How to support someone with an eating disorder

Anyone from any walk of life can have an eating disorder. As family or friends, it's important to know the right ways to approach helping someone that lives with a disorder and educate yourself. Dr Misba Hussain, Lecturer in Psychology, gives us her top tips on how to support someone with an eating disorder.

What is an Eating Disorder?

An eating disorder (ED) is an umbrella term for a range of psychological conditions that cause unhealthy eating behaviours to develop. These behaviours can include significantly limiting the recommended daily calorie intake, consuming significantly more than the recommended daily calorie intake within a short period of time, getting rid of food eaten through unhealthy means or a combination of these behaviours. Yet, ED's are not just about food, they can often be about difficult feelings or situations that someone may struggle to cope with. The focus on food can allow someone to feel in control of their feelings and problems. ED's can affect people from all backgrounds including age, gender, and ethnicity. In the UK, it is estimated around 1.25 million people are affected by an eating disorder, and around 25% of those who are affected by an eating disorder are male.

Types of Eating Disorders

There are a number of different eating disorders, and whilst some people with an eating disorder can be underweight, many are also within the average weight or overweight range. The symptoms between different ED's can indeed vary, but there can also be some overlap between some eating disorders. So, it is possible for someone to move between different diagnoses depending on changes in their symptoms.

Anorexia Nervosa (AN)– People with anorexia nervosa may try to control their weight by limiting how much they eat or drink, overexercising or making themselves sick.
Bulimia Nervosa (BN)– People with bulimia are caught in a cycle of eating large quantities of food (called bingeing), and then trying to compensate for that overeating by vomiting, taking laxatives or diuretics, fasting, or exercising excessively (called purging).
Binge Eating Disorder (BED) – People with binge eating disorder eat very large quantities of food without feeling like they are in control of what they are doing.
Other Specified Feeding or Eating Disorder (OSFED) - Anorexia, Bulimia, and Binge Eating Disorder are diagnosed using a list of expected behavioural, psychological, and physical symptoms. However, sometimes a person’s symptoms may not completely match with the expected symptoms for any of these three specific eating disorders. As such, they might be diagnosed with an “other specified feeding or eating disorder” (OSFED).
Avoidant Restrictive Food Intake Disorder (ARFRID) – A condition characterised by the person avoiding certain foods or types of food, having restricted intake in terms of overall amount eaten, or both.
Rumination Disorder- An illness that involves repetitive, habitual bringing up of food that might be partly digested.
PICA – A feeding disorder in which someone eats non-food substances that have no nutritional value, such as paper, soap, paint, chalk, or ice.
Orthorexia - An unhealthy obsession with eating “pure” food. Food considered “pure” or “impure” can vary from person to person. It is not currently recognised in a clinical setting as a separate eating disorder.

You can read more about the symptoms of these different types of eating disorders on the BEAT website.

Tips and support you can offer

It is important to remember that an eating disorder is never the fault of the person experiencing it. Those who are experiencing an ED deserve efficient and compassionate support. If you are worried about someone then it is important to encourage them to seek professional help. You can find more information on how to do this on the BEAT and Mind websites.

There are also additional ways outside of professional help and treatment where you can offer support to the person experiencing an ED.

Let the person know you are there for them, and you are available to listen and help them find support.
Ask the person how they are feeling and what you can do to help – it is important to avoid making assumptions.
Avoid discussing weight, shape, food and diets, as well as making any comments on the person’s appearance.
Continue to include them in social activities, these do not have to involve food but can instead consist of going for a walk, watching a movie or any other hobbies that they might enjoy.
Be patient and gentle with the person. It can take time for the person to recognise and accept the problem and seek help.
Reassure the person that recovery is possible.

Hollie Gower, specialist eating disorder Dietitian and BCU alumni, says: "Remember that the person you are supporting is not behaving like this by choice, and it is being driven by the disorder. Avoid explaining why the person with the eating disorder needs to eat a certain way to recover when they are feeling stressed or anxious (such as at meal times). They likely won’t be able to take in the logic. They instead may benefit from calm reassurance, support, and appropriate distraction."

Tips for you

When supporting someone with an ED, it is also important to remember to look after your own physical and mental wellbeing.

Remember recovery is a lengthy process and may not always be straightforward. Accepting and recognising that it is outside of your control will help ease the pressure that you may be placing on yourself.
Seek support for yourself – this could be in the form of counselling or chats with your friends and family.
Allow yourself to meet your own needs – do what you enjoy, this might be a hobby, spending time with friends or simply having “me time”. You will be able to support the person more if you are looking after yourself.
Ask for help – don’t be afraid to ask for help from your loved ones, this could be in the form of day to day things or direct help with the person you are supporting.
Practice self-compassion – it is important to remember that you are not to blame for this. Take time to be kind and compassionate to yourself. You can find exercises to help you practice self-compassion here.