How to Help Someone With an Eating Disorder

Watching someone you love struggle with food is frightening, and most people are afraid of saying the wrong thing. That fear is a good sign. It means you want to get this right.

Partners, parents and friends are often the first to notice, and the first to reach out. This guide covers how to help someone with an eating disorder: what to notice, what to say, what to avoid, and how to help an adult take the next step.

Signs Someone You Love May Have an Eating Disorder

Eating disorders affect people of every age, background, body size and sex[1], so it helps to watch what someone does rather than how they look. Things you might notice:

• Skipping meals or eating alone
• A shrinking list of foods
• Bathroom trips right after eating
• Exercise that cannot be missed
• Food disappearing in secret
• Pulling away from shared meals

Not every eating disorder is about weight. Some adults restrict because of texture or fear of choking, which is ARFID, the most common diagnosis among the women in our program right now. Others binge in secret. And close to half of the people in our eating disorder program are men, whose signs are often mistaken for discipline; our guide to eating disorders in men covers what to look for.

How to Help Someone With an Eating Disorder: Before You Talk

Pick a private moment when neither of you is rushed, and start gently[2]. Not at a meal, not in front of others, and not in the middle of an argument. It can help to write down two or three specific things you have noticed, so the conversation stays on what you have seen rather than on labels.

Eating disorders are not a choice[1]. Going in with that in mind changes your tone. You are not there to catch them out; you are there because you are worried about someone you love.

What to Say to Someone With an Eating Disorder

Start with "I" statements about specific behaviors you have seen, say plainly that you care, and make it clear you are not criticizing or judging[2]. Then offer one small next step, such as making a call together.

What Should You Not Say to Someone With an Eating Disorder?

Avoid comments about their weight, body or appearance, even compliments, and avoid commenting on what or how much they eat. Skip ultimatums, blame and labels. Each of these tends to feed the shame that keeps the disorder hidden.[4]

Focus on behavior and on how they seem to be feeling, not on food or on naming a diagnosis[2]. That is the same principle our team uses at the table in treatment: meals in our villa are supported by staff who understand the anxiety eating can trigger, and nobody is punished for struggling.

What If They Say Nothing Is Wrong?

Expect it. Shame and guilt make it very hard to ask for help, and many people deny the problem when someone first raises it. A denial is not the end of the conversation; it is usually the start of several.

Stay calm, say you love them, and let them know you will bring it up again. Keep showing up to the parts of life that are not about food. If you are worried about their safety, act on it rather than waiting for them to agree.

At home, try not to turn meals into a battleground. Monitoring every bite or arguing over portions usually pushes the behavior further out of sight. Eat together when you can, keep conversation at the table about anything other than food, and save the harder conversations for calmer moments. In treatment, our dietitian and specialty eating disorder techs carry the meal plan, which frees family to just be family.

How to Help Someone With an Eating Disorder Get Treatment

Early treatment matters for a full recovery[3]. For an adult, you cannot make the decision for them, but you can make it much easier to say yes. You can call us before they are ready, ask what treatment would look like, and check their insurance on their behalf.

When you call, our admissions team will ask what you have been seeing, verify insurance, and explain how a clinical assessment works; that assessment, not the phone call, decides the right level of care. Virtue works with commercial plans that include mental health benefits, including out-of-network plans. If someone needs medical weight restoration or tube feeding first, that happens in a hospital, and residential care with us is the step after it. Admissions can talk with you and their doctors about timing.

Virtue treats adults 18 and older in a dedicated residential eating disorder program on our Corbett campus in Las Vegas. The villa has private rooms and its own program space. Specialty eating disorder techs and a chef prepare each meal to the person's plan, our dietitian, Laura De Fiesta, MS, RD, LD, leads nutrition care, and any co-occurring substance use or mental health condition is treated in the same plan. Family therapy is part of the program, so you are not left on the outside of it.

If your loved one is a veteran, their VA team can refer them through VA Community Care; our page on treatment for veterans explains how. If you are a parent of a teenager, our program is for adults, but admissions can talk through what you are seeing and help point your family toward care built for their age.

Look After Yourself, Too

Supporting someone through an eating disorder is exhausting, and you cannot pour from an empty cup. Lean on people you trust, keep some parts of your life that have nothing to do with their illness, and consider support of your own. When someone enters treatment with us, family sessions give you a place to ask questions and learn how to help at home after discharge.

Sources

1. [1] National Institute of Mental Health. Eating Disorders: What You Need to Know. National Institutes of Health.
2. [2] Cedars-Sinai. (2019, February 24). How to Talk to a Loved One About an Eating Disorder.
3. [3] National Institute of Mental Health. Eating Disorders. National Institutes of Health.
4. [4] NHS. Eating disorders: advice for parents.

Written by

Dani Jo Turnbo, RN

Director of Nursing

Dani Jo Turnbo is a Registered Nurse and Director of Nursing at Virtue Recovery Center Killeen, a behavioral health and addiction recovery leader passionate about clinical excellence and changing lives. In her role, she leads the nursing team in delivering safe, attentive medical care for clients throughout treatment, helping ensure that each person receives compassionate, whole-person support at every stage of recovery.

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Clinically reviewed by Laura De Fiesta, MS, RD, LD, Director of Nutrition and Culinary Services