How to help someone with anorexia nervosa

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If you’ve found yourself on this page, it’s likely because someone in your life has anorexia nervosa (AN), and you want to help them. That’s a wonderful thing, and you’re probably concerned that you may say or do the wrong thing, especially when your loved one is in a vulnerable state.

We understand how helpless that can make you feel, as no one likes to see someone they care for in psychological and physical pain. But you’re not alone. Many people have been in this situation and with a little information and the right guidance, you can provide a lot of comfort and support to your loved one with AN.

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In this article

Signs your loved one may have anorexia nervosa (AN)

Your concern about your loved one’s thoughts and behaviors around food may have brought you here, but how do you know whether their behaviors indicate warning signs of anorexia nervosa? 

It can be difficult to distinguish certain eating disorder behaviors because some disordered habits have become extremely normalized and even admired in mainstream culture.

This is why it’s really important to be educated on the signs and symptoms of AN, particularly as someone suffering from an eating disorder can’t recognize the problem in themselves. Contrary to the stereotype, anorexia nervosa can occur in people of any gender and any body size. Some common signs and symptoms of the disorder include, but are not limited to:

Behavioral

  • Dramatic and sudden weight loss
  • Intense fear of gaining weight
  • Preoccupation with food, weight, and body image
  • Restricting entire food groups from the diet
  • Making excuses to avoid mealtimes of eating in front of others
  • Regularly commenting that they feel fat despite weight loss
  • Engaging in behaviors to purge calories, such as excessive exercise, diuretic or laxative use, or self-induced vomiting
  • Social isolation

Physical

  • Non-specific gastrointestinal complaints, such as stomach pain, constipation, and acid reflux
  • Menstrual irregularities (in individuals who menstruate)
  • Dizzy spells and fainting
  • Fine hair all over the body (lanugo)
  • Dry skin and brittle hair

How to help someone with anorexia nervosa

Starting the conversation

If you haven’t approached your loved one before about your concerns they may have AN, it’s certainly not unusual to feel anxious about it.

Probably, the best time to share your concern is outside the context of a meal and away from food altogether. Try to find a quiet space where you can be alone with your loved one and let them know with compassion what you have witnessed and why it concerns you.

Try to stick to “I” statements, followed by what you have seen, such as “I notice you don’t join us for meals anymore, are you feeling okay?”. Your direct observations will show your concerns in a way that someone in denial about their eating disorder is more likely to hear. 

Additional conversation tips include:

  • Rehearse what you want to say
  • Avoid over-simplistic solutions, such as “please stop”
  • Remove the potential stigma and remind your loved one there is no shame in having anorexia nervosa
  • Be honest and talk openly about your concern
  • Don’t be discouraged if they refuse to talk about it
  • Show compassion and ask if there is anything you can do to support them

Expect resistance

It’s not easy for anyone to admit that they are suffering from anorexia nervosa or any other eating disorder for that matter. At first, your loved one may deny that there is a problem and will probably try to rationalize their eating behaviors to you.

This is actually a symptom of their eating disorder known as anosognosia, a condition where people with AN and other eating disorders can’t perceive their condition accurately, possibly due to the effects of malnutrition on the brain. (1)

While you can’t force someone to admit they have a problem, you can continue to provide support to them until they feel ready. Let them know that you’re always there to listen without any judgment, and when they are ready to ask for help, you’ll be by their side every step of the way.

Encourage them to seek professional help

Anorexia nervosa can be life-threatening. If your loved one has yet to seek professional help, encourage them to take that challenging step. 

Research the treatment options for yourself, so you can go into this discussion fully informed. Let them know that they don’t have to live with anorexia nervosa and that treatment for this eating disorder and others can be successful. The sooner your loved one seeks treatment, the better their chances for a complete recovery.

Offer to go with them to a doctor or therapist for their initial appointment and promise that whatever treatment they need, you’ll be there to support them completely.

Tell someone

It’s hard to know when, or at all if you should tell someone about your concerns. It may feel like a violation of trust to speak to another person about your loved one’s issues around food restriction and body image.

If you fear that your loved one’s health is in danger, it may be appropriate to reach out to another person they trust to discuss ways to provide them with more care and support. 

Offer support in social situations

It’s easy for a person with anorexia nervosa to become withdrawn, so it may take some extra effort to involve them in social situations to stop them from isolating themselves. Some useful tips include:

  • Keep inviting them to join in with family and group activities, even if they often say no.
  • Plan social events that don’t revolve around food or exercise. Instead consider trying out activities that are engrossing and distracting, such as board games or crafting.
  • Encourage your loved ones to return to hobbies they used to enjoy or try out some new hobbies that fit in around treatment
  • When you get together, avoid always talking about treatment or the eating disorder unless they bring it up first. Watch a movie together, start a book club, or take your dogs for a walk together.
  • Avoid any comments about their body, weight, or appearance. 
  • If you do end up in a situation around food, ask what kind of support would be helpful. They probably do not want you to micromanage their eating, but it may help them to eat a feared food together, or to have you tell a distracting story during a group meal to make them feel less self-conscious about eating around others. 

Don’t despair

Even if your talk with your loved one did not go well, or if you don’t feel you got through to them with your concerns, don’t get disheartened. You did the right thing by sharing your concerns with your loved ones, letting them know that you care about them. 

You may have also given them something to think about, planting a seed that perhaps their behaviors surrounding food and their body are not what they should be. It may take time, but the concern from friends and family may just be the wake-up call they need, helping them take the steps towards recovery. At Within Health, we will help support you through treatment for anorexia nervosa. Speak with our team today to learn more about our virtual care program.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Resources

  1. Anosognosia - StatPearls - NCBI Bookshelf. (n.d.). Retrieved June 10, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK513361/ 
  2. Warning signs and symptoms. National Eating Disorders Association. (2017, February 26). Retrieved June 10, 2022, from https://www.nationaleatingdisorders.org/learn/by-eating-disorder/anorexia/warning-signs-symptoms 
  3. How to help a loved one. National Eating Disorders Association. (2021, August 27). Retrieved June 10, 2022, from https://www.nationaleatingdisorders.org/learn/help/caregivers 
  4. Hogan, L. (n.d.). How to support someone struggling with an eating disorder. WebMD. Retrieved June 10, 2022, from https://www.webmd.com/mental-health/eating-disorders/features/how-to-support-someone-eating-disorder

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