The Dos and Don'ts of Speaking to an Anorexic!

Don't say:

You look so skinny! 

You're wasting away!

You're a bag of bones!

As much as these statements may be true, they are not helpful to the person who is suffering from Anorexia.  Being told you look too thin tells Anorexia that you are doing a great job and should keep getting thinner.  They might also think you are trying to trick them into putting on weight and you might even enter enemy territory, being thought as someone who wants to make them fat, causing them to withdraw from you.

Do say:

I'm worried about you...

You don't seem happy...

Is there anything that's bothering you?

It's okay to let someone with Anorexia know that you are worried about them but you will get much further if you don't link this concern to their physical appearance.  What a lot of people forget is that Anorexia is a mental illness with physical consequences, it's just the physical result that a lot of people see first.  Anorexia is often used as a coping mechanism, people who turn to it obviously are likely to have a great deal of emotional distress and aspects of their life that they are desperately unhappy about.  They've probably had so many people nagging them about their weight and what they're eating and very few asking them quite simply how they are.

Don't say:

You look so healthy!

You look so much better now!

It is probably best not to comment on their physical appearance at all as it is likely to be taken the wrong way and fuel anorexic thoughts.  If you are suffering from Anorexia, being told you look healthy is the equivalent of being told you look fat.

Remember that just because a person has put on weight does not automatically mean they are 'recovered' or 'better'.

Anorexia is a mental illness.  Ironically, it is when an anorexia sufferer has started to put on weight that their thought processes may be the most disorder.  It does make sense though as this is the time when they are fighting against everything their mind is telling them to do.  Being told they now look healthy could be the trigger that sends them back into the opposite direction.

Do say:

You seem happier in yourself, are you?

You seem to have a lot more energy recently.

It's lovely to see you feeling more positive.

Instead of concentrating on how they look, try and focus on how they might be feeling.  It's always best to ask the person how they are feeling first before making assumptions.  An eating disorder can cause people to put on a bit of a facade at times.  Someone can appear really happy, bubbly and positive when what is going on inside is quite the opposite.  Encouraging them and giving them space to express their feelings if and when they feel ready to will really help them in their recovery.  Anorexia is fueled by secrecy so any attempt by them to open up should be supported and encouraged.

Don't:

Facilitate their eating disorder!

Offer dieting advice!

Talk about dieting or losing weight in their presence!

Say you were suffering from Anorexia if you went round to a friend's house for a meal.  The friend pulls you to the side and says something along the lines of: "Don't worry, I've got a tiny little salad for you. You can have that instead!"  This friend probably thinks they are doing you a really big favour.  They are just trying to make you feel more comfortable.  

However, the reality is they are facilitating your eating disorder.  They have made an assumption about the amount and what food you are able to eat and they have allowed you to eat a smaller and different meal to everyone else.

I imagine it can be really difficult to be a friend to someone with an eating disorder.  You witness them becoming so physically depleited and it can make you desperate to just get them to eat anything, no matter how small, so long as they just eat!  You might start trying to convince them that they can eat this food or that food and they won't put on weight because it's really low calorie.  You might encourage them to have smoothies or shakes because it's not really food, it's a drink.  

The problem with this is that you are actually encouraging disordered thinking around food.  You are reinforcing the message that some foods are safe, some are not and eating makes you put on weight.  They may start to see you as a bit of an ally who accepts their Anorexia and that can be dangerous.

If you really want the person to recover and have a healthy relationship with food, your behaviour towards them has to reflect that you love, care and support them but you don't accept or like their eating disorder.

Following on from this, talking about dieting or wanting to lose weight it their presence is a real no go!

Anorexia can be quite a competitive illness.  

Any mention of losing weight or dieting is going to be picked up on their radar even if the conversation is not directed at them.  They are going to take whatever approaches or tips mentioned to an extreme.

Instead of surrounding them with conversation that is going to fuel their illness, show them what it means to have a healthy relationship with food by example.

Do:

Ask them how best you can support them...

Going back to the example of having someone who is suffering from Anorexia coming round your house for a meal, instead of making assumptions as to how they are going to be able to manage, ask them what you could do to make them feel more comfortable.  As a general rule, it may be best to put food in the middle of the table and let everyone serve themselves.  This way, the person with anorexia is made responsible for picking out a selection of food they feel they can manage but no special arrangement has been made for them.  The person themselves is going to be the best expert on what they can manage and how they can manage at the time.  It may be that eating in front of others is a step too far for them at the moment, so they may ask if it's okay if they come along later after everyone has eaten.

Don't:

Force them to get help!

Obviously you want them to get help and can see that they need it but unless they want to get better, it will never work.  This can be frustrating but if you nag someone into getting help before they feel ready, it is just going to cause more heartache for you and them.  It is going to feel like they're disappointing you or letting you down every time they slip up.  It is common for people with eating disorders to go through phases of denial.  If you put it out there that you think they've got a problem and need help, you could end up at logger heads and lose their trust.  Engaging with professional help has to be their decision and initiative.  If they sound as though they may be open to getting help, you could suggest it or say that you'd support them if that was something they wanted to do.  

That's the most it should be though, a suggestion.

Do:

Let them know that you are always there...

Sometimes just being there is the most powerful thing you can do.

Accept and be understanding if they don't want to talk or shut you out.  Give them space, time and listen when they do want to talk no matter how little they say, it's progress.

You have to show them that you are always going to be in their life no matter if they're sick or working on their recovery.

Support them in any positive decision they make regarding their recovery.  If they decided to see a doctor for the first time, you could offer to go with them or meet them after the appointment.

Don't:

Only talk about their eating disorder!

It can so easily happen that your every conversation ends up about their eating disorder.  So much of the person's time and thoughts will already be absorbed in thinking about their eating disorder.  It is important that their eating disorder does not become the only thing you talk about.  It can cause them to become more absorbed in it.  Also, especially if the person is receiving some care for their eating disorder, they may start to feel as though all everyone sees is their eating disorder.  They may feel at times that no one can see past it, no one cares about who they are and how they feel anymore.

Allow them to talk about their eating disorder if they initiate it but make sure you talk about other things as well.  A bit of distraction can be a good thing, talk about TV shows, what you've been up to recently, try and have a laugh with them!  Try to think about what you used to talk about before their eating disorder.  All these things will help remind both of you that there is much more to their life than just an eating disorder.

Do:

Focus on the person not the eating disorder!

Encourage any interests that are not related to their eating disorder...

Try to see past the eating disorder and focus on who they are as a person.  It can help them to see that at the moment, the eating disorder is just one aspect of their life but there is so much more to them than that.  Focus on the things they enjoy, the things that make them smile and their interests before their eating disorder.  All the time they are doing something else, is time that they are not thinking about their eating disorder so plan things you can do together that will distract them.  It can give them something to look forwards to.  If you know the person used to like art or played a musical instrument you could encourage them to start up again.  Having positive interests aside from their eating disorder can really aid them in their recovery.

Don't take it personally!

It's not them it's their eating disorder talking!

Anorexia can make people secretive, deceitful, irritable, numb, dismissive etc.

That can be really hard if you are on the receiving end.

You have to remind yourself though that it's not the person who is behaving this way, it is their eating disorder.  Sometimes it can feel like you are talking to a completely different person and that can be scary.

Try and show them that you will always be there no matter how much their eating disorder wants to push you away.

Love and Strength,

The One Day Seeker