Recovery from an eating disorder is a long process. It can take months or even years; there is an ever-present risk of relapse and a minefield of potential triggers to avoid. Fortunately, most people can count on a support system to help them get through the challenges of recovery. The most important factor in maintaining a recovered life is the support of family and close friends. In the formative adolescent years, this is doubly true.
Most eating disorders begin to present themselves during adolescence, making residential treatment programs for adolescents a necessity. In these programs, teenagers with anorexia nervosa, bulimia nervosa, binge eating disorder, and other eating disorders can count on round-the-clock support. There are medical and psychiatric experts available, as well as therapists, mindful fitness instructors, and nutritionists, all of whom collaborate to promote a healthier lifestyle free from disordered eating behaviors.
What happens when that 24/7 care is over?
Stepdown Programs Can Help, But They’re Not Everything
In many cases, when a person discharges or “graduates” from a residential eating disorder treatment program, they engage in a stepdown program. This normally consists of regular day treatment sessions, in some cases IOP or PHP programs if they are medically warranted, and meeting with alumni groups. However, the people closest to the individual can make the difference between recovery and relapse.
During stepdown and after, the recovered person will be vulnerable. They’ll need the people around them to really be there, to be present, and to be sensitive. That’s where you, as the parent, spouse, sibling, or best friend can step in. Here, we’ve put together a few tips on how you can support your loved one after they’ve finished residential eating disorder treatment.
5 Steps You Can Take to Help Your Loved One
Don’t Try to Be a Therapist
When your loved one leans on your for support, it’s a natural inclination to want to give them advice or your opinion on their mental health. However, unless you are an actual therapist, this is the wrong course of action. Even if you are a therapist, it’s not a wise move to provide therapy to your immediate family or closest friends.
Providing support doesn’t mean you’re there to fix everything. Your loved one has just finished 30 days or more of round-the-clock therapy. They might even be sick of talking to therapists all day long.
What you can do, however, is to let them know that if they are struggling, or just need someone to talk to, you’re there. It sounds cliché, but from time to time people just need to get something off their chests. In these situations, you can best help them by listening without judgment.
Be Sensitive About Body or Food-Related Messages
Although eating disorders are more about a person’s self-perception and anxiety over body image than they are about food, thoughtless discussions about food can be unsettling or trigger to a person fresh out of eating disorder treatment. One of the worst things you can do while trying to support someone recovering from an eating disorder is to discuss your body (or someone else’s) or any food restrictions.
For example, if you’re on a diet, that doesn’t mean you are showing disordered eating behaviors. Many people try to eat healthier on the advice of their doctors or simply because they want to lose a little weight. And of course, diet culture is extremely prevalent in America; every day we’re bombarded with the diet industry’s messaging on TV and social media. For most people, this might make them feel bad about their weight or body. But for a person with an eating disorder, these messages are powerful triggers to resume disordered eating behavior.
Of course, you can’t stop the diet industry from advertising, but if you’re providing support for someone with an eating disorder, you can control the messages you send, even unconsciously. Make an effort to avoid talking about how you feel about your body or someone else’s. It should be obvious to never discuss your loved one’s body or weight. If you’re on a diet, make sure you don’t bring it up around them, and if possible keep diet food packaging out of sight.
Mealtimes can also be sensitive. Try not to comment on how much or little the person is eating in the moment. If they’re noticeably not eating much or not at all, wait until a less stressful time to bring it up, or urge them to speak to a professional or their alumni group.
Always Be Open and Honest
This is good advice for life in general, but when providing help to someone with a mental health illness, it’s essential not to lie or prevaricate to the person you’re supporting. Start by asking their permission to be completely honest. Once given, you can build trust in e recovery context with your loved one by telling them how you feel, and encouraging them to do the same.
Keep your comments positive and constructive, however. “Honest” doesn’t necessarily mean “brutally honest.” Although you don’t want to baby your loved one or treat them like an invalid, you should remember that they are rebuilding their lives and recovering from a severe mental health illness.
A good rule of thumb is to avoid “you” statements, as well. They might be something like, “You still have some lingering disordered thoughts, don’t you?” While that might seems sensitive from a non-disordered point of view, it can come off as accusatory. It’s better to ask a question like, “Are there any thoughts or feelings you’re still worried about?” and let them take the lead if they feel comfortable.
Educate Yourself About Eating Disorders
Although almost everyone is at least somewhat aware of eating disorders, they’re still dismissed or misunderstood by many. It’s still not uncommon for TV shows or movies to make fun of disordered eating behaviors, and that’s a real shame, because it’s cruel to people who are at great risk. Eating disorders are the most dangerous of any mental health illness, not only because of the physical complications of malnutrition and starvation but because of the high rate of suicide among people with eating disorders.
In residential treatment, your loved one will spend considerable time learning how to objectively view their disordered eating behaviors in therapy. They’ll learn a lot about how eating disorders work so that they can prepare to identify and avoid those behaviors after graduation. One of the ways you can provide better support for them is to learn more about their disorders for yourself.
Most eating disorder treatment programs offer some kind of family support sessions in addition to the residential program. In some cases, the family will be invited to group sessions with their loved one while still in treatment, and in others, the family may attend training sessions without them present. These are wonderful opportunities to learn from the pros about what they can do to support their loved ones and be sensitive to their needs when they return to “normal life.”
You can also educate yourself by reading up on eating disorders before they come home. Here are a few places to start:
Don’t Change Everything About Your Life to Accommodate the Eating Disorder
This might sound counter intuitive in light of recommendation #2. Although it is essential to be careful about inadvertent triggers, you can also provide a troubling example if you let the eating disorder dictate your own actions.
As an example, a person who’s completed an anorexia nervosa treatment program might still feel uncomfortable or anxious about eating in restaurants. Your inclination might be to skip a trip to your favorite burger joint and eat at home with your loved one (if they refuse to go with you). This seems sensitive, but in a way, it’s accommodating their eating disorder.
The point of eating disorder recovery programs is to return the client to regular eating patterns and eliminating the thoughts and actions that prevent them from getting the most out of life. In the above example, letting their disordered thoughts prevent you from enjoying a visit to a restaurant shows them that it’s OK to allow eating disorders to interfere with that enjoyment.
Of course, you should never force them to do something they truly aren’t ready to face. For parents of an adolescent with an eating disorder, this might seem like their prerogative as a parent, but it will do more harm than good. With time and continued work on recovery, they’ll eventually get to a place where they can engage in recovered eating patterns and getting the most out of life.
You Can Be the Foundation for Your Loved One’s Recovered Life
There are many more things you can do to provide a supportive base for your loved one’s recovery. Make sure you speak with the staff at their residential treatment center to get more ideas and pointers from them. Family support and that from close friends is the key to long-term maintenance of recovery; that’s why the programs so often include family sessions.
If you’re looking for additional resources, Psychology Today offers a wide variety of articles about mental health illness, including eating disorders. Your doctor or therapist should also be able to provide some materials or suggestions, as can the staff at an eating disorder treatment center. Recovery is a long process, but you can help your loved one make it stronger.