Supporting someone with an eating disorder
If you suspect that someone you love or care for has an eating disorder, or you have made some discoveries that worry you, then we do recognise your fears and heartache. Here we provide some information on the signs to look out for, how you can support the person, and what to do next.
Signs to look out for
Below are some of the main signs of a possible eating disorder.
Please bear in mind that this is not an exhaustive list, so if you are unsure, do get in touch for a confidential chat, or speak with your GP.
- An obvious and persistent change in mood – sadness, depression, anger, withdrawal, tearfulness.
- Tactics and excuses to avoid eating.
- Dieting or refusing certain foods such as fats, carbohydrates, or snacks.
- Weight loss that would not be considered normal, or unless on a medically supervised diet.
- Signs of self-induced vomiting with or without weight loss.
- Stress, anxiety, pressure of work or school, coupled with a changing attitude towards food or eating.
- Friendship and relationship problems in addition to a changing attitude towards food or eating.
- Perfectionism and obsession with achievement that impacts food and eating habits.
- Excessive exercising over and above what would be considered normal. More about excessive exercising.
- Complaining of stomach aches and feeling full even though food intake is low or reduced compared to normal.
- Low self-esteem, body hatred, or self-harm. More about self-harm.
- Lethargy, tiredness, but not sleeping well at night.
- Constantly feeling cold or trying to keep warm with baths/showers.
- Wearing clothes that are too big.
- Hair loss or hair lacking lustre, growth of fine body hair particularly on backbone or arms.
- Irregularities with periods, stopping altogether or failing to start at puberty.
- Frequently visiting the bathroom directly after meals.
- Signs of vomiting including raw knuckles, sore throat, swollen salivary glands.
How to talk to someone you are concerned about
One of the questions many parents and carers ask us is ‘will I make things worse if I talk to them about it?’. We understand how daunting it may feel but are here to reassure you that although the conversation will not be an easy one, it is very important to have it. Planning and preparation are therefore key.
We can offer tips and ideas on how to approach the conversation, what reactions you might get and how to reassure your loved one you are there to help them. Our team includes those that have lived experience of supporting a child or loved one through diagnosis and recovery from an eating disorder. They understand only too well your position and can offer you ideas that work and save you from wasting time on those that don’t. Book a call.
Some key points to remember:
- First, allow yourself to accept, without recrimination towards yourself or your loved one, that there may be a problem, and that expert help and advice is needed. Remember, eating disorders are a mental health illness and no one is to blame.
- Encourage them to talk to you, or somebody else they trust, about their difficulties. If the person they want to talk to is not you, try not to take it personally and keep reminding yourself the most important thing is that they do confide in someone. Talk to your loved one and ask if you can then speak with that person too – maintaining trust between you is vital. Explain that you/they are willing to listen, without judgment – this is a very important point that will encourage your loved one to be honest.
- Once they start talking, try to listen without interrupting, and avoid confrontation and arguments. It is important to acknowledge their difficulties and concerns as being very real even though you may not understand them yourself.
- Do everything you can to stop them getting anxious, particularly around food or at mealtimes. Ask them what they feel will help them. Perhaps they need more time to eat or wish to sit next to someone specific at the meal table. Try to meet their needs as far as you can. This will help them feel they can trust you with their worries and more likely to involve you going forward.
- For children and younger people, it can help to explain that one of the consequences of not eating means a lack of energy may prevent them from taking part in hobbies, sport, going to school etc. However, do be careful how you communicate this information as it may be seen as confrontational or as a threat. You know your child best, so tailor your approach to suit; again, maintaining trust is essential.
- Talk to other members of your family and ask them to avoid continuously probing your child with questions or views about their eating patterns. Constant questioning may be interpreted as judgment and may make your loved one more likely to withdraw. This can make it much harder to get them to accept the help they need.
- Show unconditional love and support. There will be many behaviours and patterns that appear irrational to you but do remember these are part of the eating disorder and are not something your loved one can just stop. As a parent, partner, or family member, this can be extremely difficult to see – do book a call with us to talk through ways to cope.
- Build trust by keeping their confidence and do not share anything they ask you not to.
- Note: You may need to explain that you may have to talk to professionals about what they have told you, such as a GP, but that is so the right people can help them to get better.
Your role in supporting someone
It is natural to feel concerned by the enormity of the situation and that is why it is important for you to also to draw on the support of other family and friends, and from professionals or support services too.
Parents and carers of children and young people
For those supporting and caring for a child you will play a key role in helping them to get better. You know your child best; you understand what makes them tick and the type of approaches that will best support them. You are likely to see things professionals may not and can guide them on the individual characteristics and needs of your loved one.
It is important that your views and knowledge of your child are considered. Many parents/carers tell us that they often feel side-lined or even excluded once their child enters treatment programmes, there’s a sense of the professionals taking over. If this does happen, do try to talk to the professionals concerned and calmly explain your position. Our support team, which includes registered nurses, can also help with suggestions and advice of how best to talk with professionals and how to advocate for your child’s needs effectively. You can book a call with one of the team.
Watching your partner or spouse struggling with an eating disorder may make you feel unsure what to do to help and can create a lot of difficult emotions for you both. You might feel powerless, you might feel angry or frustrated with them, or you may feel guilty that you didn’t spot the signs before now. All these feelings, and any others you might be experiencing, are very natural and you should not blame yourself for feeling that way.
Do try to communicate openly with your partner about what they are experiencing and feeling. Encourage them to be as honest with you as possible and do not judge what they tell you. Encourage them to seek professional help, usually by first making an appointment with their GP, and if they feel it would be helpful you could go to support them too. Ask them how you can best support and help them going forward; the more you can maintain open lines of communication, the better. Of course, do avoid commenting on their appearance or any weight loss or gain, it will not help them and could make things worse over time.
If you are worried about your partner, or they already have a diagnosis and you would like to chat things through confidentially, get in touch with our support team.
If your brother or sister has an eating disorder, please remember that it is okay for you to find the situation hard too. Siblings often struggle with feeling guilty or with worrying if something they have said or done caused the eating disorder. Remember that an eating disorder is very complicated. You will not have caused it.
“I felt frightened and helpless – a bit of a spare part really. I also felt angry at the situation and with everyone. The advice and support we received helped me understand my feelings and made me realise that I did have a part to play in my sister’s recovery and that together we could all get her through.” Holly
As a sibling, you’re in a good place as your brother or sister may feel most comfortable talking to you. You will have a different view of the issues your sibling is struggling with, and you may be able to better understand any social, work, or academic pressures they may be facing. You might be able to better help them to identify what could be behind their worries. It is tempting to avoid socialising with them, especially if they have become withdrawn but do include them in social activities and group events. An eating disorder can cause the person to be particularly introspective; helping them to look to future goals can help gain a wider perspective and support recovery.
Your needs are important too. It is natural to feel worried and unsure how best you can help. You can talk confidentially to our support team for emotional support, guidance, and information.
If a friend of yours has an eating disorder, or you are worried that they might have one, it can be tempting to jump straight in and try to work out what is happening, especially if you have a very close friendship.
It is important not to act too hastily, however. Your role as a friend is an important one but it’s crucial they feel they can trust you with something that is deeply personal and often distressing to them. They may feel uncomfortable opening up about it to start with so go slowly. Allow them to talk without fear of judgment and try to focus on how they are feeling, not what they are or aren’t eating.
It is important to maintain their trust in you so do encourage them to seek help (from a parent, partner, or GP), and if it helps offer to go with them to any appointments.
Having said that, if you are both under 18 years of age, we recommend talking to your friend about seeking advice and support from an adult you both trust. This is important for your friend, but also for you so that you have someone to talk to and do not feel overwhelmed by the situation.
Most of all, keep in mind that your friend may feel more able to share how they are feeling with you more easily than with their parents, partner, or family members. Whilst this may feel like a good thing, it may also feel like a big responsibility. Our team are here for you too, to listen to your concerns, and to help guide you in supporting your friend positively. If you don’t want to talk to us, you can email us.
What will happen next
For anyone with eating distress and/or associated problems such as excessive exercising or self-harm, the first step should always be to make an appointment with your/their GP. It is a good idea to go prepared with your concerns and questions noted down beforehand, especially if you feel you will find it difficult to talk about. Taking someone you trust to the appointment can help too.
The GP will ask questions about eating patterns and behaviours, weight loss or gain, and any other physical symptoms that might indicate the presence of an eating disorder. If they have concerns, they will run some tests and checks. Read more detail on what to expect during the appointment.
Where necessary your GP may refer you or your loved one for specialist treatment. For those under 18 years (in some areas it may be 16 years and under), a referral may be made to CYPMHS (Children and Young People’s Mental Health Services) – formerly, and often still known as CAMHS, or an adult eating disorder service.
Treatment will vary depending on the type of eating disorder, its severity, and the age of the person. However, a combination of psychological therapy, such as CBT or family therapy, medication such as antidepressants for any symptoms of depression or anxiety, and diet and nutrition support is generally offered. Find out more about treatment options.
Services and waiting times do vary by area and so it is a good idea to talk to your GP and ask them to explain how it works in your area. Organising a support network for you and/or your loved one is also a good idea. If you/they do have to wait for treatment, and unfortunately this may be a long time, having a network around you really helps. Identify friends or family you can talk to regularly, and you can also book a regular support call with our team.
We can help and our support services are here for you too. We offer a range of ways to get in touch with our team, plus online support groups for family and friends.
Are you worried that you, or a loved one may have an eating disorder? Our Peer Support Team have lived experiences of eating disorders and recovery.
To talk to someone who understands, book a 1:1 support call, we’re here to help.