If you think or know a loved one has an eating disorder, supporting that person can be game-changing for them.
Eating disorders affect at least 9% of the world population, which includes around 30 million Americans. More than 10,000 people die from eating disorders every year, and that’s just in the United States. And the pandemic has led to an increase in the number and severity of cases, according to a January study published in the journal The Lancet Psychiatry.
Those closest to someone with an eating disorder play “a huge role in just paying attention and identifying potential risk factors or signs,” said Alvin Tran, assistant professor of public health at the University of New Haven in Connecticut. Tran does research on eating disorders and body image.
One of the easiest things to do is ask how to help, said Joann Hendelman, clinical director of the National Alliance for Eating Disorders. But you need to get educated first, she added, since not knowing enough can be harmful.
Here’s what else you should know about supporting someone struggling with an eating disorder.
1. Know the signs
Since early intervention is key, being able to recognize signs of eating disorders is important, Tran said. Knowing the facts about weight, nutrition and exercise can help you reason with someone about any myths fueling their habits, according to the National Eating Disorders Association.
Here are some common signs that can indicate weight loss, body size or shape, and control of food are becoming primary concerns, according to NEDA:
Emotional and behavioral
- Frequent looking at reflection for perceived flaws
- Preoccupation with weight, food, calories, carbohydrates, fat grams and dieting
- Refusal to eat certain foods or whole categories of foods
- Discomfort eating around others
- Food rituals such as eating only a certain food or food group, excessive chewing or not letting foods touch
- Skipping meals or eating small portions
- Withdrawal from friends and activities
- Extreme mood swings
- Noticeable increases or decreases in weight
- Complaints of gastrointestinal problems, such as stomach cramps, constipation and acid reflux
- Difficulties concentrating
- Dizziness, especially when standing
- Feeling cold often
- Cuts and calluses on finger joints (from intentional vomiting)
- Discolored teeth, cavities or tooth loss
- Dry skin and hair, and brittle nails
- Swelling below the ears
- Fine hair on body (lanugo)
The National Eating Disorders Association has lists of warning signs for each eating disorder, but know that symptoms don’t always fit into a box.
2. Share your concerns
If you want to confront your loved one about the signs you’ve noticed, rehearsing what you want to say can help alleviate some of your nervousness, according to NEDA.
Schedule a time to talk in a private setting. Instead of asking if someone has an eating disorder, making accusations or giving opinions, use factual “I” statements about what you have noticed.
That could mean saying, “‘Hey, I noticed that you’re fixated or that you’re talking more about dieting,’” Tran said. “Or ‘I noticed that you’re uncomfortable eating in front of people. Please know that I’m here to offer that support should you ever need it.’”
Bringing up someone’s weight or appearance is rarely appropriate or helpful, Tran and Hendelman said. And don’t give simplistic advice such as “just eat” or “just stop eating,” NEDA suggests.
“It’s like going to somebody with an addiction for a substance or somebody who’s a smoker and saying, ‘Just quit,’” Tran explained. “It’s not that simple of a process, and oftentimes you will experience backlash when you make comments like that.”
Be prepared for defensive reactions to your educated advice, too. Some people might get angry if your awareness threatens their chances of getting what they want from their eating disorder. If this happens, repeat your concerns, but don’t force it – say you care and leave the door open for conversation, NEDA says.
3. Encourage them to seek help
People with eating disorders need professional help to heal. If they don’t have a physician or therapi