An eating disorder is a serious condition with potentially life-altering and even life-threatening health consequences. Nearly one in 10 Americans will experience an eating disorder at some point in their lives. Support from loved ones can help them survive and overcome these dangerous conditions. If you’re looking for answers about how you can support someone with an eating disorder, here are a few ways you can help.

What is an Eating Disorder?

An eating disorder is a mental health condition that causes preoccupation with food, weight, and/or appearance, resulting in behaviors, thoughts, and feelings about food and eating that threaten overall health. There are many types of eating disorders, including:

• anorexia nervosa – People with this disorder severely limit their food intake. Anorexia is a very serious health condition, associated in many cases with extreme weight loss, and carries a higher risk of death than any other mental health condition, including depression.
• bulimia nervosa – People with bulimia use a variety of strategies—including throwing up or taking laxatives (called laxatives) or exercising too much—to “shrug off” or burn off calories. People with this disorder binge (eat a large amount of food at once) at least a few times before engaging in purge behaviors. Discharge may also occur after eating a small meal or snack.
• binge eating disorder – This is the most common eating disorder. People with this condition eat large amounts of food in a short period of time, often alone or in secret, because they feel shame, guilt, and pain about what they eat. Bulimia involves binge eating without purging.

Many factors can affect whether a person develops an eating disorder. These include family history, deep-rooted eating behaviors (such as dieting or restricting food intake in the past), other mental health conditions (such as anxiety, depression, or OCD), stress, and social pressure.

Anyone can develop an eating disorder—regardless of age, gender, racial/ethnic background, or weight. While anorexia and bulimia are more common in women and girls (although they can still occur in men), bulimia affects almost as many men as women.

treatment and support

If you’re wondering how to support someone with an eating disorder, guidance from Dr. Gary Litovitz can help. Dr. Litovitz is Chief Medical Officer at Dominion Hospital and Medical Director of the Reflections Eating Disorders Treatment Center at Dominion Hospital in Falls Church, VA, which is part of our larger HCA healthcare network. Here, Dr. Litovitz offers advice on how friends and family can encourage someone on the road to recovery.

Encourage positive self-esteem and coping mechanisms

First, focus on building positive self-esteem and a sense of self that isn’t based on looks or being thin, says Dr. Litovitz. “You want to avoid focusing on weight, size, or thinness as a marker of success,” he explains. This is especially true for those who weigh more than healthy. “Don’t talk about losing weight, but talk about eating a variety of healthy foods in the context of health and proper nutrition.”

Instead of thinking and talking about good and bad food, emphasize balance and moderation in your food choices. This promotes trust and encourages healthy habits.

Family and friends should not praise weight loss, which can sometimes cause or exacerbate eating disorders. Our society tends to glorify weight loss and thinness, says Dr. Litovitz.

“People sometimes see eating disorders as some sort of badge of honor,” he explained. “They don’t realize the cost or the real impact on health and life goals.” He encourages people to share accurate information about how eating disorders such as anorexia nervosa affect overall health and even risk of death.

Dr. Litovitz added that eating disorders can develop during stressful or stressful situations. Encouraging healthy coping mechanisms can help prevent and treat eating disorders. For example, he encourages loved ones to normalize seeking help in difficult situations. This may include talking with a school counselor or mental health professional.

If someone says they want to deal with an eating disorder or other mental health issue on their own, it’s often a sign that they feel stigmatized or intimidated about mental health treatment, Dr. Litovitz said. There was “no shame” in asking for help or seeking mental health care, he added. In fact, seeking help during times of stress is a hallmark of resilience and healthy coping strategies.

understand the signs

Loved ones should watch for signs of an eating disorder, such as skipping meals, avoiding family meals and other social situations that involve eating, sneaking food, or disappearing to the bathroom after meals. Weight loss may be another sign, but anyone at any weight can have an eating disorder.

If you notice any signs, Dr. Litovitz recommends talking to the person in a nonjudgmental way. “Expect rejection,” he said. “Eating disorders can cause shame and embarrassment.”

He explained that it’s important to create a safe environment so people can feel comfortable talking about their illness. “Let them know how common eating disorders are and that you want to help with their difficulties with eating and body image,” Dr. Litovitz says, urging “nonjudgmental listening without criticism or threats.”

consider treatment options

Many people with eating disorders try to evade treatment. However, the sooner they are treated, the better their chances of recovery.

When considering treatment options, Dr. Litovitz explained that there are multiple levels of care, including outpatient treatment, partial hospitalization, and inpatient or inpatient care. Treatment for eating disorders can be very different from other mental health conditions, so it’s important for professionals to have specialized training outside of general psychiatry or psychology. Family members and partners should also be expected to participate in therapy, Dr. Litovitz said.

A multidisciplinary team of therapists, dietitians, and physicians—all with specific training in eating disorders—can best determine an approach for a particular situation. While eating disorders often occur with other mental health conditions, such as anxiety or depression, they should still be treated at an eating disorder clinic, Dr. Litovitz said. “Nutritional disorders can affect mental health, so it’s important to treat them first,” he explained.

Dr. Litovitz said treatment takes time and commitment from individuals as well as from family and friends. It may take several attempts before treatment leads to recovery. Recovery may look different for everyone – it can mean no more disordered behavior and regaining weight for those whose bodies need it. However, Dr. Litovitz said, “Treatment is the best path to a healthy future.”

Find information on mental health resources from HCA Healthcare, our larger health network.