Tips For Loved Ones Supporting Adults With An Eating Disorder

In the UK, this week is Eating Disorder Awareness Week. I am always uncomfortable about these awareness weeks because of the amount of damaging, stereotypical information on eating disorders that still rears its ugly and harmful head every year, but I wanted to do something to acknowledge the week in my own small way. Therefore, this year, I have written a small post that might just be helpful for any loved ones out there of adults with eating disorders:

I have often thought in my journey through eating disorder recovery, that the one group in the eating disorder ‘community’ (for want of a better word) who are probably the most under served and supported are the relatives, loved ones and carers of adults with eating disorders.

That’s not to say that any other groups in the eating disorder community are well served in terms of support and treatment of course… There are enough posts on this website about how lacking eating disorder treatment is the world over. But, people with eating disorders do have a few more options now in terms of support and treatment and family of young people / teens with eating disorders also have a handful of support groups or services available (predominantly from charities or non-profit organisations, such as FEAST).

In my case, when it came to eating disorder recovery, my main support, despite being a 40 year old woman, ultimately came from my parents. When in the depths of trying to support me, I know that they felt completely lost and overwhelmed, scared to ‘say the wrong thing’ or know what to do. They needed access to people who understood what they were going through or information about the recovery process to at least refer to but there was so little available to them… especially because I was an adult.

And I know this is the case for spouses and partners too. When I was very first ill with the eating disorder, I was married and there was absolutely no option of involvement for my partner or information or support for him, and this is is a situation that I believe has changed little since then.

Therefore, this post is to provide a few little tips for any readers out there who do not have an eating disorder themselves but who support someone with an eating disorder and feel lost in what they should or should not do. These tips are particularly aimed at relatives, partners or carers of adults with eating disorders, but many of the tips can be transferred to youngsters too.

Tips For Loved Ones / Carers Of Adults With An Eating Disorder

Before I start on the tips, I just want to say, please understand that eating disorders are now recognised as biological and genetic brain based illnesses, triggered by a period of energy deficit (from any cause). Eating disorders are now known not to stem from vanity, teenage peer pressure or being deliberately difficult and definitely not from poor parenting or other family factors. The illness is powerful and real and the level of fear response that your loved one experiences when trying to make changes to their eating, other routines and disordered rituals is all consuming and incredibly strong. No matter how irrationally they appear to be behaving, to them it is real and terrifying.

Now we have that out the way, here are my tips, in no particular order:

• Avoid allowing the eating disorder to become the elephant in the room. Try to talk about it or ask about it when you can. You might not get a positive response, you might get your head bitten off for asking(!) but somewhere, deep down, it reminds your loved one that the eating disorder is not just being accepted as a part of them and they will appreciate the fact that you are showing you care and are there to support them when they feel they can accept that support.

• This one is hard, especially if your loved one has had an eating disorder for years and so their little behaviours and restrictive eating has almost become ‘normal’, but please try to avoid doing things that collude with the illness. What I mean by this is avoid things like expecting that your loved one won’t eat with you or won’t eat certain things; or avoid encouraging or even just not discouraging certain eating disordered behaviours, such as exercise, dieting or talking about weight and shape. When your loved one is going for that daily, habitual walk (which is a strong part of the illness), instead of simply saying, “have a good time”, try to start challenging them or at least demonstrating that you recognise this walk is not innocent and is a symptom that needs to be addressed if they want to recover.

• Trust your gut instinct on things! You know your loved one, possibly better than anyone else does, so no matter what anyone else says or believes about them, no matter what they say or do, trust your gut instincts when it comes to things that might best support them. I’m a great believer that our guts know better than our minds sometimes!

• Sometimes professionals don’t know best, your loved one does, so listen to them…. This is where trusting your gut instinct (see above) also comes back into play!

• Please, please hold onto hope for your loved one, no matter what they do or say, how long they have been ill or how ill they have been or are… They hate this as much as you do but they are terrified and really need someone to keep that hope alive when they can’t find the hope for themselves. It makes such a difference.

• Love them – simple as that really. If you love them (which I know you do because you are reading this!) then just hold onto that love and they will feel it and gain strength from it.

• Try to be consistent when it comes to responding to questions over food, exercise, weight…. If they say, “I’ve eaten too much”, “I’ve gained too much / too fast”, “I’ve been too sedentary”… the answer is ALWAYS, “No you haven’t!”.

• Remember who your loved one is beyond the illness. That person is still there, behind the fear, the behaviours, the restriction and the bursts of anger or emotion.

• They will be irrational, emotional, angry and depressed at times… In recovery, your loved one will go through intense periods of distress and you might want to ease it for them by telling them that they don’t have to eat more or rest today but that approach won’t help in the long run, so simply hug them and love them through the distress, but help them stay on track.

• It is almost guaranteed that your loved one will direct their anger and irritability at you during their recovery. Please remember when they do that this is their brain trying to make sense of big swings in irrational but real fear responses, which make them feel threatened by small things and they are dealing with emotions that are new and frightening… The anger is never really likely to be about you, it just might not feel like that in the moment!

• Your loved one will likely need time to recover and many need to give up other pressures, in terms of studies, work or family commitments for a few months or a year.  This can make all the difference to recovering or not. The alternative, otherwise, is staying sick and losing years of quality life. Therefore, if you can support them to feel safe and take any pressure off them around keeping up their work / studies for a time so they can focus on recovery, it could be a huge benefit.

• Remember recovery does take time… Don’t fall into the trap of noticing that your loved one has gained a bit of weight, that they are eating more and they seem to be coping better with life and so believe them to be fully recovered.  It is a long road and sometimes the most support a person in eating disorder recovery needs comes later when people think that they are ‘ok now’.

• One thing that is true beyond words is that eating disorders thrive in isolation! Your loved one will very probably attempt to isolate themselves, particularly when in the depths of the illness. It is not easy, with an adult to entirely stop them doing this but stay as connected as you can with them.

• Whenever you can, avoid obvious dieting behaviours, exercising or talking of these things or of weight loss in yourself or others around your loved one. If you do want to diet, lose weight (and I don’t recommend it!) or if you want to hit the gym yourself, wherever possible, aim to be discreet about it. Consider these things as similar to lighting up a cigarette right in front of your partner who is really trying to quit or having a glass of wine in front of an alcoholic giving up the booze. It’s not going to help them!

Now, I am aware that this is a long list of ‘tips’ that are do’s or don’t do’s for those of you supporting adults in eating disorder recovery but the thing I should have said at the start or that should intercept each and every one of these other ‘tips’ is:

Please remember that NOTHING YOUR LOVED ONE DOES OR DOESN’T DO IS YOUR FAULT!

Ultimately, your loved one is responsible for their choices as an adult and you are not the professional there to ‘treat’ them. You can listen, guide, reassure and encourage but you cannot force them into anything and eating disorder recovery is something that will come when the person is ready to take that responsibility themselves. Support from you will help but support alone is not going to get them well, so never beat yourself up if they don’t get better yet.

And most importantly of all,

Look after yourself too… It is such a long road when it comes to eating disorders and recovery and you will need self care, as well as time to get through this and process your own emotions as much as they do. Whatever it is that helps you to cope mentally and emotionally (as well as physically) throughout all of this, please do it.

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I now work as a coach and mentor, working with people (and their loved ones) who are overcoming eating disorders, disordered eating or low body confidence. If you are interested in knowing more about my coaching work, then please take a look at my coaching website: www.hellybarnes.com