HOW TO SUPPORT SOMEONE WITH BINGE EATING DISORDER
It's no surprise that Binge Eating Disorder is on the rise. Every other mental health problem has surged in lockstep with the pandemic. A key component to Binge Eating Disorder recovery is a solid support system. I'm asked daily by clients how family and friends can support recovery. I get WAY too excited when someone reaches out asking how they can support a romantic partner or a family member. Sadly, this isn't common. Most of the time family and friends aren't aware that they're making the situation worse. Sometimes they don't want to change. It can be hard to know the right things to say or do. Here are my recommendations for supporting someone you care about as they work to end binge eating.
SUPPORT BY LEARNING ABOUT BINGE EATING DISORDER
Binge Eating Disorder is misunderstood by many, which can be frustrating to those affected by it. You will show your loved one that you are on their side if you take time to research it yourself, and even attend a therapy session with them. (IF they are ok with that!) A few key things to know:
It's about 50% determined by genetics. It’s a mental health diagnosis, it is NOT about a lack of self-control or willpower. Like all eating disorders, the development of BED is influenced by genes, and also by one's environment.
It's a very common disorder. BED is the most common eating disorder for females and males.
It's hard to recover. Some research suggests recovery from Binge Eating Disorder takes longer than for the other eating disorders. Knowing that it’s biologically based can be very validating and reduce shame for those suffering.
It's about 50% determined by a person's environment. As the genetic researchers say, genes don't act alone! They interact with one's environment, which can increase or decrease the chances that one develops disordered eating. Knowing that the environment is about half the problem, you can support the person with BED in making changes. YOU, what you say, and how you behave are part of that environment. We will discuss this more below. It needs to be said more than once. :)
SUPPORT BY LEARNING ABOUT DIET CULTURE
According to research, diet culture is the largest environmental contributor to the development of Binge Eating Disorder and other forms of disordered eating. This can't be said enough. It's the air we breathe. Christy Harrison, a well-respected author and eating disorder expert, defines diet culture as:
"... a system of beliefs that:
Worships thinness and equates it to health and moral virtue, which means you can spend your whole life thinking you’re irreparably broken just because you don’t look like the impossibly thin “ideal.”
Promotes weight loss as a means of attaining higher status, which means you feel compelled to spend a massive amount of time, energy, and money trying to shrink your body, even though the research is very clear that almost no one can sustain intentional weight loss for more than a few years.
Demonizes certain ways of eating while elevating others, which means you’re forced to be hyper-vigilant about your eating, ashamed of making certain food choices and distracted from your pleasure, your purpose, and your power.
Oppresses people who don't match up with its supposed picture of “health,” which disproportionately harms women, femmes, trans folks, people in larger bodies, people of color, and people with disabilities, damaging both their mental and physical health."
In Culbert et al.'s Research Review: What we have learned about the causes of eating disorders - a synthesis of sociocultural, psychological, and biological research, they conclude that the best-known environmental contributor to the development of eating disorders is the sociocultural idealization of thinness. The data is clear. Our cultural preference for thinness is damaging to all of us, whether we have an eating disorder or not.
SUPPORT BY LEARNING ABOUT INTUITIVE EATING AND HEALTH AT EVERY SIZE
A healthy relationship with food and body is the cornerstone of Binge Eating Disorder recovery. Intuitive Eating will likely be the nutrition model your friend or loved one with Binge Eating Disorder learns about. This approach helps them build trust in internal signals to guide eating, rather than the ineffective focus on external measuring and weighing.
Health at Every Size is an evidence-based model that highlights the benefits of body acceptance and health improvements at all body sizes. (See my blog post about Health at Every Size). I think the most helpful thing my clients learn from this approach is that research indicates health is more influenced by your behaviors than by the number you see on the scale.
If you can try to embrace these concepts, it will be invaluable for the person with Binge Eating Disorder to have you on their side. Because it's tough and lonely fighting a world whose message is that skinny equals healthy. If it's too hard for you to support this idea, just keep an open mind and remember what works for you doesn't work for everyone else. NOT discussing this with them may be the most helpful thing you can do. :)
SUPPORT BY CHANGING THE ENVIRONMENT FOR THE PERSON WITH BINGE EATING DISORDER
The environment is the only thing we CAN change to support the person with Binge Eating Disorder in recovery. Understand that YOU and what you say and do are part of their environment, too! This can help you change your actions around the person with an eating disorder. Here are my suggestions:
Change your talk
Obviously, teasing and shaming the person with Binge Eating Disorder is a no-no, but there are much more subtle ways talk can have a negative impact. Research shows that making positive or negative comments in the presence of your loved one about anyone's body, eating and/or exercise habits is a risk factor for them developing an eating disorder. So, don't comment about physical appearance, especially weight or shape. Don't talk about eating habits and exercise habits. This includes complements or critcism about you, your loved one, or anyone else.
Help manage triggering media
You don't need to confiscate technology or force them to cancel all of their social media. But if you live with a person with an eating disorder, maybe pay attention to what you share or post. For example, sharing articles or social media about the latest diet and exercise trends. Or photos of the tons of celebrities (or people you know personally) that have lost weight and gotten their "best body yet!" during quarantine.
Model healthy behaviors
Change your behaviors as a way to support them in changing theirs. Don't count calories, fat or carb grams. Don't count calories burned. Instead of saying "I have GOT to get to the gym!" or "I need to burn off those cookies I ate last night!" as a way of compensating for calories eaten, reframe exercise as physical activity that helps improve health and mobility. This may be perfectly fine for YOU. But it can be distressing to the person trying to regain a healthy relationship with food and body.
If it's not possible for you to change your behavior, keep it to yourself. Or talk about the healthy reasons you exercise or eat certain foods. For example, perhaps you have high blood pressure or blood sugar and are trying to manage it, in part, by changing your eating and exercise habits. Just have an open conversation and consider making changes if it's hard for the person with Binge Eating Disorder to cope with.
SUPPORT BY MODELING GOOD EMOTION REGULATION IF YOUR CHILD HAS BINGE EATING DISORDER
Research suggests that poor management of strong emotions is a significant contributor to all mental health disorders. When a person lacks the skills to manage strong emotions such as anger, sadness, and anxiety, they are more likely to turn to a not-so-healthy way to calm their nervous system. Enter substances like nicotine, marijuana or alcohol. Or behaviors such as overeating, overexercising, or self-induced vomiting. Here are some ideas to help improve emotion regulation for yourself:
Educate yourself about the importance of emotion regulation. My blog post about emotion regulation skills for clients with Binge Eating Disorder might give you some ideas.
Seek your own therapy or self-help (books, podcasts, support groups) to improve how you cope with stress or improve communication skills. This might be individual counseling for you or couples counseling with your partner. It might include family therapy with everyone. It's not easy to change family patterns, but it's possible.
SUPPORT BY COMMUNICATING: ASK HOW YOU CAN HELP
This one requires a lot of practice and patience. It's hard. But it will be a work in progress. Sometimes it can help to attend a therapy session with the person with Binge Eating Disorder to talk this through. They may not be great at telling you the things you do that trigger them. They may have tons of shame about their behaviors. Know that they will be working on identifying their emotions and expressing them in healthy ways. You may be shocked at what you find out. Many clients dislike having comments made about their bodies, even if the person commenting is giving what they perceive as a compliment (such as, "You look great!"). It's your job to listen nonjudgmentally and accept what they share.
SUPPORT BY HELPING ACCESS PROFESSIONAL HELP FOR BINGE EATING DISORDER RECOVERY
The person with Binge Eating Disorder may not want your help with this. Ask them if you can help. Know that they will likely start treatment with a therapist and/or dietitian. Look for one whose website advertises their knowledge about Binge Eating Disorder in particular. Otherwise, the guidance they offer may actually worsen the client's relationship with food. If possible, seek a professional who is certified by the International Association of Eating Disorders Professionals.
It can be challenging to find psychiatrists and primary care doctors who specialize in/are knowledgeable about Binge Eating Disorder. Therapists and dietitians usually have some good referrals if needed. Ideally, the chosen medical professionals are familiar with Health at Every Size. If not, it's best to find one that does not primarily focus on dieting and weight loss as ways to beat Binge Eating Disorder. There is SO much more to recovery than this! I teach clients to advocate for themselves at medical appointments. You can help with this, too!
When you've educated yourself about what helps and hurts in supporting a person with Binge Eating Disorder, it's easier to know where you can make a difference.
If you or a loved one could use help with binge eating, please call me for a consultation. I can help. I have over 20 years of experience helping adults improve their mental health. I specialize in anxiety and eating disorders like binge eating, emotional eating and overeating, anorexia and bulimia. I offer in-person sessions at my Plano office and online therapy in Texas. Contact me for a free 15-minute phone consultation and take the first step toward recovery. If I can't help, I can connect you to another great therapist!
