Recovery from an eating disorder takes a long time. Even if you are aware of this, you may still be inclined to think that the person should be improving faster and that more progress should be made. Long-term thinking and endless patience is necessary. Research suggests that full recovery will most likely take several years.
Avoid power struggles
Just as with approaching someone to get help, as much as possible find alternatives to power struggles, especially when it comes to eating and weight. Don’t make mealtimes or eating a battle of wills. Don’t try to force or overly control eating. Leave these issues to the therapist, dietitian or other treating clinician unless your involvement is discussed, requested and worked out with help from the professionals.
Avoid blaming or demanding
Don’t try to find causes or someone to blame for the eating disorder, and don’t plead or demand that your loved one stop their behavior. Neither of these actions will help; they will only serve to oversimplify the situation and may cause shame and guilt. It is easy for your loved one to feel responsible for your or someone else’s feelings. Go to therapy together.
Don’t ask how you can help – ask a professional
Your loved one will not know how you can help and may feel worse if you ask. Another possibility is that he/she thinks they know what will help but is wrong, and this will make matters worse. Trying to help when you are unsure of what to do might cause more fighting and new problems. A professional is in a better position to give you advice.
Show affection and appreciation verbally and physically
A little unconditional love goes a long way. There are many ways to show affection and support besides talking (e.g. hugging or spending special time together). Consider writing letters or just little notes to your loved one, even if you live together. This is a good way to express encouragement, concern, and support without expecting a response or putting the person on the spot.
Do not comment about weight or appearance
Avoid making looks a focus. Don’t comment about their or other people’s weight or appearance. It is a trap to answer questions like, “Do I look fat?” If you say no, you won’t be believed, and if you say anything else or even hesitate for a moment, your reaction may be used as an excuse to engage in eating disorder behavior. Telling someone with anorexia that they look too thin is a mistake. This is what they want to hear. Telling someone with bulimia they look good on a particular day may reinforce their binge/purge behaviors if they believe they are responsible for the compliment. Instead, answer honestly with some version of the following:
“You and I know that there is no answer I could give you that would really work or make things better”
“I think it is best if we stay away from talking about your weight”
“You know this kind of question is a dead-end street for us”
Do not use bribes, rewards, or punishments to control eating behavior
Generally speaking, trying to externally control eating disorder behavior through bribery, punishment, or enticements – if it works at all- is only temporary. It puts off the person having to deal with internal means of controlling their behaviors.
Do not monitor their behavior, even when asked
Do not become the food or bathroom police. Loved ones may ask you to stop them if you see them eating too much or tell them when they have gained too much weight. They may seek your praise for the amount of food they are eating. Monitoring their behaviors may work for a short time, but usually ends up backfiring. Get professional help and become a monitor only when and how advised.
Accept your limitations
Accepting your feelings and limitations means learning to set rules or say ‘No’ in a caring and reasonable but firm and consistent manner. You may have to discuss cleaning the bathroom, limiting the amount of food she goes through, charging for binged food or establishing a rule that laxatives aren’t allowed in the house. You may have to tell her that you can’t always be available. Don’t try to become a substitute for professional care. Eating disorders are very complicated and getting professional help is essential.
Getting help and support for yourself
If you care about someone who has an eating disorder, it can be painful, frustrating, and confusing. You need knowledge, guidance and support in dealing with the situation. The more knowledge you have about eating disorders and what to expect in regard to assessment and treatment, the easier it will be for you. You are going to experience a range of emotions: from helplessness to anger to despair. You may find yourself losing control of your feelings and actions. It is important to get help for yourself. You need to talk about your own feelings as well as getting guidance about how to deal with your loved one. Good friends are important, but a therapist or support group may also be necessary. You may need to go to an individual therapist where you can discuss you particular situation, feelings, and specific needs in detail. Whether or not your loved one gets help, let them know you are getting help for yourself. This may not help them take the situation more seriously; even if it does not, you must take care of yourself. If you do not stay healthy and strong, you will not be able to help someone else.
~Taken from The Eating Disorder Sourcebook, Carolyn Costin, M.A., M.Ed., M.F.T.