It can be awkward and even scary to approach someone you suspect of having an eating disorder. You never know how they might react — angry, dismissive, upset, disbelieving. But consider the fact that they might also be relieved.
Because even worse than having a potentially uncomfortable conversation with someone you care about is having them battle a horrific and debilitating mental illness alone and in silence. We know that when it comes to eating disorders, ignoring the problem won’t make it go away and it’s often extremely difficult for people living with an eating disorder to ask for help themselves.
That’s why it’s crucial to say something if you suspect someone you care about might be struggling with an eating disorder.
There is no right or wrong way to have this conversation and given your knowledge of the person, you are best placed to determine what will work best for them. However, there are a few key points that may help you in ensuring the conversation is productive.
Pick the right time and place
One of the key times we get together with people we love is around meal times and it can be tempting to bring up any concerns you have at this time. However, being around food is already likely to make the person you’re worried about feel anxious and therefore unreceptive to an honest conversation about their disordered eating. Pick a time that isn’t too long before or after a meal, and when you’re both feeling relaxed and comfortable.
It’s important to pick somewhere they feel safe, such as in their home. Try to choose a room that isn’t potentially triggering, such as the kitchen or dining room. If being in their home isn’t possible (for example, if you are a co-worker), suggest going somewhere like a park or somewhere else quiet and peaceful. Being in a busy, crowded place could make the person feel exposed and embarrassed.
Educate yourself about eating disorders. You are not only going to be able to empathise more greatly with what the person is going through but it also shows that you have made an effort to find out more and have evidence to back up your concerns. There’s nothing wrong with writing down a few notes on what you want to say too, to make sure you are getting your points across clearly.
Learn about what their options for seeking help are. This will be useful not only if the person is prepared to seek help, but also if they are sceptical or fearful about recovery. Tell them about the EDV Hub, and how they can call for a judgement-free and confidential chat with someone who has lived experience with an eating disorder.
What to say
- “I am concerned about you” — by talking specifically about how you are feeling (rather than about how they are making you feel), you are showing them that you care for them and are here to help, not to criticise or accuse.
- “I’ve noticed X lately and I was wondering if you want to talk about it” — use clear, specific examples of behaviours that have worried you but then ask them for their perspective. Don’t take on the role of therapist and try to analyse certain behaviours with them. Open up the conversation so they feel they can speak freely about what’s going on.
- “Do you want to change?” — only use this if the person has acknowledged they have a problem. While they may not be interested in changing for themselves, there may be another reason they are open to seeking help (to improve a relationship, to study, to go on holiday etc). Asking this question can open a discussion about what life might look like for them without an eating disorder.
- “I’m here when you need to talk again” — don’t assume you’re going to convince the person you’re worried about to seek help straight away. Some people might dismiss you as soon as you start the conversation. Others might be happy to have a chat but then assure you that they’ve got it under control. The important thing is to be patient and let them know that you care, that you believe they can overcome this, and that you are there for them, whenever they are ready.
What not to say
- “You have an eating disorder/anorexia/bulimia” — even if you suspect this is the case, you shouldn’t make assumptions or judgements, especially when you don’t know someone very well. Weight loss can be attributed to a lot of things such as anxiety, stress or other medical issues. And if the person IS experiencing an eating disorder, they might get instantly defensive if you are to come straight out with this statement.
- “You have lost so much weight” — try to focus more on behaviours and feelings that you are concerned about, about rather than focusing on eating or weight. The person is more likely to recognise that they have been unhappy or withdrawn, so talking to them about their feelings is a good way to get them thinking about why they think they might feel that way. They also may be highly protective of their eating behaviours and weight.
- “You are looking really skinny” — again, this is focusing on their appearance, which they may already be feeling sensitive about. Furthermore, some people may take this a compliment and it could encourage them to continue with their eating disorder. Best to avoid appearance-based remarks at all.
- “X is also worried about you” — don’t bring up the names of other people who may have expressed their concerns to you as well. This gives the impression that they are being ganged up on or that their loved ones are talking about them behind their back. Stick to how you feel and tell the other person to also raise their concerns if they feel it’s appropriate.
For more ideas and tips, see the EDV fact sheet What should I say to someone with an eating disorder? Or call the EDV Hub on 1300 550 236.