How to support someone with an eating disorder

You've noticed the skipped meals. The new rules around food. The quick exit from the table after dinner and you're scared to say anything in case things get worse.

Saying nothing is not an option. But where do you start?

Start with what you've noticed

Rather than raising the conversation during a meal, find a time away from food to talk about the changes you've noticed and why you're concerned.

Keep the conversation focused on the person rather than their weight, appearance or what they have eaten. You might mention that they haven't seemed themselves lately, that they appear more anxious or withdrawn, or that you've noticed they are avoiding things they previously enjoyed.

Ask how they are going and give them time to respond. They may not be ready to talk, or they may disagree with what you've noticed. You don't need to convince them that something is wrong. Let them know you're concerned and you're there for them.

What not to say

Even well-meant comments can make things harder. Where possible, avoid:

• Comments about weight or appearance. 

  Even comments intended as compliments, such as "you look healthy", can increase the focus on weight and appearance and may be experienced very differently by someone with an eating disorder.

  
  

• "Just eat" or "it's only food."

  Eating disorders are more complex than simply choosing to eat differently.

  
  

• Threats, bribes or blame. 

  People with eating disorders may already experience significant guilt and shame. Adding to this can make it harder to talk openly about what they are experiencing.

  
  

• Comparing them to others, or talking about dieting, calories or weight loss. 

  These conversations can reinforce the focus on food, weight and body image and may make eating disorder thoughts more difficult to manage.

  
  

They may not see what you see

Eating disorders can become increasingly consuming. Rules around food, worries about weight or body image and changes in routines and social activities can gradually take up more of a person's time and attention. They may also begin withdrawing from family, friends or activities they once enjoyed.

This can be particularly difficult for the people around them. You may be watching someone you care about change while they tell you that everything is fine.

They may genuinely feel they have things under control, minimise what is happening or become upset when you raise the subject. This doesn't mean you should stop caring or never raise the subject again.

You don't need to convince them in one conversation. Keep the door open. Let them know what you've noticed, that you're worried because you care about them and that you're there to help.

If you remain concerned about their physical health or safety, seek professional advice even if they don't believe there is a problem.

If you're the parent of a teenager

Watching your child become anxious around food, avoid meals or withdraw from things they once enjoyed can be hard. It is also easy to question yourself. Is this a phase? Am I overreacting? Should I wait and see?

You don't need to have all of those answers before asking for help. Early assessment is important when an eating disorder may be developing.

Start with your GP

Make an appointment and tell your GP what you have been noticing. Changes in eating are important, but so are changes in exercise, mood, sleep, socialising, behaviour and how much time your child is spending thinking or talking about food, weight or their body.

Eating disorders can also affect physical health in ways that may not be obvious from looking at someone, which is why medical assessment and ongoing monitoring can be an important part of care.

Expect to be involved

Parents and families can play an important role in treatment. How involved you are will depend on your child's age, their needs and the type of eating disorder.

Treatment is not one-size-fits-all. It may involve psychological therapy, family-based approaches, nutritional support and medical monitoring, with different professionals working together as needed.

Think about the conversations happening at home

When food has become difficult, mealtimes can become stressful for the whole family. Arguments about what has or hasn't been eaten can easily take over.

Where possible, keep meals predictable and be conscious of the way food and bodies are discussed at home. Conversations about dieting, calories, weight loss, body shape or being "good" or "bad" for eating particular foods can be difficult for someone already preoccupied with these things.

Find support for yourself

Supporting a child with an eating disorder can bring worry, frustration and uncertainty, and parents often have

questions about what they should and shouldn't be doing.

Eating Disorders Families Australia (EDFA) provides information, education and support specifically for families and carers of people with eating disorders, including online carer support groups and counselling services.

You don't have to work everything out on your own.

Getting help for an eating disorder

Starting the conversation is an important first step. You don't need to know exactly what is happening or have all the answers before reaching out for professional support.

Our psychologists and counsellors provide eating disorder therapy for children, adolescents and adults in the Sutherland Shire and across Sydney, with online appointments also available.

You can also contact the Butterfly National Helpline on 1800 33 4673 for information and support.

If you're unsure where to begin, our Client Care Team can assist. Call 02 8519 4197 or use the button below to request an appointment.