9 Healthy Ways to Support a Friend in Recovery From an Eating Disorder

While I’ve had moderately mild issues with eating and self-image, I know that my challenges are nothing compared to that of someone who has or is living with an eating disorder. According to the Diagnostic and Statistical Manual of The American Psychiatric Association, they exist in eight different categories and under each of those lies a list of obviously disheartening symptoms, some of which overlap with one another.

And from what I’ve read (via the testimonies of eating disorder survivors), the recovery process to eliminate them and face the disease head-on isn’t any easier. As a bystander, I’ve never really known my role in the recovery process. For one, I’m not especially close with someone who has been diagnosed with an eating disorder, but if the statistics are any indication, I know that I’m likely in close proximity to someone–friend, family member or otherwise–who may be battling one in private.

So, being that I’m one of those “stay ready so you don’t have to get ready” type of women, I decided to reach out for advice on exactly how I can support a friend in recovery without sounding like a therapist or causing harmful triggers. Ahead, psychotherapist, parenting consultant, educational speaker and published author, Emily Roberts (also known as The Guidance Girl), shares 9 key ways to do it.

MORE: The Problem with Before-and-After Transformation Photos in Eating Disorder Recovery

Stand Firm in Your Role

Your role as friend remains the same. If you want to be a part of their support system, treat them as you always have by being frank, upfront and asking what they need from you. That’s all you can do.

“If you have a friend that is struggling from an eating disorder, it’s important to remember you want to be their friend and you can’t be the expert–they don’t want that from you, so doing too much to prepare may backfire–they may feel like everyone is on top of them,” says Roberts.

Treat Yourself With Respect

At the same time, remember to keep your own self-care habits in tact.

Roberts says, “Don’t change your eating behaviors. The goal of recovery is to live in the real world and so if you’re craving a burger, get the burger. You are a model of listening to your body and this helps more than words—continue to treat your body with respect and they will be inspired, too.”

Listen and Honor Their Process

Open ears and a closed mouth are best when communicating with a friend or family member in recovery. Of course you should be yourself, but also honor the process they are working through.

“If you’re having this conversation, don’t do it in a public place, like a loud restaurant—for obvious reasons; you want to make sure they are completely comfortable,” says Roberts. “When someone is recovering, they often assume that others don’t want to hang out or feel like they’re going to act ‘weird’ around them. Keep the invitations open, even if you think they won’t want to come. It helps them feel like are included and no matter what they are struggling with, they are still part of your friend group.”

MORE: Is It Possible to Ever Fully Recover from an Eating Disorder?

Be Open and Seek Resources

Don’t ever tip-toe around a subject or make assumptions. Instead, when you’re conversing, “say something like, ‘Hey, I am thinking of you and can’t wait to see you. Let me know what I can do to help you and when you are free to catch up.'”

The National Eating Disorders Association also has a hotline and great resources for friends and family.

Avoid Triggers

Fat talk, body shaming of self or discussion of calories and diets are triggers for everyone, not just people struggling with an eating disorder.

“If they start to take the conversation there, then don’t act like their therapist,” says Roberts. “Change the topic to something else. Be mindful of your own discomfort if your gut is getting freaked out. It’s likely that you’re going into a place it doesn’t want to be—so listen.”

Turn Off the Therapist Talk

Above everything, you are their friend and that means accepting them with or without the disease. Deviating away from that role and trying to be an expert could make them feel uncomfortable.

“Don’t act like their therapist. This will really hurt your friendship. They may depend on you too much for help or develop resentment towards you. If they are struggling with a meal or you observe that they are emotional and want to help, do what you would have done before. ‘Hey, what’s wrong, how I can help?,'” says Roberts.

MORE: This Is How Eating Disorders Can Affect Fertility

Create Healthy Distractions

Normally, distractions get a bad wrap, but if you notice a friend is struggling to eat, ask if you can help. Maybe it’s something you’ve done before or perhaps it’s something as simple as showing them a cute video of puppies—seriously.

Roberts says that often times, when anyone is struggling with intrusive thoughts or anxiety, a distraction away from the topic helps them come back to it with less anxiety.

“Don’t force them to eat, or act frustrated. If you notice that this behavior is frequent and you are concerned, this is when you say something. ‘Hey, I’ve noticed that when we are together, you’re not eating. I don’t want to be your therapist—and as your friend I’m concerned because want you to feel good. How can I help?’”

Use the Sandwich Technique

Another way to navigate a difficult conversation is to use what Roberts calls the “sandwich” technique. The assertive statement is the sticky part (the peanut butter), sandwiched between two positive statements (the bread). This will encourage your friend to listen and engage with you.

For example:

Bread: “Hey I care about you.”

Peanut Butter:  “I don’t know what to do when I see you eating so little. It concerns me.”

Bread: “What can I do to help?”

“If you are close with their family or significant other, you can express your concern—ideally by voice or face-to-face, as they may be able to help give this information to their therapist/treatment team. This isn’t tattle tailing; this is a friend who is suffering. What would you do if your friend had diabetes and wasn’t taking their insulin? Eating disorders are deadly—they aren’t a choice, they are a disease that interferes with thoughts and does irreversible damage to one’s body.”

MORE: How Therapy Helped Me Deal with My Debilitating Anxiety

Focus on Feelings

Body talk just reinforces triggers and causes the both people to steer away from the heart of the matter. So avoid pointing out others’ bodies in terms of how good they look or how much they’ve changed.

“Be mindful they may look different if they have gone to treatment. Don’t tell them, ‘you look healthy,’ or ‘you look so good,’” says Roberts. “This is the worst thing you can do, as the eating disorder mind converts ‘healthy’ into obese. Focus on feelings, not their body. Instead you can say, ‘You look happier.'”

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