It’s often difficult to know what to do when you live with someone with an eating disorder. Here are some ideas for everyone — from parents, grandparents and siblings, through to partners and roommates.
Encourage the person to seek professional help
Overcoming an eating disorder can be very difficult without assistance, so accessing professional help is an important goal. Remember that when someone has an eating disorder, they are often protective and private about it. They can feel threatened if someone tells them they need to seek help for it and may lash out in anger or denial. Try not to take it personally and try again later. Reassure them that you are only acting out of concern for them and that you are here to support them.
Encourage the person to recognise their other skills and attributes
Use your knowledge of the person to encourage them to see the positive effects change can bring. Keep communication positive and open — take time to talk about a variety of topics. Focusing on the eating difficulties creates a stressful environment, which may result in the person withdrawing from contact with you. Try and focus on their positive behaviours, rather than the more destructive ones. Don’t compliment their physical appearance; comment on their personality, their intelligence, their talents, their dreams. Get excited when they express an interest in something outside of food, dieting or body image. Ask them questions about the topic.
Use laughter as a means of communication
Humour is a great communication tool. Laughter helps a person to relax and let their guard down a bit. This doesn’t mean you should pounce on them about their eating disorder after a good laugh but you might be able to get them to start talking a bit more openly about what they are going through.
Take the focus off food and weight
The person with the eating disorder is already overly focused on food and weight issues. Don’t talk negatively about your own body or appearance around someone with an eating disorder. Try not to put emphasis on the things you ate (for example, don’t ‘pat yourself on the back’ for eating a salad or berate yourself for eating chocolate). Don’t change your own eating habits around the person with an eating disorder but try not to make a big deal of it either.
Mealtimes should not become a battleground
Frustrations and emotions need to be expressed but not at meal times; this is already likely to be a very difficult time. Try to keep the conversation away from the eating disorder when there is food on the table. If you are doing meal support for someone with an eating disorder, give authentic encouragement, such as “I’m really proud of your hard work” and empathise with how they are feeling (“I know this is very difficult for you”).
Accept limitations in your responsibilities
The support and encouragement of family and friends is vital; however, it is the person with the eating disorder’s responsibility to take the necessary steps towards recovery. You cannot deal with all the problems associated with the disorder. Your role as a family member or friend is unique and something that a therapist can’t be — just as the therapist’s role is something a family member or friend can’t take on. Don’t blame yourself when things go wrong or the person you care about relapses or has a bad day.
Consider promoting independence as a long-term goal
It is healthy and developmentally appropriate for adolescents and young adults to work towards increasing independence; however, this can be difficult if the person is unwell and unable to make good decisions for themselves. It is well-recognised that family members can play an important role in supporting recovery of an eating disorder, however the level of family intervention and involvement will depend on the person’s age, the degree to which their health might be compromised, and other factors such as living arrangements and meal support. Having a goal of being able to live independently and support themselves may act as an incentive to keep working towards recovery.
If someone is behaving in a way that is difficult for you, it is okay to let them know that their behaviour is not acceptable or you aren’t able to assist at this time. Only set boundaries you can enforce. For example, if the person with an eating disorder asks you to support them when you are having a bad day or need some alone time, it is best to be honest. Respectfully tell them that while you aren’t able to help today, perhaps they could ask another friend or family member. Boundaries are a huge part of self-care and actually strengthen a relationship, rather than hurt it.
Do things as you usually would
The person with the eating disorder needs to learn to co-exist with food and with other people, rather than you learning to co-exist with the eating disorder. Try not to make any changes to meal times, food shopping, outings, topics of conversation, or other interests.
Separate the person from the disorder
Remind yourself that the person’s behaviour is often a symptom of the eating disorder, rather than a reflection of their character. By separating the person from the disorder, we are reminded of the person we knew before and also the person they can become again. That person is still very much present but their illness is preventing them from being themselves fully.
Enjoy things together
It is important not to let the eating disorder become the focus of the family or relationship. Continue to enjoy things together that you have always done. Tell them about your own life and what is exciting or interesting to you. This may give them more hope towards recovery, when their mind won’t be preoccupied with their body or food.
Spend time with other members of the family or friendship group
The person with the eating disorder is important, but no more so than other people. Don’t neglect your other relationships while caring for someone with an eating disorder. Make sure you give yourself time with people who are completely separate to the person with an eating disorder, so you get a break and don’t burn out.
Information about eating disorders, recovery stories, developing coping strategies and attending support groups can be useful. There are many resources and books written for families and friends. The more educated you are, the more you’ll be able to empathise and understand what they are going through, which may help you to better support them and yourself.
Look after yourself
Get as much support and information as you need. Support groups, relatives, friends, counsellors, telephone support lines and other professionals may be useful. Looking after yourself is as important as looking after the person with the eating disorder.
Eating disorders are complicated and recovery can take some time. Sometimes it’s important to remind yourself that the person does not want to be unwell, but they lack the ability to overcome the disorder quickly. There is no specific timeframe for recovery.