michellepugle
How to Support Someone With Anorexia
Updated: Feb 11
It can be hard for others to understand what's going on inside the mind of someone living with anorexia.
You may think encouraging someone with anorexia to eat because they're "thin enough" or "already beautiful" is helpful, for example. While you have the best of intentions, anorexia doesn't care where you're coming from. Anorexia also doesn't care about what you think is "thin" or "thin enough" or "already beautiful." In fact, anorexia can develop in people with bodies of all shapes and sizes and looks. Someone can be living with anorexia at any weight (and age).
Learning a few quick tips can help you navigate a sensitive situation with strength and move forward as a supportive parent, partner, or friend.
Quick Facts: What is Anorexia?
Anorexia is an eating disorder characterized by extreme calorie restriction and an intense fear of gaining weight, even in cases where the person is dangerously underweight. However, being underweight is an extreme end of anorexia - and there are many points in between. Someone may live with anorexia and never become categorically underweight, for example.
Anorexia is so much more than the number on the scale or the look in the mirror. Anorexia can include exercise purging to compensate for calories consumed and it can involve obsessive behaviours and food rituals. Anorexia steals concentration, inner peace, sleep, and confidence. Anorexia is a debilitating and disabling eating disorder that can be difficult to understand and challenging to treat.
Anorexia has the highest mortality rate of any mental illness. Yes, actually.
It can be incredibly challenging to support someone who is trying to recover from anorexia, as it takes a serious toll on the person living with this illness and their ability to maintain relationships.
Here are some dos and don'ts for supporting someone who has anorexia. These tips come from personal experience and research on ways to support someone living with an eating disorder. If you want to learn more, check the resources at the end.
What to Avoid
Generally speaking, you should try to avoid making the focus of your relationship their eating disorder or disordered eating behaviours. There are many reasons for this, including that the person living with anorexia is likely already overwhelmingly consumed with thoughts about food and their body. Helping them take a break from this by not booking food events or not bringing it up unless they bring it up first can be a great relief that opens a space of connection that can be a real catalyst for recovery.

Avoid focusing on their weight.
Don't focus on their weight, size, shape, or appearance at all (even if to say something you think is positive). The mind on anorexia can twist remarks, and also, a lot of compliments acceptable in other settings are downright enabling or triggering for people living with a history of anorexia.
Avoid focusing on their food choices.
Don't try to tell them what to eat or what not to eat. The less you focus on food, the better. Anorexia isn't about food- it's about control. Trying to take control back from someone with anorexia is a surefire way to make them double-down on their disordered eating behaviours.
Avoid making comparisons.
Comparisons keep people sick. Don't make comparisons to other people's behaviors or experiences. Trust me when I say the brain on anorexia is making comparison constantly. No need to add to this. Instead, bear in mind that every case of anorexia is as unique as the person who lives it.
Avoid pushing your idea of recovery on them.
Don't insist on medical treatment if they aren't ready for it. Recovery is a process, and it can't be rushed. Instead, try asking how you can help, what they need today, or how they're feeling in general.
Avoid feeling like it's all good just because some weight was gained.
Don't forget that recovery is not just about weight gain - it's about getting back (or creating for the first time) a life and a sense of self that has been lost. Even after weight stabilization (which isn't a linear process, either), recovery continues.
Avoid taking bad days, moments, or convos personally.
Don't take things personally. Anorexia can make your loved one irritable, angry, uncooperative and even downright mean towards you. While it can feel personal, and you certainly don't deserve the treatment, please try not to let this damage your relationship. Try to be patient and understanding; this helps them feel safe enough to tell you how they really feel. This is where recovery can begin.
How to Help Someone Living with Anorexia: What to Try
The following are suggestions on what you can do to support someone with anorexia. If you're feeling lost, hopeless, or like your loved on is never going to "get better," it may be time to talk to someone about the strains of being a caregiver. It's important to seek support for yourself, too, so you can be well while being of support.

What you can do to help someone with anorexia
Do provide a safe and compassionate environment for your loved one to express themselves. If you think you have a safe and compassionate environment but your child or spouse is not comfortable speaking to you about their innermost problems, there is a chance the way you present yourself to others and the world around you has signalled to them that it is not indeed safe. For example, if you say your loved one can tell you literally anything, but then you deny their experience (ie., that can't be true, that didn't happen, you don't feel that way, everyone feels that way so what's the big deal, etc.) it's not a safe and compassionate space.
Do understand that anorexia is not just about food or weight; it's a psychiatric disorder and an attempt to control something when life feels out of control (and this attempt to control something can get out of control really quickly).
Do remember that anorexia is not "attention seeking."
Do help them move towards seeking treatment. This can include letting them know that when they're ready to seek help, you will be there to help in the way they ask. Let them know all they need to do is ask, but do not add pressure and do not give timelines or ultimatums.
Do commit to your own physical health/wellness and get support for yourself from family and friends too.
Do recognize that your loved one's experience is different than yours. This is true whether or not you have ever experienced an eating disorder.
With the prevalence of anorexia on the rise, this issue is becoming increasingly important. Eating disorders not only take a devastating toll on the person struggling with them, but also strain the relationships of everyone around that person. Knowing what anorexia is, what to avoid, and how to help can make all the difference to someone living with anorexia or considering recovery (or returning to recovery after relapse).
Thank you for reading this post. If it made an impact on you, please feel welcome to share with others.
-Michelle Pugle
Resources for learning more on anorexia
Anorexia Myths & Facts. https://www.everydayhealth.com/eating-disorders/the-truth-about-anorexia-nervosa-myths-and-facts/
Anorexia. https://nedic.ca/eating-disorders-treatment/anorexia-nervosa/
What Is Anorexia? https://www.verywellhealth.com/anorexia-nervosa-5101748
What Causes Eating Disorders? https://psychcentral.com/eating-disorders/what-causes-eating-disorders