How to Find a Better Way to Talk About Eating Disorders
Written by Harrison Whittle, Dietetic Intern
If you’ve never experienced the painful depths of an eating disorder before and are witnessing someone struggle with one, a seemingly obvious question likely circles your mind. “Why don’t they just eat?” It’s a fair enough train of thought because for those of us without an eating disorder, the solution is staring everybody down. Person isn’t eating —> put food in mouth, chew, swallow, enjoy, repeat. But folks with eating disorders are experiencing food differently, and there are many reasons why phrases like “just eat” are not helpful, nor solutional advice. One of these reasons is, the person affected by the eating disorder most likely has already thought of this question long before your suggestion. And, if this seemingly obvious solution has been incorrect every second of every day for months or potentially years, then that solution is most certainly incorrect.
Eating disorders can be difficult to understand for those affected and unaffected. The “just eat” crowd often means well, but there are better ways to talk to someone with an eating disorder. If you have little or no exposure to eating disorders in your life then this blog post is here to help you understand your struggling loved one better. And if you are experiencing an eating disorder, I’m truly sorry, hopefully this post can help you give yourself a break and verbalize a better way for people to communicate with you.
Extraordinarily basic, Eating Disorder 101 (Primary 3):
The physiological consequences of eating disorders can be minor, like constipation or weakness. But the consequences can also be severe, like brain damage, bone loss or even death from malnutrition. The psychological spectrum of consequences similarly ranges from symptoms like difficulty concentrating, all the way to suicidal thoughts. While the underlying triggers of eating disorders are intricately layered, they frequently stem from similar places: biology, genetics, mental health, life experiences, stress, trauma, cultural pressures, and a complicated relationship with food and body image. There isn’t one single cause of an eating disorder, and not everyone with an eating disorder has experienced trauma.
Eating disorders may look like a struggle with food on the outside, but are infinitely more complex within. Hopefully knowing this, it now makes sense why the advice “just eat,” is at best unhelpful. Eating disorders don’t fit black and white thinking. It’s critical to understand people living with the disorder occupy a grey space.
Genetics and biology can both influence someone’s vulnerability to developing an eating disorder, while life experiences, stress, and environmental factors can also play a role. A major life transition, such as going to college, may be stressful or body shocking for some people without being a direct “cause” of an eating disorder. Contrary to modern myths that the primary issue is one of aesthetics, eating disorders are often much more complicated than simply wanting to change an outward appearance. Eating disorders are not a choice, a lack of willpower, or a sign that someone doesn’t care about the people around them.
Exploring the “grey space”
In our partisan modern culture, the grey spectrum can be a very uncomfortable place to occupy. Eating disorders are portrayed in the media as an unequivocal, discussion-less, BAD thing. But the uncomfortable grey truth is that they are not inherently bad. They often serve a temporarily life-saving purpose to the person living with them. In many instances, eating disorders help people regulate their emotions (4)(5)(6). Anyone who has had a stressful day at work understands the debilitating nature of negative feelings. Where a more common response to heightened emotions might be talking to a friend or family member, not everybody has the privilege of getting this more positive coping instilled in them. Everybody has different ways of dealing, and for some people, these habits can be fully self-destructive. But, the self-destructive nature of something does not negate its necessary, immediate relief in order to continue living.
A main issue with self-destructive emotional control is that escapism often comes with subsequent unbearable feelings of guilt and shame. The escapism-to-shame pipeline of eating disorders interestingly parallels another disorder - drug addiction (1). Eating disorders and substance use disorders are different conditions, and shouldn't be treated as interchangeable. However, both can involve behaviors that temporarily change how a person experiences difficult emotions while creating significant consequences over time. These conditions are as complex as any human condition. If the advice, “stop,” was effective, there would be significantly fewer people struggling with eating disorders and addiction.
The power of curiosity
On the note of painful emotions, in real estate there’s the old adage, “location, location, location.” To put a similar level of importance on how to help someone living with an eating disorder, one could consider thinking “individualize, individualize, individualize.” Not quite as catchy with twice the syllables, but it gets the point across. One of the best things someone can do to support a person living with an eating disorder is to be curious instead of judgmental. It’s important to remember that a helpful curiosity is about understanding another person’s perspective, not a means to getting your own point or perspective across. So, how can we be curious without judgement?
“I” statements are one of the most effective ways to communicate without judgement. The problem with a statement like “why won’t you/they just eat?” is that it puts blame and shame on the person living with the eating disorder. It focuses on your perspective of what the other person has failed to do. Instead, try the statement, “I’m worried about you, and I want you to know I’m here to support you.” This statement focuses more on your own experience of the situation and leaves out your perspective of the other person’s actions. An “I” message helps communicate your own experience, while reducing blame and defensiveness (2).
If you have never experienced an eating disorder or are unfamiliar with them, you may be feeling angry, scared, confused, or all of the above and more. It’s important to not let anger and negative emotions fuel your discussions. Conversing like this does require a full dose of adult responsibility, but I know you can do it. Your feelings are valid too. Being the loved one of someone with an eating disorder can be frightening, frustrating, and exhausting. But try to find a place outside of the person with the eating disorder to process those feelings (whether with a therapist, support group, or someone you trust) so the person you’re supporting doesn’t have to carry them for you.
Listen to what the person with the eating disorder is saying without interrupting, and double check that you understand them. Saying something like, “I understand you’re feeling [insert emotion], is that right? Thanks for sharing that with me, I know that was hard.” or “It sounds like you’re feeling really overwhelmed right now. Did I understand that correctly?”.
Remember: you don’t have to validate the eating disorder or agree with an eating disorder thought in order or validate the person experiencing it. The goal is to help them feel heard, supported, and less alone.
How to be an ally to someone living with an eating disorder
List of things to consider saying (3):
“I know this can be hard to talk about. Thanks for trusting me with this.”
“I am not trying to fix your behaviors”
“Would you like help finding a professional to talk to?”
“How can I help?”
“What have you tried already?”
“You don’t have to figure this out by yourself”
“Is there anything that would make this feel a little easier right now?”
List of things to not say (3):
“Look at what you’re doing to us”
“But you look great, there’s no need for all of this.”
“You’ve never been like this before, what happened?”
“You always make things hard for us.”
“Why do you hate yourself like this?”
“You need to eat”
“You look healthy right now, so you must be better.”
Even comments intended as compliments can be complicated during eating disorder recovery. Comments about someone’s weight, body, appearance, or how “healthy” they look can unintentionally reinforce eating disorder thoughts. When in doubt, focus your comments on the person rather than their body.
Actions can also sometimes speak louder than words. Help them meet their specific needs whether it’s going further than normal to get groceries, or doing some meal prep for them. You might also offer to sit with them during a meal, help with grocery shopping, reduce distractions around meals, or simply ask what kind of support would feel useful.
To be a proper ally to someone living with an eating disorder, you should strive to remain accepting and curious. Your curiosity is also not about fulfilling the answers to your own questions (i.e. “why won’t they just eat?”) but instead to offer validation and understanding to the person living with the condition.
So, how can the “just eat” crowd find a better way to talk-to and help the people in their lives who suffer from an eating disorder?
Well, in the words of Gabor Mate (an addiction psychologist), ask “why the pain?” When he counsels his clients, rather than asking them “why the drugs?”, he leads with depth, and understanding that the behavior is not the root of the issue, the emotion is. Instead of focusing on the problem, focus on where the problem is coming from and remember that it’s not from a place of control.
So perhaps a good place to start is leading our conversations with curiosity and asking the question, “what makes eating feel so difficult right now?” as opposed to “why can’t you just eat?”
As You Are Nutrition is a team of compassionate and non-judgmental dietitians who specialize in eating disorder work. Click below to learn more.