Friends and Eating Disorders: A Supportive Approach

Approaching the Sensitive Topic of Eating Disorders: A Guide to Helping Your Friends

Eating is vital to life and used to be instinctive but has become more complicated over time. Consider dinner- the evening meal was traditionally eaten at home with family and friends.  Food was served family style, often with the motto, “You get what you get, and you don’t pitch a fit.” Conversation flowed easily, as long as no one brought up religion or politics, and systemic reviews suggest that family dinners are associated with a reduced rate of eating disorders in youth.  

The New Normal

Fast forward to 2024, and the number of families who sit down to dinner together is lower; more people, adults, and kids, are hyper-focused on nutrition, fitness, and individual success. When family meals do happen, they are often stressful; with about fifty percent of the population following a special diet or eating plan, it is increasingly difficult to prepare one meal that meets everyone’s preferences. Dinner table conversations are also more complicated. Many people believe their way of eating is morally superior to others' diet choices, dividing family members between Low FODMAP, paleo, vegan, vegetarian, “clean” eating, etc. 

The deeply rooted beliefs about diet have become a part of many people’s identity. If you listen to people talk about their experience with food, it appears the new cultural norm is that eating is often accompanied by guilt, anxiety, and stress, blurring the line between “normal” societal obsession with the nutritive properties of food and eating disorders. Eating disorders have become harder to spot and even harder to talk about. 

If you are concerned about someone’s eating, consider the below tips when preparing to have the tough conversation.  

1. Warning Signs Beyond Appearance: 

Widen your view of eating disorders. They will affect nearly 30 million Americans in their lifetime- across all genders, races, sexual orientations, weights, and ages. Forget stereotypes that eating disorders have a “look.” Someone can have a BMI in the obese category and have anorexia, athletes can look like the picture of health- but be struggling with purging, and someone can appear to be the picture of self-control but binge secretly.  

Understanding that eating disorders are not about physical appearance will allow you to notice warning signs earlier (limited diet, preoccupation with thoughts of food or body, withdrawing from things that bring pleasure, find more examples here) and hopefully get your loved one’s help more quickly.   

2. Preparedness Saves Lives:

Be prepared. The National Eating Disorder Association (NEDA) estimates that someone dies from an eating disorder approximately every 60 seconds, and yet only 10% of people with this disease will receive proper treatment. Educate yourself on the types of treatment- in-patient, partial hospitalization programs, intensive outpatient, outpatient counseling, and dietitian support- and have a plan when you talk with your loved one. 

For example, “I am concerned that food is interfering with your quality of life, and I think we should go talk to x person to explore it further. I have scheduled a tentative appointment for x day and time and hope we can go together.”   

3. Speak with Love, Act with Empathy. 

As discussed previously, shame is an ineffective motivator for change. In fact, it typically has the opposite effect, causing people to withdraw and hide the behaviors they feel judged for. Food choices and body image are sensitive subjects, so before you have a discussion about either, imagine yourself in their shoes. For example, think about how you would feel if what you saw in the mirror was vastly different from the reality of what everyone else saw, or imagine your greatest fear, elevate that fear, and imagine having to face it at least 3 times (i.e. eating meals). Validating your loved one's experiences and feelings is helpful in the healing process.  

4. Consistency in Action:

Don’t be a hypocrite. If you are constantly trying to lose weight, discussing the latest diet trends, or pointing out the appearance of others, you are likely not a safe person to have an eating disorder discussion with. These behaviors send a message that thinness, diet, and appearance are important to you, so why should your loved one not pursue them at any cost? 

Another sticky slope is how you view and discuss health. Eating disorders can look “healthy” compared to societal standards. Orthorexia is an obsession with the pursuit of health through clean eating and exercise and quickly becomes unhealthy as a person’s diet and lifestyle become more and more limited. Educate yourself on orthorexia and health at every size so that you can be a safe place.   

5. Continuous Learning:

Learn and grow. Eating disorders are a mental illness and require professional treatment for healing and recovery. Understand what you can offer as a friend, parent, or partner– clearly communicate your role to the best of your understanding and refer loved ones to professional resources for things outside of your scope. Do not collude or enable the eating disorder. Work with your own therapist on appropriate boundary setting when talking to and helping a loved one through recovery.  

Do not be afraid to call disordered behaviors what they are without excuse. In the same way, if you recognize you have been part of the problem, acknowledge and make amends (ex. I know that I have dieted with you in the past, but now that I know people who diet are significantly more likely to develop an eating disorder, I am sorry and will not be dieting myself anymore and would like to be a support person for you in recovery). 

Normalization through Conversation

Discussing eating disorders with loved ones can be awkward and difficult, but normalizing mental health issues and treatment is vital to recovery. The National Eating Disorder Association (NEDA) hosts an awareness week the last week of February each year and provides great resources for those with an eating disorder and their support systems. Learn how you can be involved here. 

1. _{Bunnell, D. (2024, February 1). Eating disorder statistics. National Eating Disorders Association.}
2. _{Crawford, E. (2022, May 19). IFIC: More Americans are dieting, but fewer consider the healthfulness of what they consume. Foodnavigator USA.}
3. _{Dennis, A. B. (2024, January 5). Orthorexia. National Eating Disorders Association.}
4. _{Eating disorders awareness week #EDAW- Neda. National Eating Disorders Association. (2024, February 5).}
5. _{Facts about eating disorders: What the research shows - KFF. (n.d.).}
6. _{Harrison, M. E., Norris, M. L., Obeid, N., Fu, M., Weinstangel, H., & Sampson, M. (2015). Systematic review of the effects of family meal frequency on psychosocial outcomes in youth. Canadian family physician, 61(2), e96–e106.}
7. _{The health at every size® (HAES®) principles. ASDAH. (2023, April 1).}

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