A Dangerous Disorder

Eating disorders (ED) can be very dangerous and often hard to treat. This is partly due to their complex nature, which usually involves influences we are unable to control or manage. Suffice it to say, ED are about far more than food. Negative body image based on unrealistic societal norms around beauty are part of the problem; the influence of family, peers and authority figures is another dimension.

Here are some ways you can support your loved one with an ED.

·         Be willing to confront and intervene. Eating disorders thrive in secrecy. The person who is struggling with an ED may go to great lengths to deny, minimize and rationalize their thinking and behavior toward food, weight and body issues. Those who care for a loved one with an ED must be willing to challenge these thoughts, beliefs and behaviors in a loving way. The National Association of Anorexia and Associated Disorders (ANAD) has a guide that outlines how to lovingly confront those with ED successfully.

·         Educate yourself. Before you attempt to challenge someone you love with an ED about his/her thinking, beliefs or behavior, get the facts. Learn what you can about different eating disorders and ways that you can help (or hinder). It is important to be prepared with information and resources before you attempt to confront your loved one. Contact some of the national organizations and ask for guidance.

·         Get support for yourself. Like addictions, eating disorders affect family and friends of the person with the ED. Another commonality ED share with addictions is that family and friends may inadvertently contribute to the development and maintenance of faulty thinking, unrealistic expectations and harmful behavior; this is especially true of parents, grandparents, children and siblings. Get help from a professional who can explain the complex issues involved in ED, suggest alternatives for any ways you might contribute to the problem and support you emotionally.

·         Be honest about your role in the problem. Talk openly to your loved one about how your own thinking, beliefs and behavior may have inadvertently contributed to the problem. Even if you do not have an ED, your thinking and comments about your own body may have modeled unrealistic expectations. Your ability to be honest and vulnerable about your role in the problem will demonstrate appropriate behavior for healing.

·         Be a part of the treatment. By offering to be involved in the treatment, you set a good example and also demonstrate a willingness to make the necessary changes required to support your loved one. Family therapy is a major part of treatment for ED, especially for those who live in the same home. Because there are often issues related to control, interpersonal and family dynamics underlying ED, this work is crucial.   

·         Make changes as a family regarding food and movement. Healthy eating and activity that is embraced by everyone in the family is much more likely to result in long-term changes. Instead of focusing your efforts and attention on the person with the ED, make changes in how the family eats and exercises. Establish healthy eating patterns for everyone by buying and serving nutritious, healthy food and snacks. Develop habits of healthy exercise by doing things as a family, ie. going for a walk after dinner, playing tennis, biking or hiking together. To be successful, treatment will result in lifestyle changes that can be carried out long-term.

·         Be careful what you say/do and how you say/do it. Because one of the primary issues related to food is around control and power (those who feel powerless in other areas often control or lose control with food), it is important that you do not make overt or covert attempts to control your loved one’s food except as agreed upon as part of treatment. A slight frown of disapproval can have the same emotional impact as a verbal assault. Talk to the therapist about how to communicate around the issues related to food and exercise. Realize that you may need to do some work on your own thoughts and beliefs about food, weight, body issues and control; get help in individual therapy if you need it.

·         Recognize how perfectionism and feeling of unworthiness are involved. Often people with ED are very critical and hard on themselves about their appearance, size and shape, as well as other issues. It is not uncommon to find ED over-represented among high-achieving individuals who push themselves to excel in their studies and/or work. They often judge themselves and others harshly based on unrealistic standards for performance and appearance. They may use exercise to control or punish themselves. Perfectionism is generally about feeling unworthy or unlovable. Acceptance and tolerance are the antidotes. Gently offer alternative ways of thinking or behaving when you recognize perfectionistic tendencies in your loved ones. If you have perfectionistic tendencies, work on those with a therapist in order to model more realistic behavior and acceptance in yourself and others.

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1. National Association of Anorexia Nervosa and Associated Disorders. (2010). How to Help Someone with an Eating Disorder. http://www.anad.org/wp-content/uploads/2010/11/How-to-Help-Someone-2013.pdf

2. National Eating Disorders Association. (2014). What Can You Do to Help Prevent Eating Disorders? http://www.nationaleatingdisorders.org/what-can-you-do-help-prevent-eating-disorders 

About the Author

LuAnn Pierce, LCSW

I am a clinical social worker, therapist and writer. Currently, I offer online therapy and coaching services to people in Colorado and Wyoming. As a provider for the CO Department of Vocational Rehabilitation and the National MS Society, my expertise in counseling people who have disabilities and chronic illness is considerable. I have written for About.com, DailyRx.com, Theravive.com, GoodTherapy.org, SelfHelpMagazine.com and contribute to several other online health and mental health sites.

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