How to Help Someone with an Eating Disorder

Eating disorders affect people from all walks of life, male and female, all races, cultures, and body types. A person does not need to be very thin to have an eating disorder.

Understanding Eating Disorders: Eating disorders come in various forms, including anorexia nervosa, characterized by extreme food restriction and fear of gaining weight; bulimia nervosa, involving episodes of binge-eating followed by purging; and binge-eating disorder, marked by regular episodes of excessive eating without purging.

It's a common misconception that eating disorders only affect certain body types or genders. In reality, they can impact anyone, regardless of their physical appearance. It's crucial to understand that these disorders are complex mental health conditions influenced by a range of factors.

9 Warning Signs of an Eating Disorder

• Obsession with body weight, calories, food, or nutrition.
• Regular or constant dieting or restricting food intake.
• Binge-eating, chronically or periodically.
• Purging food by vomiting, fasting, exercising vigorously, or using diuretics and laxatives.
• Unrealistic body image (sees oneself as fatter or thinner than is true).
• Making excuses to be able to skip meals.
• Going to the bathroom directly after eating.
• Hiding food.
• Lying about food.

10 Ways to Help Someone with an Eating Disorder

• Promote the person’s self-esteem independently from food. This helps shift their self-worth away from body image and eating habits.
• Evaluate the food habits in your home; is there room for improvement? Creating a positive food environment can support recovery.
• Be firm but caring. Set boundaries while showing empathy and understanding.
• Focus on the emotions behind the food and eating, not the food itself. Eating disorders often stem from deeper emotional issues.
• Do not get involved in a power struggle regarding food and eating. It’s about supporting, not controlling.
• Do not comment on their appearance, but raise concerns about their health. This avoids reinforcing appearance-focused value systems.
• Do not blame them or make them feel guilty.
• Do not expect them to ‘just stop’, but acknowledge the seriousness of the matter.
• Encourage them to commit to a psychotherapy process.
• Participate in family therapy, which can be crucial in addressing underlying dynamics and improving communication and support within the family.

Recovering from an eating disorder is a challenging and often lengthy process, typically involving several relapses. It's important for loved ones to manage expectations, provide consistent support, and understand the complexities of the recovery journey. Each step forward, no matter how small, is a significant achievement in the path to recovery.

It is important not to become overwhelmed with your loved one’s eating disorder. Remember, it is their disorder; all you can do is try to help. Never forget to look after your well-being as well. Provide words of encouragement and understanding, support, and love.

What does Science Say?

• Psychotherapeutic Approaches: Psychotherapy is central to the treatment of eating disorders, addressing behavioural, psychological, and social factors.
• Research has shown that psychotherapeutic interventions are more effective than placebo, waitlist, or other treatments. However, there's still much room for improvement in these outcomes, indicating the need for continued research and development in this field.
  
• Evidence-Based Therapies: Among the therapies studied, cognitive-behavioural and family-based therapy have the largest evidence base for treating anorexia nervosa, bulimia nervosa, and binge eating disorder. Interpersonal and dialectical behaviour therapies also show positive treatment outcomes. There's emerging evidence for using Acceptance and Commitment Therapy, Integrative Cognitive Affective Therapy, Exposure Therapy, Mindfulness, and emotionally focused therapies, though further research is needed to establish their full efficacy.
  
• Growing Support for Varied Modalities: The research supports the use of self-help, group, and computer/internet-based therapeutic modalities for eating disorders. However, there is a lack of evidence for therapies targeting avoidant/restrictive food intake disorders and other unspecified feeding and eating disorders, highlighting a gap in current research and treatment options.
  
• Hypnotherapy in Treatment: Studies have shown that patients with bulimia and some with anorexia are more responsive to hypnotherapy. A specialized 13-step protocol involving hypnotherapy combined with cognitive-behavioural skills and family therapy has been developed, addressing various aspects of eating disorder treatment.
  
• NICE Guidelines: The National Institute for Health and Care Excellence (NICE) guidelines recommend group or individual CBT for anorexia nervosa, bulimia nervosa, and binge-eating disorder, as well as family therapy for adolescents with anorexia nervosa and bulimia nervosa, as per the empirical findings supporting the use of these therapies.
  
• National Institute of Mental Health (NIMH) Insights: The NIMH emphasizes that eating disorders are serious and often fatal illnesses associated with severe disturbances in eating behaviours and related thoughts and emotions. They highlight that preoccupation with food, body weight, and shape may signal an eating disorder and stress that these disorders are not a lifestyle choice.

Frequently Asked Questions

Can anyone develop an eating disorder?
Yes, eating disorders can affect individuals of any gender, race, culture, or body type. They are complex conditions influenced by genetics, psychological, and social elements.

What are common signs of an eating disorder?
Key signs include an obsession with weight and food, dieting or food restriction, binge eating, purging, distorted body image, avoiding meals, and secretive behaviour around food.

How can I help a loved one with an eating disorder?
Focus on their emotional well-being, create a healthy eating environment, avoid power struggles over food, and encourage them to seek professional help.

Should I comment on a loved one’s appearance if I’m worried about an eating disorder?
Avoiding comments about appearance and expressing concern for their health and well-being is best.

What role does psychotherapy play in treating eating disorders?
Psychotherapy, including CBT and IPT, helps address the emotional and behavioural aspects of eating disorders and is a key part of the recovery process.

Is family therapy beneficial for someone with an eating disorder?
Family therapy can provide crucial support and understanding for the individual and the family.

How long does recovery from an eating disorder typically take?
Recovery varies for each individual, often involving several relapses, and requires patience and ongoing support.

What should I do if I feel overwhelmed by my loved one’s eating disorder?
It’s also important to take care of your well-being and seek support if needed.

Can changes at home h elp someone with an eating disorder?
Yes, creating a supportive and non-judgmental home environment can aid in recovery.

Are eating disorders only about food and weight?
While they often manifest in food and weight-related behaviours, eating disorders are complex and also involve emotional and psychological aspects.

How important is it to promote self-esteem in someone with an eating disorder?
It's vital to encourage self-esteem unrelated to food or body image, as this can be a key part of recovery.

What's the significance of focusing on emotions in eating disorder treatment?
Addressing the emotions behind eating behaviours is crucial, as eating disorders often stem from emotional and psychological issues.

Why should power struggles over food be avoided?
Engaging in power struggles can exacerbate the situation, making it harder for the individual to cope with their disorder.

How can I be firm but caring in helping someone with an eating disorder?
It’s important to set boundaries and be supportive without enabling harmful behaviours.

Why is it crucial to acknowledge the seriousness of an eating disorder?
Recognizing the severity of the disorder helps take appropriate treatment steps and shows the individual that their struggles are being taken seriously.