Eating disorders can be frustrating for loved ones to deal with.

Like schizophrenia and heart disease, eating disorders have a biological, psychological, and social component.

• Biologically, each has a genetic component and can run in families.
• Psychologically, they each are associated with other mental health factors.
• Socially, each has a history of stigma and public oppression.

Without treatment, eating disorder symptoms, like schizophrenia and heart disease, can progress over time. Each can cause long-term physical and psychological damage, if they are not addressed.

Comorbidity (the presence of 2 or more conditions) exists between eating disorder and other mental health conditions like anxiety, depression, obsessive-compulsive disorder or ADHD. There is a similar comorbidity with schizophrenia and substance use disorders and depression. Also, heart disease can coexist with depression and anxiety.

Therefore, overlapping diagnoses make treatment complex, because it often involves addressing multiple interrelated mental and physical health issues.

We know environmental factors like stress, trauma, and lifestyle can intensify symptoms of both schizophrenia and heart disease.

Eating disorders are also heavily influenced by societal pressures, stress and trauma.

Societal factors like body image ideals or personal trauma can act as triggers for disordered eating, just as stress or lifestyles can exacerbate schizophrenia and heart disease.

Eating disorders, like schizophrenia and heart disease, are often misunderstood by the public.

People can view them (eating disorders, schizophrenia, and heart disease) as something the person brought on themselves and as a function of moral failing where they have not “tried hard enough” to get better. This stigma is in large part the reason people do not want to seek help.

Often people will say, “why can’t you just control yourself and your eating.”

Treating eating disorders often requires a multidisciplinary approach, including medical, psychological, and nutritional treatment. Similarly, management of schizophrenia or heart disease requires a combination of medication, mental health therapy, family and lifestyle changes.

Eating disorders, like schizophrenia and heart disease are treatable (there is hope) it needs understanding treatment providers to assist the person to get better.

Since Eating Disorders are so complicated, how can you support a loved one who is struggling with an eating disorder?

First, you do not have to respond perfectly to your loved one with an eating disorder each time. Give yourself grace to not respond and forgive yourself for what you might have said and done in the past.

You are probably scared your loved one might die or be incapacitated. Your fear makes sense. It is hard to support someone who has an eating disorder, especially when you do not understand it.

I have talked to many loved ones who genuinely feel great love but feel frustrated that the person is not stopping their behavior. I empathize with your situation, and I can honestly say that letting go of your anger can be so helpful to you and your loved one.

Second, increase your constructive and positive communication skills.

This can be easier said than done when it is YOUR loved one that you must interact with. There are many communication skills that can help you.

Try to refrain from judgment.

Seek to understand where they are coming from. Move away from questions and comments that are shaming such as:

1. Why did you do that?
2. Why don’t you stop?
3. What is wrong with you?
4. Just eat.
5. Don’t eat.

Ask your loved one to help you understand where they are coming from. Let them tell you, not you tell them. A good question is, “I feel confused, can you help me understand.”

When we seek to understand, we can then begin to come from a place of empathy for their situation.

Another great communication skill is active listening, where you listen deeply to what they say. It can be hard to listen when you feel frustrated, and active listening can help decrease the frustration. 

Third, seek support for yourself to understand how this is affecting you. It is hard to help someone who has an eating disorder. You have learned a lot from the world about food, weight, and the value of dieting, making it difficult to push aside the societal expectations.

Ask for referrals for a therapist or counselor who can support you in this process.

The professional will be able to help you understand your feelings, thoughts, and reactions. They will be there for you, because when we have a loved one with an eating disorder it seems all the focus is on them. You can also be suffering and deserve a place to feel better.

Fourth, encourage your loved one to seek qualified professional help: a therapist or counselor who is specially trained to work with people with eating disorders.

The suggestion to seek professional help should come from a place of love.

Tell them you love them and are concerned about them.

If the person is talking about the problem, you can suggest they might want to talk to a professional about it. This can be a slow process, and they might say no. That is ok, this is on their timetable, not yours.

If your loved one says no, I encourage a family member to contact a mental health counselor or therapist who specializes in eating disorders to consult. When I, as the therapist, get these types of calls from loved ones, I listen to their situation and give them some non-shaming language to use to encourage the person to make the call.

Fifth, seek out support groups that offer education about eating disorders. Group members can provide their personal experiences about how they handled situations that may spark ideas for you. You can feel isolated being around a loved one with an eating disorder, so seek out others who are trying to eat through an intuitive eating and body positive lens.

Balance between offering support and respecting the autonomy of a loved one with an eating disorder.

There are different ways to respond to a person with an eating disorder based on what the eating disorder is AND how it is affecting their lives. There can be situations where the person is truly in a life-or-death situation. In that instance, work with treatment professionals to determine boundaries to take appropriate and immediate action.

When the eating disorder is not an immediate life-or-death situation, it is important to determine:

• The timing to offer support.
• When you need to give the person the space to make their own decisions.
• If you must set firm limits.

Determining when you offer support and when you respect their autonomy can be something you bring to your own mental health professional or treatment group.

In the end, I want anyone with an eating disorder reading this to know there is hope and there is help. Dealing with eating disorders is complicated and you might feel out of control. The first step can be to admit there is a problem and to ask for help

I know from experience your eating disorder can be treated. There is hope, there is help.

This article was initially published in full in Authority Magazine and Medium.com. Read the full article here: https://medium.com/authority-magazine/kim-mclaughlin-of-lmft-on-how-to-support-a-loved-one-who-is-struggling-with-an-eating-disorder-f5ecd2088ec3

You can find the article video here: https://youtu.be/awGrVXeCCYI

Kim McLaughlin, MA is a Psychotherapist, Speaker, Author, and Coach who specializes in working with people who suffer from binge eating and emotional eating. She is a Certified Intuitive Eating Counselor. She is the author of the best-selling book Feed Your Soul Nourish Your Life! A Six Step System to Peace with Food and the Amazon #1 Best Selling book Discovery Your Inspiration.

You can find Kim on her podcast Feed Your Soul with Kim and you can find it on all podcast platforms.

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