Perhaps one of the most challenging aspects of supporting someone with an eating disorder is knowing how to broach the topic in the first place. There’s no manual on the dos and don'ts of sharing your concerns with someone you suspect may be struggling, and it can be uncomfortable to discuss sensitive topics, like food, weight, and body image.

All of this could, understandably, make you consider staying quiet. But if you’re worried about someone you love, it’s important that you find the courage to speak up—because many times, that's what gets someone on the path to recovery.

To help you out, we asked eating disorder experts how to talk to someone with an eating disorder. Whether you're concerned about your loved one's behavior or you want to support them as they work through treatment, this advice will help you be the changemaker your loved one needs to start healing.

Why it’s so hard to talk to someone with an eating disorder

Talking to someone with an eating disorder isn’t easy. For one thing, eating disorders often thrive in secrecy: people who are struggling may lie about what they’ve eaten, or engage in bingeing, purging, compulsive exercise, and other disordered behaviors in private. This can make it challenging to spot warning signs and gauge if someone's behaviors are worrisome or not. It can also make it difficult to point to specific examples of why you’re concerned.

Second, eating disorders (particularly anorexia nervosa) can be egosyntonic, meaning the person believes the disorder aligns with their goals and values, and because of this, they don't want to change their behaviors. Additionally, many people with eating disorders have anosognosia, meaning they don't believe they’re ill and therefore don't believe they need help. In turn, they might react defensively or shut down the topic if you try to talk to them, says Equip peer mentor Elizabeth Moscoso.

And lastly, many of us are just scared to say the wrong thing. “There seems to be this genuine, empathetic concern that you might trigger your loved one and make their behaviors or disorder worse,” says Laura Sproch, PhD, CEDS-C, psychologist and owner of Vibrant Psychology.

Despite all of these real challenges, it's essential to talk to someone with an eating disorder. In many cases, the intervention of loved ones is what leads a person to get the care they need. “I've heard from many patients through the years that sometimes they’re waiting for someone to offer support,” Sproch says. “Some people need someone else to help along the way, to offer care, and to identify what they're concerned about.”

The sooner this can happen, the better. Patients who start treatment earlier have better outcomes: they show greater reductions in eating disorder behaviors and psychological distress and greater improvements in overall functioning. “Approaching someone you are concerned about nonjudgmentally—with objective things you’re noticing and appropriate resources—can help get folks evaluated and, if need be, treated,” says Sam Kolander, MD, a psychiatrist specializing in eating disorders and former medical director at Equip.

How to talk to someone you’re worried might have an eating disorder

So you know you need to bring up your concerns and are ready to do it—but exactly how do you talk to someone with an eating disorder? “Having these conversations can be intimidating. Maybe you've never had to talk about this before, or it makes you really uncomfortable. That's totally valid,” Moscoso says. “Know that it can be powerful to ask meaningful and respectful questions and show the other person that they matter.”

The tips below can help you prepare, so you feel confident approaching your loved one.

1. Learn about eating disorders

You don't need to be an expert; however, you may feel more prepared and less worried about saying the “wrong” thing if you educate yourself about eating disorders. “When you don't know the facts, your mind can create scary scenarios,” says Equip Community Advisor Kym Piekunka. “Learning about the illness will help you better understand some of your loved one's experience and their behaviors. It will remove the terrifying thought that you are somehow to blame, and you will have a better idea of what to expect.”

2. Find the right time and place

“Don't bring it up at meal time or when lots of people are around. Instead, choose a place that's quiet and comfortable for both of you,” Moscoso advises. This allows both you and your loved one to be calm and untriggered, so you can focus on the conversation. It’s also helpful to give them a heads up so they don’t feel ambushed, which can put them on the defensive from the get-go. Try something like, “I'm hoping we can have a conversation about some things I've been worried about. I care about you and want to give you the space to talk. When’s a good time later today?”

3. Share specific observations

Rather than zeroing in on their body or other potentially triggering topics, focus on their behaviors and how this impacts them and your relationship. This could include:

• I've noticed you haven't come out to Trivia Night in a while. I miss laughing so hard with you that we both cry.
• We haven't baked together in weeks. I look forward to that every week. Is this just a really busy time for you right now, or is something else going on?
• You seem to be exercising a lot recently, and I’ve noticed that you’ve been tired and getting sick more frequently. I wonder if those two things could be connected?
• You haven’t been wanting a snack when you get home from school anymore. Do you know why that changed for you?

4. Be curious and listen

Your loved one may not talk much during the conversation. If that's the case, let them be. “You probably planted some seed and, later on, they might process this conversation in a different way and want to proceed with seeking treatment,” Sproch says.

If they do talk, truly listen. Don't interrupt, knowing that it's likely hard for them to talk about this, and their words may come slowly. Letting them steer the conversation (without letting them get too off topic) can give them a sense of control during a time that feels out of control, and helps them feel heard. Consider using reflective listening skills, which basically means paraphrasing what they said: “I hear you say that you're feeling anxious about starting a new school. Is that accurate?”

5. Stay positive

Don't forget that your loved one has wonderful gifts and strengths. If you can, incorporate those into the conversation. “You've been through so much in your life, and you are so resilient—you have done X, Y, and Z already. I want to support you in living the best life you possibly can in the way you want to see it,” Sproch suggests.

6. Offer to help

If your loved one is open to seeking treatment, offer to look at resources together or ask if it would be okay if you looked into some eating disorder specialists in your area and emailed a list to your loved one. Doing these kinds of tasks can feel extremely overwhelming to someone affected by an eating disorder, and your help can be a game changer. While they may not act immediately, having this information handy could help them make that phone call when they do feel ready.

7. Expect pushback

“A whole host of emotions might happen. Someone might feel angry, someone might be relieved, someone might be sad, someone might be worried, someone might have a whole mixture of emotions. All of that is okay, and it doesn't mean you triggered them. It's likely the eating disorder reacting,” Sproch says. Even if your loved one walks away, remain available to them. This type of reaction isn’t unusual, and you’ll likely need to have multiple conversations.

8. Plan a follow-up

At the end of the conversation, Sproch suggests planning a way to check back in, even if they feel frustrated or defensive. Ask them, “What would feel supportive to you? When can we do that? What will that look like?” For some people, that may mean talking face-to-face in five days; for others, that may look like texting once a week to check in on them and reassessing from there.

How to talk to someone in eating disorder treatment

If your loved one has started eating disorder treatment, it's common to still worry about potentially saying the “wrong” thing. It can be helpful to flip the script, and instead consider how talking can help them in their recovery journey.

“Eating disorders are really severe illnesses that can affect all aspects of life—psychological, social, financial, academic, occupational, emotional, physical—and so oftentimes, people need support to help them navigate their recovery journey,” Sproch says. “We know support people can make quite a difference. When we're doing really hard things, having other people alongside us can be very useful.”

Here are some tips to keep in mind when talking to someone in eating disorder treatment.

1. Ask what they need

If they’re uncertain about what would help, offer some ideas: maybe you can help them set up a comfortable space in their home to join virtual sessions, have dinner together twice a week, or redo their social media accounts to block unhelpful content and follow supportive accounts. Whatever it is, let them guide you, and ask again down the road. “What someone needs to begin with may be very different five or 10 weeks into treatment. Just be there for the type of support they need,” Sproch says.

2. Be their accountability person

Accountability is crucial during the eating disorder treatment process. Some patients choose a support person and text them at the end of every therapy session to share what they’ll be working on that week and make a plan for checking in on progress: “Here are two things I'm working on this week. I'll text you at 8 p.m. every night to let you know how this goal is going.” If you don't hear from them by that time, you reach out, leading with curiosity. “You've been doing so well with X goal. How'd it go today?”

Accountability could also look like sending pictures of meals and snacks, providing daily updates about exercise behaviors, or anything else they need help sticking with.

3. Join a session

Research shows that having loved ones involved in treatment can support recovery. This is often family, but can also include partners, friends, or other support people. If their treatment program includes loved ones, offer to be a part of the journey, whether that means ongoing involvement or joining a session or two. “This can be exactly the time to talk about what is going on and any concerns you're having,” Sproch says. “It's a safe place because you have a professional there.”

At Equip, support people are integrated into the recovery process at whatever level feels most supportive to patients and their loved ones. For young patients doing FBT, supports play a key role in the process.

4. Seek your own support

Supporting someone through eating disorder recovery is hard, and it’s important to take care of yourself. “I've worked with support people—sometimes they need their own support,” Sproch says. This could be an eating disorders specialist who can educate you about these diseases and treatments, a therapist who focuses on self-care, or a trusted friend. At Equip, loved ones have a dedicated Family Mentor with lived experience helping someone recover from an eating disorder who can provide empathy, compassion, and real-life advice.

How to talk to different types of people with eating disorders

There are no rules around who can be affected by eating disorders—or on how to “best” talk to any one person. Still, if your loved one fits any of the categories below, these tips may help.

• Males: Ask what their goals are for working out more, adjusting their diet, or whatever their behavior is. If the person is your son, “Openly ask if they are reducing calories, restricting food, or more concerned about their bodies than they previously were,” says Equip Family Mentor Linsey Henry. “If any answers hit an alarm button in your gut, reach out to your local doctor.”
• Students: Teachers may be among the first to notice shifts that could indicate an issue with food, exercise, or weight. Start the conversation with your observation. For example, isolating from peers is a common early symptom of an eating disorder. If that's the case, you might say something like, “I notice you aren't hanging out with X, Y, and Z like you used to. Is there something going on you can share with me?” “A student's reaction to caring questions can be informative,” says Equip's Director of Lived Experience, JD Ouellette. It’s also important to share any concerns with the student’s parents.
• Student athletes: Athletes are at an increased risk of developing an eating disorder. If you’re a coach or trainer, it’s important to know the red flags and speak up if you see any. “Ask simple questions with an observation, such as, 'I've noticed that the past week you've been skipping the pre- and post- practice snack, how's your energy feeling?’” Moscoso suggests. “This gives the student the opportunity to open up.” Again, if there is a concern, talk to the parent.
• Coworkers: “This is tricky territory and will depend on your closeness to this co-worker and their level of visible impairment,” Ouellette says. “If you feel you can or must say something, be mindful of timing, the setting, and your demeanor. It might also be important to involve human resources if you have a strong safety concern for them.”

If you're concerned a loved one has an eating disorder, speak up

Initiating a conversation about eating disorders with someone you care about may be challenging, but it may also be life-saving. Here are some important tips to remember that can make the discussion more productive:

• Choose a quiet time and place
• Share your observations without judgment
• Avoid any talk about appearance or weight
• Ask questions, and truly listen to the answers
• Expect pushback, and know you may need to have multiple conversations

Above all, don't be discouraged. Eating disorders don't go away on their own, and early intervention saves lives. Your actions may be just the thing your loved one needs to seek help—even if that's not right this instant. “You are planting seeds. They might not grow immediately,” Sproch says. But over time, with more conversations, texts, and other types of support, your loved one will likely choose recovery.

If you’re concerned about a loved one, schedule a call with an Equip team member to learn more about our evidence-based, at-home treatment.