In this season of shared holiday meals with celebratory foods, supporting a friend who is recovering from an eating disorder can feel like both a necessity, and big question mark. You may be wondering: how can you help your friend with an eating disorder, when they’re faced with the difficulty of communal meals and togetherness around food?
Transitioning to recovery is a process
Eating disorders are tied to control, soothing difficult feelings, and working around painful emotions and thoughts, particularly about self-worth and self-image. Even though your friend has sought treatment and is working on recovery, they are likely still in the process of dismantling the effects of their eating disorder. Disordered eating can bring a host of feelings, including shame, guilt, and severe anxiety.
How can I support my friend with an eating disorder?
Being patient, kind, and open-minded is the best starting point in helping your friend cope. Your friend may be struggling with denial or defensiveness. There is also a grief component for many who work toward recovery; that structure of life being changed is a loss, even if that loss is ultimately for the better. That loss also means loss of coping mechanisms, which can leave your friend feeling adrift. They are likely working on building up healthy coping mechanisms in treatment, like the skills offered in DBT, but the transition to healthy coping can take time.
How to help your friend with an eating disorder as you share a meal
Talk with your friend
Ask your friend how you can best support them; what works for some may not work for others. Know that what might seem easy to you, just a bite of something, may feel impossible to them. Offer your friend the space to try, and accept their word on what they’re capable of. Showing willingness to hear them without judgment can build trust and safety, allowing them space to try and try again.
Work with your friend and their care team
If your friend has a nutritional care team, ask if you can work with them to figure out meals that are both suitable for treatment milestones, and take into consideration nourishment as well. If they are no longer working with a nutrition team, asking your friend what works for meals is also a great place to start; meals that can be shared that feel safe, or even a small challenge food that you support them in trying without offering shame or blame, can help your friend through recovery.
Take a look at your own approach to food
Do you discuss dieting or restricting foods regularly? Consider whether this talk is helpful, both to your friend in recovery, and even to yourself. Look at your approach to foods; are some “good”, and some “bad”? When supporting a friend in recovery, this narrative can hurt their progress. You can help by attending to your own approaches to food, and taking a neutral stance on all foods while involving your friend in meals. Helping your friend with their recovery may be a good starting place for offering yourself the same grace and gentleness you offer them around food.
Don’t take it personally
Your food is delicious, your support is wholehearted, and sometimes your friend will still be unable to eat in a healthy way. When someone is wrestling with an eating disorder, seeing food as neutral or positive becomes very difficult. Know that your friend isn’t being difficult or rude, they’re unwell and trying their best.
Ask your friend how you can help integrate their DBT skills
Dialectical Behavioral Therapy, or DBT, is a highly effective therapy structure for treating eating disorders. It’s a structure that involves individual and group therapy, as well as a suite of skills designed to help with mindfulness, emotional regulation, interpersonal effectiveness, distress tolerance, and middle path thinking.
If you find yourself wondering how you can support your friend with an eating disorder, working with them on their DBT skills is a great place to start. A particularly helpful DBT skill for eating disorder recovery is interpersonal effectiveness. Sharing food is a communal act, and disordered eating often robs someone of a lot of interpersonal interaction they need. When they are working to rebuild that community, you can support them by working with the skills they’re developing in DBT. Conflict can arise around shared meals when a friend has an eating disorder, but using structured DBT skills can make a tremendous difference in how that conflict is resolved.
One such example for support around eating disorders and conflict around food is the DEAR MAN tool. With this tool, your friend can advocate for themselves around food, while also negotiating some compromises. As you witness them use it, engage with them deliberately as the other side of the conversation.
- D- describe their current situation, factually.
- E- express themselves, including feelings and decisions.
- A- assert themselves; ask for what they want, specifically, or state their “no”.
- R- reinforce to the person they’re speaking to the positives of them getting what they want, or the consequences if they don’t.
- M- mindfulness; focus on the goal, keep asking for it, regardless of the responses they get.
- A-appear confident. Speak clearly, make eye contact.
- N-negotiate; see where compromise can happen, that meets their goals but also offers something in return.
The DEAR MAN tool is simply one example of many skills your friend will develop when using DBT to recover from an eating disorder. Asking them to involve you in their healing, working with them on their skills, can be a tremendous support as they recover. Your sustained, patient friendship through the hard moments is one of many supports your friend needs, and is always worth the investment.
If your friend is in need of more substantial support on their recovery journey, consider having them get in touch with THIRA Health today to see how we can help.