How to Provide Support to Someone Struggling with an Eating Disorder
Eating disorders are mental health concerns characterized by increased thoughts about food, changes in eating patterns, and focus on shape and weight. Common symptoms of eating disorders include calorie restriction, excessive exercise, vomiting, binge-eating, weight loss, weight gain, and body dissatisfaction. Supporting a child or loved one with an eating disorder can be incredibly challenging. Oftentimes, friends and family members have trouble understanding how eating disorders start, develop, and worsen. Loved ones of a person struggling with disordered eating may ask, “why are they doing this?” and “how can I help them to stop?” Supporting someone with an eating disorder begins with gaining a deeper understanding of disordered eating, learning ways to validate your loved one’s experiences, and adjusting your own relationship with food and appearance.
Due to media representations of eating disorders and society’s emphasis on dieting and appearance, many people believe that eating disorders are simply diet and weight concerns. However, eating disorders are often complex methods of coping with difficult experiences and regulating strong emotions. For someone with an eating disorder, changing how they consume food may provide control in an environment in which they often feel powerless. Similarly, consuming or restricting food can provide a rewarding experience for the individual. Feelings associated with control and reward may help individuals cope with difficult emotions such as sadness, shame, guilt, and anxiety.
Furthermore, disordered eating is not a choice and is a cycle of structural and functional changes in the brains of individuals with eating disorders (Berner et al., 2019; Leenaerts et al., 2022; Wierenga et al. 2015). More specifically, those with eating disorders experience changes in the brain’s reward system. Those who have anorexia and severely restrict their food intake experience increased feelings of reward when refusing food (Wierenga et al. 2015). Additionally, the brain becomes sensitized to food during starvation and therefore, those with anorexia experience both increased focus on food and increased feelings of reward for refusing it (Wierenga et al. 2015). Similarly, binge-eating behaviors characteristic of bulimia and binge-eating disorder also sensitize the brain to food stimuli. This leads to an increased drive to seek out food and engage in binge-eating behavior (Berner et al. 2019; Leenaerts et al., 2022).
These changes in the brain’s reward system cause those with eating disorders to experience difficulty controlling thoughts about food and eating. This is also one of the reasons it is so difficult to stop engaging in disordered eating behaviors. Therefore, telling someone with an eating disorder to “just eat” or “stop purging” is completely ineffective and invalidating.
Disordered Eating & Identity
In western culture, diet, exercise, and weight loss are championed as ways to make life improvements. For example, we often hear messages about “being our best selves” and “getting on track.” In many cases, these messages imply that changing our bodies and eating habits will help us to be better people all around. Many times, eating disorders start as journeys towards self-improvement. However, dieting, exercise, and weight loss are not going to give us perfect lives as modern media would lead us to believe. This can be a very difficult idea for those with eating disorders to disengage from.
Oftentimes, those who engage in disordered eating believe that restricting and purging calories will help them achieve an ideal body, which will lead them to overall success and fulfillment. Therefore, the disordered eating behaviors become tied to the individual’s identity and visions of their future. For this reason, it can be extremely invalidating when loved ones challenge the individual’s eating behaviors.
Instead of challenging the individual’s thoughts about food and eating, try supporting their goals and dreams without discussing the eating behavior. For example, if an individual holds the belief that they have to achieve a certain weight or appearance before they can begin dating, try asking them about other things they value in romantic relationships. While it may be tempting to say something like “you don’t need to lose weight to find a partner,” this statement invalidates the person’s strongly held belief and may make them less likely to seek support from you in the future.
Another important way to support a loved one with an eating disorder is to examine your own relationship with food, body image, and diet culture. As mentioned earlier, those with eating disorders are highly sensitive to food stimuli and often experience a barrage of thoughts about food and eating throughout the day. Therefore, they are likely to pick up on even the slightest comments about food and weight. For example, someone without an eating disorder might say something like, “I’m going to skip dessert so I can have a big dinner later.” To someone with an eating disorder, this statement may trigger thoughts of restricting and weight comparison. Therefore, it is important to eliminate even small comments about food, weight, diet, and appearance around loved ones who struggle with disordered eating.
If you are concerned that your child or a loved one struggles with disordered eating or has been diagnosed with an eating disorder, it is important to seek professional help!
For more resources on eating disorders check out:
For related topics on food and body image, check out my posts on How to Manage Picky Eating, Talking to Kids About Food, and Signs Your Child May Be Experiencing Body Image Concerns.
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Berner, L. A., Brown, T. A., Lavender, J. M., Lopez, E., Wierenga, C. E., & Kaye, W. H. (2019). Neuroendocrinology of reward in anorexia nervosa and bulimia nervosa: Beyond leptin and ghrelin. Molecular and Cellular Endocrinology, 497. https://doi.org/10.1016/j.mce.2018.10.018
Leenaerts, N., Jongen, D., Ceccarini, J., Van Oudenhove, L., & Vrieze, E. (2022). The neurobiological reward system and binge eating: A critical systematic review of neuroimaging studies. The International Journal of Eating Disorders, 55(11), 1421–1458. https://doi.org/10.1002/eat.23776
Wierenga, C. E., Bischoff-Grethe, A., Melrose, A. J., Irvine, Z., Torres, L., Bailer, U. F., Simmons, A., Fudge, J. L., McClure, S. M., Ely, A., & Kaye, W. H. (2015). Hunger does not motivate reward in women remitted from anorexia nervosa. Biological Psychiatry, 7.