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How to talk to someone about an eating disorder

Before a person ends up in a psychologist’s office, a lot of important work has already occurred. People don’t usually just wake up one morning and decide that they ought to go talk to a psychologist or a therapist. Deciding to seek professional help takes courage and willingness to take a personal risk.
Many times a family member, friend, boss, or spouse has played an important role in getting a person to obtain professional help. Talking to someone about a difficult problem and suggesting that they see a therapist is, at best, a tricky business. It isn’t surprising that these conversations sometimes don’t go very well. So how do you bring something like that up?

Talking to someone about an eating disorder, like anorexia nervosa or bulimia, is probably one of the more difficult conversations to have. Eating disorders continue to be a major concern in America, as people struggle to find a balance between increasing rates of obesity, developing a positive body image, and maintaining a healthy lifestyle. Friends and family often are the first to develop concern that a loved one has an eating disorder.

One thing that makes talking to someone about an eating disorder so difficult is that the issue of control is a significant part of most eating disorders. Eating disorders typically develop during adolescence, when issues of control and developing independence are front and center. Encouraging, or insisting, that your teenager see a counselor about an eating disorder often triggers strong resistance and a struggle over control. And, if you are not careful, the harder you push the more resistance you encounter. Finding the right balance is a lot like walking a tightrope.

So, how do you walk the tightrope successfully, and talk to someone about something like an eating disorder? These tips might help you get off on the right foot.
First, try to think of the initial conversation as a starting point, not an ending point. It may help to keep in mind a time when someone brought up something to you that you didn’t want to change, at least initially. Maybe when someone brought it up you told them to get lost. Or worse! Perhaps you became very defensive. But, chances are that you thought about what was said. And, with any luck, sometime soon you were able to continue the conversation.

A second tip is to learn more about eating disorders and treatment options before you talk. Having an understanding of the behaviors, feelings, and treatment options for eating disorders will help you to feel more confident and supportive. Good information sources include the American Psychological Association’s help center (www.apa.org), the National Institute of Mental Health (www.nimh.org) and the National Eating Disorders Association (www.nationaleatingdisorders.org)
A third tip is to express your concerns without focusing solely on the eating behavior. Avoid statements like “you are putting on weight” or “you are getting too thin.” Rather, focus on your own experience and impressions. Something like: “I’m worried about you.” may be a good starting point. Asking the person if he or she or has considered that something is wrong is generally a helpful question which begins to build a dialogue. People with eating disorders have usually given the issue a great deal of private thought. If you bring up the issue, you may not have to say all that much. Asking questions and then carefully listening is often the best way to show support.

Finally, don’t be afraid to take a break if things are highly stressful. Remember, control is usually an important issue in eating disorders. Insisting that a difficult conversation be finished “here and now” can often lead to a control battle. Coming back to the conversation in a supportive way shows your commitment and willingness to have some give and take.

Most people that I have worked with in treatment can recall the details of what led up to them seeking help, including people that were supportive and encouraging. In hindsight they often acknowledge that they were resistant, stubborn or downright rude to people who were trying to help. More often than not, they make a point of going back and saying thank you.