My friend might have an eating disorder – how do I help them?

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Eating disorders can be very scary, confusing and anxiety provoking illnesses for everyone involved.  This includes friends and relatives.  It is unusual for a week to go by without us being asked for advice on how to help, support or confront a friend or relative who has or might have an eating disorder  For that reason we thought we’d make that the topic of our latest blog: how to help a friend.

The first essential thing to remember when talking to or supporting a friend with an eating disorder is that it is pretty much impossible to always say the right thing.  Expect to get it wrong sometimes and don’t let this put you off trying to help.  At some point your friend will probably need to see a professional who is trained in supporting people to over come an eating disorder.  You should never try to take responsibility for helping your friend alone.

Below we have tried to offer some guidance about what to do and what not to do to best support a friend.

What to do…

  • Do talk to your friend about your worries:  The first conversation with a friend can often be very difficult.   Think about what you are going to say in advance and pick a moment when you have enough time and privacy to have an open conversation.   
  • Be prepared for your friends reaction: Your friend may not respond well to your concerns initially.  Be prepared for this and try not to let this put you off.  The most important thing is that your friend gets help, even if this means they get upset or angry at first.  If you really can’t talk to your friend about your worries, you may need to tell someone else.
  • Communicate in a helpful way: Try to remain concerned, understanding, open and honest.  Explain that you’re worried. Be as gentle as possible, and try to really listen to and be supportive of what your friend is going through. 
  • If your friend isn’t getting better or isn’t getting help, think about you else you can talk to.  This might be your parents, their parents, the school guidance counselor or nurse or a teacher that you trust. This can be very hard to do because it can feel like betraying your friend. But part of being a good friend is doing everything you can to help.
  • Ask your friend what they need from you:  Tell your friend you want to help him or her get healthy again. Ask them what you can do to help, or what they want you to do.
  • Give your friend a list of resources that might help:  There are so many books and websites now offering support and guidance to help people overcome eating disorders.  Do a bit of research and show your friend a few of the options that you have found.  A really good place to start is our national eating disorders charity (www.b-eat.co.uk  or www.mengetedstoo.co.uk).  Both have great websites and links to other sources of support.
  • Ask your friend if they want you to go with them to see a professional: It is so important that you dont try to help your friend alone, but offering to go with them to speak to a professional might be one way that you can really support them.  They may want you to wait in the waiting room for them, or even to go in to the room to speak to someone with them.  Offering to support them in this way can be a really important sign that you are there to support them.
  • Keep trying to include them:  When someone has an eating disorder they often stop doing the things they used to do.  Even if they do stop, keep invited them and suggesting things to do, just as you did before.
  • Remind them that you love and care about them: Make sure you friend knows that you are their for them and are heppy to listen to them or offer support when it is needed.  Remind them that their friendship is important to you and that you care about them getting better.
  • Get support for yourself: It can be very stressful and scary to watch someone you care about struggle with an eating disorder.  It is important that you also have help and support to cope with these emotions.  This might involve talking to your parents or friends or you might want to think about looking for some specialist support to help you cope, which you can access through B-eat or through most private eating disorders clinics.

What not to do…

  • Don’t take responsibility for your friend getting better:  Even people who have trained for over 10 years can still struggle with treating someone with an eating disorder.  It is essential to recognise your own limits and not to try and be a therapist for your friend.
  • Don’t avoid talking about what is going on:  Even though your friend may not like talking about what is going on for them, it is important not to ignore it or pretend that there isn’t a problem.  Try to find a way of talking honestly and openly to your friend about your worries, even if they dont seem to want you to.
  • Don’t let it become the only thing you talk about:  It is crucial to get the balance right – not ignoring the eating disorder, but also not letting it take over all of your conversations.  Keep talking about the same things you did before you became worried about them.
  • Don’t doubt yourself:  Many people with an eating disorder struggle to recognise their own difficulties, or are so afraid of treatment that they will try to persuade or convince everyone that they are fine.  It is important that you recognise that your friend may not be being honest with themselves, or with you.  Go with your gut instinct – if you think there is a problem then there usually is.
  • Don’t simplify what they need to do to get better:  Comments like ‘just eat’, ‘just stop exercising’ aren’t helpful.  It is incredibly hard to overcome an eating disorder and involves a lot more than ‘just eating’.  Recognise the battle that your friend is probably going through.
  • Don’t misunderstand what an eating disorder is:  People with eating disorders still feel hungry, they still like food, they dont always see themselves as fat, they dont just want attention – eating disorders are very complicated illnesses, you dont have to understand them, but it is important not to misunderstand them.
  • Try not to talk about food, weight or calories with them: Usually these topics are very difficult for people with eating disorders to tolerate.  If possibly try to limit how much you talk about these things in front of your friend.
  • Don’t gossip to others:  People with eating disorders can often feel very ashamed or embarrassed about their illness and will often be very anxious about how others will see them.  Try not to use your friends eating disorder as something to gossip about.  Only talk to others if you need their support or think they can help.
  • Don’t comment on their weight:  It is important to express your concerns to your friend but try to talk about the changes or the behaviours that you have noticed rather than about their weight.  Comments like ‘you look too thin’, ‘you look really healthy’ can be taken the wrong way by someone with an eating disorder and so are best not said.
  • Don’t try to force them to do something they don’t want to do:  People with eating disorders often feel very ambivalent about change.  Trying to force them to eat, to stop exercising, to seek help can backfire.  Try to be encouraging and understanding rather than forceful.
  • Don’t expect them to recover instantly:  On average it takes months if not years to overcome an eating disorder.  Be patient with your friend and dont expect them to recover straight away.
  • Don’t be overly watchful of your friend’s eating habits, food amounts, and choices. People can often be very anxious about being watched / judged / noticed but others.  It is fine to express your concern to a friend but not to watch every move they make as this can leave them feeling criticised or judged.
  • Try not to give advice or criticism. Give your time and listen to them. This can be hard when you don’t agree with what they say about themselves or with what they are eating but try just to listen, rather than to ‘correct’ or ‘fix’ what they are saying.

Remember, you don’t have to know all the answers. Just being there is what’s important. This is especially true when it feels like your friend or relative is rejecting your friendship, help and support.

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