Have your conversation in a comfortable environment. At their core, eating disorders are anxiety disorders. The person will be the most rational and open to listening when they are in a place where they feel at ease. This means that you shouldn’t have any food, fashion magazines, or judgmental friends or family around. Meeting alone with the person may help them feel more comfortable.
Try to get a friend or loved one who has recovered to talk to the person. It really does take one to know one. It’s very hard to understand what someone with an eating disorder is thinking and why. Eating disorder thoughts aren’t rational. This person will be able to talk to the sufferer and sympathize with their feelings.
Expect to hear “I don’t need help.” True eating disorder recovery can’t happen until the person chooses to get healthy again. But this doesn’t mean that you should stop letting the person know that help is available, and that there are people and program that can make them feel better.
Express love and concern. Tell the person that you can see they are suffering. Let them know that you care about how they feel and want to help them feel better. They may feel embarrassed by their behavior. Let them know that it is nothing to be ashamed of because many people struggle with these issues, possibly even people they know and love. Feel free to tell them that they are beautiful but understand that they may not believe you, or may even believe that you’re intentionally lying to them. Focus on feelings and behaviors, not appearances.
Suggest that a dietician could help the person make good choices about what to eat and how much. Typically an eating disorder treatment team will consist of a dietician, a psychologist, and sometimes a psychiatrist. For many people the idea of seeing a psychologist or psychiatrist carries a social stigma and they will refuse treatment because of this. Visits to a dietician don’t carry the same stigma as visits to a psychiatrist. The dietician can eventually guide them towards being willing to see a psychologist.
Make it easy for the person to find a professional who can help them. Not everyone who has an eating disorder knows where or how to get help when they decide it’s time. The person may also have concerns about how to pay for the treatment. Before your conversation, find some treatment providers (individual dieticians, therapists, or outpatient/residential treatment centers) and be willing to show the person what you’ve found. Don’t force this information on them. Just let them know that it is available. Also let them know that there are many options for paying for treatment. Financial concerns shouldn’t be allowed to stop someone from getting help.
Be empathetic. An eating disorder is a coping mechanism. It dulls the pain of uncomfortable events or feelings in the person’s life and makes it easier to deal with those issues and emotions. Understand that something stressful in the person’s life is causing this problem. Let them know that you want to help them work through the underlying issues.
Let them know that a better life is out there. The stress of having an eating disorder is exhausting. Many eating disorder sufferers want to stop their behaviors but are afraid of what will happen to their weight, their bodies and their lives if they discontinue their behavior. Let them know that it is possible to live a life where food and dress sizes aren’t scary.
Realize that not all eating disorders fit the categories of “anorexia,” “bulimia,” or “binge eating disorder.” Just because someone’s behavior doesn’t match up perfectly with one of these disorders doesn’t mean that they don’t need help. Continue to encourage them to seek treatment.