Supporting a friend through an eating or body image disorder
Supporting a friend with an eating disorder can feel overwhelming, especially since they might not always be able to express the kind of help or support they need from you, which is often the case for those struggling with disordered eating. As a friend, it’s normal to feel unsure about how to help or what to say. It's important to recognise that it may be incredibly difficult to say the right thing or offer the right support to your friend all of the time. However, your understanding, compassion, and steady support can make a meaningful difference in their journey towards recovery. You don’t need to have all the answers, and in fact can’t have all of the answers, you are a friend, not a therapist.
The Role of Friends in Recovery from an Eating Disorder
Whilst professional treatment is almost always essential for recovery, the presence of a caring and supportive network can also make a huge difference. Just being there, offering a safe space, and listening can provide immense comfort to those going through treatment. Sometimes, simply being a consistent, reassuring presence can help your friend feel less isolated, more hopeful about recovery, and more motivated to overcome their eating difficulties.
Recovery Is Not a Straight Line
Healing from an eating disorder will have ups and downs, and is never a linear process. There will be progress, setbacks, and moments of uncertainty. It can be important to anticipate these ups and down in order to maintain hope and patience whilst supporting your friend. Knowing that recovery takes time and having realistic expectations about their recovery can also help you to manage your own feelings of frustration or helplessness which can go hand in hand with supporting a friend with an eating disorder.
Understanding Eating Disorders
Eating disorders are mental health conditions, and though the symptoms you may be aware of may be mainly behavioural, the underlying causes are a combination of psychological, emotional, genetic and environmental factors. It can be incredibly difficult to really understand eating disorders unless you have experienced one or are a professional who specialises in them, however, recognising that there are different types of eating disorders may be a helpful step in understanding what you are seeing your friend going through.
Types of Eating and Body Image Disorders
Each person’s experience is unique, but some of the most common types include:
Anorexia Nervosa: Characterised by severe food restriction, a fear of gaining weight, and a distorted body image. People with anorexia nervosa are usually underweight or losing weight.
Bulimia Nervosa: Involves cycles of binge eating followed by purging or compensation behaviours, such as vomiting or excessive exercise. People experiencing bulimia nervosa usually don’t ‘look’ unwell as they tend to maintain a healthy weight. They will almost always feel dissatisfied with their weight or appearance.
Binge Eating Disorder: Involves recurrent episodes of consuming large amounts of food, often linked to emotional distress. Again people with BED may be a healthy weight, or may have a larger body.
The three eating disorders listed above are the most well known forms of eating disorder, however there are a number of others including avoidant restrictive food intake disorder (ARFID) and other specified food intake disorder (OSFED). There are also related difficulties that are not classed as eating disorders but may share some of the same concerns or symptoms including Body Dysmorphic Disorder (BDD) or other forms of Obsessive Compulsive Disorder (OCD).
Eating disorders can affect anyone, regardless of age, gender, appearance or background. No one is immune from an eating disorder, so just because your friend doesn't fit with the stereotype of what you think an eating disorder might look like, it doesn't mean that they aren't struggling, or aren't at risk of serious medical or psychological consequences. It's also important to understand that eating disorders are not simply about food or appearance but that they stem from deeper emotional and psychological difficulties.
Recognising the Signs of an Eating or Body Image Disorder
Spotting the signs of an eating disorder early can provide a valuable opportunity to seek help sooner. Some signs you might notice if your friend is struggling with an eating disorder might include:
Physical Indicators: Noticeable weight changes including weight loss, rapid weight gain or weight cycling.
Behavioural Changes: Avoiding meals, skipping social events involving food, or following rigid eating rituals.
Emotional Clues: Increased withdrawal from both relationships and social events, heightened anxiety or low mood. Increased distress around weight or appearance.
By recognising these signs early on, you may be able to express concerns to your friend and encourage them to seek support.
How to Approach Your Friend with your Concerns
Starting a conversation about eating disorders can feel extremely daunting. Here are some suggestions to help you approach the conversation with care and sensitivity:
Finding the Right Time: Choose a quiet, private moment when both of you are calm and free from distractions.
Focusing on Their Well-Being: Rather than focusing solely on eating habits, express your concern for their overall health and emotional well-being. Let them know you’re there for them, without judgement. Ask them if there is anything that they are concerned about, or if they have noticed anything being or feeling different.
Express your concern and your desire to help: Ensure that you name your concerns and express worry in a way that doesn't feel critical or judgemental. Share that you feel worried and that you are there to help if they want you to.
Offer to help them find suitable support: If they are open to the idea of finding further support, offer to help them find suitable treatment options, or to talk to people that may be able to help them access support such as a parent, their partner or a teacher.
Respect Boundaries: While you can offer support, it’s important to respect your friend’s boundaries and allow them to take ownership of their recovery. They may not feel ready to acknowledge or admit their difficulties so don't feel put off if the conversation doesn't go as you’d hoped. Continue to offer support and let them know you are there for them if or when they need your support. This is likely to ensure that your friendship remains strong and that your friend feels they can come to you when the time is right for them.
Supporting a friend with an eating disorder is undoubtedly challenging, but your kindness, patience, and empathy can be life-changing. Eating disorders are serious conditions that impact many people, often in ways that are difficult to understand. It’s important to approach them with empathy and a genuine understanding, while also recognising that they require specialist care and expertise for effective treatment. Private clinics like The London Centre for Eating Disorders provide specialised care. To speak to a specialist clinician reach out to the London Centre here.