Friday, 25 January 2013 08:20

What Should I Say to Someone with an ‎Eating Disorder?‎

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When you recognise that someone you know might have

an eating disorder, it is difficult to know how and when to

approach the person with your concerns.

It is important that these concerns are raised with the

person. Here are some ideas that might help when working

out what to say. Remember that the goal is to maximise the

chance of the person engaging in positive conversation with

you about your concerns.

 

Being Prepared…

Approaching someone with your concerns may be difficult

and confronting for all involved, some thought probably

needs to occur about the best way to do this.

There are a few things to think about when raising your

concern with someone who potentially has an eating

disorder:

 Early intervention is the best way to assist with successful

recovery. If ignored, the problem is not likely to go

away.

Think about who might be the best person to raise the

concerns. In most cases the best person is someone

who cares about the person, who can provide them with

ongoing support, and who sees them regularly. For many

young people, this will most likely be their parent. For

older people it might be their partner or a close friend.

Inform yourself about eating disorders – you are more

likely to be able to express that you understand what the

person is going through if you are informed.

Be informed about options for seeking help. This will be

helpful, especially if the person is prepared to seek help,

but also if they are sceptical or fearful about recovery.

Anticipate a negative or emotional response – it may

be one of denial, anger or even relief. This response is

usually driven by fear or confusion. A negative reaction

does not necessarily mean that there is not a problem.

You may need to be persistent. Try to remember that

the person is likely to be feeling a great amount of shame,

embarrassment and fear about the eating disorder, and

this may be playing a large part in their angry or denying

response.

 It is normal to feel hesitant about approaching someone

– raising concerns can be confronting. Sometimes people

are unsure whether their suspicions of an eating disorder

are correct. Remember that you are unlikely to ever be

100% certain unless the problem has been diagnosed or

acknowledged by the person.

What do I say?

 Choosing the right words can be very hard. It can helpful

to think about what you are going to say before you talk

to the person.

 Try to maximise the chances of positive conversation. Your

knowledge of the person will help you to determine the

best way to approach the situation.

Choose a time to talk when you are both feeling calm

and are unlikely to have any distractions. Pick a safe and

comfortable place.

 

How do I say it?

Communicate your concerns. It is important that you let

the person know that you are only raising your concerns

because you genuinely care about the person. Come

straight to the point and have examples to back up

your concerns. Tell the person that you have observed

behaviour that is of concern to you.

 Tell them that you are worried that they have developed

an eating disorder. It can be useful to have a list of

warning signs or behaviours that you have observed. Be

up front about your observations – it can be more difficult

for the other person to deny things, if you have some solid

examples.

Focus on feelings – yours and theirs. This will lessen

the chance of what you are saying being interpreted as

an attack or a judgment.

 Own your feelings, demonstrate that you are taking

responsibility for your own feelings. Use “I”

statements.

 Try to focus on behaviours and feelings that you are

concerned about rather than eating and weight. The

person is more likely to recognise that they have been

unhappy, withdrawn or miserable. They may be highly

protective of the eating and associated behaviours.

How do I do it?

Try to avoid the following:

 Comments about appearance, weight or food

 Naming other people who are also worried

 Demanding change or berating the person

 Power struggles

 Tricking or forcing the person to eat

 Labelling statements, blaming statements or judgemental

language.

Example: “You” statements. For example, avoid saying

things like: “You are completely unreasonable”, “You need

help”, “You aren’t eating enough”, “You are bulimic, anorexic

or you have an eating disorder”, “You are being silly”, or “Just

get over it and eat”.

It can be more helpful to raise your concerns in other

ways, for example:

 “I’ve heard you throwing up in the bathroom. I am

concerned for you. I would like us to try and get some

help.”

 “I am really concerned about this at the moment. I am

finding it hard to talk with you because we seem to end up

fighting whenever I bring it up.”

 “I am feeling anxious because I have noticed… I see you

skip meals… run to the bathroom… or how much exercise

you are doing etc”

 “I am very worried about you, you don’t seem to be as happy

anymore. I am concerned about how stressed you are, and

am wondering how you are managing this. I would like to

be able to help you to get some help. Is there anything that

you would like to talk to me about?”

 “I am concerned about you because I have noticed a few

changes. I have noticed that you seem to be very concerned

about how you look, and you seem to be giving yourself a

pretty hard time at the moment. I don’t see you enjoying

time with your friends anymore, or spending time doing

things that you once enjoyed. I want you to know that I care

a lot about you, and I think that you deserve to feel better

than you seem to have been feeling lately. I would really

like to help you to feel better about yourself and would like

us to try and get some help.”

 “I have noticed that your moods are changing more often

than usual.”

 “I am finding it difficult to cope when you raise your voice

at me. I don’t expect you not to get angry or frustrated, but

I don’t accept you speaking like this.”

What if the person is unwilling or not ready

to talk?

In this situation, remember that raising the subject has

opened a door for further conversations. Try not to get

caught up in power struggles about whether they have

a problem or not. In this situation you might want to say

something like:

“Even if I can’t convince you to get help now, I can’t stop

caring”.

Be patient and persistent – but be cautious not to nag.

Focus on the future, recovery and your willingness to help.

The person may feel threatened by your discovery or

observations. Sometimes we need to allow them some time

to absorb what you have said and to respond. Listen to

them and ask them to listen to you. Let them know that you

have heard what they are saying.

Consider the approach to the person as opening a door for

them and understand that it may take some time for them

to accept the offer. Realise that they will need to work at

getting better at their own pace.

You might want to say something like: “I understand that

you might find facing this very difficult, and it takes a lot of

courage to admit that something is not right. I will not let you

continue to struggle alone. I will be here for you when you are

ready to accept my support and I am here whenever you feel

ready to talk.”

Is the Person Safe?

If you are concerned that the person is in immediate physical

danger, or at risk of harming themselves, then it is necessary

to take a more direct course of action. Get immediate advice

from a health practitioner, call an ambulance, take them

to emergency, call our Helpline, etc depending on the

situation.

It might also be helpful to be honest and open about your

concerns and what action you are taking with respect to

your fears. It can be very effective to develop a contract

with them. For example ‘I care about you and your health.

You need to know that I have decided that if you…(Faint, or

can’t get out of bed, or whatever) I will…(Call an ambulance,

take you to Emergency etc…)’.

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