How to help someone with an Eating Disorder – Autonomy and Boundaries

One thing that can easily get blurred with an eating disorder are our boundaries. When family is involved, it is particularly easy for these to be encroached upon as emotions can begin to cloud our judgement. It is easy to offer a concession from time to time, especially when someone we love begins to plead with us. We also know that any individual with an eating disorder who can learn to make their own decisions, will do better throughout recovery. That said, allowing someone with an eating disorder to do entirely what they want will rarely result in a positive outcome. We must balance an individual’s autonomy with firm boundaries around what is acceptable with regards to their behaviour.
An image of a tennis ball right next to the line on a court
It is vital we establish clear boundaries relating to behaviours around eating disorders
In general, when it comes to controlling behaviours around food, allowing individuals to eat alone, allowing them to eat 'special' foods differently to everyone else, and allowing them to refuse that others cook for them are just some of the things we might want to look out for. These will be individual to each person, but it is these types of behaviour that will be perpetuating their problems. For these we will want to draw a line in the sand. We will need to learn to say - NO. Because of their situation, it is vital that they accept that some things will be non-negotiables for them. Yes, other people might be allowed these 'luxuries', but for this person, right now, they need to understand that somethings are not helpful and that they must make and effort to change. This can be hard for many of us to enforce, but developing this assertiveness is often exactly what is needed in this type of environment

How to help someone with an Eating Disorder – Dealing with Denial, Focus & Honesty

What problem?

It is often common for the person you believe to have an eating disorder to deny they have a problem at all. This is where things get tricky. You certainly don't want to engage in a futile and often inflammatory battle of wills, but nor should you completely surrender to their denial. In learning about eating disorders, you will come to understand that this denial, and subsequent anger or refusal to seek help is a part of their illness. They will likely be ashamed of their situation and moreover, fear that by seeking help that they will lose control of their own weight.

Denial
Denial that there is a problem is particularly common in those with an eating disorder

To compromise, you might want to offer up information or point them in the direction of resources that could help them. Allow them to deal with these in their own time. If receptive, you could also offer to go to 'just one' appointment with a doctor, eating disorder specialist or nutritionist with them. This might help start to turn things around without demanding a commitment to ongoing treatment.

Where possible, focus on the person too

When someone's behaviours around food seems problematic, it can be very easy to focus only their eating habits when you speak with them. Likewise, it can be very hard to bite your tongue when someone is blatantly not looking after themselves. Understand that these problems are more about their own emotional battles and difficulties with self-worth than they are about fats and carbs. If and when you do talk about food, make sure you balance it with your concerns about them as an individual.

Be honest, be brave

picture of eggshells
Don't walk on eggshells with an eating disorder, but be careful about how you deliver your message

There is a very fine line between being honest about your feelings relating to someone's behaviour and emotionally unloading your problems onto them. For people with eating disorders, it is good for you to model for them that it is both important and acceptable to get in touch with feelings that might be the source of shame or feel dangerous. Let them know what behaviour or action they have taken you want to discuss, how it has made you feel, and how you are going to personally deal with it. Explaining to them how you have taken the time to learn about eating disorders and just listening to them are great ways of showing them you care without making it seem like you are forcing them to change