How to have a Conversation

1. Trust your gut
   If you think something is wrong you are more than likely right. Go with your gut feeling.
2. 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.
3. 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.
4. Be knowledgeable
   Before approaching your loved one, have some understanding of eating disorders. Reading suggestions at the end of this section
5. 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.
6. 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.
7. 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.
8. 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.
9. 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.