How to Support a Loved One in Eating Disorder Recovery
Supporting a loved one in eating disorder recovery can feel overwhelming, confusing, and scary. Despite the best of intentions, your attempts to help your loved one can, unfortunately, land poorly and even do harm in their recovery journey. That’s why we’ve compiled the following list of ways to support your loved one in their recovery, as well as actions to avoid in how you offer help. Over the years, we’ve had the privilege of hearing from our clients the type of support they appreciate most and the actions they wish their friends and family would avoid. We encourage you to use the following list as a resource and have a conversation with your loved one about their own experience of receiving support.
DON’T problem-solve (unless asked): Although it may be well-intentioned, problem-solving is not always the support that your loved one is needing during their recovery. Problem-solving often minimizes the complexity of eating disorders to be a matter of choice (see next bullet point).
DON’T assume eating disorders are a choice: Given that most clients desperately want to relieve the suffering that their ED causes them, assuming that they have a choice in this issue can feel incredibly shaming. Trust us, if your loved one could choose to not have an eating disorder, they would have done so already.
DON’T expect progress overnight: Recovery takes TIME. Many eating disorder behaviors have been learned and reinforced over many years, maybe even decades. Consequently, it also takes time to unlearn these procedurally learned ways of coping. Chances are, your loved one already feels worried about their own timeline in treatment, so reinforcing this fear typically just adds more pressure.
DON’T make food judgments: While you may not think you send harmful messages to your loved one about food, food judgments have become so normalized in “health & wellness” culture that we often don’t realize that we are partaking in this harmful action. Here are some common examples:
Calling certain foods “good” for you, and others “bad”, “indulgent”, or “treats”.
Statements like, “I can have dessert tonight because I’m going to the gym first thing in the morning” (this can be a big one around the holidays/vacations).
Messages like, “But this food is healthy/organic/vegan/low-carb, so you shouldn’t feel guilty or worry about it.”
DON’T play the “food police”: Monitoring what or how much food your loved one is consuming is not your job as a support person. Such monitoring may actually encourage your loved one to lie to you about their intake in an effort to avoid judgment and shame. Trust that their providers will monitor this as needed, and therefore you do not need to play this role in monitoring unless directly instructed to be a part of this type of support. We hope this comes as a relief to you as well!
DON’T assume you know what is best for their recovery: Unless you have fully recovered from an ED yourself, you likely will never understand just how hard and difficult the recovery journey can be. Rest assured that their treatment team is working and collaborating with them to determine what is best for THEIR recovery.
DON’T attempt to “logic” them out of their eating disorder & behaviors: Once again, if the “logic” method of treatment worked, eating disorder recovery would be a much quicker and easier process than it unfortunately is.
DON’T question their need for a higher level of care (e.g. residential treatment): Trust us when we say that insurance companies will NOT pay for a higher level of treatment than is needed. This being said, trust your loved one’s clinical team to make decisions about their treatment needs.
DON’T make comments about bodies (your’s or other’s): Whether you’re expressing dissatisfaction with your own body or making comments about a celebrity’s body, this sends the message that you believe a person’s outsides (their appearance) are more important than their insides (who they are). Unfortunately, body shaming is a form of social bonding (especially among women), and therefore, it is a radical act to choose to not engage in this behavior.
DON’T assume progress is only related to weight and eating behaviors: Eating disorders are both about food and not about food. This means that although your loved one may be using food to cope, their eating disorder is not actually about food. Your loved one’s eating behaviors are just the tip of a very complex iceberg. This being said, progress cannot be measured solely by behavior and weight changes.
DON’T take offense by meal incompletion: If your loved one does not enjoy or complete the meal that you spent hours cooking, this does not mean that you are a bad cook, so don’t take it personally! Food carries a lot of meaning for those with eating disorders, so we encourage you to do your best to remain unattached to how your meal lands with them.
DON’T reinforce diet culture & fatphobia: Here lies a catch-all for all the subtle ways in which you may (unknowingly) be reinforcing diet culture & fatphobia:
Mentioning your success or frustration with your new diet or “wellness program”. (Yes, this includes WW, Noom, & Intermittent Fasting).
Discussing numbers related to weights, calories, macros, steps, carbs, miles, burpees, points, etc.
Logging your food intake or exercise output (aside from issues deemed as medically necessary such as diabetes & chronic inflammation).
Making assumptions about others and their health status based on their body size or what they’re eating.
Commenting on another person’s food choices or how much they’re eating.
DO educate yourself: Do your own research on eating disorders and how they impact your loved one’s life. Below are a few of the topics many of our clients wish others understood about recovery and treatment:
Recovery takes time and setbacks are not only expected, but they are also an important part of the process
Weight/body size is NOT indicative of health! This is a huge misconception that even doctors/medical professionals perpetuate, but thankfully “Health at Every Size” (which we encourage you to study up on) is starting to gain some momentum and much-deserved attention in research and media.
Eating disorders are complex issues with roots stemming from both mental and physical distress. Just like other maladaptive coping mechanisms, individuals develop eating disorders in order to cope and survive through deeper struggles and issues.
DO your own work: Yes, this means therapy. If you have a loved one in ED treatment, we strongly recommend you seek out your own therapy as well. When all parties within a relationship are doing their own work in therapy, the relationship itself is less prone to frustration and conflict. Additionally, this journey is likely hard on you, and YOU are deserving of support as well.
DO practice your listening skills: This one may seem obvious, but listening without judgment, advice, or input is harder than it may seem! As mentioned earlier, your loved one is typically not looking for a solution to their problem, but rather, simply needing you to be present and listen. A simple Google search on “reflective listening” can go a long way.
DO model recovery-focused eating: A key component of treatment is re-learning adequate meal portions and timing necessary to nourish and fuel the body. Therefore, you can support your loved one during this process by following a similar meal structure (i.e. not skipping meals or “going light on the carbs”) during your meals together.
DO recognize that your loved one’s boundaries may change: During their time in treatment, your loved one will learn and practice many new skills, one of which is boundary setting. Boundaries are incredibly important for individuals to maintain their independence and practice self-agency. As a support person, this may change the nature of your relationship with your loved one, and therefore, this may bring up a lot for you. It is normal to have a reaction to someone setting boundaries, but we ask that you process this on your own time rather than placing the onus on your loved one—another reason why we recommend your own therapy!
DO process your own relationship with food & body: Eating disorder or not, we all have relationships with food, body image, and movement that range from healthy to disordered. Disentangling our own beliefs about food, body, and movement from societal messages can be a challenging and lengthy process. However, examining this for yourself is an important and helpful step in supporting your loved one in their recovery journey.
DO find your own support system- It is understandable to feel frustrated and challenged in the recovery/treatment process with your loved one, which is why it is important that you have others to process your challenges with; otherwise, you may unintentionally take such frustrations out on your loved one.
DO ask: As this list may feel overwhelming, there is no expectation to fully understand and adapt immediately. However, what you CAN do is open a conversation with your loved one if you wish to gain more information/examples on any of the points mentioned above. We recognize the learning curve is steep when it comes to understanding eating disorders and the recovery process, but we always appreciate those who are willing to learn!