Why Don’t You Just Eat?
Eating disorders are puzzling illnesses. They are also serious mental illnesses. The idea that someone would be unable to nourish their bodies with enough food seems illogical and beyond understanding for many people. It is confusing when your loved one won’t eat. It is tempting to say, “Why don’t you just eat?” Many people with eating disorders are exceedingly intelligent and competent in all other areas of their lives, resulting in people thinking that a logical argument can “fix it.” However, there are complex biological, genetic, and socio-cultural issues at play that make the person unable to eat an appropriate amount. People with anorexia nervosa are terrified of eating. Asking them why they won’t eat isn’t helpful. It can also seem blaming and shame-inducing.
Why Don’t You Stop Throwing Up?
If a person with anorexia or bulimia struggles with self-induced vomiting, they likely want to stop. Asking them why they won’t only serves to increase the amount of shame and guilt that they likely are already experiencing. Unfortunately, shame and guilt (and other negative or difficult emotions) can be triggers for future binge and purge episodes.
You Look Great/Healthy/Better Than Ever!
This one seems like it should be something that would be helpful to say. However, patients report time and time again that this is an incredibly triggering comment. Unfortunately, eating disorders can change the way a person perceives different words. Because a person with anorexia (or bulimia) may need to gain weight as a part of treatment, the eating disorder will cause any comment noting a change in appearance to be confirmation of the weight gain. Thus, to an eating disordered mind, healthy means fat.
What Diet Are You On?
Our society praises weight loss and people constantly want to know about the newest and best way to lose weight. However, if a person with an eating disorder is losing weight and gets positive feedback from other people about weight loss, this can encourage disordered eating behaviors. It is best not to comment on appearance at all. Focus on being happy to see the person or the person being in a good mood. Alternatively, ask about other non-appearance related qualities of the person.
You Look Unhealthy
These may seem like words of concern, but the eating-disordered mind often equates unhealthy with thinner. And thinner is the goal of the eating disorder. In general, it is a good policy to avoid any reference to a person’s size, shape or weight.
I’m Glad You Ate
Avoid commenting on what a person with an eating disorder has eaten unless it’s part of a treatment plan such as family-based treatment (Maudsley). People with anorexia and bulimia often believe that other people are watching what they are eating and judging them for it. Commenting on what they have eaten only serves to confirm this to their eating disorder. Even when a family is using an FBT approach, successes in eating are typically not reinforced. This is because such comments increase the patient’s guilt over disobeying the eating disorder.
Does This Make Me Look Fat?
Avoid “fat-talking” about yourself. Many people with eating disorders are hyper-aware of what people around them are eating, how much they weigh, and how they look in their clothing. Commenting negatively on your own body can make a person with anorexia or bulimia even more focused on weight and food issues. Instead, focus on accepting yourself as you are.
A Word From Verywell
Be aware that individual or even repeated comments do not on their own cause an eating disorder. So, if you have said any of the above things to your loved one, do not beat yourself up. Instead, focus on being more supportive going forward.
