Misconceptions about eating disorders and how they affect how we speak about them
There are many misconceptions about eating disorders. A common one is that an eating disorder is a choice. The fact is, eating disorders are not about willpower, and people don’t choose to have them.
And, while you may not overtly think that, sometimes this long-held belief can seep into the way we talk to one another, particularly when we recommend that someone simply stop doing something. For example, “Can’t you just stop using laxatives?” Or if we suggest they try a different behavior or attitude. Such as, “Why don’t you try self-love?”)
Another myth about eating disorders is that they are a way for the person to get attention. This myth is particularly stigmatizing and harmful, as it can minimize the severity of an eating disorder and induce profound shame in the person who has one. And this misconception may inadvertently find its way into our language as well, so it’s important to debunk these myths and change how you think about eating disorders.
Eating disorders are complex mental illnesses with many biological, psychological, and sociocultural risk factors. These risk factors and influences interact with one another in intricate ways to ultimately cause someone to develop an eating disorder. There is no one known cause, although trauma and adverse childhood experiences (ACEs) are commonly seen in those with eating disorders.
Society also plays a vital role in eating disorder development, as we are constantly inundated with harmful messaging from the media, the healthcare profession, family, friends, and more. Our cultural beliefs, mindsets, practices, and traditions relating to health and wellness also feed into eating disorders, particularly our fixation on fitness, food, weight, and “good” health.
Things to avoid saying when talking to someone with an eating disorder
Sometimes the most well-meaning person can still say the wrong thing that sends a loved one into a downward spiral. When supporting someone with an eating disorder, here are some things you’ll want to avoid saying to them:
1. “I think you look fine”
Eating disorders are not about appearance, and comments about a person’s body can be triggering and cause great distress. Also, recovery is more about how the person is feeling, not about how they look.
2. “You look great—did you gain/lose weight?”
This goes along with the previous comment. A person in eating disorder recovery is trying to heal their relationship with their body, food, and exercise, and focusing on their appearance hinders that progress and can cause feelings of discomfort.
3. “You aren’t underweight.”
People of all sizes and weights can have eating disorders. Making a comment like this can invalidate and shame a person and further entrench disordered eating behaviors.
4. “You don’t look anorexic.”
A person cannot “look anorexic,” and suggesting they can implies only malnourished or thin people can have anorexia, which is untrue. Atypical anorexia nervosa (AAN) occurs in many different body shapes and sizes. In addition, it isn’t great to use the word “anorexic” as person-first language is preferred. People in higher weight bodies can have anorexia, and this attitude can lead to not diagnosing the eating disorder at all.
5. “You look healthy.”
As helpful as this may seem, eating disorders and recovery can change how someone interprets a word. Because someone with an eating disorder may need to gain weight as a part of their treatment plan, telling them they look healthy could cause them to associate healthy with “fat” or weight gain. Plus, you can’t tell if a person is “healthy” or not just by looking at them.
6. “You just need to eat more.”
Although you may be frustrated or upset because your loved one won’t eat, suggesting they eat is counterintuitive and triggering for them. It can also be interpreted as blaming. Eating disorder recovery is not as simple as making the decision to eat—if it were, people wouldn’t require professional treatment.
7. “You just need to eat less.”
Just as restricting is not in a person’s control, overeating, or binge eating, is also not a choice and is not something someone can simply decide to stop doing.
8. “Try cutting down on (food or food category).”
People with binge eating disorder already struggle with severe shame and isolation. Telling someone with binge eating disorder to cut down on a food or food category, like bread, sweets, carbohydrates, or sugar, can add to the shame they feel. It also communicates to them that you think they should lose weight, which is stigmatizing and hurtful and leads to binging
9. “You should try (diet or trend).”
People with eating disorders engage in disordered and abnormal eating behaviors, such as restricting calories, overexercising, using laxatives and diuretics, cutting out entire food groups, mirror checking, and frequent dieting. You should never encourage a person with an eating disorder to try a diet, as it encourages their disordered eating.
10. “Why don’t you stop throwing up (or using laxatives or diuretics)?”
If a person with an eating disorder self-induced vomiting, they likely want to stop but are unable to. Pressuring them to stop compounds the shame they already feel, which is a trigger for continued disordered eating and compensatory behaviors.
11. “Try exercising more.”
Someone with an eating disorder has a fraught relationship with their body and movement, and telling them to exercise more can not only be seen as blaming but also make the person feel worse about themselves and engage in more harmful behaviors.
12. “Do I look fat?”
Engaging in negative self-talk can trigger your loved one with an eating disorder. They are likely hyper aware of the behavior and attitudes of those around them, including what they’re eating and how they feel and talk about their bodies. Criticizing your body can make them even more focused on weight. Overall, it’s a good practice to eliminate negative body talk from your vocabulary and try to engage in body positivity or body neutrality.
Three helpful things to say when supporting a loved one
Now that you’ve learned what to avoid when speaking to someone with an eating disorder. Here are some helpful things you can say:
“This must be so hard. How can I best support you?”
This communicates to your loved one that you empathize with their struggle and that you are open to providing them with whatever type of support they need, whether that’s going to the grocery store with them, attending family therapy together, letting them vent, or agreeing to practice meditation with them.
“I’m sorry you’re hurting. I’m here for you.”
Sometimes all a person needs to hear is that you are there for them and that you aren’t going anywhere. You aren’t expected to have all the answers or to be able to fix their eating disorder. Simply acknowledging that someone is in pain can help them feel validated and understood.
“I love you. Please let me know how I can help you.”
Sometimes we may get so caught up in trying to help our friend or family member we forget to say the most important words of all. We can show our love in many different ways, and saying it is just one way.
Change your perspective and approach
One way to help you refrain from saying triggering things is to change how you think and talk about eating disorders, food, movement, and weight. An essential part of changing your perspective is to take the focus off appearance and shift it to your loved one’s feelings. Make sure you validate them and let them know that you care about them. Avoid giving advice unless they explicitly ask for it.
Whenever you are stuck, remember to lead with compassion, empathy, and a nonjudgmental attitude. If you want to express yourself or your feelings, avoid blaming statements by beginning sentences with “I feel.”
The most important thing you can do is show your loved one how much they mean to you and how much you believe in them. Recovery from an eating disorder can be a long, hard process. But knowing there’s help and support makes the journey a little bit easier.
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