Helping Those with Eating Disorders

| McKenzie Hoopfer, LCSWA

Intense levels of anxiety often feel like a giant pit in the stomach and a loss of appetite. 

Now, imagine gripping your stomach in pain as it roils with nausea and three people enter the room. The first person plops down a plate full of food in front of you and says, “Eat every last bite.” The second person kneels beside you and whispers in your ear all your greatest insecurities: ‘You’re going to get so fat’ … ‘Everybody will stare at you.’ The third person — your parent or significant other — enters the room and starts getting frustrated with you. “Just eat the food,” they say. “It isn’t that hard!” You start to cry because you are not living up to their expectations and disappointing the people you love most in this world.

This is the common mealtime experience for someone recovering from an eating disorder. 

So, What is Meal Support?

Due to the complex nature of eating disorders, support is often needed both during and outside of mealtimes. While your loved one is engaging in hard work through psychotherapy and nutrition therapy, one of the best ways you can show up and support them is during mealtime. Some of the hardest and most important work in eating disorder recovery is done at the table.

Because your loved one may be entering the meal with higher levels of anxiety and negative thoughts, being there to support them can help provide a distraction, accountability, and rational thoughts. But meal support does not end when the meal is done! Post-meal support is also vital, as feelings of regret, shame, and strong compensation urges rise to the surface after your loved one just “disobeyed” his or her eating disorder during the meal. 

The Dos & Don’ts 

Talking with your loved one before offering this support is essential to overcome eating disorders. Eating disorder thoughts can be triggered in different ways for each individual. Before engaging in meal support, be sure to have an open conversation about what type of support works best for them.

The general rule of thumb is to avoid any talk of numbers like weight or calories. Avoid words such as “healthy,” “unhealthy,” “good,” or “bad.” The food on the table does not need labels – it is just there to nourish our bodies! It can also be overwhelming to comment on how good the food tastes, looks, or smells. In addition, statements such as “Just eat it,” arguing, negotiating, and yelling often result in more distress and less compliance during meals. 

What often tends to be the most helpful for overcoming eating disorders is staying grounded in what we call the “Four C’s.”

1. Calm

2. Confident

3. Consistent

4. Compassionate 

Your loved one likely already has a meal plan outlined by their dietician. You can remain confident in knowing this was curated by a professional, with eating disorder experience, for your loved one’s nutritional needs. Your role is to remain consistent with those expectations. Mealtimes are not a time to negotiate or make bargains. Ultimately, remember your loved one is truly doing their best. You can offer empathy and understand that they probably do not feel hungry. Offer compassionate validation that this really is a hard task, and you are there to support them. 

Distractions can also be helpful during mealtimes. A great way to offer distractions is to have a few go-to conversations and games. Great table games include 20 Questions, the alphabet game, and I Spy. Casual conversations and talking about fun plans can also help distract from urges and negative thoughts people with eating disorders often face. 

If you feel like you are struggling with supporting your loved one through meals, consider asking to join their therapy session to have a safe space where they can vocalize what is helpful for them at the table and receive additional psychoeducation from a treatment provider. 

For more information and support on eating disorder recovery, see:

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