Supporting Young Women with Eating Disorders: A Guide for Family Members & Close Friends

Eating disorders affect millions of young women. If you are reading this information guide, you may be a family member or close friend of someone struggling with an eating disorder. It is normal to feel helpless and confused at times. The chronic nature of eating disorders can drain a parent of physical and emotional energy. Learning about eating disorders can help you provide proper support. Keep in mind that all suggestions are not appropriate for everyone. This guide was created to offer ideas on how to help a young woman with an eating disorder. This guide does not replace recommended treatment or care from a physician, counselor, or nutritionist.

The Road to Recovery

Be Patient. It is important to remember that just as it takes a long time for someone to develop an eating disorder, it may take a long time for someone to recover from one as well. There are many different factors that can trigger disordered eating. Years of messages from the media, food industry, and peer groups contribute to dieting behaviors and unrealistic ideas about body image. These messages negatively impact the thoughts of young women suffering from eating disorders. There is no quick fix or cure. Because changes in thinking and behavior happen slowly, the road to recovery takes time. Try to look at health trends (eating behaviors and weight) weekly rather than daily.

Offering Support at Meals and Snack Time

Eat together. Meals and snack times are often the most difficult part of the day for young women with eating disorders. They may be very anxious at meal times and feel guilty for eating. Meal times often require support and supervision. If someone they trust eats with them, the experience of eating can be more comfortable.

Keep conversation positive. Discuss neutral topics of conversation rather than focusing on food, calories, or weight. Try to talk about something fun, like your favorite sports teams, hobbies or music.

Consider adopting a mealtime agreement. Agree in advance not to discuss disordered eating thoughts such as portion size, calories, carbohydrate, or fat content at meal times. Many young women with disordered eating have continuous negative thoughts about food. Mealtime agreements often work to reduce tension and stress associated with eating.

Plan ahead. As a family, agree on the structure of mealtimes: what time you will eat, the content of the meals (food selections), and who will be present at the meal.

Grocery Shopping, New Foods & Cooking

Some young women recovering from eating disorders are able to participate in grocery shopping and cooking. Speak with your teen’s health care provider or nutritionist to determine if she is ready for this step.

Grocery shop together. Explore your favorite grocery store or visit a different market. Check out new foods and set a goal to try one new food each week. Young women with disordered eating often have a small list of "safe foods" that they can feel more comfortable eating. Usually, these foods are low in calories, or are not from a food group that the person with an eating disorder has a hard time tolerating such as carbohydrates and/or fat. During recovery, it is important to increase food choices. A nutritionist can be very helpful with setting goals and coaching a patient.

Make sure that all foods that you will need for meals are available. This helps lessen worry at mealtime. Sometimes, if a food item is not available at the designated eating time, it can lead to panic and restricted food intake.

Cook together and try new recipes. Many young women like to cook with someone they trust. Learning how to cook provides another skill towards recovery. Trying new recipes also helps increase the “safe foods” list. Take a look at our “Quick and Easy Recipe for Teens Cookbook” for ideas.

Healthy Attitude

Encourage new interests. Suggest new activities such as art classes, volunteering, community service, clubs at school, music, or yoga. It is important to replace the unhealthy, disordered eating behaviors (excessive or ritualistic exercise patterns or restrictive dieting) with healthy interests. Teens and young women struggling with eating disorders often choose activities that are based on dieting, weight regulation, and exercise. It is difficult for young women to break away from these patterns. However, developing new interests can help reverse the disordered eating behaviors and over time improve self-esteem.

Plan a special event. Make an appointment for a new haircut, manicure, or massage. As young women recover from an eating disorder, their body shape, facial structure, hair texture, and overall appearance may change. They often feel they do not deserve special things. A special event can be a nice way of helping your teen adjust to her new look. It also sends the message that they deserve to treat themselves to something fun.

Shop for clothes. Because clothing sizes often fluctuate during recovery, it’s best to buy a few new pieces of clothing at a time rather than an entire wardrobe. Some young women with eating disorders have a difficult time clothes shopping because of dressing room mirrors. It can also be difficult for a teen to buy a different size than she is used to. Ask your teen if she would like to go shopping of if she would prefer that you pick up new items for her.

Talking with Teens

Avoid commenting directly on physical appearance or body shape. Statements or questions such as "You look great!" or "You look better”, “You've gained weight" or "You've lost weight-what's going on?" often make teens and young women feel extremely uncomfortable. During recovery, teens often look much healthier, brighter, and stronger. However, commenting on this is often interpreted negatively by the teen. A remark such as "You look so much better now that you're not all skin and bones!" may be interpreted as "I am fat!" by a young woman with an eating disorder.

Comment on health and energy level. Statements such as, or "You are full of energy!" or "You look well rested" are more appropriate and often make young women feel supported in their recovery. These types of conversations show recognition of 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 any illness. Worried looks or tears often make young women feel very guilty about their eating disorder and may lead the teen to feel 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 a teen with an eating disorder.

Positive Thinking!

Sharing positive thoughts with a loved one who is struggling with an eating disorder and body image concerns is helpful. Check out nationaleatingdisorders.org for "Ten Steps to Positive Body Image" for some suggestions to reverse this negative thinking.

Support for Yourself

If you feel overwhelmed with your child’s illness seek support from a professional such as a counselor or therapist.