How to support a loved one living with an eating disorder

(Article originally published by Triple J‘s Hack on 18th July 2017. Written by Ange McCormack)

For 21-year-old Madeleine from Coffs Harbour, who spent eight months in clinical treatment for anorexia, being approached about her eating disorder by her loved ones didn’t always go down well.

“I’ve been known to just physically leave conversations, and just walk off,” Madeleine told Hack, “I was in complete denial about it, I didn’t want to accept that that could be something that was wrong with me.”

Madeleine says people would sometimes try and support her by being too intrusive and overbearing.

“Sometimes people can try to help too much, they can try to make you want to talk about it too much or they can be too supportive which I know sounds silly but being when you’re so deep into it and you can’t find a way out, having an escape where there’s a place and people don’t want to talk about your weight and they don’t want to talk about what you’ve eaten that day or haven’t eaten, it’s just you – separate from your disorder and everything that you think is wrong with you. They just let you be you.”

For Madeleine, her friend Sarah was that escape. “I could just go to her house bawling my eyes out crying over something as stupid as a brownie, and she’d accept that, and she was fine with that and she’d just tell me to let it be and it would pass. And it always would.”

If someone you love is living with an eating disorder, approaching them should be done with tact, warmth, and thought, says clinical psychologist Dr Ben Buchanan, from Foundation Psychology Victoria.

Here’s some of his tips.

The right and wrong times of having ‘the conversation’

“Any approach should always be done in a situation where both of you are feeling really safe and where you’ve got a lot of time, and not as a reaction to seeing a behaviour that’s problematic,” Dr Ben Buchanan told Hack.

“For example, if you have heard them in the bathroom, or seen them doing compulsive exercising, or over meal time – those are the wrong times to be having the chat.

“It should not come across as these people have been engaging in a ‘shameful’ or ‘criminal’ behaviour – that people will ‘catch’ them out on. That would be sort of making it seem like a sin or something that’s really bad and wrong.

“Even the language around ‘calling someone out’ or ‘catching them’ feels a little punitive. Use language like, how can we be of assistance, how can we support you in this, how can we help you make good choices.

“So while it’s always better to get these things out in the open – if they are living with an eating disorder, they are not a bad person that needs to ‘confess’. But rather have it framed as, they’re a person struggling that needs assistance.

“The right time to talk is when you’ve cultivated a safe space where you know you’ve got half an hour where you’re just chatting – over a cup of tea, or after you’ve watched a movie or something like that.”

What NOT to say

When someone is living with an eating disorder and is underweight, for example, it seems like food is a logical “cure”. But forcing them to eat in a certain way isn’t your job, and it probably won’t help, Dr Buchanan says.

It’s important NOT to be the food police, and not to monitor their food all the time or check in with them about their food.

“It’s also not about giving them advice – people don’t need advice-giving, they need an ear, they need people to listen. Advice is not about listening, it’s about telling. So it’s really opting for listening over advice-giving.

“You can ask them, what are the avenues for treatment and intervention? And then if they don’t know the answer to that question, see if you can provide them with the resources and information and the number to call,” Dr Buchanan says.

Don’t buy into the “lie” of the eating disorder

Commenting on your loved one’s appearance to make them feel better isn’t the way to go, Dr Buchanan says.

“Often boyfriends of women with eating disorders will try and help by saying that they’re beautiful or they’re stunning or that everyone thinks they’re the hottest person ever.

“That’s a problem for two reasons. Firstly it probably won’t be believed, so it’s probably not doing any good by saying it.

What to do if there’s denial or resistance

“Often the reaction from a person experiencing an eating disorder will be denial or deflection,” Dr Buchanan says. “I think it’s really important to respect that person – if they’re saying they don’t want to talk about it, do not press them or push it too much.”

Dr Ben Buchanan says if the first time you approach the person doesn’t lead to a healthy dialogue, taking time and trying again can be worth it.

“You’ve really got to respect them, but not give up and say, right it’s over I tried my best. Try and approach it in a different way and waiting a week – the problem is not going to go away.

“Eating disorders are often around for years. So while it is really important to be opening up a dialogue with someone you care about, avoiding a sense of it has to happen right now is important – really cultivating as much patience as you can.”

Make sure you’re the right person to be giving support

If the person living with an eating disorder is resisting from talking about it or not feeling comfortable, it’s possible that you’re not the right person that should be having the conversation with them in the first place, Dr Ben Buchanan says.

“Or if you’re a friend of that person – and you’re their top one or two or three friends, then you’re potentially the right person. But not everyone’s best friend will have the emotional capacity and sensitivity to intervene in a positive way.

“Certainly I wouldn’t be doing it with someone who you’re an acquaintance with or you don’t count as in your top five friends.”

Separate the disorder from the person

Dr Ben Buchanan says it’s important to “externalise” the eating disorder, and remember to treat your loved one as a person – not a problem.

“Externalising the problem is about saying, ‘how are YOU coping with the eating disorder today?’, so making a distinction between them and the eating disorder.

“That way it diffuses the blame a bit, so you might say, ‘how are you doing with the bulimia,’ rather than saying – ‘how are you going with eating?’.

“You could say, ‘Where is the eating disorder up to today?’, or, ‘Is the eating disorder getting the best of you at the moment?’ That way if there are any remnants of blame, it puts it on the disorder – not the person.

“The person didn’t choose to get the disorder, but they can choose to make decisions that will get them out of it.”