In lieu of a regular weekend reading roundup this week, I’m sharing a few words to help commemorate NEDA week, an annual event that’s intended to help bring more consciousness to eating disorders.
This year’s theme is “it’s time to talk about it.” When I first saw this, I assumed that the primary focus would be how to communicate with those who have eating disorders. This is a worthy topic, as it’s very hard to know what the “right” thing to say is when someone is struggling.
As the NEDA website makes clear, though, the theme is a lot broader than that. It’s about bringing more attention to eating disorders in all of their range and complexity, about breaking the stigmas that surround the topic, and celebrating those who have gathered up the courage to challenge their illnesses. Or, as NEDA puts it:
It’s time we take eating disorders seriously as public health concerns. It’s time we bust the myths and get the facts. It’s time to celebrate recovery and the heroes who make it possible. It’s time to take action and fight for change. It’s time to shatter the stigma and increase access to care.
I’m so glad that awareness is being framed this way. It’s all too easy to treat EDs as something aberrant or other. But these illnesses will probably touch all of our lives sooner or later, and we can all participate—or choose not to participate—in the cultural norms that enable them.
This year, I’m thinking about how we might share our voices in service of a more open, honest, and healing dialog about EDs. Here are a few of the conversations that have been on my mind, along with some personal thoughts on how best to approach them.
If you’re expressing concern to someone who has an ED:
- Understand that your loved one may respond defensively or with expressions of denial that something is wrong. It’s OK. Even if the conversation is short, even if it doesn’t go very far, you’ll still have an opportunity to plant a seed of awareness and concern. This seed may grow into your loved one’s being able to understand and appreciate that he or she is cared for and that the struggle hasn’t gone unnoticed.
- Don’t approach the dialog with an agenda. The defensive reflex will probably be stronger if your loved one senses that you want him or her to do something or respond in a certain way. Instead, treat your part of the conversation as a heartfelt, non-judgmental expression of love. Let your loved one know that you’re paying attention and are there to help and support in any way you can. This may not be all that needs saying, but I think it’s a good place to start.
- Remember that it’s not your job to fix or treat. ED treatment should be administered by professionals who have specialized training and an understanding of the process. It’s totally OK to recommend resources or offer to support your loved one in finding a treatment professional. It’s not your job to come up with a treatment plan of your own, or to push your recommendations on your friend, partner, or family member.
- Educate yourself about the realities of EDs, so that you can better understand what your loved one is going through. Many of us have a certain idea of what EDs look like or how they show up, which may or may not be overly limited or narrow. NEDA offers resources and toolkits that help to broaden the dialog and supply a fuller vision. This may help to feel better equipped for a dialog. You can also check out memoirs, blogs, and websites like Project Heal.
If you’re supporting a caretaker or family member of a person with an ED:
- Supporting the recovery process on the home front can feel like a full time job. If you know a parent, partner, sibling, or close friend of someone with an ED, you can make an offer of coffee, a casual friend date, or even a phone/online chat. This kind of support can mean so much to a caretaker.
If you’d like to change the conversation surrounding EDs in our society:
- Expand your understanding of eating disorders, disordered eating, and body dysmorphia. Challenge the assumptions you draw about how people who have EDs might look or behave. Understand that EDs aren’t associated with any single appearance or shape. Know that a person may behave in a way that seems “normal” and still be suffering. Listen closely to the words people use to talk about food, anxiety, fear, stress, and worry: they may give you clues to an underlying struggle.
- Work to erode the stigma, discomfort, and unease that surrounds EDs. Many ED sufferers are afraid to ask for help because they’re ashamed of how they’ll be perceived; it doesn’t help that perfectionism and fear of making mistakes is a risk factor for developing EDs in the first place. The more we dismantle stigmas surrounding mental health and mental illness, the sooner healing can begin.
- Create more awareness within your community, whether by hosting a talk, arranging for a lecture or workshop within a school or workplace, or simply learning more about what you can do.
- Advocate for ED treatment to be covered by more health insurers. This is an uphill battle, especially as health insurance itself may be under threat for many individuals. Still, it’s worth familiarizing yourself with the difficulties that many families face in trying to secure affordable treatment for a child or spouse, and to read more about what can be done if treatment isn’t covered.
If you’d like to help create a more body-positive culture:
- Cultivate a body-respecting lexicon. This means avoiding “fat talk,” judgment that’s based on shape or size, and any presumptions that have to do with weight.
- Celebrate food as a source of nourishment—nourishment that extends to the soul as well as to the body. Avoid language that demonizes certain types of food or ingredients. Steer clear of food alarmism. Resist the urge to participate in or normalize diet talk (or cleansing/detoxing talk). Celebrate moderation, balance, and perspective when it comes to eating.
If you’re struggling with an ED:
- Consider speaking up to someone you trust. If you’re scared, anxious, or fighting off fears that this person will use the information you’ve shared against you, close your eyes. Think about the times he or she has truly shown up for you, truly had your back. Think about the love that he or she has extended to you in the past. Try, if you can, to remember that your loved one is on your side.
- You don’t have to speak to a close family member or friend if such a dialog feels threatening. You can open up to a school counselor or teacher, a mental health professional, or someone on the other end of a helpline. Speaking to a trained professional or an experienced stranger may feel safer than speaking to someone you know.
- Communicate the struggle in your own language. You may not yet be ready to say the words “I think I have an eating disorder,” or you may not feel as though such a statement is truthful. But you may be ready to say “sometimes I wonder if I’m struggling with disordered eating.” It may feel right to say something more open and curious, like “I’m having a lot of anxious thoughts around food, and I just wanted to tell someone,” or, “I’m worried that I may be using food to cope with my sadness/anxiety/fear,” or, “lately I feel as though I’m spending a lot of time thinking about food, and it worries me.” Capture your feelings in a way that feels authentic.
- Listen to your intuition. Online screening tools for EDs are important and helpful, but they can sometimes give the impression that one has to meet all of the criteria of an ED in order to have a problem that’s worth talking about. This isn’t true. If your intuition tells you that something is wrong, or if there’s a part of you that suspects that the behaviors you’ve been justifying or normalizing may not be so healthy after all, listen. And try to talk to someone about it.
I’ve participated, or tried to participate, in all of the above conversations. But it’s of course the experience of speaking up about my own ED, and being spoken to by family and friends, that is most vivid to me as I think about NEDA week and its theme this year.
My behavior when I was sick is a prime example of why it can be so hard to talk about EDs. I was in furious denial, which made it hard for anyone to speak up at all. I was incredibly knowledgable about nutrition—and indeed, pretty smug about how I ate—which made my loved ones afraid to question or challenge my food choices. And I was very highly functioning, even at my most disordered, which meant that I could do a pretty good job of hiding how bad things were.
A few of my friends had the courage to speak up along the way, to tell me that they were worried about my weight, the fact that I’d stopped eating in groups, and all of the elaborate food rules, dressed up as healthy eating principles, that I’d embraced. They didn’t get very far. I responded with calm, confident assurances that everything was perfectly fine; when my mother repeatedly vocalized her worries, I was more vehemently defensive.
In the end, I opened up about my anorexia by going to therapy. After so many years of defensiveness and guarding, that was the space that felt safe to me. This doesn’t mean that my conversations with friends over the years went unnoticed, though; on the contrary, they planted very important seeds.
They showed me that I didn’t appear to be “in control,” even if I had convinced myself that I was. They taught me that I wasn’t living in a vacuum after all, but rather in a web of relationships, and that my behaviors caused great pain to those around me. They forced me to realize how transparent my habits were, how visibly and obviously troubled. Most of all, they reminded me that there were people who loved me and were hoping for me to be myself again. Awareness of this love gave me courage when I did ultimately work through the mess of recovery.
If you’re hoping to talk to someone about his or her relationship with food, know that your words will have an impact, no matter how oblique or indirect or slow. Know that your love will be felt, sooner or later. Know that so many of us who have lived through the recovery process can think back to a conversation or exchange we had with someone who had the guts to be honest with us, and we can remember that moment as a turning point in the way we related to our illness, whether or not we were able to act on the consciousness right away.
Before I wrap up, I think it’s important to mention that “talking about it” often forces us to confront our own language, biases, and baggage. Many people with EDs live in homes where food, weight, and nutrition are constant topics of conversation. Even as that person’s illness is challenged, the diet talk and casual commentary about size and shape continues—sometimes at the dinner table itself. It is so, so difficult for recovery to unfold in an environment where food and bodies are being policed, no matter how subtly or unconsciously.
“Talking about it” means taking a good, hard look at our language and conversation and vowing to speak about food and bodies in a more compassionate, caring way. It means questioning the harsh judgments we bring to the business of eating. It means speaking up about the fact that all of us, whether we’ve experienced disordered eating or not, sometimes struggle with food. It means bringing deep humanity to these conversations, being willing to see glimpses of our own experience in someone else’s struggle. It means working to be more empathic, rather than carelessly problematizing what we can’t immediately understand.
If you or someone you love is struggling with food, know that there are so many avenues for conversation and acknowledgment. You can begin by exploring the NEDA site and checking out some of the resources offered, then heading over to Project Hope for additional resources and information. There are many other sites that offer comprehensive tools, so don’t be afraid to keep looking until you find an outlet that feels supportive and safe.
This year and every year, I send my love and boundless hope to those who are working to make peace with food. You’re not alone.