If a friend or loved one has been diagnosed with anorexia, bulimia, orthorexia or a binge eating disorder, they may not “look” as if they’re struggling with an eating disorder. Sometimes, this can make it difficult to avoid triggering words and phrases, since it seems like this person isn’t “that sick.” But in the mental health world, it’s important to remember that appearances are deceiving—and keeping that in mind, it’s also important to know what not to say to someone with an eating disorder. “Large-bodied people can have eating disorders as well, even anorexia,” says psychotherapist Haley Neidich, LCSW. “Don’t assume based on someone’s size or appearance that they have a healthy or unhealthy relationship with food or their bodies.” According to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), 28.8 million Americans will have an eating disorder in their lifetime. This means that someday you could know, or are already connected with, someone with an eating disorder. There are four main types of eating disorders: Anorexia Nervosa (restriction of food intake), Bulimia Nervosa (eating large quantities of food in short periods of time and then purging), Binge Eating Disorder (eating a large amount of food in a short period of time and having a lack of control during those episodes, without purging), and Avoidant/Restrictive Feeding and Intake Disorder (restriction of food intake). When diagnosing an eating disorder, professionals particularly pay attention to weight, eating habits, exercise habits, obsession/talking about food, low mood, high anxiety, perfectionism, and people-pleasing. First of all, if you suspect that a close friend or loved one is dealing with an eating disorder, it’s important to encourage proper medical care and, if necessary, therapy as well. And it’s key to be mindful of what you’re saying. “More than any other mental health disorder, individuals with eating disorders are easily triggered by language used in social interactions,” Neidich says. “Many people with disordered eating also suffer from some social anxiety due to fear of what people might say to them which can lead to social isolation and, in turn, worsen their mental health outcomes and increase vulnerability to depression.” Like any mental health condition, your friend or family member may have an eating disorder, and you might not know it. This is why it can be helpful to choose your words carefully in general, especially when it comes to commenting on appearance. “Regardless of whether someone has an eating disorder, we need to stop commenting on each other’s bodies and appearance,” Neidich says. “Yes, this means even a compliment. You never know if what you’re complimenting is actually an illness.” Landry Weatherston-Yarborough, LPC, CEDS-S, NCC, Clinical Director of the Eating Recovery Center, agrees with this line of thinking, and says, “I actually think that it’s important to choose our words carefully in every conversation, not just when we know that someone has an eating disorder. In many cases, you may not know when someone is struggling with an eating disorder.” Whether you’re knowingly speaking to someone with an eating disorder or not, it can be beneficial and compassionate to avoid the following phrases.
What not to say to someone with an eating disorder
“That is a good/bad, healthy/unhealthy food.”
Weatherston-Yarborough says, “Polarized views about food are very harmful for people who have eating disorders, because they tend to have black-and-white thinking patterns already.”
“Just start eating!”
It’s not quite this simple for someone who has an eating disorder. As Neidich points out, eating disorders are actually very rarely about food. “They’re about control,” she says. “If it were as easy as ‘just start eating’ to recover, people wouldn’t be dying every day from these disorders.”
“You can’t possibly have an eating disorder because you aren’t underweight.”
Weatherston-Yarborough shares that 94% of people who have eating disorders are not classified as underweight. “The stereotype that all people who have eating disorders are underweight is inaccurate and harmful because it keeps those who look different from having their eating disorder taken seriously,” she says.
“Males/people of color/heterosexual people don’t get eating disorders.”
“Eating disorders do not discriminate,” Weatherston-Yarborough says. They can impact all genders, ethnicities, and levels of socioeconomic status. She states, “Whereas it used to be believed that eating disorders only impacted women, there are many men that are diagnosed and treated for eating disorders—about one in four. Eating disorders often go unrecognized because of these stereotypes.”
“Purging is like flushing money down the toilet.”
This is a very upsetting thing to say to someone with bulimia or binge eating disorder, since, as Neidich says, there is a compulsive component to their behavior that can also lead to financial issues when they’re spending large quantities of money on food. “This behavior is often hidden, and when loved ones find out, they often react poorly,” Neidich observes.
“You don’t look like you have an eating disorder.”
“To someone with any type of eating disorder, this is by far one of the most damaging things you can say,” Neidich says. “Particularly for people with anorexia—saying they look fine can actually worsen their illness. Saying someone doesn’t look like they have an eating disorder is invalidating the deep pain they’re in.”
“You should know better than to [engage in that behavior].”
Judgmental words will not help someone with an eating disorder. Weatherston-Yarborough says that in most cases, eating disorders aren’t about a lack of information. The person is often very aware that the behaviors they’re engaging in are harmful. However, eating disorder behaviors function as emotional coping skills, which can feel very helpful or important to the person at the same time, as she puts it.
“You should eat more/less of that.”
Remind yourself that you are not your loved one’s doctor or nutritionist. Instead, “allow the person to follow the nutritional recommendations of their treatment team,” Weatherston-Yarborough advises.
“Just stop throwing up.”
This might be an easy concept to you, but to someone with an eating disorder, you may as well ask them to climb Mount Everest. “Purging is one of the hardest symptoms to stop for individuals with bulimia,” Neidich says. “The notion of stopping their purge behavior is incredibly frightening and suggesting it is not at all helpful in their recovery process.”
“You just want attention.”
No, people with eating disorders, or any mental health disorders, don’t want attention. In actuality, they are likely feeling quite a bit of shame. As Weatherston-Yarborough says, “Most people do not want others to know that they are struggling. Blaming the person for having an eating disorder is unhelpful and inaccurate.”
“You look scary skinny/you look like you’ve put on some weight.”
Neidich says that commenting on anyone’s appearance is no longer considered socially acceptable and “people need to stop doing it.” She says, “For those with disordered eating, any comment that draws attention to the fact that you’re staring at or judging their bodies is going to alienate them from you.”
“You can get better if you try harder.”
This seems to be a common phrase that people hear whenever they’re dealing with any mental health challenge, and this includes eating disorders. Neidich puts it this way: “Would we tell someone with diabetes, cancer, or an autoimmune condition to just try harder or think positively? No! An eating disorder is an illness, not a problem with willpower. Eating disorders require therapy, nutritional and psychiatric care, social support, and lots of time.”
“Can you give me some diet tips?”
“Questions like this communicate a lack of understanding of the serious and life-threatening nature of eating disorders,” Weatherston-Yarborough says.
“Please stop doing this to yourself! Can’t you see how it’s hurting me?”
Although it’s hard, you need to avoid making the conversation about yourself when speaking to a loved one with an eating disorder. “This is another phrase that will alienate the sick person from someone they love,” Neidich says. “By believing they are hurting you, not only will they not get better, but they will likely stop talking to you about their illness and increase their efforts to keep it secret.”
“I hate my [body part].”
Weatherston-Yarborough says, “Negative comments about your own body set an example that judging your body is the norm, even for people without eating disorders.”
“Did you see how much weight [so-and-so] has gained?” or “Wow, [so-and-so] looks really great since losing weight!”
Again, commenting on people’s appearance, in general, isn’t helpful to anyone, whether they’re suffering from an eating disorder or not. “Commenting on others’ bodies, even when it seems like a compliment, reinforces the diet culture standard that bodies are supposed to be judged by others as good or bad,” Weatherston-Yarborough says. “Our society’s unrealistic body standards influence the development of eating disorders for many people.”
“Just focus on being healthy.”
To a person with an eating disorder, “healthy” may mean something completely different than how you view it. Neidich says that a focus on health is usually what gets people into disordered eating to begin with.“Diet and ‘wellness culture’ are two of the biggest culprits when it comes to eating disorders in general,” she says. “Orthorexia is acknowledged by most eating disorder therapists as being a distinct diagnosis which overly focuses on only eating clean, ‘healthy’ food. This disorder often leads to the development of other eating disorders.”
“If you’re unhappy with your weight, just diet and lose it.”
“People with binge eating disorder or those with eating disorders in larger bodies will frequently hear diet-culture language like this,” Neidich says. “The reality is that diets do not work long-term for over 95% of individuals who lose weight and can contribute to the worsening or development of disordered eating. Telling someone with disordered eating that losing weight will cure their obsession with food and/or their bodies is not helpful at all and furthers the false notion that weight loss will fix the pain they’re in.”
“You are going to have an eating disorder forever.”
This is simply not true. Like any mental health disorder, through hard work, a compassionate support team of experts, family, and friends, and therapy, it’s possible to experience healing. “Full recovery from an eating disorder is possible,” Weatherston-Yarborough says. Next up, read about Taylor Swift’s struggles with an eating disorder. Sources
Haley Neidich, LCSW, a psychotherapist in Tampa Bay, Florida.Landry Weatherston-Yarborough, LPC, CEDS-S, NCC, Clinical Director of the Eating Recovery Center in Denver, Colorado.National Association of Anorexia Nervosa and Associated Disorders (ANAD): “Eating Disorder Statistics”
