping with day-to-day tasks. You could coordinate this with other friends. If someone is supporting the person with the eating disorder full-time, this could help them, too.
Involve them in the same things you would have done before they were ill – eating disorders can be very isolating, and your friend may be worried about people pulling away from them. If they’re undergoing treatment, they may be keen to keep things as normal as possible elsewhere in their life.
Try to find things to do that don’t centre around food.
Looking after a colleague
If you’re worried and you don’t feel able to talk to a colleague yourself, speak to their line manager about your concerns.
While you may not be close with a colleague, following the advice for how to approach someone with an eating disorder should still be helpful. Talk to them somewhere that you both feel comfortable, and reassure them that they aren’t in trouble.
It may be that they are already aware of and getting help for their eating disorder, in which case offering to help with their workload if they need to take time off to make appointments could be a good way to support them.