How to Cope with Eating Disorders

Nearly 30 million Americans, across all ages and genders, struggle with eating disorders, with the majority being women. If you or someone you know exhibits signs of an eating disorder, it is vital to take action immediately. This condition has the highest mortality rate among mental health disorders, so seeking help for yourself or a loved one could potentially save a life.

Learn about the types of eating disorders. This article focuses on three main types of eating disorders. According to the DSM-V classification of mental health disorders, eating disorders include three primary forms: anorexia nervosa, bulimia nervosa, and binge-eating disorder. It's also important to note that there are other types of eating disorders. If you feel discomfort or unhappiness with food, it's essential to talk to a healthcare professional or therapist who can help identify the specific issue you're dealing with.

• Anorexia nervosa is an eating disorder characterized by extreme food restriction and significant weight loss. Individuals with anorexia have an overwhelming obsession with weight loss. This disorder has three key features: an inability or refusal to maintain a healthy weight, an intense fear of gaining weight, and a distorted perception of their body.
• People with bulimia nervosa often binge eat and then engage in purging behaviors, such as vomiting or excessive use of laxatives, to avoid gaining weight from the overeating.
• Binge-eating disorder occurs when someone impulsively consumes large quantities of food. Unlike bulimia, individuals with binge-eating disorder do not purge after eating, although they may sometimes restrict their food intake due to feelings of guilt, self-hatred, or shame.

Understanding the Factors Contributing to Eating Disorders. There are several risk factors associated with eating disorders, including biological, neurological, and genetic influences, low self-esteem, high anxiety, a desire to be perfect, the need to constantly please others, relationship struggles, physical or sexual abuse, family conflicts, or a lack of emotional expression.

• For further information on eating disorders, you can explore reputable websites such as National Eating Disorders Association, National Institute of Mental Health, and National Association of Anorexia Nervosa and Associated Disorders.

Consider Donating to Organizations that Support Those with Eating Disorders. Many organizations are working actively to raise awareness about eating disorders and assist those affected. If you care about someone struggling with an eating disorder, consider donating to these organizations to help combat eating disorders by improving services and spreading knowledge.

Stop Body Shaming. Body shaming involves criticizing either your own or someone else's appearance. People may belittle themselves by saying things like, 'I could never wear a swimsuit with a belly like this.' Family members, friends, and even parents can also shame others, either to their faces or behind their backs. For instance, a mother might make a harsh comment to her daughter, such as, 'You’ll never find a date for prom unless you lose a few pounds.'

• If you can't say something positive or encouraging about yourself or others, it's best not to say anything at all. Words can be hurtful, and what may feel like a joke to you could be perceived as serious by others.
• Speak out against people who body shame others (such as friends, family, colleagues, the media, etc.), and encourage those who promote positivity about all body types.

Be Aware of Warning Signs of Physical Distress. It’s important to be honest with yourself when you notice warning signs of an eating disorder. This condition can be life-threatening, so don’t underestimate its severity or think you can manage it alone. Some warning signs to look for include:

• Underweight (less than 85% of the healthy weight for your age and height).
• Poor health – feeling bruised easily, lack of energy, pale skin, dull and dry hair.
• Dizziness, feeling colder than others (due to poor circulation), dry eyes, swollen tongue, bleeding gums, and water retention.
• Women missing three or more menstrual cycles.
• Individuals with bulimia may also exhibit symptoms such as teeth marks on fingers, nausea, diarrhea, constipation, and joint swelling.

Recognizing Behavioral Signs of an Eating Disorder. In addition to the physical changes that affect the body, eating disorders can also impact behavior and emotions. These signs may include:

• If someone tells you that you're underweight, and you refuse to believe it or even argue against it; you might not be able to accept that you are actually underweight.
• You may often wear baggy clothes to hide the significant or sudden weight loss.
• You continuously avoid meals or try to eat very little, hide food, or throw it away afterward.
• You become obsessed with dieting, frequently talking about restricting food and looking for ways to eat less.
• You dread the idea of gaining weight, being overly critical of your body and weight.
• You follow a rigorous and exhausting exercise routine that may be considered excessive.
• You avoid relationships or social interactions with others.

Consult with a Specialist in Eating Disorders. A trained professional can assist you in overcoming the thoughts and feelings that lead to excessive dieting or binge eating. If you're too embarrassed to talk to anyone, ensure that the doctor will not make you feel ashamed of yourself. Doctors are dedicated to their profession and are committed to helping patients overcome eating disorders. They understand what you're going through, they recognize the underlying causes, and most importantly, they can guide you through this process.

• The best treatment for managing an eating disorder is therapy or counseling combined with careful monitoring of nutritional needs and medications.
• While undergoing treatment, you can expect:
  • To be listened to with respect.
  • To have the opportunity to share your full story and request specific help.
  • To be free from pressures imposed by family or friends. The therapist may act as a mediator and advisor to them or, at least, teach you strategies to handle family conflicts during recovery.
  • When treated as a person of value and assured of it, along with appropriate and well-placed measures, you can regain your health.

Identify the Reasons Behind Your Disordered Eating Habits. You can aid your treatment by exploring the reasons that drive you to constantly lose weight and disregard your body. Some signs may help you better understand how your eating habits have gradually turned into an unhealthy coping mechanism to deal with issues like family conflicts, emotional neglect, or never feeling comfortable with yourself.

• Are there areas of your life where you feel out of control? Have there been any recent unwanted changes (divorce, moving to a new city) that you couldn’t control?
• Have you ever experienced physical, emotional, or sexual abuse?
• Does your family have rigid or perfectionistic standards? Does your family overly protect you, control you, or disrespect your boundaries?
• Do your parents show indifference or detachment from your life?
• Do you compare yourself to others? Media is the worst culprit in this regard, but your friends, celebrities, and people you admire may also be sources of comparison.
• Do you eat unhealthy foods or overeat when you're emotional? If so, this could become an unconscious habit, replacing healthier coping activities like challenging negative self-talk or learning to self-praise for positive accomplishments.
• Do you believe that having a slimmer body will make you better at sports? While certain sports like swimming or gymnastics may favor smaller, more flexible bodies (especially for women), don’t forget that many other factors determine success in any sport. No sport is worth sacrificing your health for.

Maintain a Food Journal. A food journal serves two main purposes. The first is practical: to track what you eat, when you eat it, and how you consume it, allowing you and your doctor to monitor your dietary habits. The second, more abstract purpose, is to record the thoughts, feelings, and emotions connected to your eating habits. Finally, it offers a space where you can confront your fears (to face them) and your dreams (to start setting goals and aspiring). Some points to consider when keeping your food journal include:

• Reflect on what you might be going through. Are you comparing yourself to magazine models? Are you under significant pressure (from school, work, family, or friendships)?
• Write about the routines you have developed surrounding food and your emotional responses.
• Note the feelings you experience while attempting to control your eating behaviors.
• If you’re deceiving others to hide your behavior, how does this affect your relationships and the closeness with others? Analyze this in your journal.
• Record the achievements you’ve made in life. This will help you recognize the progress you've made. This list will make you feel more content with yourself as you see more good things accumulating.

Seek Support from a Trusted Friend or Family Member. Share what you are going through with them. Most likely, they will be concerned for you and ready to help you overcome your eating disorder, even if it’s just by being there for you.

• Learn to express your feelings and find peace with them. Assertiveness isn’t arrogance or selfishness – it’s about communicating to others that you have value and deserve respect.
• A major contributing factor to many disorders is the inability or unwillingness to fully express your feelings and desires. When this becomes a habit, losing your assertiveness can lead to feelings of worthlessness and a lack of ability to handle conflicts and sadness. As a result, the disorder becomes a coping mechanism, “manipulating” everything (though in a distorted and unhealthy way).

Find Alternative Ways to Handle Emotions. Consider positive outlets to relax and unwind after a stressful day. Allow yourself moments of solitude where you focus solely on yourself. Some ideas include listening to music, taking a walk, watching a sunset, or journaling. These activities are endless – they are engaging and create a sense of calm, helping you deal with stressful and harmful emotions.

• Do something you’ve always wanted to do but never had the time for or couldn’t arrange. Sign up for a new class you’ve been interested in, start a blog or website, learn a musical instrument, go on a vacation, or read a book.
• Some alternative therapies might help treat eating disorders. Talk to your doctor about trying activities like meditation, yoga, massage, or acupuncture.

Adopt Healthy Coping Mechanisms to Deal with Stress. Rely on yourself when you feel out of control. Call someone and focus on their voice, touch the objects around you like your desk, stuffed animals, the wall, or hug someone who makes you feel safe. Use methods that help you reconnect with the present moment instead of sinking into the past or present troubles.

• Get a good night's sleep and develop healthy sleeping habits. Sleep can help restore your outlook and energy. If you’re not getting enough sleep due to stress and anxiety, find ways to improve your sleep routine.

Be Kind to Yourself as You Are to Others. Look at the people around you whom you find beautiful in their own unique ways, and evaluate yourself the same way. Focus on your inner beauty instead of paying attention to perceived flaws. Stop being harsh about your appearance – every human body is a miracle, each moment of life is infused with the continuity of time, and you deserve happiness right here, right now.

Put the Scale Aside. Stepping on the scale daily is something no one should do, whether you have an eating disorder or not. Doing so creates an unrealistic weight fluctuation chart and sets an obsessive standard based on numbers rather than focusing on the bigger picture. Gradually reduce the frequency of weighing yourself until it becomes just once or twice a month.

• Use clothes as a measure instead of the scale. Choose an outfit in a healthy weight range that you feel most comfortable in and use it as your standard for a pleasing appearance and appropriate weight.

Take Small Steps. Cherish every small change towards a healthier you and consider it a significant step in your recovery process. Gradually increase your food intake and decrease the amount of exercise, etc. Trying to stop abruptly not only makes it more emotionally difficult but could also shock your body and create other health issues. It’s important to note that this process should be supervised by a professional, like an eating disorder specialist.

• If you are severely underweight, taking small steps is not an option. In such cases, you will need to be hospitalized and treated with a special nutrition plan to ensure your body gets the essential nutrients it needs.

Learn How to Recognize Eating Disorders. If you notice that a friend shows signs of an eating disorder, don’t hesitate to intervene. This condition can become very serious once the signs mentioned above appear, and helping your friend overcome it as soon as possible is crucial.

• Read up on eating disorders to gain more knowledge.
• Be ready to do whatever you can to help them get the proper treatment as soon as possible. Also, be prepared to support the treatment process and play the role of a helper if necessary.

Have a Private Conversation with Your Friend. Pull your friend aside gently, ask her what she's going through, and share what you’ve noticed. Be kind, and most importantly, avoid being judgmental. Let her know you’re concerned and want to help in any way you can. Offer to assist in any way she suggests.

• Be a source of calm in her life. Avoid exaggerating, showing shock, or making a scene.
• For instance, avoid blaming her by saying, 'I knew you shouldn't hang out with those girls. They’re all so skinny.'

Express your concern using sentences that begin with 'I'. Instead of scolding your friend, allow her to see how much you care. You could say something like, 'I care about you and hope you stay healthy. How can I help?'

Be there for them. Listen to their problems without judgment, and encourage them to share their feelings so they don't feel that you’re indifferent to their struggles. This requires genuine listening skills, and it’s important to reflect or summarize their feelings to reassure them that you understand their pain. Offer support, but avoid trying to control the situation.

• Check out the 'How to Listen' article for more tips on active listening.
• Be tender, caring, and open. Love them for who they truly are.

Don’t talk negatively about food or weight. For example, when out for lunch, avoid saying things like, 'I really crave ice cream, but I shouldn’t…'. Also, avoid asking about what she’s eaten or not, how much weight she has gained or lost, and never express disappointment about her weight loss.

• Avoid asking her to gain weight.
• Never insult or blame someone for their eating disorder. It’s beyond their control.
• Be careful not to make jokes about body weight or other topics that your friend might misinterpret.

Maintain a positive attitude. Give your friend compliments and help boost her self-esteem in all the things she does, not just concerning her appearance. Shower her with praise when she’s with you. Support your friend with an eating disorder to overcome challenges with kindness and love.

Seek professional help for your friend. Discuss with a counselor, therapist, partner, or parents to find the best ways to support her. As mentioned earlier, this is the most crucial part of the patient's recovery, so do everything in your power to create the best conditions for that.

Consider the advice in the section for friends. Many of the approaches mentioned are also applicable to those who care for or live with someone with an eating disorder. Above all, you must ensure that the person receives medical care and treatment; if you are their legal guardian, you must immediately seek professional help for them.

• This section is largely geared towards individuals with eating disorders who are children or adolescents, but even grown children or other family members may exhibit many of the same symptoms.

Stay calm and provide support. As a family member, you will interact with your child frequently, and they need to know that you are not angry with them or going to overwhelm them with demands every time you meet. This requires great self-restraint, but this is a time when both you and the patient must learn, and you need patience, courage, and calm to be a positive and effective supporter.

• Show affection and care. The person in need should know they are loved. "I love you______. We will get through this together."
• Support the therapy process without infringing on your child's privacy or trying to take control. Avoid asking invasive questions or directly discussing their weight, and if you have specific concerns, speak with their therapist.

Maintain love and attention for all family members. Don't neglect others just because you are focused on helping the patient. If all your attention and concern is directed solely at the sick child, others may feel ignored, and the patient may feel overexposed. As much as possible, aim to create balance, which nourishes and supports everyone in the family. (And ask everyone to do the same.)

Always be ready to offer emotional support. It may be tempting to withdraw or ignore your child if you feel helpless or angry about the situation. However, withdrawing emotional support will cause significant harm to your child. You can love your child and effectively manage their controlling behaviors. If it becomes difficult, talk to a doctor for advice.

• Your child will recognize your care if you refrain from pushing them and make it clear that you are always willing to listen whenever they need to talk. "I know you're feeling confused. I understand that you may need time to get through this. I just want you to know that I'm always here for you, and you can talk to me about anything."

View eating as an essential part of maintaining life, nourishment, and a balanced family routine. If someone in your household brings up food or weight with an obsession, they need to exercise restraint. Talk to anyone in the family who engages in this behavior without thinking. Additionally, don't use food as punishment or reward when raising children. Food should be respected, not used as a token or prize. If the family needs to change their perspective on food, this is a great way to move forward together.

• Do not attempt to restrict the food intake of the patient unless instructed by a healthcare professional.

Teach your child to critically assess media messages. Teach your child not to immediately accept the messages presented by the media. Instill in them critical thinking skills and encourage them to question the messages they see in the media and challenge the opinions of friends and others who influence them.

• Encourage open communication from an early age. Teach your child to speak honestly and openly with you, and you should engage with them in the same way. If your child feels no need to hide anything, the primary trigger for eating disorders will have been eliminated.

Foster your child's self-esteem if they are struggling with an eating disorder. Show them that you love them no matter what has happened, and make sure to praise them when they demonstrate positive behaviors. If they fail at something, accept it and help them learn how to accept it too. In fact, one of the best lessons a parent or caregiver can teach a child is how to learn from failure and use it as motivation to try again.

• Help your child accept and love their body. Encourage them to engage in physical activities and build self-confidence from a young age. Explain the importance of resilience and strength through exercise, helping them understand the value of spending time outdoors and connecting with nature by regularly walking, biking, hiking, or jogging together. If possible, participate in family fun runs, cycling events, or triathlons, so your child grows up seeing these activities as healthy and bonding experiences.