If you are a family member of someone with an eating disorder, this article is for you! It can feel overwhelming. You probably have many questions about what to do and what not to do. A good place to start is to encourage your loved one to seek professional help for her eating disorder.
The following are a few tips that can be helpful for family members when a loved one is going through treatment for an eating disorder. This list comes from The Eating Disorder Sourebook: A comprehensive Guide to the Causes, Treatments, and Prevention of Eating Disorders (Second Edition) by Carolyn Costin.
Eating disorders are not easy to treat. It can take at least two years or longer to work through an eating disorder. The length of treatment depends on the client, the type of eating disorder, the severity of the eating disorder, and whether past trauma is evident. It is important not to rush the loved one struggling with an eating disorder to “get better.” Allowing your loved one to understand you are supportive of her treatment and will give her the time she needs to recover, communicates to your loved one you care about her.
Avoid Power Struggles
A first instinct of most people who have a loved one struggling with an eating disorder, is to just make their loved one eat. This is not recommended. Do not make meal time a fight between you and your loved one. It will not be beneficial for you or her. It will actually create more problems for you. For example, imagine you spend time making a special birthday cake for the loved one struggling with an eating disorder, and she refuses to eat it. You may feel hurt and angry. Maybe this hurt and anger comes out by demanding she eat the cake you spent so much time on. While it is definitely understandable, you feeling hurt and angry and trying to force your daughter to eat the cake will not improve the eating disorder behaviors. Instead, with permission of your loved one, speak to their counselor, dietitian, psychiatrist, or other professionals involved in the care of your loved one. They can help you know what is best for her treatment and explain how you can be most helpful.
Avoid Blaming or Demanding
It is not helpful to try to find someone or something to blame for the eating disorder. This over simplifies the issue (Costin, 1999). Also, do not demand immediate change from your loved one. As we discussed earlier, you need to have patience with your loved one’s treatment. Blaming someone or something and being demanding only increase the shame and guilt your loved one already feels about her eating disorder (Costin, 1999). It is important to communicate and model that each member is responsible for their own emotions and you will not take responsibility for others’ emotions. For example, if you find yourself angry or frustrated and you yell at one of your children, it would be best for you to take responsibility for your anger and use another method to express it. It may sound like this: “I am sorry I yelled at you. I am not upset with you. I am angry about a situation at work and it came out on you. I am going to take some time to myself in order to understand my feelings of anger. I will work on better ways of dealing with my anger rather than allowing it to come out at you.”
Deal with Feelings of All Family Members
When a family member is in treatment for an eating disorder, it impacts the entire family. The attention of the family might focus on this loved one and her treatment. Other members of the family may feel neglected or unheard when the focus is on the one with the eating disorder. Therefore, each member of the family should learn to identify, communicate, and cope with their own emotions. It can be helpful for parents to encourage and help family members have a safe place to work on expressing emotions. Parents may encourage their children to journal about their emotions. Also, scheduling a time with each of your children to talk about how they are feeling and what the experience of having a loved one who suffers from an eating disorder is like for them.
Show Affection and Appreciation Verbally and Physically
Expressing unconditional love is a necessity in a healthy family. You may believe your family members know you love them, but you need to communicate this in a variety of ways. Write a note or send a card to let a family member know you care about and are thinking of them. Give someone you care about a hug. Spend quality time with your family members doing activities each of you enjoys. Identify positive aspects about each family member’s personality or ability and verbally praise these positive aspects when you notice them. Using a variety of ways to show your love helps get the message to your family members that you truly care.
Do Not Comment About Weight and Looks
Another easy mistake is to comment on the weight and/or looks of the family member struggling with an eating disorder. While you may think these comments are helpful or motivating to your loved one, they may be confusing for them. For example, stating someone with anorexia has gained weight may give fuel to the eating disordered thoughts. On the other hand, telling her she is thin may be what she wants to hear. Someone with bulimia may equate looking good with the eating disordered behaviors she has engaged in on that day. There is excessive focus put on beauty and looks in the media therefore, it can be helpful to praise other aspects of our loved ones.
Do Not Use Bribes, Rewards, or Punishments to Control Your Loved One’s Eating Behavior
These are temporary and conflict with the loved one’s internal mode of controlling behaviors (Costin, 1999). While you may have used these methods when your children were younger, they are not helpful on eating disordered behavior. For example, do not tell your loved one who is struggling with an eating disorder that you will take her shopping if she eats a certain food. Along the same lines, do not ground your family member for not eating certain foods.
Don’t Go Unreasonably Out of Your Way to Purchase or Prepare Special Foods
Your loved one may tell you the only thing she can eat is a certain type of food at a restaurant 20 miles away. In order to get her to eat, you may feel the urge to give into her demands. Giving into these demands encourages this behavior and gives your loved one control over you through eating disordered behaviors. Allowing these demands feeds the eating disordered thought patterns which continue to fuel the eating disordered behaviors. You will need to have a conversation with your loved one that sounds something like this: “I love you very much. I understand you would like me to go to _______ because this is the only food you feel comfortable eating. Because I love you I cannot take you there. After talking with the professionals helping you, they have helped me understand this behavior does not help in your treatment. I understand you may be upset with me, and I care about your feelings, but I also care about you overcoming your eating disorder”
Do Not Monitor Someone’s Behavior for Her, Even When Asked
It may seem harmless to you that your family member asked you to tell her when she has eaten too much or gained weight. You think to yourself, it could be helpful in her treatment. Or maybe, you find yourself monitoring the bathroom to see if your loved one has purged that day. It is not your responsibility to monitor your loved one’s behavior, unless requested by a healthcare professional. This actually creates co-dependent behavior. Your loved one becomes depended on your monitoring and you give in to please or appease your loved one. This is not helpful to you, your family member, or the treatment of the eating disorder.
Don’t Allow Your Loved One to Dominate the Rest of the Family’s Eating Patterns
The loved one in your family who is struggling with an eating disorder may want to prepare food for the family. It is important that the loved one eat what she prepared, and you do not allow the distorted eating habits become a part of your family’s eating patterns (Costin, 1999). While the loved one suffering from an eating disorder may feel controlled by it at times, it is important that the eating disorder does not also control your family. For example, your loved one who is suffering from an eating disorder may only eat vegetables or salad and try to convince you this is a healthy way to eat. While these food choices are healthy, these are not the only food items you should eat. At times it can be confusing for family members of individuals struggling with an eating disorder to identify when an eating pattern is harmful. Consulting with eating disorder professionals can be helpful in identifying these unhealthy behaviors.
Accept Your Limitations
Supporting someone in treatment for an eating disorder is difficult. Accept you cannot always be there for your loved one in the way you would like. You need to know when to ask for help or gain support from others. When you do not know how to help, it is best to ask a professional. Give yourself permission to ask for help and to know it is okay to not try to fix the problem yourself. It is your loved one’s job to work on her eating disorder, and it is your job to be supportive of her treatment to the best of your ability.
Costin, C. (1999). Guidelines for significant others. The eating disorder sourcebook: A comprehensive guide to the causes, treatments, and prevention of eating disorders (2nd ed) (pp. 95-106). Los Angeles, CA: Lowell House.