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Eating disorders are serious mental illnesses that affect thirty million Americans at some point during their lives. Even more men and women never receive a clinical diagnosis but still struggle with body dissatisfaction and disordered eating attitudes and behaviors.

With National Eating Disorder Awareness Month upon us, I’ve been reflecting on my own recovery. For the past seven years, I’ve been in recovery from anorexia nervosa. The more open and honest I’ve been in my journey, the more freedom I’ve experienced. Being open has also allowed me to connect with people who are struggling and previously felt alone in it.

As I’ve gotten healthy, I’ve noticed that our country is obsessed with what we eat and how we look. Think of how many times you’ve seen a blog post about eating clean. How many times you’ve seen the hashtags #fitspo and #goals on Facebook and Instagram. How many times you’ve seen a headline about some celebrity’s pregnancy weight. We are bombarded with this information from multiple platforms on a daily basis, and the prevalence of eating disorders has continued to rise.

I have previously written about what not to say to someone who has an eating disorder. But in response, many of you asked what you should say to someone with an eating disorder, and rightfully so. Learning how to speak around a friend who you know struggles or has struggled with an eating disorder or body image is a process. Every person is different; their stories are unique. So while what I write in this article has been helpful and encouraging to me in my recovery, please remember that your friend’s individual needs may differ.

Talking to a friend whom you suspect has an eating disorder—but has not admitted that to you—is incredibly difficult. Regardless of what she—or he, as one in four individuals with eating disorders is male—is experiencing, approach them with love and care. If your friend is struggling, and you want to talk to her, I would suggest keeping a few things in mind:

  1. Be intentional. Set aside time for a private, distraction-free discussion. Frame the conversation by stating that you are concerned and are bringing this up to her because you truly care. Assure her that you love her no matter what.
  2. Ask questions. Start by asking if she is struggling rather than placing blame or judgment. She will feel better knowing that you gave her a chance to speak and didn’t automatically assume she has an eating disorder.
  3. Be specific. It is best to tell her specific examples of why you are concerned, according to the National Eating Disorders Association. Gently let her know of behaviors you’ve witnessed that raise a red flag. Start your sentences with “I” rather than “you.” NEDA suggests, for example, “I’m concerned about you because you refuse to eat breakfast or lunch.” Or, “It makes me afraid to hear you vomiting.”
  4. Know that it’s not as simple as what to eat. An eating disorder is about so much more than food. Saying that she should simply eat more, quit binging and purging, or avoid overexercising is oversimplifying recovery and will make her feel more isolated. The root of an eating disorder varies but often stems from overwhelming desires for control, approval, and perfectionism. Keep that in mind when talking to your friend.

If your friend has already told you that she has an eating disorder (a huge step in any recovery), you will be able to have conversations that look a bit different than those with a friend whose eating disorder is still secret. Here are a few of the things that have been helpful to me in my own recovery:

“I love you, and I don’t think of you any differently.”

This is perhaps the most important statement you can make. Assure her that she is worthy and loved, and nothing she says or does will change that.

“How are you doing?”

Give her a call to catch up. Ask how she has been doing not just with food but with all aspects of her life. Like any other friend you have, she needs commitment and consistency to keep the friendship alive.

“We all have our struggles. In fact, I struggle with X.”

Even if you don’t wrestle with an eating disorder, chances are that you have some sort of struggle of your own. Opening up to her fosters trust and will help her be fully honest with you in her recovery.

“You are more than your weight/fitness routine/the food on your plate.”

Talk about her character, not her physical appearance. We so often resort to looks—from body shape to hairstyles to clothing—when starting a conversation with someone. Compliment your friend on her intelligence, her kindness, and her courage. She is already hyper-focused on her body, so even if you think telling her “You look healthy!” or “You are beautiful!” is helpful, keep the focus on her internal values instead. Remind her how brave she is for choosing recovery and healing.

“Would you like to come over for dinner on Friday?”

Friends who cook for me and invite me to dinner are such a gift. Someone who is in recovery will need lots of support around her, particularly during mealtime. Help her make food fun again by enjoying meals together.

"How can I best be a friend to you during this time?”

This gives her the opportunity to tell you how you can best serve her. If she is in recovery, she can tell you what she needs from you, and she will so appreciate that you asked.

Please know, if your friend is harming herself, it is absolutely appropriate to suggest she seek professional help. ANAD offers a free guide on how to talk to someone and intervene if necessary. Psychology Today is also an excellent resource for finding specialized therapists, psychiatrists, support groups, and treatment centers in your area. You can tell her you read this article and want to help however you can. Every day counts in recovery—the sooner she can address the problem, the greater the likelihood she can fully recover.

If she rejects help, then I would continue to let her know that you’re there for her. Ultimately, she has to be ready to recover on her own. No matter how much you want that as her friend, recovery has to come from within her on her own time.

Photo Credit: Regina Leah Photography