Counseling & Psychological Services (CAPS)

Disordered Eating: What to Say

What To Say To Someone You're Concerned About

It can feel quite intimidating to approach someone who you believe is struggling with disordered eating.  You likely have observed several warning signs that make it seem obvious to you that there is a problem.  However, it's difficult to come up with a way to voice your concern without fearing that you are going to be met with a strong reaction of denial or anger or both.   Because both reactions are quite possible, it is important to approach this person in such a way that minimizes defensiveness and delivers the message that you are available as a supportive person.

When and Where To Approach?

If there have been enough indications that warrant taking the chance to approach someone about disordered eating, the first thing to consider is when and where to talk to the person you are worried about.  It is important to choose a calm time to have the discussion.  Do not begin if there have any recent arguments or other incidents that have been emotional.  As a rule, this almost certainly means that approaching a person struggling with eating issues should not occur during or near a meal time. Choose a neutral time such as the middle of the day or the middle evening hours.  Meal times and transition times are stressful for a person struggling with disordered eating and respecting that she or he experiences a lot of vulnerability around this issue is important.  Confronting her/him during a stressful time is likely to be unsuccessful.



Also, it's important to select a place that feels safe for the person who is struggling.  Have only the closest person or persons present, but no more than 2 or 3.  Too many people may be overwhelming, and this might make the experience seem like attacking more than caring.  Again, avoid places that are associated with weight or food such as kitchens, dining rooms, and fitness areas.  With the fundamental environment as safe as possible, you have a greater chance of being heard and, in return, hearing what the person you're trying to support is actually feeling.

Finding the Right Words

Of course, the most intimidating and difficult aspect of approaching someone struggling with disordered eating is actually finding the right words.  In fact, coming up with what to say first is often extremely difficult.  As simple as it sounds, what may be both the easiest and most effective is to simply state that you have something you want to talk about.  You are likely to be feeling anxious, perhaps even downright afraid of doing more harm than good.  It's okay and natural that you have these feelings. In fact, your feelings can play a role in helping you approach the person you're worried about:  Share those feelings!   If you examine the feelings you have, you will probably find that you have conflicting feelings that place you in a bit of a predicament:

You want to respect his or her privacy
BUT
you are worried or scared for his or her well being.
 
You want to help,
BUT
you are afraid you're going to cause even more hurt or problems.


The first thing to keep in mind is that all of these feelings are valid and true.  Change the word but to the word and, then share all of these feelings with the person to whom you are offering your support.  Consider the following suggestion:



Can We Talk?

"I want to talk to you about something, and it’s hard for me because I know it’s very personal. I’m torn between wanting to help and wanting to keep quiet so I don't upset you or push you away."

Approaching this way can have a positive effect in several important ways.  First of all, it involves you sharing your feelings, and this helps to keep the emotions from running the show. (That can risk breaking down crying or getting unexpectedly angry).   Once acknowledged, emotions are more likely to simply just "be there" rather than "taking over" making your words come out wrong or getting in the way of your first priority: communicating that you want to help. Another advantage of beginning by sharing your feelings is that she/he is likely feeling quite a storm of emotions also.   But she/he may not have named them as such.  By you saying what you are feeling, the person struggling will be more likely to say, “I feel that way, too” or at least say “I’m feeling a lot, too”.  This leads to the most important advantage of expressing your emotions:  it centers emotions as the topic of the conversation rather than an impersonal and distressing eating disorder.Now that you have introduced the issue and set the stage by sharing the emotions that are being felt by everyone involved, what next?  Well, she or he may suspect that you are going to bring up the disordered eating because she or he has most likely been aware of it and struggling with this.   Of course, this may be the most vulnerable part because your very act of approaching her/him may be the thing she/he has most dreaded: dealing with others knowing she/he is struggling.  So, approaching with sensitivity and caring is critical.  Pay attention to whether she/he is becoming overwhelmed by the discussion.  If she or he asks what it is you want to talk about, gently but confidently tell her or him what you know:  that you’re worried about someone you care about.

“What is it?”

"Well, I’m worried about you.  I’m worried about the way you are with food (or weight). I don’t know much about it, but what I do know is that you might be struggling with something that REALLY hurts inside and I want to help."


There are a few things to pay attention to with the above suggestion of what to say.  Notice, first of all, that the term eating disorder is not part of what is said.  The eating behaviors or body image focus is not the actual problem.  These concerns are actually the consequences of the real problem. This leads to the 2nd thing to highlight about the above suggestion.  It emphasizes that the problem is something “that really hurts inside.”  A person struggling with disordered eating is hurting inside and most likely hurting a great deal.  Much of the hurt is that she/he experiences a great deal of shame about the problem and feels that  others will view her (or him) as “weak” or “disgusting” or “vain” or “superficial” and that nobody has any idea of the depth of the confusion and hurt.  Approaching a person struggling with disordered eating is most effective when it becomes what it should be: approaching somebody that is really hurting inside and has grown quite lonely in that hurt.

and THEN what?

There can be no scripted guidelines on what to do from this point because the emotional experience that emerges will be unique to each collection of human beings involved.  Generally, you want to proceed if the person you are approaching indicates an open stance.  If she or he responds with anger or shutting down, perhaps even asking you to leave, then it’s important to respect her/him.  Simply re-iterate, quietly--not in an angry or defensive tone, that you meant to be helpful and apologize if you upset her/him.  Then, as you leave, offer her/him an open invitation to talk.

“If you change you mind and feel like talking later, it’s okay.  Just let me know.”

If she/he has not become closed off and guarded or very defensive and angry, it may mean that you have approached her/him with enough sensitivity and respect that she or he feels safe to move forward…. Perhaps, it is a tremendous relief to finally share this difficulty with somebody. She/He may become emotional…. In fact, you may, too. This is okay, and simply acknowledging tears with validating support-statements such as “I know this is really hard” or “I know this must really hurt inside” can be helpful.   

When you get to the point where you actually bring up the disordered eating behaviors, it’s important to focus on the behaviors---as specifically as possible.  Otherwise, you risk focusing on a “disorder” which feels more defining than specific behaviors.  Also, since she/he will still likely have some level of defensiveness, it’s easy to debate whether or not one has an eating disorder, but harder to debate whether specific behaviors have occurred.

"I notice you often don’t eat even when you’ve not eaten anything all day."

"I see that you work out 3 times a day and it still doesn’t seem enough for you"

"I find a large amount of food wrappers stuffed away."


Keep in mind, however, that the most important thing to focus on is the emotional upheaval.  While it is helpful to refer to specific behaviors to be clear about what triggered your concern, your concern is really based on the emotional vulnerability the person you’re worried about is experiencing.  Therefore, it’s important to cite the emotional upheaval in an integrated fashion of describing your concern.

"I see how much your  moods change and I know you must be really struggling inside"
 
"I see all these warning signs I’ve learned about and I keep thinking how much you must be hurting."

 
If you’ve gotten this far, then you’ve gotten far enough to suggest that she or he consider some professional help.  You may be surprise to learn that she or he is already seeing a therapist.  Encourage her/him to continue and by offering to be a part of the support team can be a tremendous gift.  Whether the person you’re worried about is currently seeing a mental health professional or will consider seeing one at your suggestion, having you offer anything that will reduce the aloneness that he or she likely feels can be more helpful than you may ever realize.



If they are already seeing a mental health professional,

“I’m glad you’ve got someone who understands a lot more about this than I do.  But if you ever just want to vent to a friend or talk about what has always seemed so important to keep inside, I’m willing to listen.  I want to listen.”


If they are not already in counseling for this struggle,

“I’d like you to think about seeing somebody, like a professional who knows more about this difficulty than I do.  But I also want to be there for you as much as I can.  If you ever want to talk about just anything that stresses you out or gets you mad or even somebody you really want to go out with…. anything…. I want you to know I can be a part of the support you need.  I can’t be the only support, because I don’t really know how to best help, but I do know you don’t have to go through it alone because I’m here for you if you ever just need to talk.”


Some Things To Consider

Here are some final things to consider as you plan to approach someone you care about and wish to help with their struggle with disordered eating.  As highlighted throughout this page, it’s important to avoid talking about food and weight as much as possible.  Never force them or pressure a person struggling with disordered eating to eat.  Not only does this add to the already tumultuous struggle they experience, it likely will force them away from ever considering you as someone who understands.  Also, as tempting as it may be to share your perceptions of how thin or how attractive the person struggling with disordered eating is, it’s important to not base your support on your perceptions of their thinness or attractiveness.  Although it may seem like a logical thing to compliment a person for being attractive, several negative consequences are possible.  The most likely thing is that they won’t believe that you’re telling the truth.  It isn’t so much that the person thinks you are a liar, but more that you are just saying something untrue out of kindness.  Or, they may believe that you are telling the truth from your perspective, but that it’s an incorrect perception.  Finally, often a person hears a compliment such as “You’re so thin already!” or “I think you are the most attractive person I’ve ever met” and interpret this as an indication that the disordered eating behavior is successfully giving them what they so desperately strive for.  One of the central factors that helps to maintain disordered eating is that the person struggling reduces him or her self to extremely concrete dimensions.  To pay compliments about physical features, however well intentioned, can serve to reinforce the distorted self-perception that physical features are what defines the individual.  Compliments about intelligence, kindness, humor, unique ideas, and assertiveness are likely to remind the person struggling that there is so much more to her than the number they are measuring themselves by.

Plant Seeds, Not Trees

Helping individuals struggling with disordered eating can be an emotionally draining experience if you begin to measure yourself by the same tangible results that they likely measures themselves by.  Keep in mind, your role is not to heal her/him or to remove the difficulties she/he is facing.  Your job is to do what you are able to reduce the aloneness she or he experiences in her or his struggle.  You may want to see quick results.   You may even reach a point where you feel you need to see the person make some visible changes for the better.  This is a recipe for frustration and possibly conflict.  It may take a long time because it’s far more than just eating behaviors and attitudes that need to change for growth and healing to take place.  It’s about learning to think about things in life differently.  It’s about learning to develop trust, perhaps for the first time in her or his life.   Think of yourself as a planter of seeds.  When you plant seeds, it takes quite a while for things to show up above ground that testify that a seed was ever planted.  Your friend or loved one that is struggling with disordered eating is a magnificent living being with many dimensions and components; it will take time for the roots to be restored, for them to learn how to use the nourishment to develop into a trunk, then begin expanding into branches, then giving birth to leaves and blossoming flowers or fruits.  You are not planting fully formed trees.  You’re offer of help and support is planting a seed of recovery and re-discovery for the person who has been struggling with disordered eating.

If You Need More Support

As you can imagine by this point, there is quite a lot involved in helping support a person struggling with disordered eating.  It can feel overwhelming and discouraging at times.  Help is available to help you deal with the confused feelings you may experience as you strive to be there for the person you’re worried about.  The staff at CAPS can consult with you on how to best approach or to listen as you need to talk about the challenges you’re facing. If you’d like some support or consultation in this endeavor, simply call 660-1000 and tell the receptionist you’d like to consult about someone you care about. You, like the person you care about, don’t have to go it alone.

© 2001. LifeShops. Gary D. Glass, Ph.D.