How to have a Conversation
Talking about it is the first step
If you suspect someone you are close to has an eating disorder, then it’s important to talk to them about it.
Why? Because an eating disorder can be very serious.
People who develop eating disorders are at a high risk of developing medical and psychological complications, in fact, eating disorders have the highest death rate than any other mental illness.
But there is good news…
You can start early
Don’t wait until you think it is serious to talk about it.
The earlier treatment is sought, the greater and quicker the chance of recovery.
This is why treatment is encouraged as soon as possible.
It’s okay to make a mistake
Getting the balance right when supporting your loved one is challenging.
It’s important to be kind to yourself when you make a mistake. You might like to take a break and do something nice for yourself. You might like to take time to reflect on what you could do differently next time. You might like to acknowledge the mistake to your loved one. This role models to your loved one that it is okay to make mistakes, we can learn from them and continue moving forward.
People DO recover
Most people recover from an eating disorder. And recovery is always possible regardless of age and length of illness.
It is important to seek medical advice as soon as possible. A multi-disciplinary treatment team of (at least) a doctor, dietician and therapist is recommended.
When someone with an eating disorder is approached about their behaviours, often they are not able or ready to acknowledge the existence or seriousness of the disorder.
Sometimes the shame is so great that the individual feels they can’t be honest with anyone about what they are doing, sometimes denial is in direct response to starvation, as this affects their thinking styles. Ambivalence or shame can be a source of confusion and frustration for families and friends who are keen to support their loved one to get well.
Have a positive conversation? Yes, you can.
Holding back on talking to someone with an eating disorder? Worried about what to say – or making things worse? This is understandable, and very common.
A person with an eating disorder is likely to already be feeling isolated. So approaching them, rather than avoiding the topic, is a good step in the right direction.
The following is a general guide on how to work towards opening up communication with you loved one. If you would like guidance regarding your specific situation in details, you can contact the Carer and Family team at EDQ HERE.
- Trust your gut
If you think something is wrong you are more than likely right. Go with your gut feeling.
- Take notes
It may be helpful to keep a note of behaviours that are causing you concerns – this can help keep a conversation focussed and it may also help to have it available when you (or the person you care about) visits with the GP.
- It’s not your fault
It’s helpful to remember you are not the cause of or to be blamed for the eating disorder. Development of an eating disorder is complex and usually has more than one contributing factor – you can, however, can be part of the treatment and recovery.
- Be knowledgeable
Before approaching your loved one, have some understanding of eating disorders. Reading suggestions at the end of this section
- What stage of change?
It may be helpful to also read Understanding the Stages of Change in the Recovery Process. While reading, think about what stage the person you are concerned about is at.
- Choose the right time
As with all important conversations, approach the person you care about when you can have time and privacy. It’s important that the conversation isn’t rushed. It’s also best to choose a time when you/they are not eating, or just finished a meal.
- Approach with awareness
Approach them in a way that is appropriate to where you think they are in terms of readiness to change (in terms of stages of change point 5). Do not despair if you get a negative response initially.
- Care, don’t judge
When speaking with the person, ensure you are not critical or judgemental. Instead let them know you care and want to help. Express your concerns are using ‘I statements’. But rather than saying “I am really mad at you, you are choosing not to eat” you may want to say something closer to “ I am really concerned. I can see that eating is becoming difficult for you and I wonder if you may have an eating disorder. What do you think?”. It may be helpful to practice once or twice first.
- Seek professional support
An eating disorder is a mental illness – and it is complex. You need to get professionals involved.
- Avoid judgement
When talking with a person struggling with an eating disorder, avoid being critical. They are already trying to manage their own strong self-criticism. Positive support helps the most.
- Avoid personal comparisons
Many people experience fluctuations and challenges with food and their body. However, this is different to an eating disorder, which is a mental health concern. If you’ve had a lived experience of an eating disorder yourself, avoid giving advice based on your own experience. Eating disorders vary from person to person, so what worked for you, may not necessarily work for them.
- Avoid trigger topics
When having a conversation with someone who has an eating disorder, it is recommended to steer clear of the following topics: weight, appearance, food, calories, diets, being perfect.
- Active listening/Motivational interviewing
Ask questions, listen and then reflect what you have heard. It is strongly recommended not to jump in to find the solutions but meet and stay with them where they are at. Check out our “What to say & not to say” video playlist below for more information, our visit our YouTube playlist here.
- Take the focus off food and weight
A person with an eating disorder is likely to be overly focused on food and weight issues. It is recommended to help them zoom out to the bigger picture, and talk about other subjects where possible.
- Introduce positives
Highlight their positive attributes and qualities, such as:
– personality (e.g. kindness/ thoughtfulness)
– strong skills and abilities (e.g. ability to share their feelings)
– their laugh and sense of humour
– how they are a good friend, mother, worker etc
– praise their efforts
- Interest areas
Talk about general areas that they are interested in (not involving food or significant exercise).
- What engages? What closes?
While talking, pay attention to what engages the person. And also what conversations or words shut them down. Learn from each conversation. You can also ask them straight out what topics to avoid so they feel more comfortable with you.
- Social engagement
Encourage and invite them to be part of social situations that are not focused around food or significant exercise. Go to the movies, the beach etc.
- Be aware of moments of clarity
When the person with the eating disorder has a moment of clarity about their situation this can be a significant turning point in their recovery. Positive reinforcement of moments of clarity can be helpful.
- If you need to talk about the eating disorder…
Externalise the condition. For example you can say: “Is that the eating disorder influencing you?”. This helps to motivate change, decrease the risk of the person feeling judged and clarify in your mind that the person has a disorder and it not them being ‘difficult’.
This being said, there may be times when just ‘being there’ without a lot of conversation is the best support you can give.
As long as they know you are aware and care about their situation, and are open to talking about it supportively.
Caring for a loved one with an Eating Disorder
A Carer’s Guide to Understanding the Illness and Keeping Well. January 2015. Austin Health & St Vincents Hospital. P 17-25 and also P.28 are particularly relevant.
If you need help, reach out.
If you need assistance, or are interested in any eating disorder services, get in touch.
We can help with more information, referrals and/or arrange an assessment appointment.
You can also contact us through Eating Disorders Queensland
Eating Disorders Queensland 89 Sherwood Road, Toowong Qld 4066