3 Ways to Support a Friend Who May be Struggling with Disordered Eating
Top tips from an eating disorder dietitian on how to support a friend struggling with disordered eating
This shows us that eating disorders and disordered eating are increasingly prevalent therefore it is important to be aware of the signs and symptoms and know how you can help.
What are eating disorders and disordered eating?
Eating disorders and disordered eating both share similarities, but they are different. Eating disorders are clinically diagnosed mental illnesses that meet specific standards set out in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). There are five clinical eating disorders:
- Anorexia nervosa (AN)
- Bulimia nervous (BN)
- Binge eating disorder (BED)
- Avoidant restrictive food intake disorder (ARFID)
- Other specified feeding or eating disorder (OSFED)
Disordered eating describes a pattern of eating that is restrictive, limiting, or leads to preoccupation with food and body. It doesn’t necessarily meet the criteria for a clinical diagnosis of an eating disorder, but it can be detrimental to one’s health and quality of life. It is important to note that just because someone doesn’t meet the criteria for an eating disorder they still deserve and need support.
For many individuals, what often starts off as disordered eating quickly develops into a full-fledged eating disorder. Unfortunately, disordered eating has been normalized in our society. It is common to hear a friend say that they are swearing off all sugar, never touching bread again, or going on a juice cleanse. This is not normal eating and often leads to preoccupation with food, wellness, and the body.
Both eating disorders and disordered eating should be taken seriously. It is important as a friend of someone struggling with disordered eating to notice the potential red flags, check-in, and create a safe space. It can be extremely difficult for someone with an eating disorder to reach out for support and admit they have a problem. Eating disorders are complex and often stem from difficulties dealing with distressing life situations, intense emotions, trauma, or difficult life transitions. There is no expectation for you to solve the problem, but you can support a friend struggling with disordered eating in moving towards getting help.
Who is at risk for an eating disorder?
Everyone is at risk for an eating disorder. People of any gender, race, age, body size, sexual orientation, and socioeconomic status can be impacted. You may be concerned about your friend but think “They don’t look like someone who would get an eating disorder, so they must be ok.” It is important to know that the typical picture of an eating disorder is not so typical at all! You may be surprised with the following statistics:
- Less than 6% of people struggling with an eating disorder are classified as “underweight”
- People in larger bodies are half as likely as those at a “normal weight” or “underweight” to be diagnosed with an eating disorder
- Transgender college students report experiencing disordered eating at approximately four times the rate of their cisgender classmates
- Gay and bisexual men are significantly more likely to fast, vomit, or take laxatives or diet pills to control their weight
- Black, indigenous, asian, and hispanic people are half as likely to be diagnosed or to receive treatment for an eating disorder
- 46% of 9-11 year-olds are “sometimes” or “very often” on diets
Remember that even if your friend doesn’t “look” like they have a problem they can still be struggling!
What are some red flags that may signal disordered eating?
If you notice these signs in a friend, it is important to talk to them and direct them towards appropriate supports:
- Eating less at social events, avoiding social eating, avoiding certain foods, or commenting that they cannot eat many foods
- Frequent dieting and/or rigidity around food choices
- Appearing distressed around making food choices
- Frequently talking about food, exercise, weight, and their body
- Increased irritability, fatigue, and low self-esteem
- Body checking (i.e. grasping wrists, pinching body, checking themselves in the mirror or windows multiple times)
- Frequent comments about their body or expressing concerns over what they have eaten that day
- Social withdrawal- lack of interest in activities they used to participate in
- Rigid exercise routine
- Counting or tracking calories or food intake
- Frequently weighing themselves
- Disappearing into the bathroom after meals
- Weight changes (although this doesn’t happen for many individuals, even if they are struggling)
- “Destroying” food so it is inedible (i.e. pouring salt on their meal so they cannot eat anymore, cutting food into small pieces, taking tiny bites and chewing for a long period of time)
This is not an exhaustive list, but are some red flags you may come across. My biggest piece of advice is to trust your gut! If you feel like your friend is off or their eating habits and behaviour around food and their body has changed it is important to reach out and support them.
What can you do to help?
1. Be curious and compassionate
To support a friend struggling with disordered eating, approach them with kindness, compassion, and curiosity. Instead of jumping in with blame and “you” statements such as “you really need to stop exercising as much,” understand that the person is not choosing this and may be feeling consumed by it. Shame and denial are common in individuals struggling with an eating disorder. Expressing genuine concern, compassion, and care is key. An example of how this can be done:
“I have noticed you seem a bit off recently and want to make sure you are ok. I am really care about you as a friend and want to check-in. Can you tell me a bit about what is going on for you?”
It is common for individuals struggling with an eating disorder or disordered eating to deny or “mask” eating struggles. It is important to not force or coerce them. If they deny that anything is happening I would recommend to continue to let them know you care and are there for them. Do not completely abandon the conversation. Individuals with eating disorders will often self-isolate. By letting them know you are there for them, open, and willing to talk about the issue they are more likely to reach out when they need help.
2. Remain non-judgmental
Sometimes as a support person it can feel frustrating and you may be tempted to ask “how could you let this happen to yourself?” As mentioned above, often times the person struggling with disordered eating will feel like it is out of their control. It can feel like a compulsion and very, very scary to move away from it. Let them know you care about them no matter what. Refrain from commenting on their body, as this can be triggering. Let them know you appreciate them as a friend and what inner qualities you appreciate about them. For example: “I love that you are so thoughtful. You have such a good heart.”
3. Refrain from diet talk or body bashing
To support someone struggling with an eating disorder or disordered eating it is important to ensure you are not engaging in dieting, body bashing, or diet talk! Be aware of how you comment on your own body, other people’s bodies, others’ food choices, and your own behaviour around food. It is fascinating how quickly a conversation can steer into diet culture with everyone bringing up their least favourite body parts, how they “must go on a diet,” and who is currently doing keto and how much weight they have lost.
These conversations are in no way helpful or supportive for someone struggling with an eating disorder or disordered eating (we could argue these conversations are not supportive for anyone!). If conversations are heading in this direction, change the subject and steer the conversation to a different topic. When someone is struggling with disordered eating it can be really tough for them to speak up. You will be providing them a great gift by speaking up and ensuring diet talk is off the table.
Where to find more resources:
If you are looking for more information and resources on how to support a friend struggling with disordered eating check out the following websites:
- National Eating Disorder Information Centre
- National Eating Disorders Association
- Kelty Eating Disorders
- FED-UP Collective
- Silver Linings Foundation
If you are concerned about your own eating patterns, or those of someone you care about, please reach out to the qualified eating disorder dietitians at Health Stand Nutrition for additional support.
If you enjoyed this blog post, check out our other articles on eating disorders:
Disordered Eating, Emotional Eating & Chronic Disease
Thoughtful and empathetic are words often used to describe Courtney. She strives to create genuine connections with clients and works to create an inclusive space for all. She is passionate about working with individuals struggling with health issues, yo-yo dieting recovery, disordered eating and helping clients feel at peace with food and their bodies.