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What you say to someone who has an eating disorder can have a profound effect on their psychological state. Here are three things to keep in mind when you speak with people

There are no absolutely wrong and absolute right ways to speak with people who have eating disorders, but these 10 principles can help you figure out the best way to communicate.

Learn about eating disorders before you start talking about eating disorders

It's OK to ask a friend or a family member questions about their eating disorder, but understand that they may have difficulty talking about their problems because of shame or embarrassment. Or they may be in denial about their problem.

Before you have an intense conversation about the eating disorder and before you attempt an intervention, make sure you are as informed as possible about the eating disorder with which your family member or friend has been diagnosed.

If your friend or family member has not gone to the doctor yet, be ready to tell them calmly and objectively what you think the problem is and assure them that you will be there for them.

Choose the right time and the right place to have your conversation

Don't start talking about eating disorders in the heat of an argument. Don't broach the topic for the first time when you are angry or tired or feeling sick yourself. Keep in mind that eating disorders can be a cause of guilt and shame, so have your conversation in a private place where the other person feels comfortable. Usually this is their home or your home. It's never a place where strangers or unsympathetic family members can listen in.

Use the right language when speaking with someone about their eating disorder

It's also important to choose your words carefully when talking about this highly emotional subject. Here are some general guidelines.

  • Speak about your concerns in first person. Show how "I care about you" rather than how "You have a problem." Say "I am concerned about you rather than "You worry me."
  • Don't rush through a statement you composed in your head. Let the conversation be two-way. Give them time to speak before you share all of your concerns.
  • Listen respectfully to what your loved one has to say — even when you know they are in denial or they are not yet being completely truthful with you. It's not necessary to jump on every white lie told to save face, although if you loved one is speaking in totally unrealistic terms you may respond with "I see it this way."
  • Don't be condescending. Don't speak to your friend or loved one as if you don't have the eating issue because of your superior willpower or character. Eating disorders are not a failure of willpower or character.
  • Put the focus on feelings, not food. Let them speak about how they feel. Don't lecture them on how they should eat more or less.
  • Don't manipulate the other person. Don't make their problem about you, as in "I just don't know how you could do this to me." No one develops an eating disorder to hurt or influence another person (although people who have eating disorders can attempt to be manipulative, too).
  • Don't try to be a therapist unless you have been academically and professionally trained to be a therapist. Even if you think you understand the principles of psychotherapy that are sometimes used to treat people with eating disorders, you don't have all the answers. (Neither does a therapist.) You fill a different role in their lives. You help them understand and deal with issues that they may be hesitant to share with a therapist, or that don't fit into the limited time the therapist has for a session.
  • Don't try to threaten the other person. Don't tell them "If you don't change, here's how I will change things in a way that hurt you." Don't threaten to cut them off if they don't change right now — or any time soon. Recovery from an eating disorder takes years.
  • Encourage ongoing conversation. Keep your discussion open-ended. You will probably need to have many more.
Do you need some icebreakers to get the conversation going? Try these:
  • "How are you?" Then give them time to respond. Remember, all their lives aren't about food.
  • "Let's do....together!" People who have eating disorders are often isolated and need opportunities to get their minds off food.
  • "It's OK to take a rest day. Here's how I will help you do that." It's hard to keep up with school, work, or running a household when you have an eating disorder. If you can give your friend or family member a break from their responsibilities now and then, that can be extremely helpful.
  • "I like your shirt/blouse/bag/briefcase." Be complimentary when you can.
  • "You're more to me than your eating disorder." Self-esteem takes a beating in eating disorders. Share the reasons you value your relationship. Build your friend or loved one's self-esteem.
  • "I love you." People who have eating disorders usually don't love themselves, and they don't know or can't remember why others might love them. Remind them.

  • Linville D, Cobb E, Shen F, Stadelman S. Reciprocal Influence of Couple Dynamics and Eating Disorders. J Marital Fam Ther. 2016 Apr. 42(2):326-40. doi: 10.1111/jmft.12133. Epub 2015 Jul 20. PMID: 26189490.
  • Rodríguez Lazo M, Hernández Camacho JD, Bolaños Ríos P, Ruiz-Prieto I, Jáuregui Lobera I. [FAMILY EATING HABITS AND PERCEPTION OF RISK IN EATING DISORDERS]. Nutr Hosp. 2015 Oct 1. 32(4):1786-95. doi: 10.3305/nh.2015.32.4.9635. Spanish. PMID: 26545551
  • Vázquez-Velázquez V, Kaufer-Horwitz M, Méndez JP, García-García E, Reidl-Martínez LM. Eating behavior and psychological profile: associations between daughters with distinct eating disorders and their mothers. BMC Womens Health. 2017 Sep 6.17(1):74. doi: 10.1186/s12905-017-0430-y.
  • Photo courtesy of SteadyHealth

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