If you have a friend or family member who is showing signs of disordered eating, it’s hard to know how to help. People with anorexia, bulimia, binge eating, or avoidant/restrictive food intake disorder are often in denial and may resist aid.
Eating disorders — which are some of the most dangerous mental illnesses — have become increasingly common, particularly among teenagers and young adults. Yet early detection and treatment can help individuals achieve a full recovery.
If you suspect someone you know is struggling with an eating disorder, it’s imperative to raise concerns and offer support without shaming, alienating, or triggering them. That requires tactfulness and close listening, says Pamela Ramos, MD, a psychiatrist specializing in eating disorders who has worked in the field for the past decade. And it requires care to distinguish the person from the disorder.
Stress Source
Our society often praises, and encourages, disordered eating behaviors. Thinness and weight loss are culturally affirmed and even moralized, while overindulgence and gluttony are habitually endorsed as celebratory behaviors.
It’s difficult to know for certain whether someone has an eating disorder — and you’re afraid to approach them about it unless you’re sure it’s a problem. There’s often a level of shame associated with disordered eating, Ramos says. And common warning signs fly under the radar when people hide, minimize, or explain away disordered eating behaviors.
At the same time, unconscious bias is misleading. Although there’s a pervasive stereotype of eating disorders as primarily affecting young, thin, white women, Ramos emphasizes that you can’t tell whether someone has an eating disorder based on appearance alone. Anyone of any age, body type, race, or gender can struggle with one.
Your loved one has become irritable or aggressive when you’ve tried to approach them about your concerns. To the person with an eating disorder, your attempt to address the problem may feel like you’re trying to deprive them of a source of comfort.
“These behaviors serve as a kind of maladaptive coping skill,” Ramos says. “The person who binges doesn’t enjoy binging as such, but when they’re doing it, there is a sense of either numbness from feelings they don’t want to feel, like fear, or there’s a high. The idea that you would take that away from them can be incredibly scary.”
The eating disorder may be a strategy for managing underlying stress, anxiety, or trauma that needs to be addressed and treated. “These disorders are illnesses of comorbidities,” says Ramos. “Many times, it’s not only the eating disorder from which they suffer but an anxiety disorder, a mood disorder, a substance [use] disorder.”
You’re afraid of unintentionally triggering your loved one. You want to find the best timing and approach for talking about their behavior related to food and eating.
You feel frustrated, afraid, and even angry if they resist your help or relapse. It can be hard not to take it personally if a loved one resists your attempts to help them or slips back into old patterns after starting treatment.
Success Strategies
1) Avoid talking about bodily appearance — in any context. Whether you are hoping to engage someone in a conversation about eating behaviors or merely complimenting them, Ramos cautions against referring to their body.
Expressing admiration about weight gain or weight loss can generate self-consciousness and shame. If you want to compliment someone, she suggests, “tell them that you like the style and color of their new shoes, or their hair, or their clothing.” This helps avoid perpetuating unhealthy attitudes and behaviors around food and weight. (Many of us inadvertently use language that reinforces the idea that thinness is better. Here’s how to start speaking with compassion.)
2) Prepare before sharing your concerns. When you approach someone about concerns related to eating behaviors and mental health, the interaction is likely to be challenging and emotionally charged. It’s wise to prepare for the discussion by educating yourself about eating disorders, anticipating responses from your loved one, and rehearsing your own statements and responses.
Consider seeking support from a therapist or other mental health professional who can help you formulate your thoughts, and avoid projecting your own relationship with food onto your loved one; this is especially helpful if you have a history of disordered eating. You’ll need to approach the conversation with compassion and without bias, which is difficult if you have yet to sort through your own baggage.
3) Share your concerns calmly, respectfully, and nonjudgmentally. Because it’s common for people with eating disorders to become defensive and anxious when someone raises concerns about their relationship with food, it’s crucial to avoid blame and judgment. Remember that eating disorders are not a choice; they are serious mental health issues.
It’s also best to pick a quiet time — other than a mealtime — when you are feeling calm and grounded.
4) Talk about circumstances you’ve observed. It helps to be specific and objective when you broach your concerns, Ramos says. “You can say things like ‘I’ve noticed that you’re buying different clothes’ or ‘When we go out to eat, I’ve noticed that you’re eating much less and you go to the restroom quite often, and I wanted to check in with you about that.’ Or ‘I’ve noticed a lot of empty cookie boxes in the trash can.’”
5) Listen with compassion and neutrality. “You need to give them some time to say whatever they want,” Ramos says. “It may be denial. Or they may say, ‘I don’t want to talk about this.’ Or they may admit the problem and express a lot of relief.” (See “5 Ways to Be a Compassionate Listener” for more.)
6) Shift to eating-disorder issues. After listening, your next move is to raise the subject of eating disorders gently and tactfully, says Ramos, reassuring the person that you are on their side:
“I’m bringing it up because I’ve been reading about eating disorders, and I read that people with eating disorders do some of these things. I also read that eating disorders are serious medical illnesses. I’m no expert, so all I’m doing is making sure you’re OK. I love you and I want the best for you.”
If your loved one is receptive, that’s great, but even if they resist, you will have conveyed your concern and that you’re not being judgmental.
7) Separate the person from the disorder. It’s important that you — and your loved one, when they’re ready — understand that the disorder is not who they are but something they are experiencing. It’s not their fault; it’s a serious medical condition, Ramos says.
When someone is dealing with an eating disorder, the disease is behind much of what they say and do, she adds. This applies to isolating, denying the condition, resisting treatment, and relapsing. Instead of attributing these behaviors to the person, it can be helpful to look at them as stemming from the eating disorder.
8) Ask the person how you can help and support them. “If they acknowledge that they have an issue, reassure them that you’re going to be supportive in their recovery in whatever way they want,” Ramos says. “You can make suggestions: ‘If eating is hard, can I eat with you? If shopping for clothes is hard, I’d be happy to go with you.’”
9) Connect your loved one with professional support. The most important aid you can offer someone with an eating disorder is to point them toward professional help. “If your loved one actually has an eating disorder, it’s likely that they’re going to need treatment,” Ramos notes. It isn’t something that most people can work through on their own.
Eating disorders can lead to numerous medical issues, and people with eating disorders have high mortality rates. Ramos suggests sharing materials from organizations like the National Eating Disorders Association. You can also offer to drive them to a healthcare clinic for an assessment.
Renewal
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This article originally appeared as “Helping Someone With an Eating Disorder” in the March/April 2025 issue of Experience Life.
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