Eating Disorders: To Confront or Not?

On The View today, the cohosts discussed Portia de Rossi’s upcoming appearance on Oprah. Portia de Rossi was about to talk about her battle with anorexia. The co-hosted posed this question: “Would you confront someone about their weight if it dropped dangerously low?” Some said "yes" they would express concern. Others indicated that you should, “mind your own business.”

What would hold them back? The women expressed many of the common fears people have about talking to someone who has had a noticeable or dangerous change in weight. They feared that saying something may cause anger, denial, or possibly make it worse by reinforcing the behavior (saying you look thin may make them feel successful in their disorder because other people are noticing) etc.

Their concerns are understandable. Approaching someone about their weight is incredibly tricky. Here are some general tips if you are in this position.

1) Approach Instead of Confront. Start with things like, “I’m concern” or “I’m worry…” rather than “You are doing x, y and z”…

2) Instead of asking about weight, inquire about how he or she is doing in general. Remember that eating disorders aren’t really about weight and food. They are expressing something else troubling happening in their life. The person you are concerned about may be much more willing to talk about the other things that are really bothering them—stress, grief, or anger etc. They may discuss the things triggering the eating disorder rather than the eating disorder itself.

3) Avoid making judgments. Weight loss can be caused by many different things such as a medical condition like cancer or other mental health problems like depression. Be cautious not to assume that a drop in weight is due to an eating disorder.

4) Give an Invitation to Regroup. Be prepared. The initial reaction may be denial or anger. But, after some time to think, he or she may feel differently. So, leave the conversation with, “If you ever want to talk in the future, I’m here.”

5) Give a Pathway: Have an action plan in place in case he or she is ready for some additional help. Get the name of a well-respected therapist (www.edreferral.com or www.nationaleatingdisorders.org).

The clients that I work with often mention the first person who approached them about their eating disorder. They admit that they were often initially defensive or angry. But, later, when the disorder subsided, they were incredibly grateful if that person expressed genuine concern. Compassionate words may not solve the problem but it gets the wheels turning.

For an Additional Tips: http://www.nationaleatingdisorders.org/nedaDir/files/documents/handouts/WhatISay.pdf

Susan Albers, Psy.D., is a licensed clinical psychologist, specializing in eating issues, weight loss, body image concerns, and mindfulness. She is the author of 50 Ways to Soothe Yourself Without Food, Eating Mindfully, Eat, Drink, and Be Mindful, and Mindful Eating 101 and is a Huffington Post blogger. Her books have been quoted in the Wall Street Journal, O, the Oprah Magazine, Natural Health, Self Magazine and on the Dr. Oz T.V. show. Visit Albers online at www.eatingmindfully.