Supporting Teens with Eating Disorders:

Eating disorders affect a large population of teens worldwide. Chances are if you are reading this information guide, you are a parent or a friend of one of these teens. It is normal to feel helpless and confused at times when dealing with either a daughter or a close friend who has an eating disorder. However, learning about disordered eating conditions and knowing the difference between facts and myths will help you to be supportive.

The following suggestions are some ideas on how to support a young woman struggling with an eating disorder. Not all suggestions are right for every teen and sometimes teens are ready for support in only some of the following areas. Learning how to express your concerns in an honest and nonjudgmental way will help you communicate with your teen or friend. We suggest that you talk about these ideas with the family member or close friend who has the eating disorder. It is important to remember that this guide does not replace recommended treatment or care from a physician, counselor, or nutritionist.

• Be Patient. The recovery process takes time. Try to look at health trends weekly, instead of daily.

It is important to remember that it takes a long time for someone to develop an eating disorder. Also, there are many different factors that can trigger disordered eating . Years of messages from the media, magazines, the food industry, pop culture and peer groups typically contribute to dieting behaviors and unrealistic perceptions about body shape and body image. These conflicting messages are often deeply rooted in the thoughts of teens suffering from an eating disorder. It takes time for teens to recover from an eating disorder and to change their thinking and behaviors. Realizing there is no quick fix or cure for eating disorders is important. Patience is a survival skill for families and friends who are supporting a teen with an eating disorder.

• Offer Support at Meal and Snack Time. Eat together. Discuss neutral topics of conversation: current events, movies, or the weather.

Meal and snack times are often the most difficult time of the day for teens struggling with an eating disorder. Eating itself may cause anxiety and often requires support and supervision. Rather than focusing on food, calories, fat grams, or nutrition during mealtimes, talk about neutral topics. Discussing something fun, like the movies or current events, is helpful.

Eating together is equally important. Usually, teens struggling with an eating disorder feel very guilty for eating. If someone they trust eats with them, it makes the experience of eating more comfortable.

• Invent an Eating Pact. Do NOT discuss portion size, calories, or fat content. Agree in advance that food selections and other difficult topics will not be discussed at eating time.  

Many teens who suffer from eating disorders have continuous thoughts about calories and worry about fat grams and food in general. Since part of this disease is an overwhelming fear of food and a desire to restrict calories, it is important to avoid food topics at meal times. This can reduce tension often associated with eating.

• Grocery Shop Together. Explore your favorite grocery store or visit a different market. Look into new brands or foods. Set a goal to try one new food per week or every other week.

Groceries shopping together and trying new foods are safe and slow steps towards gradually reaching long-term recovery goals. Often, teens with eating disorders create a list of "safe foods," foods that they can tolerate eating. Usually, these foods are low in calories and fat. The teen may have a small list of foods that they eat. During recovery, it is important to expand the list of foods that the teen will eat. A nutritionist is very helpful in setting goals to try new foods.

• Plan meals in advance. Make sure that all the groceries are available and ready for the meal or snack ahead of time. This works well to lessen worry for teens at mealtime. Sometimes, if a food item is not available at the designated eating time, it can lead to panic and limited food intake.

• Cook Together ~ Try new recipes. Many teens like to cook with someone they trust because they can participate in the process. Maximize health with special recipes. For example: a smoothie shake – made with fresh fruit, frozen yogurt, and milk. This has lots of muscle-building protein, bone-enhancing calcium, and nutritious vitamins and minerals!

• Encourage Interests Outside of Eating or Dieting Behaviors. Suggest activities such as art classes, volunteering, music, or yoga. Build self-esteem with a foundation of healthy interests.

It is important to replace the unhealthy, eating disordered behaviors (hyper-exercise, diet-focused behaviors) with new behaviors and interests (art, music, volunteering, etc.). Teens struggling with eating disorders often have a small number of interests based on unhealthy dieting, losing weight, and excessive ritualistic exercise patterns. It is difficult for teens to break away from these patterns and try other activities. Trying different activities, like art classes or volunteering, can help make daily routines normal.

• Plan a Special Event. Make an appointment for a new haircut, manicure, or massage.

As teens recover from an eating disorder, their body shape, facial structure, hair texture, and overall appearance change greatly. Teens who struggle with eating disorders often feel they do not deserve nice things. Something like a new haircut, manicure, or even a massage can be a nice way of helping teens adjust to their new look. It also sends teens the message that they deserve to treat themselves to a nice event. 

• Plan a Shopping Trip. Buy one new piece of clothing. Do not buy an entire wardrobe, since clothing size may continue to fluctuate with weight changes. Visit a new clothing store. Buy a special seasonal item, like a bright T-shirt for Spring or a knit sweater for Fall.

As recovery occurs, the body goes through physical changes. Clothing typically does not fit and new clothes need to be bought. Therefore, buying a few things slowly over time is a best. Trying a new clothing store or going to a different mall can be fun and less stressful. If your teen returns to a store where she used to shop, it may create anxiety, especially if she is unable to wear her previous size.

• Avoid Commenting Directly on Physical Appearance or Body Shape. Statements such as, "You've gained how much weight?" or "Don't you look great!" or "You look better…you've gained weight." or "You've lost weight? What's going on?" make teens feel extremely uncomfortable.

During recovery, teens often look much healthier, brighter, stronger and better nourished. However, commenting on this is often interpreted by teens as negative. A remark such as "You look so much better now that you're not all skin and bones!" will be thought of as "I AM FAT!" by teens with an eating disorder.

• Instead, Comment on Energy Level and Overall Health. Statements such as, "You seem like you are feeling more energetic," are more appropriate and make teens feel supported.

Other comments such as, "You look well rested," or "You look like you have a great energy level today," show recognition of the improved health status and do not focus on body shape or size.

• Smile! Happiness is contagious. A bright, cheerful, and consistently positive attitude works wonders!

It is very difficult to watch someone you care about struggle with an illness. Tears and worried looks often make teens feel very guilty for their illness and may lead to more anxiety, self-loathing, and depression. It is very important to try to be positive. A simple smile can spread a message of hope and cheer to teens with an eating disorder.

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