Living with an Eating Disorder (ED) is a great challenge for the people who suffer from it, as well as for their close environment. With this article, we aim to make the real experience of living with an ED visible, both for the affected person and for their loved ones.
In EDs, there is an excessive concern about body shape or weight and its control, which manifests in behaviors that are harmful to health; either due to excessive control (strict diet and restriction, as is the case with Anorexia Nervosa), or due to behaviors of loss of control (the presence of binge eating and compensatory behaviors, as is the case with Bulimia Nervosa). Understanding the complexity of these experiences is the first step to offering respectful and effective help.
From our psychological therapy clinic in Valencia, also with an online modality, we provide you with this guide to better understand people with an ED and foster empathy towards them. We also present various guidelines and recommendations for the environment of affected people, with the aim of knowing what is counterproductive and how to offer support with empathy, affection, and compassion.
Living with an ED day by day: what is not seen
The Silent Impact on Daily Routine
The presence of an ED can go unnoticed and be hidden behind an apparent normality. However, routine situations such as mealtime, looking in a mirror, or moments of social interaction can represent a great internal battle for affected people. Fighting these battles consumes an enormous amount of physical and mental energy, which can affect academic or work performance, social life, or hobbies.
Control, Guilt, and Recurrent Thoughts
Those who suffer from an ED may have recurrent obsessive thoughts about the body, food, weight, and its control. These negative thoughts generate unpleasant emotions (for example, guilt for eating too much or too little) and unhealthy behaviors (for example, compensating for a binge with extreme exercise). This dynamic strengthens the bad relationship with food and the body, affecting mood and self-esteem.
The Conflictive Relationship with Food and the Body
When unpleasant emotions (guilt, shame, anxiety, fear…) are linked to food, it ceases to be a source of pleasure or well-being. The same thing happens with body image. Food and the body become the enemy and an object of fear or obsession, generating stress and constant dissatisfaction.
Living with EDs and their Emotional Impact
Persistent Anxiety, Fear, and Guilt
Anxiety before meals, fear of gaining weight or losing control, and guilt for what has or has not been ingested, represent a great emotional and psychological burden that can become exhausting. A state of constant alert and worry is generated that threatens well-being.
Feelings of Shame and Low Self-esteem
Living with an ED can involve feeling ashamed of the relationship with food and the body, as well as a marked pattern of negative thinking and self-criticism that directly affects the person’s self-esteem. The distorted perception of one’s own body image deeply undermines the confidence and self-esteem of the affected person.
Isolation as a Form of Protection
Faced with feelings of incomprehension or judgment, many people with an ED tend to avoid situations where they eat in front of other people or their body is exposed. In this way, they feel protected from judgments or questioning, thus avoiding feelings of shame, guilt, or vulnerability. Despite seeming like a form of protection, isolation can aggravate the emotional burden and make it difficult to seek help.
Tips for living with an ED in the family or with a partner
How Family Dynamics Change
When an ED is detected in a loved one, the family’s or partner’s reaction is usually one of marked concern. The environment is also affected by the problem, as routines and communication in the home can be significantly altered. Mealtimes can generate arguments and moments of high tension, as can conversations about weight, exercise, or the body. All members need to adapt to a new reality and redefine roles, which is often accompanied by stress and marked uncertainty.
Difficulties Talking About the Subject Without Hurting
Addressing an ED can be extremely delicate, and it is common to experience doubts about how to offer help. It is important to learn about the topic and try to understand the person, avoiding judgments, criticism, or constant comments about their appearance and food. The key is to communicate concern empathetically from a place of love and support, rather than focusing on the eating behavior.
“I’m worried about you” is more effective than “You haven’t eaten anything” or “You have to eat less.”
The Role of Empathetic Accompaniment
One consideration to keep in mind is that, despite being framed under a common label, EDs are an individual experience. Therefore, the first approach we should take when we want to offer our help should be to ask the person who is suffering directly: “How can I help you?” or “Is there something I can do or stop doing that would be helpful?”
Taking into account the individuality of the case, we can keep the following premises in mind to provide empathetic support; without blaming, criticizing, or minimizing the emotions of the affected loved one.
- Foster an environment of unconditional support and understanding: The person with an ED should feel free to express their fears and difficulties without fear of criticism or being judged; the support should aim to build a safe space.
- Practice active listening: sometimes we just have to listen and validate the emotion being conveyed. Without needing to give advice, solutions, or opinions.
- Learn about the problem: understanding the complexity and characteristics of an ED can allow us to show more empathy and understanding towards the affected person, as well as promote a healthier and more supportive environment.
- Be patient and understanding: relapses or difficult moments can be very frustrating for the person and their environment, but they are part of the process. Recovery from an ED is not linear and requires great effort and patience.
- Celebrate the progress and achievements of the process: “I’m so glad you dared to go to the pool with your friends, I know how difficult that is for you, you are very brave.”
- Offer help in situations that may be challenging: if the situation allows and the person accepts the help, you can accompany them in tasks such as shopping, cooking, or being present during meals.
Important note: It is crucial to differentiate support from excessive control. If hypervigilance and control are excessive, the feeling of lack of control can increase for the affected person. Empathetic support aims to empower the person and foster their autonomy.
How to Take Care of the Environment When Living with an ED
- Do not make comments about physical appearance, positive or negative: by avoiding these comments, we move away from the overvaluation of image and body, whose role is central in an ED. In this way, we normalize non-normative physical traits without them being accompanied by criticism or pejorative comments.
- Give compliments that have nothing to do with physical appearance: the body or physical appearance is probably what we value the least in our loved one compared to many other qualities. It is important that we foster other types of compliments, thus helping the body not to be the only important thing. “You’re so funny,” “You did that task so well,” “You are very capable,” “Your eyes light up when you watch your favorite movie,” “What you’re telling me is so interesting, I had never thought about it,” “You are so good at taking care of your friendships,” “You are so affectionate.”
- Avoid having a scale in the home or in plain sight: weight control is often contraindicated as it often aggravates or maintains the problem. If weight monitoring and control are necessary, it is convenient that health professionals carry it out.
- Do not take on the role of therapist: the role of therapist should be filled by a mental health professional and should not be adopted by other people. Maintaining the role we already have is fundamental: mother, father, brother/sister, friend, partner… The role that existed before the problem is also very valuable and necessary.
- Distance ourselves from the identity associated with the ED: although the disorder plays a very important role in the life of the affected person and their environment, there are other topics and concerns that are also important to the person: hobbies, studies, friendships, interests… If interactions with our affected loved one revolve around the ED and food, we run the risk of them isolating themselves as a defense mechanism. “How are you doing with your final project, has your tutor answered your questions?” “Did you like the new movie you went to see? The reviews are very good.”
- Specific guidelines during meals: during mealtimes, you can try to generate pleasant emotions by introducing everyday topics other than food. You should avoid aggressively pressuring or hyper-vigilating the behavior of our loved one.
- In restriction problems: organize flexible meals, resume plans and activities around food, allow eating without restriction, offer variety without pressuring or forcing.
- In binge-eating problems: organize meals avoiding skipping any of them, encourage awareness of hunger and satiety signals, avoid compensatory behaviors if there is a binge, do not judge or blame after a binge, eat slowly and mindfully.
- Take care of the caregiver: accompanying an ED means dealing with complicated situations with a great emotional burden. It is important that we take care of ourselves and attend to our needs to be able to take care of others afterward.
- Encourage seeking professional help and transmit hope: we can emphasize the need to seek specialized professional help in Eating Disorders. Searching among the different clinics and professionals specializing in EDs can increase motivation for therapeutic intervention. Recovery from an ED is possible with the right professional help.
Is it necessary to seek psychological help for living with an ED?
Living with an ED is complex and, in most cases, it does require professional intervention for recovery. Psychological help allows for addressing the eating symptoms of the ED, as well as the associated cognitions, emotions, behaviors, and underlying psychological causes. It is also a very effective tool for the environment, providing tools and strategies to strengthen the support system and resolve any doubts.
Recovery is possible, and psychological support is essential to walk the path.
“Take the first step towards recovery. Contact us today and get the professional support you need.”
Frequently Asked Questions about Living with an Eating Disorder
Is it possible to lead a “normal” life while living with an ED?
The process of recovery from an ED can be integrated into a normal lifestyle. The implications of “normal” can vary for each person, and it is likely that, especially at the beginning, some limitations will be set. This is part of the intervention and the process, with a view to re-establishing total autonomy and significantly improving the quality of life as recovery progresses.
How do I know if someone close to me needs urgent help?
We can identify some warning signs that indicate the need to seek urgent professional help: rapid and significant weight loss, a Body Mass Index (BMI) of less than 17, signs of malnutrition (fainting, extreme weakness, or hypothermia), mineral salt imbalances (hydroelectrolytic disorders), harmful compensatory behaviors (frequent self-induced vomiting, use of laxatives and diuretics), self-harm or suicide attempts, and ideation of wanting to end their life.
What to say (and what not to say) to someone living with an ED?
- What to say
- “I care about you and I’m here for whatever you need,” “You’re not alone in this,” “How are you?”, “Is there anything I can do to make you feel better?”, “This must be very hard for you,” “I’m sorry if you’ve felt pressured,” “We can look for help together.”
- What not to say
- “You’re too thin/fat,” “You have to eat more/less,” “It’s not that big of a deal,” “You lack willpower,” “The problem is in your head, you’re not fat,” “Are you really only going to eat that?”, “Are you going to eat all that?”, “You’re crazy.”
- The 5-second rule
- Do not make a comment about someone’s physical appearance that cannot be changed in 5 seconds.
- “You got a little sauce on your face” is something that can be changed in a few seconds.
- “You’ve gained a few pounds, we’ve gotten a little too relaxed on vacation, haven’t we?” The person receiving the comment cannot change their weight gain in seconds (and perhaps, they don’t want or need to).
- Do not force or pressure a conversation about the problem
- The affected person may not always be willing to address the topic; we must adapt to their timing, leaving the door open for future conversations.
- “I’m sorry, I understand you don’t feel like talking about it now. When you feel ready, we can talk about it, I’ll be here.”
- Validate emotions instead of providing solutions or making a judgment
- For example: in a situation where the affected person tearfully says their pants from last year don’t fit them well.
- “Of course they fit you, you look exactly the same as last year, the problem is in your head, you weigh the same.”
- “Honey, I’m so sorry you feel that way, would you like a hug?”
CONCLUSION
We want to convey a message of deep empathy: we understand the vulnerability, shame, fear, and guilt you may experience. We know that behind every behavior is a person, a story, a difficult emotion, or a broken heart. For those who accompany them, we recognize the worry, fear, uncertainty, and frustration.
You are not alone. Recovery is possible, and although the process requires great effort, the goal is to reconnect with yourself, with your worth, with the love you deserve. Building a healthy relationship with food and the body is the path, moving away from obsession little by little.
Professional support and seeking help are fundamental. We encourage you to take the step. Seek specialized help and trust in the process and the professionals. But, above all, trust in yourself and your potential for improvement. Self-love is a very valuable goal, and we are here to accompany you every step of the way.
