The term ‘eating disorder’ refers to a complex, potentially life-threatening condition, characterised by severe disturbances in eating behaviours.If you are thinking of approaching a person about an eating disorder, the most important step you can take to support that person is to accept them as they are now.

It is important to show your willingness to be there for them and to listen without judgement.

Try to show the person that you are not trying to ‘fix’ them or make them stop what they are doing right now.

Show them you understand that whatever they are doing helps them feel safe, and that they may be frightened to acknowledge that there is a problem.

It can seem very difficult to start that first conversation about such a sensitive issue.

You should remember that by asking someone how they are feeling, you are showing them that they have a support network around them – your concern will not make anything bad happen.

The first step towards recovery is being able to acknowledge that there’s a problem, so by approaching someone you are giving them the opportunity to take that first step.

Before you approach someone

• Do inform yourself about eating disorders, with a view to increasing your capacity for empathy
• Do have some information about resources and support services available to the person
• Do seek support for yourself before approaching someone if you are feeling very apprehensive about it. Approaching someone from a position of fear or anxiety is unlikely to be constructive and will only add to their distress.

Starting a conversation

• Do try to approach the person at a time and place that is free from pressure (e.g. time constraints, or possible interruptions).
• Do gently let the person know you are concerned about them
• Do let the person know that you care for them and value them for who they are
• Do tell the person why you are concerned and describe specifically what you have observed that has caused that concern.

Language you use

• Don’t talk abstractly or in generalities; this is more likely to lead to a denial of behaviours. It is more difficult to deny specifics.
• Don’t focus on specifics any longer than you need – move the focus from specifics to ask how the person is feeling or whether there is something going on for them they would like to talk about.
• Do avoid judging, blaming or criticising.
• Do be open and honest about your feelings

Essential points to remember

• Do communicate an understanding that food, weight and body image issues are only part of the picture – show that you understand that there is something else troubling the person.
• Do focus more on how the person is feeling rather than what they are doing.
• Do try to separate the person you know from the eating disorder that is telling them what to do.
• Do communicate an appreciation of the energy it takes to struggle with an eating disorder. Understand that they may be battling with themselves.
• Do communicate a belief that recovery is possible, and a belief in their ability to recover.
• Do remain mindful that the experience of living with and recovering from an eating disorder is different for every individual.

How to hear what they are saying

• Do encourage them to speak as openly as possible without interrupting
• Do ask the person what it feels like to be in their shoes.
• Do accept all their feelings as real and valid
• Do ask them what they would like to happen.

Stumbling blocks

• Don’t be discouraged if your approach is met by resistance and/or rejection. It may take some time before the person feels ready to be more open to your approach.
• Don’t take it personally if they dismiss your concern or dismiss the idea that you value them as they are.
• Don’t be surprised if they deny there is a problem.

Moving forward

• Do try to negotiate a way forward together
• Do ask the person what they need from you to help reduce the stresses they are experiencing. If they find it hard to identify their needs, suggest to them what you feel might be helpful, but be sure to check with them whether they feel what you are suggesting will make things easier or harder for them.
• Do be honest with them about your own limits
• Don’t put pressure on the person to make immediate changes to their behaviour. The idea of sudden change can be very difficult. It is important for you to understand the eating disorder as a coping mechanism, and allow time for gradual change.
• Do let the person know that you are there for them to discuss the issue(s) further if they want to do that. Hopefully this will not be a once-off conversation.

To support someone else, you need to support yourself too, so remember:

• Don’t put the needs of the person you are trying to support above your own needs. Looking after your own needs first not only models healthy behaviour but will put you in a stronger position to be able to support them.
• Respect confidentiality, but do not put yourself in the position of colluding to deny or cover up behaviours by allowing yourself to be drawn into making promises to keep secrets. Where appropriate, encourage the person to talk to others who may be in a position to help them and signpost them to appropriate services.

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