If you are a spouse or parent of someone with an eating disorder, you are all too aware of that feeling of helplessness as you watch your loved one’s physical and psychological condition deteriorate. You may notice changes in personality. An individual may turn from being sociable and energetic to being withdrawn and depressed.

If you suspect a family member or friend has an eating disorder, you should discuss your concerns in private with the person. It is important to address these issues earlier rather than later after one becomes entrenched in eating disordered thought patterns, behaviors, and habits. Generally, the longer one has an eating disorder, the longer treatment will take.

It is very difficult for most people to talk to others and admit to their eating disorder. Most people feel ashamed and embarrassed by their problem. Additionally, those with this illness may fear losing the safety of their eating disorder. Eating disorders are negative ways of coping with conflict, stress, and negative feelings, but these negative coping mechanisms feel safe and comfortable, so they are difficult to break. The list below suggests how to approach the fragile discussion of addressing someone’s eating disorder:

1. Approach the person when you are composed, not when you are emotionally upset.
2. Choose a place where you can talk privately without interruption.
3. Be gentle and express your concerns for the other person.
4. Explain that you genuinely care about her and want the best for her.
5. Don’t vent your anger or other negative feelings.
6. Use “I statements” rather than “you statements.” For example, “I feel …” rather than “you make me feel …”
7. Give examples of why you suspect the person has an eating disorder.
8. Help him see not only how his eating disorder affects his physical health, but also help him understand how it affects his relationships and functioning, and interferes with achieving his goals, and how it makes him feel.
9. Avoid being judgmental and critical.
10. Build-up her self-esteem by emphasizing her good qualities and her strengths, what you admire about her. It is important to do this, because encouraging someone to seek treatment can seem like you are being critical of her and seeing only her flaws.
11. Be empathetic.
12. Listen.
13. Ask open-ended questions (- questions that require an explanation, rather than simply a yes or no response) when asking questions, in order to expand your understanding of how the other person thinks or feels.
14. Encourage him to express his feelings.
15. Don’t blame or manipulate her to change with shame or guilt.
16. Don’t give ultimatums.
17. Help him to understand there is no shame in seeking professional help. Help him see therapy as an opportunity to make one’s life better (and you want the best for him).
18. Remember eating disorders are complex illnesses, so don’t offer simplistic solutions, such as “just eat more.”
19. Reaffirm your love or friendship with the person, explaining you like him, but not the eating disorder part of him that is destroying him and your relationship.
20. Don’t let this discussion turn into an argument. Rather than argue, simply reiterate your concerns and leave it at that.
21. Be persistent (without pestering) in your efforts to encourage him to seek professional help.
22. Be prepared to provide contact information of treatment providers and information on eating disorders, if he is willing to seek treatment.
23. Offer to accompany him to an initial appointment.
24. Tell him you are available for her to confide in you, if she wants to talk to you.
25. Explain to him you are ready to support him in whatever way he needs help.
26. Respect an adult’s decision to refuse treatment as long as his condition is not life-threatening. If his condition is life-threatening, consult a therapist for an intervention to get him into treatment.

The next question is, “How do I continue to give on-going support to a family member or friend with an eating disorder?” If someone remains in denial of their eating disorder, continue from time-to-time to express your concern for the person and encourage him to seek treatment, but do so without pestering. If the person acknowledges his or her eating disorder and seeks professional help, support him or her in the therapeutic process. Eating disorders may involve a lengthy time in therapy and most likely will be marked by steps forward and steps backwards. Be patient and understanding of the person with the eating disorder. The following offers a list of ways to support a person with an eating disorder:

1. Be willing to listen when he is ready to confide in you.
2. Be empathetic, understanding the challenges in overcoming an eating disorder.
3. Be patient with her, realizing that changing thought patterns, habits, and behaviors takes time.
4. Be honest with him, but not judgmental and critical.
5. Respect her freedom to make her own decisions and choices. For example, what she eats or decides not to eat.
6. Avoid power struggles over food and other issues. He will only resent you for taking his power of control away from him.
7. Do not monitor her food intake and behavior.
8. Refrain from giving advice.
9. Try to minimize, rather than maximize his anxiety level. For example, don’t bring up subjects at meals that might upset him.
10. Make her responsible for her own behavior. For example, cleaning up the bathroom after vomiting or buying food she binges on.
11. Don’t be an enabler by inconveniencing yourself to accommodate his eating disorder needs, such as by only preparing foods he will eat or avoiding social eating situations.
12. Say things that build her self-esteem, such as pointing out her strengths, her positive character traits, and what you admire about her.
13. Acknowledge his progress in therapy by pointing out his changes in his behavior and way of thinking, ability to better connect with others in relationships, and improvements in character, functioning, and mood.
14. Don’t make comments, even positive ones, about weight, appearance, eating, or exercise as these may be taken the wrong way. For example, don’t say “you look healthier” as this may be interpreted by the person with the eating disorder as “I look fatter.”
15. Be a model of effective coping skills, healthy food attitudes and behaviors, and moderate exercise.
16. Watch your language. For example, don’t label food as good/bad and safe/unsafe.
17. Don’t talk about other people’s appearance and weight and dieting to her or anyone. Talking about these things objectifies people, basing their worth on external, rather than internal qualities.
18. If you hear others making comments about someone related to appearance and weight, shift the emphasis to the person’s internal qualities. If someone is talking about dieting in order to lose weight, shift the emphasis to health.
19. Educate yourself about eating disorders, so you are better able to help and support the person with the eating disorder.
20. Be willing to participate in therapy, if asked.
21. Be willing to seek professional help for your own issues or to get help coping with your loved one’s eating disorder.

Christopher Clark is the founder and executive director of The National Association for Males with Eating Disorders, Inc. (N.A.M.E.D.) In 2006, N.A.M.E.D was founded in order to bring much needed support to males with eating disorders who are an underrepresented, underreported, and mostly undiagnosed and untreated population. Clark’s passion to start this non-profit organization came out of his need to give meaning to his many regrettable years with anorexia nervosa. Visit the website at NAMEDinc.org or contact him at Chris@NAMEDinc.org or 1-877-780-0080.

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