Friends and family concerned about someone who may have an eating disorder.

Eating problems seem so simple. All you have to do is eat more or less, right? Unfortunately, eating disorders are incredibly complex and dangerous mental illnesses with very high mortality rates. Like any other serious disease, they require professional treatment, and with your help this can get started.

It is difficult and painful to watch someone you love suffer with eating issues. Part of the reason it is so difficult is because bringing up the problem often threatens the precious relationship that you have with that friend or family member. We desperately want to help them, but often our well-intended efforts to help seem to backfire and merely push our loved ones further away from us, so that it seems even harder to help. And all too often those with eating disorders are in denial and they are very good at persuading you that they are fine. They may convince you on some particular occasion, but you still worry about them later. And sadly enough, their doctor may have no real evidence that they are sick, since their blood-work and vital signs are normal.

But we have found, over and over again, that the intuitions of family and friends are almost always right. And we can help you. If you can get them through our doors, we can definitively prove, through metabolic testing and body composition analysis, whether or not they do have a problem, and if they do, we can see how serious the problem is. We have empirical data that they cannot deny, which will motivate them to start the path to recovery. The difficulty, though, is helping them to come in.

Here are some practical tips for friends and family

  • Make the effort to understand things from your friend or family member’s perspective. Let them feel that you care and are really listening to them and not judging them.

  • Pick a good time to have the discussion, not a time when you are tired, angry, frustrated, hurried or distracted. And make sure that you don’t have the discussion when you are eating.

  • Be prepared for resistance, and don’t take it personally. Those suffering from eating disorders often experience significant guilt, shame and/or anxiety, which can often turn to anger and/or denial.

  • For some, especially those in denial, sometimes making a quasi-bet with them works. Tell your daughter, for instance, something along the following lines: “Let’s have one visit at The Kahm Clinic. if you are fine, we’ll see; and if you are not, we’ll also see. If you really are as well as you say, why don’t you prove me wrong? Then I’ll stop bugging you about this.” You cannot go wrong if you succeed. If they are indeed healthy, you will know, stop worrying, and can remove that obstacle from your relationship. If they are sick, then she will know, and can start the path to recovery.

  • It is better to begin discussing specific actions than generalizations. Rather than say things like, “you never eat enough,” or “you eat too much,” say things like, “yesterday, I saw you do this, and the day before, I saw that, and the day before, I saw … All of these things worry me and makes me wonder whether we shouldn’t go see someone who might be able to help you.”

  • Don’t make comments about their weight or body image one way or another. For instance, comforting someone by saying that they’re not fat, only plays into their desire to be thin. Better, for instance, to talk about why they are so worried about being fat.

  • Avoid simple accusatory solutions and comments like: “why can’t you just eat more!?” or “Do you really need seconds?” Such comments never work. Remember that the goal is to get them to want help, and accusing them just strengthens their resistance. Be mindful that the root of the problem is always psychological and that eating more or less won’t ultimately solve the problem.

  • Educate yourself as much as possible about Eating Disorders. Read, read, and then read some more. There are plenty of good resources online. And the better you understand Eating Disorders, the better you’ll be able to put yourself in their shoes and have an effective conversation about your concern. Here's a good place to start.