Eating disorders support for carers
We understand that caring for someone with an eating disorder can be incredibly stressful and leave you feeling worried, helpless and confused.
Within this guide, we will look at how to support someone with an eating disorder, and how to make sure they get access to the correct treatment. We will also look at the common signs and symptoms to look out for if you are concerned that someone you care for has an eating disorder.
- Common signs and symptoms of eating disorders
- How to support a loved one
- Free UK eating disorder helplines
Are you worried that someone you care for has an eating disorder?
Eating disorders are severe and secretive conditions that a person will often try to conceal from their family and friends.
While symptoms can differ from person to person, depending on their circumstances and the type of eating disorder they are struggling with, common warning signs to look out for include:
- Preoccupation with food - they may be fixated with food, which results in them collecting recipes and ingredients, preparing lots of food without eating it, and watching hours of cookery programmes. The person may also be extremely knowledgeable about the nutritional content of the foods that they eat
- Excessive exercise - a person may carry out an excessive amount of exercise in the belief that they need to burn off calories. This exercise may take precedence over other important activities or responsibilities. They may also only sit down when instructed to by another person, fidget and appear restless a lot of the time
- Rigid dietary rules and routines - a person may eat in a very specific way, with examples including cutting food up into small pieces, leaving carbohydrates until the end and choosing to eat salad first. Their eating times may be extremely regimented and they may only use specific plates, bowls and cutlery. A person may also only eat certain foods or brands of foods that they feel ‘safe’ with as they know their nutritional content
- Withdrawing from family and friends –a person may start to isolate themselves more. Eating out, being around other people and taking part in activities they once enjoyed can become problematic as they disrupt a person’s rules and routines around food
- Wearing clothes that don’t fit – a person can start to choose clothes that are too small, with the hope they will fit into them. Alternatively, they may wear baggy clothes to hide their frame or layer clothes to keep warm if they have an extremely low amount of body fat
- Excessive use of condiments - they can begin to add more condiments such as salsa, hot sauce, gravy and salt to mask and spoil food, or to add flavour for fewer calories
- Chewing gum - excessive gum chewing may be caused by a person trying to prevent feelings of hunger
Below, we have outlined further warning signs, particularly the ones which are specific to the four main categories of eating disorders: anorexia nervosa, bulimia nervosa, binge eating disorder (BED) and other specified feeding or eating disorders (OSFED).
Further signs of anorexia nervosa
A person with anorexia nervosa may show the following warning signs:
- An extreme and irrational fear of putting on weight
- Being unwilling to put on weight
- Feeling that their body, or parts of their body, are ‘too fat’
- Becoming preoccupied with looking a certain way
- Extreme tiredness and exhaustion as a result of their starvation
Further signs of bulimia nervosa
When someone is experiencing bulimia nervosa, which is characterised by bingeing and purging, you may see the following signs:
- Exiting the room, showering or going to the toilet after meals to vomit or use laxatives
- Large quantities of food or food wrappers being found hidden, in unusual places or in the bin. You may also find that large amounts of food are going missing
- Tiredness or lethargy due to dehydration caused by vomiting or laxative use
- Scarring or swelling on fingers or knuckles caused by vomiting
- Tooth issues, including staining, cavities and sensitivity
Further signs of BED
When someone is dealing with BED, which is characterised by bingeing even when not hungry in often an uncontrollable manner, they may show the following signs:
- Like with bulimia nervosa, you may find large amounts of food or food wrappers, either hidden, in unusual places or in the bin. Again, you may find that large amounts of food are going missing, as the person will often binge in secret
- Noticeable increases in weight
- Changes to normal eating routines, including meal times and portions. A person may even go through periods of fasting. These changes can be caused by a person feeling guilty about a recent binge, or because they are planning to binge in the near future
Further signs of OSFED
OSFED is classified as an eating disorder that falls outside the criteria of anorexia nervosa, bulimia nervosa or BED. Therefore, a person with the condition will typically display the warning signs of one or more of the other eating disorders, but won’t necessarily meet the criteria for a formal diagnosis of one particular disorder.
How can you support someone with an eating disorder?
Talk with them
If you are worried that the person you are caring for has an eating disorder, talk to them. Before you do, find a good time and place for the conversation. You may want to go on a walk or drive, so that you can have the conversation privately, but in a manner that doesn’t feel too intense. Also, make sure that there are minimal distractions, so put phones away and turn off TVs and radios.
Before the conversation, think about what you want to say. Stick to facts and observations that you have made. Also, focus on “I” phrases, such as “I am worried that you aren’t eating as much as you used to” or “I have noticed that you are going to the gym a lot more than you previously did”. Also, point out observations that you’ve made which aren’t related to food or exercise, such as “I’ve noticed you’re going out a lot less with your friends”. These phrases are a lot less combative and accusatory than “why are you not eating?” or “why are you exercising so much?”
Starting a conversation about a possible eating disorder can understandably stir up a lot of emotions in both you and the person you care for. However, it’s so important to remain calm and caring in front of the person, even if they become emotional, angry or hurtful. It is common for someone to react this way, but remember that it is their eating disorder talking and not them. If you become angry, or feel angry towards them, don’t feel too guilty. It is understandably a difficult time for you too. If it does become too much, it is okay to pause the conversation and try again when things have cooled down.
When the person does talk to you about their eating problems, avoid making promises that will reinforce or perpetuate their eating disorder such as “I won’t tell anyone” or “I’ll let you skip this meal if you promise to eat something later on”. You can care for them without being manipulated by them.
Keep lines of communication open
Having regular one-on-one conversations can help the person to understand that you will always be there to listen and support them. Take the time for regular chats, so that they become a normal part of life. By knowing your willingness to listen, support and not judge them, this will encourage the person to come to you with any questions or concerns whenever necessary.
During conversations about the possibility of professional treatment, remain calm and caring, but remember that you need to be firm. It is important to encourage the person to seek help and early treatment to prevent their eating disorder from worsening and having a devastating long-term impact on their health and wellbeing.
We understand that supporting a person while insisting that they get help can be a very difficult tightrope to walk. If you approach the topic, but find that the person becomes irritable, wants to avoid the topic or denies that they have a problem, walk away and start the conversation again at a different time.
While caring for someone who has an eating disorder – or who is showing signs of having an eating disorder - is likely to be incredibly stressful and worrying, it’s important to stay calm around the person. Becoming angry or upset around them can result in the person retreating away from you, and possibly keeping their thoughts and feelings entirely to themselves.
Caring for someone with an eating disorder - or who you believe has an eating disorder – can be stressful, and have a big impact on your own health and wellbeing.
It is important for you to talk to people that you are close to, and maintain these strong relationships. Trusted and reliable family members and friends will be there to listen, support you at difficult times and help you to work out solutions to problems that you are facing. Always remember that a problem shared is a problem halved.
Attending support groups can give you an opportunity to talk to people in similar situations. They can provide you with encouragement, guidance and the opportunity to share your thoughts and experiences with people who can truly empathise. Online communities are also effective, as you can share your thoughts, feelings and experiences, and give and gain support and encouragement from others.
Make regular time for yourself too. Keep up with your own activities and interests, and set time aside for relaxation. Remember, that you are a person in your own right, and deserve to properly look after your own health and wellbeing.
Free UK Eating Disorder Helplines
There are many eating disorder support helplines around the UK that provide advice and support for those who are worried and concerned about someone they care for.
Here is an alphabetical list of helplines that provide help and support if you need to talk to somebody:
ABC provide care, emotional support and practical guidance for anyone affected by eating disorders; those struggling personally as well as parents, families and friends.
Beat is a UK charity supporting anyone affected by eating disorders, anorexia, bulimia, EDNOS or any other difficulties with food, weight and shape.
Eating Disorder Association NI provides free and confidential support for anyone living with an eating disorder, their family, friends and carers, and for professionals working with eating disorders.
Eating Disorder Support provides help and support to anyone affected by an eating problem such as anorexia nervosa, bulimia nervosa or binge eating disorder.