Walking in relationship with someone who stands in the grip of an eating disorder must feel like an impossibly delicate position.
It’s important to tune into the individual struggling and learn from careful observation, good questions, and genuine conversation to know exactly what words, phrases, and behaviors act as triggers for him or her.
I interviewed various people who have faced eating disorders, and the following comments were those many of us had in common as triggers that reinforced unhealthy binge/purge/restrict thoughts and behaviors:
1) You look healthy – I know, this sounds crazy. “Healthy” is a good thing! Consider, though, other contexts where this word is used. “That’s a healthy piece of meat” or “that’s a healthy baby,” it can often mean well fed or large. I know this may sound crazy to the average person, but looking well fed is never the goal of someone who is engaged in an eating disorder. While this is an awesome phrase to use with someone who is mentally stable, it is a comment you may want to avoid when speaking with someone who has an eating disorder.
2) Look at all that food! – I can assure you the person to whom you are speaking has spent their entire day calculating the calories of the food on their plate. They have obsessed over it since the moment they woke up, and will continue to mull over it until their head hits the pillow. It’s important to not acknowledge anything about their plate. Ever. Your goal is to emulate that there is more to life than food. Ignoring such details also may help the person recognize how trivial food is in the grand scheme of life.
3) You cleaned your plate! – This is one of the most shaming statements to someone who is facing an eating disorder. To actually clean one’s plate is often the most shameful ‘mistake’ someone with an eating disorder could make. To acknowledge this at all would be to shame the individual even though you do not mean to be shameful.
4) Have you eaten enough today? – This question is feeding the obsession. Food intake must be handled delicately by a trained professional. As a friend or family member, your role is to help re-shape their thinking, not their behaving. Encourage the individual to meet with a professional to discuss emotional wellbeing. The problem isn’t simply behavioral – it’s deeply emotional.
5) Oh look! She’s eating ____. – When he/she finally decides to have that piece of bread or that cookie, do not acknowledge it. This may reinforce a shame narrative and cause an internal, downward spiral.
6) Aren’t you full? – This is basically like acknowledging a clean plate. Do not draw attention to food consumption.
7) Do you think you need a larger size? Suggesting that clothes look a little snug is equivalent to outright saying the person is overweight – at least to someone with an eating disorder. As painful as it might be to see the individual wearing clothes that do not fit properly, try and let it go. If there is an issue regarding modesty – approach it from the position of trying to help them conceal their beauty and reference modesty as the issue, not small clothing. And do not suggest a larger size – instead, suggest a different style blouse/skirt/pant/etc.
8) You’re looking so thin! – This will be perceived as a compliment to the person, even if you mean it as an expression of concern. The best solution is to instead comment on character attributes. Focus and comment on observations regarding emotional and spiritual wellbeing rather than physical appearance.
9) Are you expecting? – I never ceased to be amazed by how many socially adept people asked me if I was expecting when I was not. Someone with eating disorder thinking patterns will not fault their outfit choice. They will fault their bodies and eating choices. If she is pregnant, she will tell you when she wants to.
10) Are you exercising enough? – Or any form of this question. It is wise to stay away from comments about physical activity as this topic could be related to over-exercising, which is just as dangerous as over-eating, under-eating, and purging. A gentle way to broach this topic would be to invite the individual on a walk or a hike. Over-exercising is an addictive behavior that often accompanies eating disorders, so remain cognizant of how your comments could reinforce extreme thinking. Encourage physical activity that is balanced through casual invitation.
* I am listing these out for the benefit of people who are supporting individuals actively engaged in an eating disorder. Ultimately, we must trust the Holy Spirit. God goes before us and behind us. If you have used these phrases before, I might suggest that you ask the individual if your words hurt him or her and open up a dialogue about trigger statements. Having open, honest conversation is the first step in the process of creating/providing a healing relationship.