Witnessing a loved one struggle with an eating disorder is never easy. To an outsider, they may appear dysregulated, controlling, different than before. For the individual suffering with the eating disorder, it’s like being trapped in a room with a screaming monster.The individual is screaming for control and something else has taken the reins. Loved ones often find themselves confused and lost, not knowing how to help. There is a great deal that happens with an eating disorder and while the struggle is in no way a reflection of character, such behaviors are often rooted in deep shame associated with body image, bingeing, restricting, and purging.
Eating disorders hijack an individual’s sense of self…
pulling them away from the people and experiences in their lives that they once enjoyed. One marker of concern is when some individuals become significantly less involved with and motivated by what used to interest them. Not only does energy become quite low, due to malnutrition, but all energy is essentially directed toward and hyper-focused on food, weight, and body image.
As a result, relationships are impacted by eating disorders, albeit in a destructive, limiting way. Despite one’s best attempt at hiding an eating disorder, they are fierce and insidious illnesses that impact more than just one’s relationship with food. Growth-fostering relationships require honesty, vulnerability, connection, mutual respect, and communication, all of which are at odds with the eating disorder.
The more consumed one is by their eating disorder, the more physically and emotionally distant they are from their relationships.
This strain on relationships strengthens the isolation supported by the eating disorder, creating a vicious cycle of diminished connection.
Emotional dysregulation, such as an overwhelming sense of anxiety, anger, or sadness, is also commonly seen and can precipitate eating disorders. In turn, eating disorder behaviors act as a way to cope with, avoid, numb, or distract from such unpleasant emotions. However, attempting to temporarily alleviate these emotions with eating disorder behaviors may actually exacerbate these symptoms.
Likewise, cognitive distortions about food and body image are common amongst individuals with eating disorders. Cognitive distortions are thought patterns of inaccurate or exaggerated thinking that we take as veritable fact. For example, dichotomous thinking, also known as black-and-white thinking, occurs when an individual struggles to see that multiple truths are possible. After eating a fear food, your loved one might say, “See! I don’t have an eating disorder anymore.” Dichotomous thinking keeps individuals stuck, narrows their focus, and leads them to miss out on nuances and other possibilities. While food and weight issues are symptoms of an eating disorder, cognitive distortions are often at the very root. This kind of thinking can lead to an increase in behavior use.
Just as there are indicators that show loved ones might be entrenched in their eating disorder, there are also markers of progress for when they are starting to recover.
Some of the main benchmarks we look for include:
- Enjoying food items that were systematically decreased or avoided when in the depths of the eating disorder
- Starting to engage and participate in activities and interests again
- Increasing social interactions
- Engaging in values-based reasoning
- Decreasing amount of time thinking about food
- Improved mood
- Cognitive flexibility
- Hoping to stay in recovery rather than revert back to the eating disorder
If you are a caregiver, parent, partner, or an individual with an eating disorder there are tools to help facilitate healing and move closer to these markers of progress.
- Reassessing values: When we talk about values, we aren’t just referring to individual values, but also identifying whether the eating disorder helps your loved one move toward the things that are important to them, or if it’s in fact, preventing them from living a values-oriented life and achieving their goals. Usually, the latter rings true for most individuals. This presents an opportunity for your loved one to understand that there are things in life – family, connection, honesty, professional goals, education – that they value more than their eating disorder.
- Externalizing the eating disorder: By separating oneself from the eating disorder and conceptualizing it as something outside of one’s self, the disorder can then be viewed as something impacting the individual rather than being something inextricably tied to the individual. This may make it easier to fight back against eating disorder thoughts and urges, and may be a helpful lens with which to offer support.
- Journaling to build awareness of novel moments: It may be helpful to document and keep track of the milestones you reach in recovery to remind you of your successes during moments when you are struggling. That time you conquered your fear food? Or that time you challenged a food rule? Write about it!
- Staying present: It’s easy to harp on the past or anxiously anticipate the future when it comes to recovery. Staying present is about increased awareness to one’s internal state of being. Staying present is helpful in navigating what underlies eating disorder thoughts and behaviors, and allows us to compassionately and non-judgmentally embrace new moments that recovery allows us to experience.
Together, with support from loved ones, these tools can help an individual challenge their eating disorder thoughts and urges and support them in their overall healing.