Does Someone I Know Have an Eating Disorder?

When someone has an eating disorder, they often try to keep their behaviors a secret. If you notice some of the signs above—or even if you don’t—you may see other signs, including those below.

  • Significant weight loss. However, many people who suffer from bulimia do not lose weight, and in fact, many gain weight.

  • Signs of vomiting when the person isn’t saying he/she feels sick.

  • Wearing big and bulky clothing.

  • Isolating from other people and feeling that it is related to appearance or not wanting to be seen.

  • Calloused areas on the back of the fingers (from inducing vomiting using the fingers).

  • Pre-occupation with eating only healthy foods; refusing or feeling anxious about eating “bad” foods.

  • Signs of restricting, binging or purging that are accompanied by depression, anxiety, obsessive or compulsive behaviors related to food, irritability, fatigue, or substance abuse.

How Should I Talk to Someone I Care About?

Because the thoughts and behaviors associated with eating disorders can start from very early in life, prevention is the most powerful tool we have. Begin talking to children at a young age about acceptance of the body as it is, recognizing that we all come in different shapes and sizes, and no matter what we look like, we are human beings with the potential to accomplish great things. However, be conscious that we all receive constant input about weight, eating and exercise, and many of us suffer from negative thinking about our own appearance, especially in terms of weight. It’s very difficult not to internalize messages and begin speaking in the language of weight loss.

Here are some tips for talking to children and adults to prevent the over-focus on weight or appearance:

  • Be aware of your own language and behavior about diet and weight. Avoid making negative statements about your own size or weight, and instead talk about eating healthy so that your body stays healthy and functions well.

  • If you are concerned that your child, family member or friend is getting heavy, avoid criticizing or making negative comments about his/her eating. If you feel that you’re the person’s eating is related to anxiety or other emotional states, focus on helping him/her talk about those feelings and finding ways to cope with them.

  • Avoid labeling foods “good” or “bad,” and help the person become aware of and focus on how his/her body feels after eating different foods.

  • Help the person tune into hunger and fullness. With children, find a fun way to measure how hungry or how full you are, and talk about this before and after eating. This helps the person recognize body messages, so that he/she is more likely to use these signals, rather than external messages.

  • If your child, family member or friend talks to you about feeling or looking “fat,” acknowledge what they say and feel with compassion, answer questions in a non-judgmental way, and make sure to bring the conversation around to what they contribute to the world.

If you feel your loved one may have an eating disorder, here are some tips for approaching the subject and helping them find help:

  • Speak in terms of your concerns about health and well-being, rather than focusing on the eating or restricting behaviors you see. For example, “You seem anxious lately,” rather than “You’re not eating enough.” Be non-judgmental and compassionate.

  • Recognize that if express concern, the person may have a negative response, including anger, defensiveness, sadness, or avoiding you. Avoid getting angry back, and understand that these reactions come from a place of fear, shame, or other unpleasant emotions.

  • Whatever the first response is, try to stay present and wait it out. Keep reiterating your concern for his/her health, and try to bring the attention to his/her hopes and dreams for the future.

  • If you feel the person is not at the point of medical risk, offer your help in finding someone to talk to, or other types of support. Recognize, however, that the person may crave a sense of control, so he/she will want to make the final decision about the next step.

  • If you are concerned about health risks, or you are dealing with a child who depends on you or other adult caregivers, it’s ok for you or the caregiver to take control of the situation.

  • In cases where the person is malnourished, be aware that the person’s cognitive abilities may be compromised. This means he/she may have difficulty in assessing, problem solving, strategizing and making decisions.

  • Avoid talking about weight in terms of pounds, inches, sizes, or other physical measurements. Speak in terms of what you notice in thinking, behavior, and moods, and how that is affecting relationships, health, school, work or other areas. Use “I” statements, such as “I’m concerned that you’re not going out with friends anymore, when that’s something you’ve always loved.”