You may have heard about eating disorders before, but what do you actually know about the disorders and what may not be appropriate to say to someone battling one? Here are the basics you need to know. Eating disorders are persistent eating behaviours that negatively impact health, emotions and a person’s ability to function in many aspects of life. The most common eating disorders are anorexia nervosa, bulimia nervosa and binge eating.
Most eating disorders have a focus on weight, body shape and food, leading to dangerous eating behaviours that can significantly impact one’s ability to get appropriate nutrition. Eating disorders can harm the heart, digestive system, bones, and teeth and mouth, and lead to other diseases.
Research indicates that the prevalence rate of eating disorders is between 2% and 3%. Based on 2016 Statistics Canada population data, an estimated 725,800 and 1,088,700 Canadians will meet the diagnostic criteria for an eating disorder. Today, we’re looking at common phrases spoken to individuals with eating disorders and providing insight on what is and isn’t appropriate.
As a loved one of someone with an eating disorder (ED), it can feel tricky to find the right words to express your love and support for them. If you’ve ever said the kinds of comments we identify below as “what not to say”, please know that you are learning and growing as we all do, and the important thing is that you are educating yourself on how best to help them. It can also be difficult because you may never know who around you is struggling with an ED (as many people suffer in silence), so it’s better to always be mindful of making certain comments or suggestions that could be triggering to someone listening.
Anything about appearance or weight
Any comments – positive or negative – that acknowledge or judge a person’s appearance or weight can fuel obsessive thoughts and negatively impact their recovery. Telling someone they look thin can validate an ED and encourage it to continue and telling someone they have gained weight can trigger a relapse and contribute to further restrictive and dangerous behaviours.
- “You would look/feel better if you lost/gained some weight.”
This is not a helpful comment, it is an unnecessary judgement on someone else’s appearance. There’s no need to make assumptions about their weight or health, so instead, focus on how they are feeling.
- “You don’t look like you have an eating disorder.”
Many people who experience EDs maintain a “normal” weight throughout their illness, and the mental and emotional sides are not apparent to someone’s physical appearance. If someone appears “normal” to you, they could still be dealing with severe underlying issues. Instead, focus your attention on positive non-physical changes that you notice in them, like improved energy or attitudes.
- “You’ve lost a lot of weight; your diet is going well” or “You’re so thin/skinny!”
This kind of comment affirms that the ED is working and can perpetuate a dangerous relationship to food and eating. If a person is constantly being told that results are visible, they’ll want to carry on and seek further validation. It also supports the belief that many of us subconsciously carry that being smaller physically makes one more worthy and acceptable, and emphasizes appearance being a great source of value for oneself.
- “Does this outfit make me look fat?”
People with EDs are often hyper-aware of the people around them and how much they’re eating, what they weigh, and how they fit their clothing. Making negative comments about your own appearance can make someone focus even more on their weight and food issues and encourage comparison to others. It’s helpful for people in illness to be around body-positive people, and it also helps you to eliminate negative self-talk for your own well-being. Instead, try saying, “I feel great in this outfit!”
- “You look great/healthy/better than ever.”
This can be a well-intentioned comment, but a triggering one as well. Telling someone in recovery from an ED that their appearance is changing can be a confirmation of weight gain, and the term “healthy” can be perceived with a negative connotation.
Anything about food or eating
Eating disorders are a mental illness that not only impact one’s relationship to and thoughts about food, nutrition, and eating, but are often the product of traumas and many other underlying issues. To make blasé comments about what or how much someone else consumes is unnecessary and very harmful.
- “Just cut out (insert food/food group).”
This only serves to encourage restrictive behaviours and dieting. For someone with a binge eating disorder, hearing the suggestion of eliminating a certain food that they binge on will only create guilt and a feeling of loss of control within them. Dieting is the largest predicator of eating disorders, so suggesting that someone create more rules and rigidity around food is only going to make things worse.
- “I’m so glad you ate today.”
This isn’t a necessary comment, unless it is part of a professional treatment plan. Part of the illness for anorexics or bulimics is the irrational belief that people are constantly watching what they eat and judging them for it – so making remarks like this confirms their worst fear. Many people in recovery feel guilty for eating and they don’t need any more attention drawn to it, so instead, you should focus on how they are feeling and what kind of support they might need.
- “Just eat like me/this and you’ll get better.”
Individuals with eating disorders are probably aware their relationship with food and eating is different than those around them, and likely compare themselves constantly. Again, even if this is well-intentioned, you do not need to tell anyone else what, when, or how much they should be eating, especially if you don’t know their history with EDs or have little knowledge about the complications of it.
Anything that perpetuates stereotypes about eating disorders
Eating disorders are most often associated with white adolescent females from an upper-middle-class socioeconomic background. This stereotype erases the experiences that so many others have with EDs, and those people need support just as much. Check yourself and your pre-conceived notions of what someone with an eating disorder “should look like” and recognize that ANYONE can suffer (and will continue to do so in silence if a supportive, inclusive environment is not available).
- “But ____ (men/older people/people of colour/less well-off people) don’t get eating disorders, so it must be something else.”
If someone is reaching out to you for support and sharing such an intimate and personal experience with you, you should meet them with nothing but love, support, and acceptance. The smallest indication of judgement, criticism, or rejection can cause them to shut down and lower the likelihood of them overcoming the illness. The fear of negative social stigmas is why so many people won’t reach out. Instead, reflect on your own stereotypes and how they are preventing you from fully embracing and understanding the experience of your loved one.
Anything that normalizes eating disorders
Eating disorders are a serious mental illness that require attention, support, and treatment. Making someone feel as though their disorder is not valid or worth looking into, can hinder their recovery journey and allow it to rampantly continue. If re-assured that what they’re doing is acceptable and right, they will be less likely to seek treatment.
- “I skip meals sometimes too.”
Even if this is a true statement, it is not the same as having an eating disorder. It minimizes the experience and severity of a real ED, which goes much further than simply skipping meals occasionally.
Anything that shows impatience or judgement
There is no room for unsupportive behaviour or comments. Anyone with a mental illness deserves patience and space to work through their underlying issues without feeling pressure or judgement. Show care and compassion and make sure they know that recovery is possible, and they are not alone.
- “Why can’t you just eat something?”
It’s not a simple choice to eat or not. Often, eating disorders have little to do with the food itself, and not eating is a symptom of many other issues at play that may include low self-esteem, personality disorders, trauma, or body dysmorphia. There are also complex genetic, biological, and socio-cultural factors that may affect an individual’s ability to eat a certain amount or type of food. To someone on the outside, it may seem like a superficial obsession with body image or food choices, but it is a serious medical condition and should be treated and respected as such.
- “Just stop binging.”
A common misconception is that binging reflects a lack of self-control or willpower. This is not true! It is often caused by trying to rigidly control eating, which only leads to feeling restricted and deprived. If you’ve identified their binging habits in the middle of an episode and call them out for it, it will create deep feelings of shame and embarrassment. You must be mindful of the fact that no one chooses to have an eating disorder, and for the individual it serves some kind of purpose in their life, whether it’s a crutch for them, a way to self-sooth during difficult times, or a coping strategy.
- “But you have so much going for you!”
Anyone can develop an ED, regardless of where they are at in other parts of their life. By saying this, you’re implying that there is no valid reason to be ill. Everyone has their own unique talents and skills, but no one is immune to struggles with food, body image, or intrusive thoughts.
- “You’re just seeking attention.”
This is simply not true, a mean-spirited assumption to make, and de-legitimizes the seriousness of eating disorders as mental illnesses.
To conclude, the most important thing to do when speaking to someone with an eating disorder is to communicate your love for them and your willingness to stick by their side and help them through the recovery journey. Though this list may seem long, there are many things you can say that are simple and encouraging:
- Are you okay? Is there anything I can do to support you?
- I’m here for you if you want to talk.
- Would you like to see someone who can help you through this?
- I love you no matter what.
- You are much more than your eating disorder.
- I know this is hard, but I’m so proud of you.
If you’re looking for recovery support groups, Avalon offers ABA (Anorexics and Bulimics Anonymous) meetings for women looking to find and maintain recovery in their eating practices and to help others gain recovery, as well as OA (Overeaters Anonymous) meetings for women dealing with compulsive overeating, food addiction, and binge eating. Learn more and register for these meetings on our website here.