Knowing how to help a friend with an eating disorder can be tricky. If you’re reading this article, you probably have a friend you suspect has an eating disorder. And you want to help but don’t know how to. You’re especially concerned that anything you say could make things worse.

Perhaps one reason you want to help is you know that eating disorders are serious. They are not a choice, nor are they about vanity or attention seeking. Eating disorders can be life threatening, especially when left untreated. Of course, you do not want your friend’s health or life in jeopardy.

What makes helping a friend with an eating disorder tricky?

• Your friend may not be ready to acknowledge the eating disorder. This happens a lot.

• Many disordered eating behaviors are so common that distinguishing them from less intense but still damaging effects of Diet Culture can be impossible. After all, dieting is praised and thinness is admired in our culture. Often at a high cost, physically and psychologically.

• Third, denial of an eating disorder is common among people with eating disorders, especially Anorexia nervosa and Bulimia nervosa. Often, the person herself does not necessarily recognize she has a problem. Or she does realize it, and wants it to remain a secret. Especially with bingeing and with purging behaviors, shame is inextricably intertwined.

1. The first step to help a friend with an eating disorder is to educate yourself.

A great place to start is with the National Eating Disorders Association, which also has a helpline and screening tool. Other excellent informational and educational sites available include the Academy for Eating Disorders, and MEDA.

A basic understanding of how an eating-disordered mind works is essential. Otherwise, there is a good chance any attempt to be helpful could make matters worse.  

2. Next, consider the approach to use to help a friend with an eating disorder.

How do you anticipate your friend responding to your effort to help? With anger? Relief? Embarrassment? Denial?

Regardless, try your hardest to remain calm and compassionate. Your friend, after all, is in a lot of pain.

When you do speak with your friend, state your concerns clearly and concisely. Do not go on and on or put your friend on the spot. You’re not the Eating Disorder Police.

Even though your intention is to help your friend, s/he may not be ready to address the problem. S/he could even resent your concern. Do not get into a fight over it.

How to help a friend with an eating disorder could go something like this:

“I notice how negatively you talk about your body lately and how little you eat and laugh when we go out. You don’t seem yourself. I’m here for you if you want to talk. Please let me know if I can help in any way.”

What not to say, although you may be tempted, are things like:

• “Just eat more!” That never works because eating disorders aren’t about food. They are about so much more. And as the friend, your role is not to “fix”. That is the job of the therapist and treatment team.
  
  
• “You look (or don’t look) healthy.” Or, “You don’t look like you have an eating disorder.” Steer clear of making any kind of appearance related comments. Also, for someone with an eating disorder, “healthy” is interpreted as “fat”, and fat is feared.
  
  
• “Your self control is amazing.” Your friend has an illness, which has nothing to do with self control. If anything, your friend is out of control; her entire life revolves around weight and food.

3. Keep in mind that your role is “friend”, not “therapist”.

Eating disorders can be resistant to treatment. Even in treatment, recovery can be something your friend feels ambivalent about. You may be tempted to ‘therapize’ your friend. Instead, focus on your friendship. Do low-key things together (e.g. painting, doing a puzzle) that may take her mind off eating disorder things.

Eating disorders are complex.

No two people have the exact same eating disorder, even though certain symptoms may overlap.

Knowing what to say to a friend who is suffering with an eating disorder can be really difficult.

Open-ended questions are helpful. You could ask, for example, how your friend feels about the eating disorder. Or ask how you can support your friend. Maybe even suggest an activity for the two of you to do together that does not involve food or weight. Or social media!

If you do not know quite what to say, that’s okay too. Sometimes, the best thing to do is to just listen.

Dr. Elayne Daniels is an international coach and psychologist specializing in eating disorders, body image, and High Sensitivity. She is anti-diet, Intuitive Eating certified and passionately believes comfort in your body at any size is your birthright.  Contact her here for more information.

Contact her here to learn more. And, if you’re struggling with overcoming an eating disorder, this e-book might be useful.