What not to say to someone with anorexia

Anorexia Nervosa is one of the leading causes of mental health related deaths. Although many can think of anorexia as this obsession with calories and weight, it goes far beyond that. For some, it turns into this controlling power dominating their thoughts every minute of the day. It’s a disease, not a diet.

Today I want to take the approach of looking at those without anorexia, yet knowing someone with anorexia. There are many websites, books, and blogs addressing those with anorexia, giving them information, but I find it difficult to find places that give genuine advice to those who know someone with anorexia.

There are a couple things one should not do. Although you may want to watch someone with anorexia eat to make sure they are eating-don’t. And don't put food in front of them or fix their plates. Don't touch them without their permission as they are very self-conscious of their bodies and may think “they can feel my fat” or “they think my bones are disgusting”. Another crucial piece of advice I have heard first hand is don't talk about the subject unless they bring it up first. They will tell you if they want you to talk about it or ask how they are doing.

In addition, you can’t say “why don't you eat normally?” Or “why don't you have normal food?” Again, it’s a disease and if they could “eat normally” they would. There are deeper emotional issues preventing them from eating properly and while eating for you may be a matter of “now I'm hungry so now I eat”, for someone with anorexia the “now I'm hungry” can turn into a mental civil war you are not aware of.

Please note they feel guilty. They aren't doing this to you. Or to break up the family and cause problems. They are doing this to themselves, and blaming them will just make them feel guiltier than they already feel. Instead of motivating them to eat, it can drive them deeper into the depression.

The standard “What have you eaten today?” question can force an extremely uncomfortable experience upon the person with anorexia. Why? Because they will either have to lie to you, making them feel guilty, or tell you the truth and possibly face a long lecture about what they are doing wrong and how they should change. Remember its not easy for them to “just change” or “snap out of it”. If they could, they would.  

Telling someone with anorexia who is going through recovery that they look great since they’ve put on some weight can quickly turn into “I am now fat.” They will not hear the compliment within that statement. If you notice they are doing great, don't show it with that type of statement. Instead, do something nice and fun with them. Perhaps take a walk in the park, or go to a movie.

On top of it all, don't mention your own weight or your size trousers and don't make negative comments about others’ bodies. Although you are not talking about their weight and size, it may lead them to compare themselves to you. Be understanding that this is a disease and perhaps the hardest thing they have ever gone through, especially as this disease usually first manifests itself during teenage years.

Anorexia isn't simply about missing meals and excessive exercise. It’s about the power behind the voice in your head. It dominates, taking over control. This feeling can extend to other eating disorders as well, not just anorexia. It is easy to be blind to the distress it brings on a person. Be compassionate and understanding, and hopefully, with your help, that person will recover. It's not about "fixing" them, it's about being there for them as they are the only ones that can change themselves.