APPROACHING SOMEONE YOU SUSPECT HAS AN EATING DISORDER

Before you approach someone you suspect has an eating disorder, I would highly recommend that you educate yourself. Too many people believe that eating disorders are only about food and weight issues, when in reality, those are just the symptoms of underlying problems. Below is a list of some things to keep in mind when approaching someone.

• Avoid talking about food and weight, those are not the real issues
• Assure them that they are not alone and that you love them and want to help in any way that you can
• Encourage them to seek help
• Never try to force them to eat
• Do not comment on their weight or appearance
• Do not blame the individual and do not get angry with them
• Be patient, recovery takes time
• Do not make mealtimes a battleground
• Listen to them, do not be quick to give opinions and advice
• Do not take on the role of a therapist

It is important to remember that when you first approach the person you suspect has an eating disorder, they may react with anger or they may deny that anything is wrong. Do not push the issue, just let them know that you will always be there for them if they need to talk. In cases where the person is extremely underweight or is bingeing/purging several times a day, you may need to step in and take control. I would only recommend doing that if the individuals health is in extreme danger. If that is the case, you may need to speak to a doctor about a forced hospitalization.

Watching someone you love slowly kill themselves can be frightening. You will probably experience feelings of distress, anger, guilt and confusion. No matter how much you want to help them, you must remember that only they can make the decision to get help. You ca not force them to do this.

You must also be careful with the remarks you make to the person suffering. Below is a list of a few remarks that should never be made because they will usually only drive the person away or cause them more inner pain and guilt.

• "Just sit down and eat like a normal person." If it were that easy, we would. Remind yourself that there are deeper emotional issues that may be preventing them from eating properly.
• "Why are you doing this to me?" We aren't doing this to you, we are doing this to ourselves. A comment like that would only cause us more guilt and make us feel worse about ourselves.
• "You've put on weight, you look great." We do not hear "you look great", we only hear "you've put on weight" leading us to believe that we are fat.
• "Are you making any progress?" If in therapy, a comment like that could lead us to believe that we are not making progress and that we are in fact failing.
• "I'll help to fatten you up." The words "fatten you up" is very terrifying to a person with an eating disorder. Comments like this can be very damaging.
• "Are you keeping anything down?"or "When was the last time you puked?" The act of purging can leave the person with feelings of guilt and shame. Having someone ask this question can cause them to re-experience those feelings and leave them feeling ashamed for having a problem.
• "You look terrible." Avoid commenting on the persons appearance. The person is already obsessed with their body, they do not need to hear any negative comments.
• "Your ruining our family." Comments like this only causes the person more guilt. It will not motivate them to eat, instead, it may drive them deeper into their eating disorder.
• "What have you eaten today?" This puts us in a bad position because we either have to lie to make you happy (which causes us to feel worse for doing so), or tell the truth and hear a lecture (which would lead us to feel like we are failing).
• "If you think you are fat, you must think that I'm obese." Even though we are underweight, we still feel fat and see ourselves in the mirror as fat. We do not see others as being overweight. The only distorted image we have, is of ourselves. Any ways, it is best not to mention size and weights around anyone with an eating disorder.
• "Go ahead and have a drink or eat that. You'll just go and throw it up any ways, so what does it matter." A comment like this is very insensitive and cruel. Unfortunately, there are actually people who would say this. We already put ourselves down enough as it is and the last thing we need is someone else making us feel guilty or ashamed for having an eating disorder. If you have nothing positive to say to us, do not say anything!
• "I wish I had that problem." or "I wish I could be anorexic for a day." No you don't! Everyday we struggle with this problem and we go through tremendous pain in trying to overcome it. We would not wish this problem on anyone, not even our worst enemies. It is hard for us to hear a comment like that because we know how terrible it is to live with an eating disorder.
• "For someone with an eating disorder - you're sure pigging out today." Believe it or not, some people would actually make a comment like that. This comment is very insensitive and it could cause the person to panic about what they have eaten and end up purging.
• "You look so healthy, you were always so thin before." If you make a comment like that, you are basically telling us that we are getting fat! We may in fact be looking better and looking much healthier, but when we hear comments like that, we will be made to feel that we are in fact getting fat. It really is best not to comment on a person's appearance.
• "I wish I could have your strength. I've tried to starve myself and I just can't. What's your secret?" I guess my response to that remark would be "Why would you want to starve yourself? Eating disorder sufferers do not starve themselves because they want to, they feel they have to. Most of wish we could eat normally so that we did not have to suffer the daily physical and emotional pain that goes along with having an eating disorder.
• "Why bother eating, you're just going to dig it out any ways." A comment like this is very insensitive and it really hurts to have someone say this to us, especially if that person is a close family member or friend. A comment like that will not do anything but cause us to feel worse about ourselves and more ashamed.
• "She's too thin now, but she'll gain it all back." If your main purpose in making a comment like that is to scare us, you have probably succeeded. Telling someone that they will gain the weight back is not a good approach. Just hearing that could cause us to panic more and try to lose even more weight.
• "I can't continue to live this way. When do I get time off from this disease?" It is very difficult to watch someone you love slowly destroy themselves, but a comment like this can do more damage. It would be best for you to seek outside support for yourself to help you cope, instead of lashing out at the person. A comment like this will only make us believe even more that we cause too many problems and we don't deserve to eat.
• "I will give you 6 months to get over this."You cannot set a time limit on recovery. Telling someone that will add even more pressure to them and if they do not recover in the time limit you set, they will believe they have failed. Everyone is different and we all do not recover in the same amount of time. Recovery does take a long time, so everyone involved needs to be patient.
• "Quit feeling sorry for yourself."We are not doing this because we feel sorry for ourselves. There are deeper emotional problems causing us to do this. A comment like this will only help to make us feel worse.
• "You just need to exercise."If someone is bulimic, this comment could lead them to believe they are indeed fat and in need of exercise. You are dismissing all the important reasons why someone is doing this.
• "You need to get your act together."Recovering from an eating disorder is not just a matter of getting our act together. Before you make a comment like that, educate yourself and find out how you can help us to overcome our eating disorder.
• "You look like you have AIDS" Once again a comment like this is focusing on the person's appearance and will only make them feel worse. Avoid commenting on their appearance, especially if you are going to say something negative.
• "What are your friends going to think." Many of us have had comments like this made to us. It only causes us to feel guilty and more ashamed of our eating disorders, which could lead to being more secretive and not seeking out help.
• "You're just doing this for attention." We do not do this for attention. Most people with eating disorders would be happy to just keep it a secret from everyone. People with eating disorders are in a lot of emotional pain and this is their way of dealing with it. They need to be encourage to seek help, they do not need to be told they are only doing it for attention.
• "I tried reading that book on eating disorders that you got for me, but it just wasn't really a page turner." Eating disorder books are meant to educate you so that you will have a better understanding.  They are not meant to keep you on edge like a science fiction novel!
• "If you are so scared of throwing up, then just don't eat." That is a ridiculous comment.  It is like telling someone who is afraid of pollution not to breathe.
• "I wish I could throw up all the food I eat, it would make things so much easier." This is yet another very insensitive comment.  Having an eating disorder does not make things easier, it makes life a living hell.
• "I barely ate once for a week, so I know what you are going through." Eating not so greatly for one week is nothing compared to having an eating disorder for years.  You cannot compare stubbing your toe, to having your leg ripped off.
• "You are never going to get better." A comment like this could be very damaging, causing the person to feel like they are failing.  You need to remember that recovering from an eating disorder is a process and it takes a long time.
• "You obviously are not trying to get better if you are just getting worse." Recovery is a long process and the person is going to have slips and relapses.  You cannot expect the person to recover overnight and relapses are normal part of recovery and they should be expected to happen.  During the rough times, that is when you need to be positive and support the person, not make them feel worse.
• "I never thought I would have a friend stupid enough to have an eating disorder." I am sure the person with the eating disorder never thought they would have a friend stupid enough to make a cruel comment like that!
• "Nobody is going to like the way you look." A comment like this only causes more damage.  It is best to avoid comments on appearances, especially ones like this.
• "If you loved me, than you would eat this food." A comment like this would do more damage, cause the person to feel more guilt and they will more than likely feel the need to punish themselves more.  If you love the person, than try to help them in a positive and supportive way. 
• "All you need is a good man to sort you out." Whoever made this comment definitely knew nothing about eating disorders.   I'm still trying to figure out how having a man is going to cure someone from their eating disorder!!!
• "I can't take you out in public because you look like a skeleton." A comment like that can devastate a person.  People with eating disorders already have a low self esteem.  Making them feel like you are embarassed to be seen with them will only cause them to feel worse about themselves.
• "If you would just sit down and eat, you wouldn't have this problem." Basically you are right.   If we could sit down and eat normally, we wouldn't have an eating disorder.   However, we do have an eating disorder and no matter how much we wish we could sit down and eat normally, we cannot do that just because you want us to. A comment like this will only lead to more guilt and the person may end up feeling the need to punish themselves even more.
• "I need to be eating soon, I'm getting hungry.   You need to eat everything you can possibly get your hands on, you're too skinny!"  Once again, it is important not to comment on the person's appearance.  Your comments can be taken the wrong way causing the person to feel worse.
• "No one is ever going to love you if you don't get some of that weight off." This comment would only cause pain to the person with the eating disorder and it is a very cruel comment.  It is time people learned it is what's on the inside that counts.  People need to love each other for who they are, not what they look like.
• "Repent of your sins and things will get better for you."  This comment could make a person feel as though their sins were the cause of their eating disorder and that they have done something terribly wrong.   They could feel like they are horrible and deserve to have an eating disorder.   No one deserves to have an eating disorder.  If a person has a strong faith in God, remind them that God loves them just the way they are. He created them and God does not make mistakes.  A comment like the above could push a person with a strong faith away from God, instead of bringing them closer to Him which is where they need to be.
• "You are just trying to be the worst case anorexic."  No one strives to be a worst case anorexic.  No one wants to go through this pain each day.  Comments like this hurt and the person does not deserve anymore pain.
• "You shouldn't go to counseling anymore. It's not helping you anyways."  Recovery does not happen overnight. It takes time and the person will experience periods of relapses.  Also, the person may not be receiving proper treatment which makes therapy difficult.  You need to encourage the person, not make them feel worse.
• "Can't you see how this is affecting me."  The person is not doing this to you, they are doing this to themselves. They do not develop an eating disorder to hurt you.  They can see how it is affecting you, but can you see how it is affecting them?  You are watching it happen, the person with the eating disorder is living it.
• "You don't even try, all you have to do is eat."   If it were just that easy, then no one would have an eating disorder.   Remember that there are underlying issues that are causing the eating disorder.   The person will need time to deal with those issues and time to learn new and healthier ways to cope. 
• "If it wasn't for you and your eating disorder, then we wouldn't have to waste all of our time running back and forth to these doctors."   First, seeking treatment is not a waste of time.  Also, a comment like this would only make the person feel worse about him/herself and cause them to feel guilty, which in turn could cause them to turn even more to their eating disorder as a way to cope.
• "Don't expect me to baby you, remember I'm not the one who got this eating disorder."  A person with an eating disorder does not want nor need to be babied. However, they do need love and support and a comment like this is not providing them with the support they need and deserve.
• "Boy, you ate a lot today." or "You were certainly hungry today."  After a comment like this, you can be sure that the person is going to spend the next few hours or days obsessed with the amount of food they ate and whether it's making them fat.
• "You look good, but you'd look even better if you worked out."  A comment like this would only confirm in the person's mind that their body does need to be altered.  It is best not to comment on a person's appearance at all.
• "The reason you feel fat in your bathing suit/shorts/other revealing clothes is that you haven't been toning your muscles."   No, the reason the person feels fat is because they more than likely have an eating disorder voice in their head telling them that they look fat. 
• "Why can't you just...
  -get on the scale once a week as a gauge;
  -keep the scale in the house and not get on it;
  -eat a little of this without freaking out;
  -stop comparing your body to other people's?"  If the person could do just that, they would have stopped a long time ago. A person in recovery from an eating disorder needs encouragement, they do not need to be made to feel worse.  Recovery takes time and a person should not expect someone to just stop having one immediately.   Recovery takes a long time and hard work. 

If you have had comments made to you that you felt were inappropriate and should not be said to someone suffering from an eating disorder, please email colleen and I will include it on this list.

Someone with an eating disorder has the best chance for recovery when they are surrounded by people that are loving and supportive. Recovery takes a lot of time and hard work, but with the proper treatment, which should include individual, group and family therapy, support groups, medical and nutritional counseling, eating disorders can be overcome.

I would also recommend to the families to get support for themselves. Dealing with someone that has an eating disorder can be frustrating and emotionally exhausting. You may want to seek the help of a therapist or a support group to help you through this difficult time.

Written by: Colleen Thompson
Resources:
-Coping With Someone You Suspect Has An Eating Disorder pamphlet - Sudbury General Hospital Eating Disorders Clinic (information from pamphlet obtained from NEDIC)
-Many thanks to everyone who submitted comments for "what not to say".

Copyright © 1996 by [Colleen Thompson]. All rights reserved.
Revised: 14 Jul 2008 10:31:07 -0400.