Supporting Young Women with Eating Disorders:
A Guide for Family Members & Close Friends
- There is no quick fix - recovery takes time.
- Avoid commenting directly on food choices and behavior at meals, physical appearance, or body shape.
Eating disorders affect millions of young women. If you're reading this information guide, you may be a family member or close friend of someone struggling with an eating disorder. It's normal to feel helpless and confused at times. The chronic nature of eating disorders can drain a parent of physical and emotional energy. Learning about eating disorders can help you provide proper support. Not all suggestions in this guide are appropriate for everyone. It's important to remain sensitive to the unique struggle of your family member or close friend with an eating disorder. This guide was created to offer ideas on how to help a young woman with an eating disorder. However, this guide does not replace recommended treatment or care from a physician, counselor, or nutritionist.
The Road to Recovery
Be Patient. There is no quick fix or cure for eating disorders. Changes in thinking and behavior happen slowly. As a family member or close friend, try to look at overall trends (e.g., in eating behaviors or weight) rather than focusing on the day-to-day "bumps".
Offering Support at Meals and Snack Time
Eat together. Meals and snack times are often the most difficult part of the day for young women with eating disorders. They may be very anxious at meal times and feel guilty for eating. Meal times often require support and supervision. If someone they trust eats with them, the experience of eating can be more comfortable. Try to model balanced meals and food as nourishment rather than something more complicated. Refrain from dieting or restricting your own intake.
Enjoy each other's company. Discuss neutral topics rather than focusing on food, calories, or weight during conversations. Avoid any urge to be a "food police." Try to talk about something fun, like your favorite sports teams, hobbies or music. Continue this conversation (or another activity) up to 30 minutes after the meal to distract from feelings of guilt or any impulse to purge after the meal. As difficult as it may be, try to keep mealtimes feeling natural, as similar as possible to before the eating disorder began.
Consider adopting a mealtime agreement. Agree in advance not to discuss topics such as portion size, calories, carbohydrate, or fat content at meal times. Many young women with disordered eating have continuous negative thoughts about food. Mealtime agreements can reduce tension and stress associated with eating.
Plan ahead. As a family, agree on the structure of mealtimes (e.g. what time you will eat, what will be served at the meals, and who will be present at the meal). Strive to honor this plan, as this can reduce mealtime stress for your teen.
Grocery Shopping, New Foods & Cooking
Some young women recovering from eating disorders are able to participate in grocery shopping and cooking. Speak with your teen's health care provider or nutritionist to determine if she is ready for this step.
Grocery shop together. Explore your favorite grocery store or visit a different market. Check out new foods and set a goal to try one new food each week. Young women with disordered eating often have a small list of "safe foods" that they feel more comfortable eating. Usually, these foods are low in calories, or come from a food group that your teen or close friend does not see as "threatening", such as carbohydrates or fat. During recovery, it is important to expand food choices and reduce the number of foods that are considered "threatening". A nutritionist can be very helpful with realistic goal-setting and coaching a patient toward positive change.
Make sure that all foods that you will need for meals are available. This helps lessen worry at mealtime. Sometimes if a food item is not available at the designated eating time, it can lead to panic and restricted food intake in someone with an eating disorder.
Cook together and try new recipes. Many young women with eating disorders would prefer to cook with someone they trust. Learning how to cook provides another skill towards recovery. Trying new recipes also helps increase the "safe foods" list to promote more "normalized" eating. Take a look at our "Quick and Easy Recipe for Teens Cookbook" for ideas!
Encourage new interests. Suggest new activities such as art classes, volunteering or community service, clubs at school, music, or yoga. It is important to replace the unhealthy, disordered eating behaviors (excessive or ritualistic exercise patterns or restrictive dieting) with healthy interests, especially those allowing room for creativity. Teens and young women struggling with eating disorders often choose activities that are based on dieting, weight regulation, and exercise. It is difficult for young women to break away from these patterns. However, developing new interests can help reverse the disordered eating behaviors and over time improve self-esteem.
Plan a special event. Make an appointment for a new haircut, manicure, or massage. As young women recover from an eating disorder, their body shape, facial structure, hair texture, and overall appearance may change. They often feel they do not deserve special things. A special event can be a nice way of helping your teen adjust to (and appreciate) her new look. It also sends the message that they deserve to treat themselves to something fun-that they are worth it!
Shop for clothes. Because clothing sizes often fluctuate during recovery, it's best to buy a few new pieces of clothing at a time rather than an entire wardrobe. Some young women with eating disorders have a difficult time clothes shopping because of dressing room mirrors. It can also be difficult for a teen to buy a different size than she has become used to. Ask your teen if she would like to go shopping of if she would prefer that you pick up new items for her. Additionally, don't bring home "health" or fashion magazines home as these may show unrealistic body shapes and focus on appearance.
Talking with Teens
Avoid commenting directly on physical appearance or body shape. Statements or questions such as "You look great!" or "You look better", "You've gained weight" or "You've lost weight--what's going on?" may make your teen feel extremely uncomfortable. During recovery, teens often look much healthier, brighter, and stronger. However, commenting on this is often interpreted negatively by the teen. A remark such as "You look so much better now that you're not all skin and bones!" may be interpreted as "I am fat!" by a young woman with an eating disorder.
Comment on health and energy level. Statements such as "You are full of energy!" or "You look well rested" are more appropriate and often make young women feel supported in their recovery. These types of comments show recognition of improved health status and do not focus on body shape or size. Even better, you may offer comments related to your teens personality or interests, such as "You are creative and thoughtful".
Smile! Happiness is contagious. A bright, cheerful, and consistently positive attitude works wonders. It is very difficult to watch someone you care about struggle with any illness. Worried looks or tears often make young women feel very guilty about their eating disorder and may lead the teen to feel more anxiety, self-loathing, or depression. It is very important to try to be positive. A simple smile can spread a message of hope and cheer to a teen with an eating disorder, and can soften an otherwise tense interaction or conversation topic.
Sharing positive thoughts with a loved one who is struggling with an eating disorder and body image concerns is helpful. Check out nationaleatingdisorders.org (Information & Resources tab) for "Ten Steps to Positive Body Image" and other helpful suggestions to beat negative thinking.
Support for Yourself
If you feel overwhelmed with your child's illness, consider seeking professional support from a therapist or social worker. Just as it is important to teach your teen that she is worthy of special things, try not to overlook your own self-care. Finding time for a peaceful walk, a yoga class, or meeting a friend for coffee is more important now than ever. This also models positive behavior for your teen.
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