If your friend, partner, or family member has an eating problem
Fear, worry, confusion, frustration, denial, anger, and bewilderment are emotions that family members and friends may feel when attempting to help women they care about overcome their eating problems. Supporters of women with eating problems may think that the solution is simple: just eat and you will be fine, just stop making yourself throw up, or just eat when you are hungry and stop when you feel full. However, there is no simple solution to the complex symptoms associated with eating problems. Moreover, it is important to remember that eating problems serve a purpose in a woman's life.
Eating problems represent a creative effort to cope with a complexity of emotional and social pressures, and are logical solutions to seemingly overwhelming situations. An eating problem may be a woman's method of coping with relationship issues, emotional distress, and negative body images due to societal pressures to be thin. Grief, anger, rage, inadequacy, low self-esteem, lack of self-knowledge, feelings of purposelessness, and a sense of being unaccepted and unknown both by herself and others are but a few of the many feelings that eating problems help offset. Thus, it is important to recognise and respect this expression of feelings that a woman may be unable to cope with or express in another way.
Since eating problems serve as such a powerful coping tool, recovery can be a slow process and there are no simple solutions or cures. In addition, recovery typically includes relapses and setbacks, and can be very frustrating for supporters. One day a woman may seem fully recovered while the next day she may appear to be struggling with her eating problems all over again.
Friends, partners, and family members need courage, patience, perseverance, empathy, sensitivity, and support when helping women face an eating problem. While every woman is unique in her struggle with eating problems, the following information may assist friends and family.
How can I help?
Addressing the problem:
1. Let a woman know that you are concerned for her and that you want to help. Pick a low stress time and choose a relaxing environment. Openly express your concern for her, without criticism or judgment.
2. A good way to express concern is by using "I" statements. "I" Statements speak of our own experiences and feelings rather than "You" statements which tend to make judgments about another person and may make her defensive.
Examples of "You" statements:
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Instead of telling a woman what you think about her, tell her how you are feeling inside, by using an "I" statement.
Examples of "I" statements:
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3. Be prepared for a woman to deny that she is experiencing difficulties with food. Eating problems may be experienced as incredibly shameful and women may go to great lengths to hide their problem. A woman may feel disgusted by her perceived lack of control over her food intake and feel full of self-hatred when she vomits or takes huge quantities of laxatives. This shame may make her feel afraid to talk about the problem, or admit that she has a problem at all. Thus, it is important to be as non-judgmental and supportive as possible.
4. Don't repeatedly accuse her of having a problem if she denies it. Work at understanding her shame and fear of losing your positive regard for her.
5. Be supportive of her physically as well as emotionally. A touch, hug, or simply sitting with a woman with eating problems can be extremely comforting, signalling that you support her and are not disgusted or repulsed by her behaviour. Continue to ask her to accompany you on activities and make plans to do things with her.
Don't focus on food and weight
The internal world of a woman with an eating problem is constantly focused on food, weight, and body image. For women with eating problems, the rich and complex package of what makes us human - our goals, dreams, aspirations, opinions, needs, desires, thoughts, interests, hobbies, and relationships - becomes reduced to concerns over calories and scales. Thus, focusing solely on food and weight for a woman with eating difficulties ignores her rich internal landscape and confirms her diminished view of herself. Reducing all conversations to food and weight reduces a woman.
Also, watching a woman eat, monitoring food intake, and discussing weight may be counterproductive. Such discussions remove the focus from the emotional issues and social pressures at the root of eating disorders.
In addition, focusing on weight and food issues may exacerbate the problem. A woman who is overweight may feel ashamed and demoralised when people comment on her appearance and food intake. Judgments like 'You shouldn't be eating' may make her feel worse and perpetuate a food binge. An anorexic woman hearing she's too thin may feel pleased and proud of her accomplishments. Thus, it is hard to know what type of reaction comments about a woman's weight and body will precipitate.
It is important to take time to talk to women with eating problems without always talking about food. It may be difficult to find other areas besides food to talk about and you may have to change the subject or redirect a conversation in order to avoid getting into a debate or power struggle about food and weight. However, remember that eating problems are an attempt to solve a variety of personal problems and issues and are hiding a much deeper internal landscape.
Finally, remove angry discussions and frustrations about food from mealtime conversations. Food and meals are sensitive, emotionally laden issues and bringing them to the table may only heighten emotions. Instead, make mealtimes a place to discuss calm and less emotional issues. In addition, it is important to keep mealtime schedules and family routines and holidays consistent, to provide structure to both the woman as well as the rest of the family.
Listen with empathy
Empathy refers to the ability to see the world through another person's eyes without judging, correcting, or evaluating their perspective. It is listening and asking questions in a way that another person feels you are in tune with them, their views, and their world.
Empathic listening has little to do with the listener's perspective, viewpoint, or beliefs. It is about understanding the experience of another human being. Empathic listening conveys to someone that their world is valuable, important, and understood, and signals to someone that you care about them.
Listening to a woman with eating problems requires an empathic ear, since her perception of her body and her weight may be much different from what is seen by others. She may be severely underweight but think that she has more weight to lose. She may have a normal shape but think that a particular body part, like her thighs, is grossly out of proportion to the rest of her body. She may firmly believe that she must be as thin as the popular supermodels in order to have a good body. While these beliefs may seem unhealthy or irrational, debating or challenging her beliefs may leave a woman feeling frustrated, misunderstood, and miserable. It is at these crucial times where a woman with an eating problem needs an empathic listener.
Examples of empathic responses include:
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Empathic responses include small encouragers that indicate your willingness to keep listening without interrupting or making inferences.
Simple empathic encouragers include:
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It may be very difficult to listen empathically to a woman you care deeply about because you see her in physical and emotional pain, and it is very tempting to try to tell her what to do to relieve her distress. However, as a partner, friend, or family member it is important to realise that support and empathy are key elements that you can offer her. Professionals, while offering support and empathy, have the key theoretical knowledge to actually treat women with eating difficulties.
Educate yourself about eating problems
Read literature about eating difficulties in order to better understand women who have eating problems. There are many excellent books on anorexia, bulimia, compulsive eating, and compulsive dieting as well as first-hand accounts of women who have survived eating difficulties. Consult our recommended reading list for some ideas.
Educate yourself about the cultural pressure on women to be thin and examine how these pressures emerge in your own life. Advertising, media, and other cultural forces impose a rigid ideal of thinness onto women, contributing to fat phobia and an obsessive pursuit of thinness among women. Western culture promises that a thin body is the key to popularity, success, happiness, and self acceptance. Body shapes that deviate from the ideal body are often viewed as fat, disgusting, ugly and undeserving of love and acceptance. Women are told that through diet and exercise, they too can have the thin body and thus eternal happiness.
Dieting and a preoccupation with body image are seen as normal and natural for women in Western cultures. Chronic dieting and poor self-images based on weight characterise thousands of women in Western cultures and have become a normal way of living. Eating in response to natural internal rhythms of hunger and satiation are replaced with a profound mistrust of one's bodily needs and one's body as a place in which we inhabit. Rather than a place that we live, love, move, dream, hope, and grow, women's bodies become untrustworthy enemies that must be scrutinised, criticised, and deprived of needed food and nourishment.
Most eating problems begin with dieting in an attempt to become thin. Thinness is supported by cultural forces as a gateway to happiness and can be seen as a magical solution to emotional problems:
If only I were thin I would be happy
Women with eating problems embrace this equation that thinness equals happiness, looking to dieting, exercise, diet pills, laxatives, starvation, bingeing, and purging as vehicles to acceptance and satisfaction. The magical solution offered by dieting and thinness ultimately blossoms into an eating problem.
Eating problems exist on a continuum. While a woman with anorexia or bulimia occupies an extreme end of the continuum, less extreme forms of body dissatisfaction are quite common in Western cultures. Chronic dieting, eating compulsively, or even waiting to go to the beach in a bathing suit until you are thinner are all related to the body dissatisfaction and cultural pressures to be thin that fuels eating problems.
Everyone, in some way, is affected by social and cultural pressures to have an ideal body shape. As a partner, friend, or family member, it is important to examine your relationship with your body, how these pressures affect you, and how they are communicated to others. Are you satisfied with your body shape? Do you value many things about yourself other than your body shape? Does your weight determine how you feel about yourself? Are you always on a diet? Do you accept many different body shapes and sizes or do you have one size? Do you make comments to family members about their weight? How are your feelings about thinness expressed in your family?
You may want to refer to our recommended reading list to examine your own feelings about weight and food or consult a counsellor or eating difficulties group in your area.
Recognise that a woman's eating difficulties and problematic relationship with food is ultimately her responsibility.
We can't MAKE a woman stop bingeing, purging, or dieting just like we are not to BLAME for a woman's eating problems. We can be open to talk, take her to counselling sessions, listen and empathise to what her experience of her world is like. However, as much as we want her to live a happy and fulfilling life, each woman makes her own progress according to her own schedule and we must honour and respect her process of recovery.
Take care of yourself
Eating problems may polarise and divide families, alienate friends, and wreck relationships. Life may seem to be put on hold while a woman battles an eating difficulty. It is important to keep routines intact and to pay attention to the needs of the other members of the family. It is also very important to take care of yourself since dealing with a woman with eating problems can be extremely stressful and tiring. Make time for yourself, for special activities that you enjoy, and for special treats. Provide yourself with a good support system of friends, family members, and resources within your community who will assist you in supporting a woman with eating problems.
Although eating problems are painful and difficult, women often find a renewed sense of confidence, self-esteem, and happiness through treatment and therapy. By working through their eating problems, women's lives may be transformed as their internal landscapes expand and their relationships grow and deepen. Thus, when the storm of an eating disorder blows over, a fuller and richer life often remains. As supporters of women with eating problems, it is important to remember this possibility of richness as you weather the storm.
